From 5fd04c0dbd496bd786f202a0d20326a38320b437 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner Date: Tue, 9 Jan 2024 16:55:37 -0600 Subject: [PATCH 001/112] Draft range guidance --- input/pagecontent/mappingGuidance.md | 222 +++++++++++++++++++++++++++ 1 file changed, 222 insertions(+) diff --git a/input/pagecontent/mappingGuidance.md b/input/pagecontent/mappingGuidance.md index 4ea42ca..b36911d 100644 --- a/input/pagecontent/mappingGuidance.md +++ b/input/pagecontent/mappingGuidance.md @@ -230,6 +230,228 @@ When mapping from FHIR to CDA, if the system is `http://unitsofmeasure.org`, the UCUM also provides the ability to include arbitrary units within a set of curly brackets (e.g. `{INR}`). No specific guidance on the use of curly brackets in unit translation is provided in this publication, however additional guidance on UCUM arbitrary units is [available here](https://ucum.org/ucum#section-Arbitrary-Units). +#### Ranges of Physical Quantities +CDA conveys ranges of values using the `IVL_PQ` data type. The `` and `` elements are normal Physical Quantity (PQ) elements with an additional `@inclusive` attribute. When this is present and set to `"false"`, the value of the boundary is not included in the range. The default value of this attribute is `"true"`, so regardless of whether it is absent or set to `"true"`, the value of the boundary IS included in the range. + +In FHIR, ranges with both a low and high are represented in the [Range](https://hl7.org/fhir/R4/datatypes.html#Range) data type, while ranges with only a low or a high are represented in the [Quantity](https://hl7.org/fhir/R4/datatypes.html#Quantity) data type using a [comparator](https://hl7.org/fhir/R4/valueset-quantity-comparator.html). + +Since a physical quantity is something that can be measured, a missing `` value or a low value of `0` can generally be represented as `<` or `<=` the high value (based on the `@inclusive` property on high). If the `` value is missing, however, it may not be appropriate to assume the result means "all values greater than (or equal to)" the low value. The `>`/`>=` comparators should only be used when `` is present. The following tables demonstrate different mappings for quantity. + + + + + + + + + + + + + + +
CDA IVL_PQ Value - High-onlyFHIR Quantity
+
+{% highlight xml %} + + + +{% endhighlight %} +or +{% highlight xml %} + + + + +{% endhighlight %} +or + +{% highlight xml %} + + + + +{% endhighlight %} + +
+ +		 +
+{% highlight json %} +"quantity": { + "value": 200, + "comparator": "<=", + "unit": "mg/dL", + "code": "mg/dL", + "system": "http://unitsofmeasure.org" +} +{% endhighlight %} + +(`<=` because inclusive is true by default) +
+ +
+
+When `@inclusive="false"`: + +{% highlight xml %} + + + +{% endhighlight %} +
+ +		 +
+{% highlight json %} +"quantity": { + "value": 200, + "comparator": "<", + "unit": "mg/dL", + "code": "mg/dL", + "system": "http://unitsofmeasure.org" +} +{% endhighlight %} +
+ +
 
CDA IVL_PQ Value - Low-onlyFHIR Quantity
+
+`@inclusive="true"` is the same as a missing inclusive attribute. + +{% highlight xml %} + + + + +{% endhighlight %} +
+ +		 +
+{% highlight json %} +"quantity": { + "value": 500, + "comparator": ">=", + "unit": "mg/dL", + "code": "mg/dL", + "system": "http://unitsofmeasure.org" +} +{% endhighlight %} +
+ +
+
+{% highlight xml %} + + + + +{% endhighlight %} +
+ +		 +
+{% highlight json %} +"quantity": { + "value": 500, + "comparator": ">", + "unit": "mg/dL", + "code": "mg/dL", + "system": "http://unitsofmeasure.org" +} +{% endhighlight %} +
+ +
 
CDA IVL_PQ Value - Low and HighFHIR Range
+
+{% highlight xml %} + + + + +{% endhighlight %} +
+ +		 +
+{% highlight json %} +"range": { + "low": { + "value": 200, + "unit": "mg/dL", + "code": "mg/dL", + "system": "http://unitsofmeasure.org" + }, + "high": { + "value": 1000, + "unit": "mg/dL", + "code": "mg/dL", + "system": "http://unitsofmeasure.org" + } +} +{% endhighlight %} +
+ +
+
+Units can be different, as long as they are equivalent: + +{% highlight xml %} + + + + +{% endhighlight %} +
+ +		 +
+{% highlight json %} +"range": { + "low": { + "value": 200, + "unit": "mg/dL", + "code": "mg/dL", + "system": "http://unitsofmeasure.org" + }, + "high": { + "value": 1, + "unit": "g/dL", + "code": "g/dL", + "system": "http://unitsofmeasure.org" + } +} +{% endhighlight %} +
+ +
+
+When high is missing, it cannot be inferred, so send as a range with only low. + +{% highlight xml %} + + + +{% endhighlight %} +
+ +		 +
+{% highlight json %} +"range": { + "low": { + "value": 200, + "unit": "mg/dL", + "code": "mg/dL", + "system": "http://unitsofmeasure.org" + } +} +{% endhighlight %} +
+ +
+ + ### CDA ↔ FHIR Provenance CDA provides a repeated set of elements within each activity which may be used in populating data to/from FHIR [Provenance.Agent](https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-provenance.html) From a2226ffffd0eea59591f06ee3d0c27beda8b2e3b Mon Sep 17 00:00:00 2001 From: Benjamin Flessner Date: Thu, 11 Jan 2024 10:31:50 -0600 Subject: [PATCH 002/112] Update after SD discussion --- input/pagecontent/mappingGuidance.md | 55 +++++++++++++--------------- 1 file changed, 25 insertions(+), 30 deletions(-) diff --git a/input/pagecontent/mappingGuidance.md b/input/pagecontent/mappingGuidance.md index b36911d..a6f5ee6 100644 --- a/input/pagecontent/mappingGuidance.md +++ b/input/pagecontent/mappingGuidance.md @@ -235,7 +235,9 @@ CDA conveys ranges of values using the `IVL_PQ` data type. The `` and `` value or a low value of `0` can generally be represented as `<` or `<=` the high value (based on the `@inclusive` property on high). If the `` value is missing, however, it may not be appropriate to assume the result means "all values greater than (or equal to)" the low value. The `>`/`>=` comparators should only be used when `` is present. The following tables demonstrate different mappings for quantity. +Since a physical quantity is something that can be measured, a missing `` value or a low value of `0` can be represented as `<` or `<=` the high value (based on the `@inclusive` property on ``). If the `` value is missing, it generally means the value was too large to measure, and the FHIR representation is `>` or `>=`. + +Note that in FHIR, `Observation.referenceRange` only contains `.low` and `.high` values, so this guidance is targeted to the actual values of observations. @@ -309,14 +311,21 @@ When `@inclusive="false"`: - + -
CDA IVL_PQ Value - High-onlyFHIR Quantity
CDA IVL_PQ Value - Low-onlyFHIR Quantity
-`@inclusive="true"` is the same as a missing inclusive attribute. - {% highlight xml %} {% endhighlight %} + +or + +{% highlight xml %} + + + +{% endhighlight %} +
@@ -330,17 +339,29 @@ When `@inclusive="false"`: "system": "http://unitsofmeasure.org" } {% endhighlight %} + + +(`>=` because inclusive is true by default)
+When `@inclusive="false"`: {% highlight xml %} {% endhighlight %} + +or + +{% highlight xml %} + + + +{% endhighlight %}
@@ -358,7 +379,7 @@ When `@inclusive="false"`:
 
CDA IVL_PQ Value - Low and HighFHIR Range
CDA IVL_PQ Value - Low and High with Numeric ValuesFHIR Range
{% highlight xml %} @@ -422,32 +443,6 @@ Units can be different, as long as they are equivalent: {% endhighlight %}
-
-
-When high is missing, it cannot be inferred, so send as a range with only low. - -{% highlight xml %} - - - -{% endhighlight %} -
- -		 -
-{% highlight json %} -"range": { - "low": { - "value": 200, - "unit": "mg/dL", - "code": "mg/dL", - "system": "http://unitsofmeasure.org" - } -} -{% endhighlight %} -
-
From e360d22f8c922b52ccffdd69202a0613c8b7ed6f Mon Sep 17 00:00:00 2001 From: Benjamin Flessner Date: Thu, 11 Jan 2024 12:21:59 -0600 Subject: [PATCH 003/112] Make race/ethnicity links - update guidance --- input/pagecontent/CF-patient.md | 8 ++++---- 1 file changed, 4 insertions(+), 4 deletions(-) diff --git a/input/pagecontent/CF-patient.md b/input/pagecontent/CF-patient.md index f032c94..5e86375 100644 --- a/input/pagecontent/CF-patient.md +++ b/input/pagecontent/CF-patient.md @@ -21,10 +21,10 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea |/patientRole/patient/sdtc:deceasedInd|.deceasedBoolean|Note: Only one of `deceasedBoolean` or `deceasedDateTime` may exist. If both are present in CDA, use deceasedDateTime. |/patientRole/patient/sdtc:deceasedTime|.deceasedDateTime|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) |/patientRole/patient/maritalStatusCode|.maritalStatus|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| -|/patientRole/patient/raceCode|.extension:us-core-race: ombCategory|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)
This should map to ombCategory extension| -|/patientRole/patient/sdtc:raceCode|.extension:us-core-race|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)
If code is in [OMB category](http://hl7.org/fhir/us/core/ValueSet/omb-race-category), use us-core-race: ombCategory; else use us-core-race: detailed.| -|/patientRole/patient/ethnicGroupCode|.extension:us-core-ethnicity|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)
This should map to ombCategory extension| -|/patientRole/patient/sdtc:ethnicGroupCode|.extension:us-core-ethnicity|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|/patientRole/patient/raceCode|.extension:[us-core-race](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-race.html): ombCategory|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)
This should be a category and map to the ombCategory sub-extension. But if it is a detailed race, then it should go in the detailed sub-extension.| +|/patientRole/patient/sdtc:raceCode|.extension:[us-core-race](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-race.html)|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)
If code is in [OMB category](http://hl7.org/fhir/us/core/ValueSet/omb-race-category), use us-core-race: ombCategory; else use us-core-race: detailed.
If the detailed race is under a different OMB category that the non-sdtc:raceCode element, then an additional OMB category sub-extension should be included as well.| +|/patientRole/patient/ethnicGroupCode|.extension:[us-core-ethnicity](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-ethnicity.html)|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)
This should be a category and map to the ombCategory sub-extension. But if it is a detailed race, then it should go in the detailed sub-extension.| +|/patientRole/patient/sdtc:ethnicGroupCode|.extension:[us-core-ethnicity](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-ethnicity.html) : detailed|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)
Used for detailed ethnicity| |/patientRole/patient/languageCommunication/languageCode|.communication.language|| |/patientRole/patient/languageCommunication/preferenceInd|.communication.preferred|| |/patientRole/providerOrganization|.managingOrganization| From fe2dbda376ae744e5c9505d81d2962fa4f0bb02c Mon Sep 17 00:00:00 2001 From: Benjamin Flessner Date: Thu, 11 Jan 2024 12:45:39 -0600 Subject: [PATCH 004/112] Clean up precondition --- input/pagecontent/CF-medications.md | 2 +- 1 file changed, 1 insertion(+), 1 deletion(-) diff --git a/input/pagecontent/CF-medications.md b/input/pagecontent/CF-medications.md index 3cdd219..819672f 100644 --- a/input/pagecontent/CF-medications.md +++ b/input/pagecontent/CF-medications.md @@ -30,10 +30,10 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea |/consumable/manufacturedProduct/manufacturedMaterial/code|.medicationCodeableConcept|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/author|.requester
&
**[Provenance](http://hl7.org/fhir/us/core/StructureDefinition-us-core-procedure.html)**|[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| |/author/time|.authoredOn|Earliest, if more than one.
[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)| +|/precondition|.asNeededBoolean = true|The presence of a precondition element indicates asNeededBoolean should be true.
More complex maps may be possible with .asNeededCodeableConcept.| |**[Indication](http://hl7.org/cda/stds/ccda/draft1/StructureDefinition-2.16.840.1.113883.10.20.22.4.19.html)**
/entryRelationship[@typeCode="RSON"]/observation/value|.reasonCode|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |**[Free text sig](http://hl7.org/cda/stds/ccda/draft1/StructureDefinition-2.16.840.1.113883.10.20.22.4.147.html)**
/entryRelationship/substanceAdministration[code/@code="76662-6"]/text|.dosageInstruction.text|| |**[Comment Activity](http://hl7.org/cda/stds/ccda/draft1/StructureDefinition-2.16.840.1.113883.10.20.22.4.64.html)**
/entryRelationship/act[code/@code="48767-8"]/text|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**
.note|| -|**[Precondition]()**
|.asNeededBoolean = true|More complex maps may be possible with .asNeededCodeableConcept.| 1\. XPath abbrievated for C-CDA Medication Activity as:
ClinicalDocument/component/structuredBody/component/section[code/@code="10160-0"]/entry/substanceAdministration From 3e1932cbeb2d305d9152a8dca8a180a1f87f7e88 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner Date: Tue, 16 Jan 2024 17:30:21 -0600 Subject: [PATCH 005/112] Draft encounters, vitals, and results from Connectathon --- input/hl7.fhir.us.ccda.xml | 200 +++++++++++++++++------------ input/pagecontent/CF-encounters.md | 33 +++++ input/pagecontent/CF-index.md | 3 + input/pagecontent/CF-results.md | 52 ++++++++ input/pagecontent/CF-vitals.md | 44 +++++++ input/pagecontent/FC-encounters.md | 1 + input/pagecontent/FC-results.md | 1 + input/pagecontent/FC-vitals.md | 1 + 8 files changed, 250 insertions(+), 85 deletions(-) create mode 100644 input/pagecontent/CF-encounters.md create mode 100644 input/pagecontent/CF-results.md create mode 100644 input/pagecontent/CF-vitals.md create mode 100644 input/pagecontent/FC-encounters.md create mode 100644 input/pagecontent/FC-results.md create mode 100644 input/pagecontent/FC-vitals.md diff --git a/input/hl7.fhir.us.ccda.xml b/input/hl7.fhir.us.ccda.xml index 670471e..7caa7c1 100644 --- a/input/hl7.fhir.us.ccda.xml +++ b/input/hl7.fhir.us.ccda.xml @@ -817,91 +817,121 @@ <generation value="markdown"/> - </page> - <page> - <nameUrl value="mappingGuidance.html"/> - <title value="Mapping General and Structural Guidance"/> - <generation value="markdown"/> - </page> - <page> - <nameUrl value="CF-index.html"/> - <title value="C-CDA → FHIR Index"/> - <generation value="markdown"/> - </page> - <page> - <nameUrl value="FC-index.html"/> - <title value="FHIR → C-CDA Index"/> - <generation value="markdown"/> - </page> - <page> - <nameUrl value="CF-patient.html"/> - <title value="C-CDA to FHIR Patient"/> - <generation value="markdown"/> - </page> - <page> - <nameUrl value="CF-allergies.html"/> - <title value="C-CDA to FHIR Allergies"/> - <generation value="markdown"/> - </page> - <page> - <nameUrl value="CF-immunizations.html"/> - <title value="C-CDA to FHIR Immunizations"/> - <generation value="markdown"/> - </page> - <page> - <nameUrl value="CF-medications.html"/> - <title value="C-CDA to FHIR Medications"/> - <generation value="markdown"/> - </page> - <page> - <nameUrl value="CF-problems.html"/> - <title value="C-CDA to FHIR Problems"/> - <generation value="markdown"/> - </page> - <page> - <nameUrl value="CF-procedures.html"/> - <title value="C-CDA to FHIR Procedures"/> - <generation value="markdown"/> - </page> - <page> - <nameUrl value="FC-patient.html"/> - <title value="FHIR to C-CDA Patient"/> - <generation value="markdown"/> - </page> - <page> - <nameUrl value="FC-allergies.html"/> - <title value="FHIR to C-CDA Allergies"/> - <generation value="markdown"/> - </page> - <page> - <nameUrl value="FC-immunizations.html"/> - <title value="FHIR to C-CDA Immunizations"/> - <generation value="markdown"/> - </page> - <page> - <nameUrl value="FC-medications.html"/> - <title value="FHIR to C-CDA Medications"/> - <generation value="markdown"/> - </page> - <page> - <nameUrl value="FC-problems.html"/> - <title value="FHIR to C-CDA Problems"/> - <generation value="markdown"/> - </page> - <page> - <nameUrl value="FC-procedures.html"/> - <title value="FHIR to C-CDA Procedures"/> - <generation value="markdown"/> - </page> - <page> - <nameUrl value="conceptMaps.html"/> - <title value="Terminology Maps (Concept Maps)"/> - <generation value="markdown"/> - </page> - <page> - <nameUrl value="mappingIssues.html"/> - <title value="Known Issues"/> - <generation value="markdown"/> + <page> + <nameUrl value="mappingGuidance.html"/> + <title value="Mapping General and Structural Guidance"/> + <generation value="markdown"/> + </page> + <page> + <nameUrl value="CF-index.html"/> + <title value="C-CDA → FHIR Index"/> + <generation value="markdown"/> + <page> + <nameUrl value="CF-patient.html"/> + <title value="C-CDA to FHIR Patient"/> + <generation value="markdown"/> + </page> + <page> + <nameUrl value="CF-allergies.html"/> + <title value="C-CDA to FHIR Allergies"/> + <generation value="markdown"/> + </page> + <page> + <nameUrl value="CF-encounters.html"/> + <title value="C-CDA to FHIR Encounters"/> + <generation value="markdown"/> + </page> + <page> + <nameUrl value="CF-immunizations.html"/> + <title value="C-CDA to FHIR Immunizations"/> + <generation value="markdown"/> + </page> + <page> + <nameUrl value="CF-medications.html"/> + <title value="C-CDA to FHIR Medications"/> + <generation value="markdown"/> + </page> + <page> + <nameUrl value="CF-problems.html"/> + <title value="C-CDA to FHIR Problems"/> + <generation value="markdown"/> + </page> + <page> + <nameUrl value="CF-procedures.html"/> + <title value="C-CDA to FHIR Procedures"/> + <generation value="markdown"/> + </page> + <page> + <nameUrl value="CF-results.html"/> + <title value="C-CDA to FHIR Results"/> + <generation value="markdown"/> + </page> + <page> + <nameUrl value="CF-vitals.html"/> + <title value="C-CDA to FHIR Vital Signs"/> + <generation value="markdown"/> + </page> + </page> + <page> + <nameUrl value="FC-index.html"/> + <title value="FHIR → C-CDA Index"/> + <generation value="markdown"/> + <page> + <nameUrl value="FC-patient.html"/> + <title value="FHIR to C-CDA Patient"/> + <generation value="markdown"/> + </page> + <page> + <nameUrl value="FC-allergies.html"/> + <title value="FHIR to C-CDA Allergies"/> + <generation value="markdown"/> + </page> + <page> + <nameUrl value="FC-encounters.html"/> + <title value="FHIR to C-CDA Encounters"/> + <generation value="markdown"/> + </page> + <page> + <nameUrl value="FC-immunizations.html"/> + <title value="FHIR to C-CDA Immunizations"/> + <generation value="markdown"/> + </page> + <page> + <nameUrl value="FC-medications.html"/> + <title value="FHIR to C-CDA Medications"/> + <generation value="markdown"/> + </page> + <page> + <nameUrl value="FC-problems.html"/> + <title value="FHIR to C-CDA Problems"/> + <generation value="markdown"/> + </page> + <page> + <nameUrl value="FC-procedures.html"/> + <title value="FHIR to C-CDA Procedures"/> + <generation value="markdown"/> + </page> + <page> + <nameUrl value="FC-results.html"/> + <title value="FHIR to C-CDA Results"/> + <generation value="markdown"/> + </page> + <page> + <nameUrl value="FC-vitals.html"/> + <title value="FHIR to C-CDA Vital Signs"/> + <generation value="markdown"/> + </page> + </page> + <page> + <nameUrl value="conceptMaps.html"/> + <title value="Terminology Maps (Concept Maps)"/> + <generation value="markdown"/> + </page> + <page> + <nameUrl value="mappingIssues.html"/> + <title value="Known Issues"/> + <generation value="markdown"/> + </page> </page> <page> <nameUrl value="the_specification.html"/> diff --git a/input/pagecontent/CF-encounters.md b/input/pagecontent/CF-encounters.md new file mode 100644 index 0000000..ef4b75a --- /dev/null +++ b/input/pagecontent/CF-encounters.md @@ -0,0 +1,33 @@ +<style> +td, th { + border: 1px solid black!important; +} +</style> + +This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, please refer to [Encounters FHIR → CDA](./FC-encounters.html). For guidance on how to read the table below, see [Reading the C-CDA ↔ FHIR Mapping Pages](./mappingGuidance.html). + +... + +### C-CDA to FHIR + +|C-CDA¹<br/>[Encounter](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-EncounterActivity.html)|FHIR<br/>[Encounter](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-encounter.html)|Transform Steps| +|:----|:----|:----| +|/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| +|/code |.class<br/>&<br/>.type|If the root code or any translation is from V3 ActCode, it maps to .class. Place all remaining codes in .type.<br/>If the code cannot be converted to V3 ActCode, use the [Data Absent Reason](http://hl7.org/fhir/StructureDefinition/data-absent-reason) extension.<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|/statusCode|.status|**TODO: ConceptMap for CPT->ActCode?**<br/>**Note:** statusCode is optional in C-CDA. If missing, fallback to effectiveTime mapping. +|/effectiveTime|.status|If effectiveTime is a single timestamp or contains a high, status = `"finished"`.<br/>If low is present and high is missing, the status may be `"in-progress"` but implementers should take care to evaluate historical values and interpret as `"finished"` if appropriate. +|/effectiveTime/@value<br/>/effectiveTime/low/@value|.period.start +|/effectiveTime/high/@value|.period.end +|/sdtc:dischargeDispositionCode|.hospialization.dischargeDisposition|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) +|/performer|.participant|*TODO: Mapping Guidance for general performers (Participant vs ParticipantRole vs Organization)* +|/participant[@typeCode="LOC"]|.location +|**[Indication](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-Indication.html)**<br/>/entryRelationship[@typeCode="RSON"]/observation|.reasonCode<br/>or<br/>.reasonReference|If the id of the indication references a problem in the document that has been converted to a FHIR resource, populate .reasonReference with a reference to that resource. Otherwise, map observation/value to .reasonCode.<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) +|**[Encounter Diagnosis](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-EncounterDiagnosis.html)**<br/>/entryRelationship/act[code/@code="29308-4"]/observation|.diagnosis.condition|Map similar to [CDA → FHIR Problems](./CF-problems.html). + + +### Illustrative example +... +### Links to example content +... +### Prior work and Expanded Spreadsheets +... \ No newline at end of file diff --git a/input/pagecontent/CF-index.md b/input/pagecontent/CF-index.md index 26392e1..698121e 100644 --- a/input/pagecontent/CF-index.md +++ b/input/pagecontent/CF-index.md @@ -9,10 +9,13 @@ #### Available Maps - [Allergies](CF-allergies.html) +- [Encounters](CF-encounters.html) - [Immunizations](CF-immunizations.html) - [Medications](CF-medications.html) - [Patient](CF-patient.html) - [Problems](CF-problems.html) - [Procedures](CF-procedures.html) +- [Results](CF-results.html) +- [Vital Signs](CF-vitals.html) Please refer to [mapping background](mappingBackground.html) for more information how maps were selected and developed. diff --git a/input/pagecontent/CF-results.md b/input/pagecontent/CF-results.md new file mode 100644 index 0000000..4a1c637 --- /dev/null +++ b/input/pagecontent/CF-results.md @@ -0,0 +1,52 @@ +<style> +td, th { + border: 1px solid black!important; +} +</style> + +This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, please refer to [Results FHIR → CDA](./FC-results.html). For guidance on how to read the table below, see [Reading the C-CDA ↔ FHIR Mapping Pages](./mappingGuidance.html). + +... + +### C-CDA Organizer to FHIR Diagnostic Report + +|C-CDA¹<br/>[Result Organizer](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-ResultOrganizer.html)|FHIR<br/>Diagnostic Report ([Lab](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-diagnosticreport-lab.html)) ([Reports](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-diagnosticreport-note.html))|Transform Steps| +|:----|:----|:----| +|/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| +|/code|.category|*TODO: Describe using LOINC classes to identify category* +|/code |.code|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|/statusCode|.status|*TODO: ConceptMap* +|/effectiveTime|.effectiveDateTime<br/>or<br/>.effectivePeriod|If low and high are identical, use effectiveDateTime. If organizer/effectiveTime is missing, use the earliest and latest observation/effectiveTime as the source of the mapping.<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) +|/specimen||*TODO* +|/author||*TODO* +|/component/observation|.result|See following table + +### C-CDA Observation to FHIR Observation + +|C-CDA¹<br/>[Result Observation](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-ResultObservation.html)|FHIR<br/>[Lab Result Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-observation-lab.html)|Transform Steps| +|:----|:----|:----| +|/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| +|(parent organizer)|.category|Use category from DiagnosticReport or map /code to a category similarly +|/code |.code|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|/statusCode|.status|*TODO: ConceptMap* +|/effectiveTime|.effectiveDateTime<br/>or<br/>.effectivePeriod|Prefer effectiveDateTime<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) +|/value[xsi:type=PQ]|.valueQuantity|[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity) +|/value[xsi:type=IVL_PQ]|.valueQuantity<br/>or<br/>.valueRange|[Ranges of Physical Quantities](mappingGuidance.html#ranges-of-physical-quantities) +|/value[xsi:type=CD]<br/>(or CE, CV, CO, CS)|.valueCodeableConcept|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|/value[xsi:type=INT]|.valueInteger| +|/value[xsi:type=REAL]|.valueQuantity|Leave unit fields empty +|/interpretationCode|.interpretation|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|/methodCode|.method|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|/targetSiteCode|.bodySite|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|/author||*TODO* +|/referenceRange/observationRange/interpretationCode|**Not Supported**|FHIR expects reference ranges to be "normal" ranges. If C-CDA includes multiple reference ranges, only map the one with interpretationCode = `"N"`. +|/referenceRange/observationRange/value[xsi:type=IVL_PQ]|.referenceRange.low<br/>&<br/>.referenceRange.high| +|/referenceRange/observationRange/value[xsi:type=ST]<br/>or<br/>/referenceRange/observationRange/text|.referenceRange.text| + + +### Illustrative example +... +### Links to example content +... +### Prior work and Expanded Spreadsheets +... \ No newline at end of file diff --git a/input/pagecontent/CF-vitals.md b/input/pagecontent/CF-vitals.md new file mode 100644 index 0000000..8803fba --- /dev/null +++ b/input/pagecontent/CF-vitals.md @@ -0,0 +1,44 @@ +<style> +td, th { + border: 1px solid black!important; +} +</style> + +This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, please refer to [Vitals FHIR → CDA](./FC-vitals.html). For guidance on how to read the table below, see [Reading the C-CDA ↔ FHIR Mapping Pages](./mappingGuidance.html). + +C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or more vitals readings together. This has been mapped to an additional FHIR Observation for the panel of vital signs. This panel contains a `.hasMember` field which references each observation mapped from the original C-CDA Vital Signs Organizer. + +### C-CDA Vital Signs Organizer to FHIR Observation Panel + +|C-CDA¹<br/>[Vital SignsOrganizer](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-VitalSignsOrganizer.html)|FHIR<br/>[Vital Signs Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-vital-signs.html)|Transform Steps| +|:----|:----|:----| +|/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| +||.category|Set to `vital-signs` from [Vital Signs value set](https://hl7.org/fhir/us/core/STU4/ValueSet-us-core-vital-signs.html) +||.code|Set to `85353-1` [CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|/statusCode|.status|*TODO: ConceptMap* +|/effectiveTime|.effectiveDateTime<br/>or<br/>.effectivePeriod|If low and high are identical, use effectiveDateTime. If organizer/effectiveTime is missing, use the earliest and latest observation/effectiveTime as the source of the mapping.<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) +||.hasMember|Reference to each vital sign observation mapped from CDA + +### C-CDA Vital Signs Observation to FHIR Observation + +|C-CDA¹<br/>[Vital Sign Observation](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-VitalSignObservation.html)|FHIR<br/>[Vital Signs Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-vital-signs.html)|Transform Steps| +|:----|:----|:----| +|/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| +||.category|Set to `vital-signs` from [Vital Signs value set](https://hl7.org/fhir/us/core/STU4/ValueSet-us-core-vital-signs.html) +|/code |.code|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|/effectiveTime|.effectiveDateTime<br/>or<br/>.effectivePeriod|Prefer effectiveDateTime<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) +|value|.valueQuantity|CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity) +|/interpretationCode|.interpretation|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|/methodCode|.method|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|/targetSiteCode|.bodySite|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|/author||*TODO* +|/referenceRange/observationRange/interpretationCode|**Not Supported**|FHIR expects reference ranges to be "normal" ranges. If C-CDA includes multiple reference ranges, only map the one with interpretationCode = `"N"`. +|/referenceRange/observationRange/value[xsi:type=IVL_PQ]|.referenceRange.low<br/>&<br/>.referenceRange.high| +|/referenceRange/observationRange/value[xsi:type=ST]<br/>or<br/>/referenceRange/observationRange/text|.referenceRange.text| + +### Illustrative example +... +### Links to example content +... +### Prior work and Expanded Spreadsheets +... \ No newline at end of file diff --git a/input/pagecontent/FC-encounters.md b/input/pagecontent/FC-encounters.md new file mode 100644 index 0000000..ae8e0d6 --- /dev/null +++ b/input/pagecontent/FC-encounters.md @@ -0,0 +1 @@ +*Coming soon...* \ No newline at end of file diff --git a/input/pagecontent/FC-results.md b/input/pagecontent/FC-results.md new file mode 100644 index 0000000..ae8e0d6 --- /dev/null +++ b/input/pagecontent/FC-results.md @@ -0,0 +1 @@ +*Coming soon...* \ No newline at end of file diff --git a/input/pagecontent/FC-vitals.md b/input/pagecontent/FC-vitals.md new file mode 100644 index 0000000..ae8e0d6 --- /dev/null +++ b/input/pagecontent/FC-vitals.md @@ -0,0 +1 @@ +*Coming soon...* \ No newline at end of file From 8c777ad8d939e7e9a610cebb3a0af5e47bbf5728 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Wed, 17 Jan 2024 08:37:43 -0600 Subject: [PATCH 006/112] Bump CPT note a line up --- input/pagecontent/CF-encounters.md | 4 ++-- 1 file changed, 2 insertions(+), 2 deletions(-) diff --git a/input/pagecontent/CF-encounters.md b/input/pagecontent/CF-encounters.md index ef4b75a..0ee9d45 100644 --- a/input/pagecontent/CF-encounters.md +++ b/input/pagecontent/CF-encounters.md @@ -13,8 +13,8 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea |C-CDA¹<br/>[Encounter](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-EncounterActivity.html)|FHIR<br/>[Encounter](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-encounter.html)|Transform Steps| |:----|:----|:----| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| -|/code |.class<br/>&<br/>.type|If the root code or any translation is from V3 ActCode, it maps to .class. Place all remaining codes in .type.<br/>If the code cannot be converted to V3 ActCode, use the [Data Absent Reason](http://hl7.org/fhir/StructureDefinition/data-absent-reason) extension.<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| -|/statusCode|.status|**TODO: ConceptMap for CPT->ActCode?**<br/>**Note:** statusCode is optional in C-CDA. If missing, fallback to effectiveTime mapping. +|/code |.class<br/>&<br/>.type|If the root code or any translation is from V3 ActCode, it maps to .class. Place all remaining codes in .type.<br/>If the code cannot be converted to V3 ActCode, use the [Data Absent Reason](http://hl7.org/fhir/StructureDefinition/data-absent-reason) extension.<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>**TODO: ConceptMap for CPT->ActCode?**| +|/statusCode|.status|**Note:** statusCode is optional in C-CDA. If missing, fallback to effectiveTime mapping. |/effectiveTime|.status|If effectiveTime is a single timestamp or contains a high, status = `"finished"`.<br/>If low is present and high is missing, the status may be `"in-progress"` but implementers should take care to evaluate historical values and interpret as `"finished"` if appropriate. |/effectiveTime/@value<br/>/effectiveTime/low/@value|.period.start |/effectiveTime/high/@value|.period.end From 095bbdc42b51fb6f43d96d7876d4ed240231ef93 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Wed, 17 Jan 2024 08:46:57 -0600 Subject: [PATCH 007/112] Add functioncode --- input/pagecontent/CF-encounters.md | 1 + 1 file changed, 1 insertion(+) diff --git a/input/pagecontent/CF-encounters.md b/input/pagecontent/CF-encounters.md index 0ee9d45..ecaec96 100644 --- a/input/pagecontent/CF-encounters.md +++ b/input/pagecontent/CF-encounters.md @@ -20,6 +20,7 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea |/effectiveTime/high/@value|.period.end |/sdtc:dischargeDispositionCode|.hospialization.dischargeDisposition|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) |/performer|.participant|*TODO: Mapping Guidance for general performers (Participant vs ParticipantRole vs Organization)* +|/performer/sdtc:functionCode|.participant.type|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) |/participant[@typeCode="LOC"]|.location |**[Indication](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-Indication.html)**<br/>/entryRelationship[@typeCode="RSON"]/observation|.reasonCode<br/>or<br/>.reasonReference|If the id of the indication references a problem in the document that has been converted to a FHIR resource, populate .reasonReference with a reference to that resource. Otherwise, map observation/value to .reasonCode.<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) |**[Encounter Diagnosis](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-EncounterDiagnosis.html)**<br/>/entryRelationship/act[code/@code="29308-4"]/observation|.diagnosis.condition|Map similar to [CDA → FHIR Problems](./CF-problems.html). From 5084309e7a7f4d2894aee9c858df888a28928ce9 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Wed, 17 Jan 2024 09:02:36 -0600 Subject: [PATCH 008/112] Add note about timezone offset preservation --- input/pagecontent/mappingGuidance.md | 4 ++-- 1 file changed, 2 insertions(+), 2 deletions(-) diff --git a/input/pagecontent/mappingGuidance.md b/input/pagecontent/mappingGuidance.md index d779a30..5e69733 100644 --- a/input/pagecontent/mappingGuidance.md +++ b/input/pagecontent/mappingGuidance.md @@ -81,12 +81,12 @@ CDA timestamp values are based on a pattern of YYYYMMDDHHmmss+zzzz and [FHIR dat To convert between the standards, systems should deploy programming logic that converts formats and preserves the level of precision. For example, "20230531" from CDA would become "2023-05-31" in FHIR (not 2023-05-31T00:00:00+00:00). Additional examples below: -|CDA Date Time|FHIR Date Time| +|CDA Date Time|FHIR Date Time|Notes| |:-----|:-----|:-------------| |2023|2023| |202305|2023-05| |20230531|2023-05-31| -|202305312205-0500|2023-05-31T22:05-05:00| +|202305312205-0500|2023-05-31T22:05-05:00|Timezone offset should be preserved Note that in C-CDA, timezone offset is a SHOULD, while in FHIR, time zone offset is required when more specific than the day. There may be instances where a CDA date-time value omits a time zone offset and other data from the document may be necessary to populate FHIR dateTime requirements. From 5ab5f9f09e0d01bf4cd4fe0c97ce33b2fa5921a7 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Wed, 17 Jan 2024 09:46:57 -0600 Subject: [PATCH 009/112] Update code/status notes from CAT --- input/pagecontent/CF-encounters.md | 11 ++++++----- 1 file changed, 6 insertions(+), 5 deletions(-) diff --git a/input/pagecontent/CF-encounters.md b/input/pagecontent/CF-encounters.md index ecaec96..19dcd4a 100644 --- a/input/pagecontent/CF-encounters.md +++ b/input/pagecontent/CF-encounters.md @@ -13,17 +13,18 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea |C-CDA¹<br/>[Encounter](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-EncounterActivity.html)|FHIR<br/>[Encounter](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-encounter.html)|Transform Steps| |:----|:----|:----| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| -|/code |.class<br/>&<br/>.type|If the root code or any translation is from V3 ActCode, it maps to .class. Place all remaining codes in .type.<br/>If the code cannot be converted to V3 ActCode, use the [Data Absent Reason](http://hl7.org/fhir/StructureDefinition/data-absent-reason) extension.<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>**TODO: ConceptMap for CPT->ActCode?**| -|/statusCode|.status|**Note:** statusCode is optional in C-CDA. If missing, fallback to effectiveTime mapping. -|/effectiveTime|.status|If effectiveTime is a single timestamp or contains a high, status = `"finished"`.<br/>If low is present and high is missing, the status may be `"in-progress"` but implementers should take care to evaluate historical values and interpret as `"finished"` if appropriate. -|/effectiveTime/@value<br/>/effectiveTime/low/@value|.period.start +|/code |.class|Only the V3 ActCode system, which may be present in the root element or any `<translation>`.<br/>Other code systems may map to V3 ActCode (for example CPT codes 99211-99215 map to `AMB`, 99221-99223 to `IMP`, 99281-99285 to `EMER`, etc), but if this mapping is not possible, use the [Data Absent Reason](http://hl7.org/fhir/StructureDefinition/data-absent-reason) extension.| +|/code|.type|The remaining codes besides V3 ActCode<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) +|/statusCode|.status|*TODO: ActStatus to Encounter Status ConceptMap*<br/>**Note:** statusCode is optional in C-CDA. If missing, fallback to effectiveTime mapping. +|/effectiveTime|.status|If effectiveTime is a single timestamp or contains a high, status = `"finished"`.<br/>If low is present and high is missing, the status may be `"in-progress"` but implementers may choose to evaluate historical values as `"finished"` or `"unknown"` if appropriate. +|/effectiveTime/@value<br/>/effectiveTime/low/@value|.period.start|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) |/effectiveTime/high/@value|.period.end |/sdtc:dischargeDispositionCode|.hospialization.dischargeDisposition|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) |/performer|.participant|*TODO: Mapping Guidance for general performers (Participant vs ParticipantRole vs Organization)* |/performer/sdtc:functionCode|.participant.type|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) |/participant[@typeCode="LOC"]|.location |**[Indication](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-Indication.html)**<br/>/entryRelationship[@typeCode="RSON"]/observation|.reasonCode<br/>or<br/>.reasonReference|If the id of the indication references a problem in the document that has been converted to a FHIR resource, populate .reasonReference with a reference to that resource. Otherwise, map observation/value to .reasonCode.<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) -|**[Encounter Diagnosis](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-EncounterDiagnosis.html)**<br/>/entryRelationship/act[code/@code="29308-4"]/observation|.diagnosis.condition|Map similar to [CDA → FHIR Problems](./CF-problems.html). +|**[Encounter Diagnosis](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-EncounterDiagnosis.html)**<br/>/entryRelationship/act[code/@code="29308-4"]/observation|.diagnosis.condition|Map similar to [CDA → FHIR Problems](./CF-problems.html).<br/>*TODO: Rename to FHIR Conditions, add a note on that page about where it's coming from; update the category code.* ### Illustrative example From 51bab428cf48c37912b09423f7712d3b71ee50f3 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Wed, 17 Jan 2024 11:49:17 -0600 Subject: [PATCH 010/112] Draft notes mapping --- input/hl7.fhir.us.ccda.xml | 10 ++++++++++ input/pagecontent/CF-notes.md | 32 ++++++++++++++++++++++++++++++++ input/pagecontent/FC-notes.md | 1 + 3 files changed, 43 insertions(+) create mode 100644 input/pagecontent/CF-notes.md create mode 100644 input/pagecontent/FC-notes.md diff --git a/input/hl7.fhir.us.ccda.xml b/input/hl7.fhir.us.ccda.xml index 7caa7c1..0c3300e 100644 --- a/input/hl7.fhir.us.ccda.xml +++ b/input/hl7.fhir.us.ccda.xml @@ -851,6 +851,11 @@ <title value="C-CDA to FHIR Medications"/> <generation value="markdown"/> </page> + <page> + <nameUrl value="CF-notes.html"/> + <title value="C-CDA to FHIR Notes"/> + <generation value="markdown"/> + </page> <page> <nameUrl value="CF-problems.html"/> <title value="C-CDA to FHIR Problems"/> @@ -901,6 +906,11 @@ <title value="FHIR to C-CDA Medications"/> <generation value="markdown"/> </page> + <page> + <nameUrl value="FC-notes.html"/> + <title value="FHIR to C-CDA Medications"/> + <generation value="markdown"/> + </page> <page> <nameUrl value="FC-problems.html"/> <title value="FHIR to C-CDA Problems"/> diff --git a/input/pagecontent/CF-notes.md b/input/pagecontent/CF-notes.md new file mode 100644 index 0000000..f313b2f --- /dev/null +++ b/input/pagecontent/CF-notes.md @@ -0,0 +1,32 @@ +<style> +td, th { + border: 1px solid black!important; +} +</style> + +This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, please refer to [Notes FHIR → CDA](./FC-notes.html). For guidance on how to read the table below, see [Reading the C-CDA ↔ FHIR Mapping Pages](./mappingGuidance.html). + +... + +### C-CDA to FHIR + +|C-CDA¹<br/>[Note Activity](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-NoteActivity.html|FHIR<br/>[DocumentReference](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-documentreference.html)|Transform Steps| +|:----|:----|:----| +|/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| +|/code|.type|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>**NOTE:** The root code in CDA is always `64109-9: Note` which matches the FHIR Binding. +|/text/@mediaType<br/>&<br/>/text/text()|.attachment.contentType<br/>&<br/>.attachment.data|If @mediaType is present, then representation should = B64, and the inner-text contents are embedded base64-encoded data. In this case, the mediaType and base64-encoded data map 1:1 to attachment.contentType and .data. +|/text/reference/@value|.attachment.contentType<br/>&<br/>.attachment.data|Convert the narrative element referenced by @value following [Narrative Text](mappingGuidance.html#narrative-text) guidance and use `application/xhtml+xml` as the contentType.<br/>If the narrative has minimal markup (i.e. only `<content>` and `<paragraph>` elements which can be converted to line breaks), it can be converted to `text/plain`.<br/>To send the raw CDA narrative without converting, use `application/cda+xml`, but this is less useful to receivers. +|/effectiveTime|.context.period|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) +|/author|.author +|/author/time|.date|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) +|/entryRelationship[@typeCode=COMP]/encounter<br/>or<br/>Parent `<encounter>` element<br/>or<br/>`<encompassingEncounter>`|.context.encounter|C-CDA requires an encounter for notes, but allows for context conduction. If the Note Activity is in an entryRelationship chain that includes an Encounter Activity, use that. Otherwise, if the document contains an `<encompassingEncounter>`, that is the encounter for the note. +|/reference/externalDocument/id|.relatesTo.target|*TODO: Appropriate?* + + + +### Illustrative example +... +### Links to example content +... +### Prior work and Expanded Spreadsheets +... \ No newline at end of file diff --git a/input/pagecontent/FC-notes.md b/input/pagecontent/FC-notes.md new file mode 100644 index 0000000..ae8e0d6 --- /dev/null +++ b/input/pagecontent/FC-notes.md @@ -0,0 +1 @@ +*Coming soon...* \ No newline at end of file From db4d8c0aa19cb0295bd577b1eeb6d95a51ca8bb4 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Wed, 17 Jan 2024 17:16:11 -0600 Subject: [PATCH 011/112] Add link to notes on index page --- input/pagecontent/CF-index.md | 1 + 1 file changed, 1 insertion(+) diff --git a/input/pagecontent/CF-index.md b/input/pagecontent/CF-index.md index 698121e..d7963ba 100644 --- a/input/pagecontent/CF-index.md +++ b/input/pagecontent/CF-index.md @@ -12,6 +12,7 @@ - [Encounters](CF-encounters.html) - [Immunizations](CF-immunizations.html) - [Medications](CF-medications.html) +- [Notes](CF-notes.html) - [Patient](CF-patient.html) - [Problems](CF-problems.html) - [Procedures](CF-procedures.html) From f641c7c1c563022674a36232b113449ae39b2841 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Mon, 22 Jan 2024 09:40:38 -0600 Subject: [PATCH 012/112] Experimentally model EncompassingEncounter mapping --- input/pagecontent/CF-encounters.md | 22 +++++++++++----------- 1 file changed, 11 insertions(+), 11 deletions(-) diff --git a/input/pagecontent/CF-encounters.md b/input/pagecontent/CF-encounters.md index 19dcd4a..f573452 100644 --- a/input/pagecontent/CF-encounters.md +++ b/input/pagecontent/CF-encounters.md @@ -6,25 +6,25 @@ td, th { This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, please refer to [Encounters FHIR → CDA](./FC-encounters.html). For guidance on how to read the table below, see [Reading the C-CDA ↔ FHIR Mapping Pages](./mappingGuidance.html). -... - -### C-CDA to FHIR +Encounter Activities in the Encounters Section (or elsewhere in the document, such as `<entryReference>` on Clinical Notes) correspond FHIR Encounter resources. If the document itself contains a `componentOf/encompassingEncounter`, this should also be converted to a FHIR Encounter resource. In all cases, when the same encounter is referenced multiple times (such as the `encompassingEncounter` and an Encounter Activity in the Encounters Section containing the same `<id>`), it should be converted to the same FHIR resource. -|C-CDA¹<br/>[Encounter](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-EncounterActivity.html)|FHIR<br/>[Encounter](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-encounter.html)|Transform Steps| +### C-CDA Encounter to FHIR +<sup>(b)</sup> - indicates element is only present in Encounter Activity in the body of the document<br/><sup>(h)</sup> - indicates element is only present in EncompassingEncounter in the header of the document +|C-CDA¹<br/>[Encounter Activity](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-EncounterActivity.html) or [EncompassingEncounter](https://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-EncompassingEncounter.html)|FHIR<br/>[Encounter](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-encounter.html)|Transform Steps| |:----|:----|:----| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| |/code |.class|Only the V3 ActCode system, which may be present in the root element or any `<translation>`.<br/>Other code systems may map to V3 ActCode (for example CPT codes 99211-99215 map to `AMB`, 99221-99223 to `IMP`, 99281-99285 to `EMER`, etc), but if this mapping is not possible, use the [Data Absent Reason](http://hl7.org/fhir/StructureDefinition/data-absent-reason) extension.| |/code|.type|The remaining codes besides V3 ActCode<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) -|/statusCode|.status|*TODO: ActStatus to Encounter Status ConceptMap*<br/>**Note:** statusCode is optional in C-CDA. If missing, fallback to effectiveTime mapping. +|/statusCode <sup>(b)</sup>|.status|*TODO: ActStatus to Encounter Status ConceptMap*<br/>**Note:** statusCode is optional in C-CDA. If missing, fallback to effectiveTime mapping. |/effectiveTime|.status|If effectiveTime is a single timestamp or contains a high, status = `"finished"`.<br/>If low is present and high is missing, the status may be `"in-progress"` but implementers may choose to evaluate historical values as `"finished"` or `"unknown"` if appropriate. |/effectiveTime/@value<br/>/effectiveTime/low/@value|.period.start|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) |/effectiveTime/high/@value|.period.end -|/sdtc:dischargeDispositionCode|.hospialization.dischargeDisposition|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) -|/performer|.participant|*TODO: Mapping Guidance for general performers (Participant vs ParticipantRole vs Organization)* -|/performer/sdtc:functionCode|.participant.type|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) -|/participant[@typeCode="LOC"]|.location -|**[Indication](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-Indication.html)**<br/>/entryRelationship[@typeCode="RSON"]/observation|.reasonCode<br/>or<br/>.reasonReference|If the id of the indication references a problem in the document that has been converted to a FHIR resource, populate .reasonReference with a reference to that resource. Otherwise, map observation/value to .reasonCode.<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) -|**[Encounter Diagnosis](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-EncounterDiagnosis.html)**<br/>/entryRelationship/act[code/@code="29308-4"]/observation|.diagnosis.condition|Map similar to [CDA → FHIR Problems](./CF-problems.html).<br/>*TODO: Rename to FHIR Conditions, add a note on that page about where it's coming from; update the category code.* +|/sdtc:dischargeDispositionCode <sup>(b)</sup><br/>/dischargeDispositionCode <sup>(h)</sup>|.hospialization.dischargeDisposition|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) +|/performer <sup>(b)</sup><br/>/encounterParticipant <sup>(h)</sup>|.participant|*TODO: Mapping Guidance for general performers (Participant vs ParticipantRole vs Organization)* +|/performer/sdtc:functionCode <sup>(b)</sup>|.participant.type|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) +|/participant[@typeCode="LOC"] <sup>(b)</sup><br/>/location <sup>(h)</sup>|.location +|**[Indication](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-Indication.html)** <sup>(b)</sup><br/>/entryRelationship[@typeCode="RSON"]/observation|.reasonCode<br/>or<br/>.reasonReference|If the id of the indication references a problem in the document that has been converted to a FHIR resource, populate .reasonReference with a reference to that resource. Otherwise, map observation/value to .reasonCode.<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) +|**[Encounter Diagnosis](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-EncounterDiagnosis.html)** <sup>(b)</sup><br/>/entryRelationship/act[code/@code="29308-4"]/observation|.diagnosis.condition|Map similar to [CDA → FHIR Problems](./CF-problems.html).<br/>*TODO: Rename to FHIR Conditions, add a note on that page about where it's coming from; update the category code.* ### Illustrative example From b7eb958d5640a0e31421c5e19ee3dc1151d584e6 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Fri, 2 Feb 2024 12:28:30 -0600 Subject: [PATCH 013/112] Add blank line to fix table --- input/pagecontent/CF-encounters.md | 1 + 1 file changed, 1 insertion(+) diff --git a/input/pagecontent/CF-encounters.md b/input/pagecontent/CF-encounters.md index f573452..94cf7f2 100644 --- a/input/pagecontent/CF-encounters.md +++ b/input/pagecontent/CF-encounters.md @@ -10,6 +10,7 @@ Encounter Activities in the Encounters Section (or elsewhere in the document, su ### C-CDA Encounter to FHIR <sup>(b)</sup> - indicates element is only present in Encounter Activity in the body of the document<br/><sup>(h)</sup> - indicates element is only present in EncompassingEncounter in the header of the document + |C-CDA¹<br/>[Encounter Activity](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-EncounterActivity.html) or [EncompassingEncounter](https://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-EncompassingEncounter.html)|FHIR<br/>[Encounter](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-encounter.html)|Transform Steps| |:----|:----|:----| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| From aab8859a25d76b4db1577c2bed11bc82e028e35f Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Mon, 13 May 2024 10:58:30 -0500 Subject: [PATCH 014/112] Add into to results --- input/pagecontent/CF-results.md | 4 +++- 1 file changed, 3 insertions(+), 1 deletion(-) diff --git a/input/pagecontent/CF-results.md b/input/pagecontent/CF-results.md index 4a1c637..30fcb3e 100644 --- a/input/pagecontent/CF-results.md +++ b/input/pagecontent/CF-results.md @@ -6,7 +6,9 @@ td, th { This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, please refer to [Results FHIR → CDA](./FC-results.html). For guidance on how to read the table below, see [Reading the C-CDA ↔ FHIR Mapping Pages](./mappingGuidance.html). -... +Results in C-CDA are collected into `<organizer>` elements containing one or more result `<observation>` element. This corresponds to one FHIR DiagnosticReport for the `<organizer>` which multiple `.result` references to FHIR Observation resources, one for each CDA `<observation>`. + +Observation values are generic - they can be of any CDA type in CDA, and *almost* any DataType in FHIR. In CDA, the type is represented by the `xsi:type` attribute on the `<value>` element. In FHIR, the type is represented by the `.value[x]` element; the `[x]` represents a choice among data types, so `.valueQuantity` represents a quantity data type, `.valueInteger` represents a numeric whole number, etc. Not every CDA type is a 1:1 match for a FHIR type, but significant differences have been included in the tables below. ### C-CDA Organizer to FHIR Diagnostic Report From ec52476b39b0204293d02e4d00136cf074b812a6 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Mon, 13 May 2024 10:58:40 -0500 Subject: [PATCH 015/112] Add social history mapping --- input/hl7.fhir.us.ccda.xml | 10 ++++++++ input/pagecontent/CF-index.md | 1 + input/pagecontent/CF-social.md | 47 ++++++++++++++++++++++++++++++++++ input/pagecontent/FC-social.md | 1 + 4 files changed, 59 insertions(+) create mode 100644 input/pagecontent/CF-social.md create mode 100644 input/pagecontent/FC-social.md diff --git a/input/hl7.fhir.us.ccda.xml b/input/hl7.fhir.us.ccda.xml index 0c3300e..7ebc65e 100644 --- a/input/hl7.fhir.us.ccda.xml +++ b/input/hl7.fhir.us.ccda.xml @@ -871,6 +871,11 @@ <title value="C-CDA to FHIR Results"/> <generation value="markdown"/> </page> + <page> + <nameUrl value="CF-social.html"/> + <title value="C-CDA to FHIR Social History"/> + <generation value="markdown"/> + </page> <page> <nameUrl value="CF-vitals.html"/> <title value="C-CDA to FHIR Vital Signs"/> @@ -926,6 +931,11 @@ <title value="FHIR to C-CDA Results"/> <generation value="markdown"/> </page> + <page> + <nameUrl value="FC-social.html"/> + <title value="FHIR to C-CDA Social History"/> + <generation value="markdown"/> + </page> <page> <nameUrl value="FC-vitals.html"/> <title value="FHIR to C-CDA Vital Signs"/> diff --git a/input/pagecontent/CF-index.md b/input/pagecontent/CF-index.md index d7963ba..2a6d04a 100644 --- a/input/pagecontent/CF-index.md +++ b/input/pagecontent/CF-index.md @@ -17,6 +17,7 @@ - [Problems](CF-problems.html) - [Procedures](CF-procedures.html) - [Results](CF-results.html) +- [Social History](CF-social.html) (Including Smoking Status, Pregnancy Observation) - [Vital Signs](CF-vitals.html) Please refer to [mapping background](mappingBackground.html) for more information how maps were selected and developed. diff --git a/input/pagecontent/CF-social.md b/input/pagecontent/CF-social.md new file mode 100644 index 0000000..408be85 --- /dev/null +++ b/input/pagecontent/CF-social.md @@ -0,0 +1,47 @@ +<style> +td, th { + border: 1px solid black!important; +} +</style> + +This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, please refer to [Results FHIR → CDA](./FC-results.html). For guidance on how to read the table below, see [Reading the C-CDA ↔ FHIR Mapping Pages](./mappingGuidance.html). + +Social History is a category of several templates in C-CDA and several profiles in US Core. At a high-level, mappings between CDA `<observation>` acts and FHIR Observation resources are similar and are represented by the top table. Differences are documented on the proceeding tables. + +### C-CDA Social History Observation to FHIR Observation +This maps to US Core version 6's Simple Observation. Previous versions of US Core did not define a generic observation, but the following guidance can still be used to create a generic FHIR observation regardless of the version of US Core being targeted. + +|C-CDA<br/>[Social History Observation](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-SocialHistoryObservation.html)|FHIR<br/>[Simple Observation](https://hl7.org/fhir/us/core/STU6/StructureDefinition-us-core-simple-observation.html)|Transform Steps| +|:----|:----|:----| +|/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| +||.category|Set to `social-history` from [Observation Category Codes](https://build.fhir.org/ig/HL7/UTG/CodeSystem-observation-category.html) +|/code |.code|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|/statusCode|.status|*TODO: ConceptMap* +|/effectiveTime|.effectiveDateTime<br/>or<br/>.effectivePeriod|Prefer effectiveDateTime<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) +|/value[xsi:type=PQ]|.valueQuantity|[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity) +|/value[xsi:type=IVL_PQ]|.valueQuantity<br/>or<br/>.valueRange|[Ranges of Physical Quantities](mappingGuidance.html#ranges-of-physical-quantities) +|/value[xsi:type=CD]<br/>(or CE, CV, CO, CS)|.valueCodeableConcept|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|/value[xsi:type=INT]|.valueInteger| +|/value[xsi:type=REAL]|.valueQuantity|Leave unit fields empty +|/author||*TODO* + +Additional fields, such as `.interpretationCode`, `.referenceRange`, `.performer` are not documented in C-CDA but can be mapped in the same manner as [Results](./CF-results.html). + +### C-CDA Smoking Status / Tobacco Use to FHIR Observation +In C-CDA 3.0, the Smoking Status - MU and Tobacco Use templates were merged into a single template to better match US Core's Smoking Status template. + +|C-CDA<br/>[Smoking Status - MU](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-SmokingStatusMeaningfulUse.html) (Deprecated)<br/>[Tobacco Use](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-TobaccoUse.html) (Decprecated)<br/>[Smoking Status](https://build.fhir.org/ig/HL7/CDA-ccda/StructureDefinition-SmokingStatus.html) (C-CDA 3.0)²|FHIR<br/>[Smoking Status Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-smokingstatus.html)|Transform Steps| +|:----|:----|:----| +|/code|.code|Prior to US Core 7, the code should be `72166-2 (Tobacco smoking status NCIS)`, but this is an extensible value set.<br/>In US Core 7, the value set remains extensible, but contains the same 4 concepts allowed in the C-CDA R3.0's Smoking Status value set. +|/effectiveTime|.effectiveDateTime<br/>or<br/>.effectivePeriod|Smoking Status - MU required a timestamp; Tobacco Use required a time range; Smoking Status (3.0) combines the two templates into one and allows for either. + +### C-CDA Pregnancy Observation to FHIR Pregnancy Status Observation +In US Core, Pregnancy Observation was first defined in version 6. + +|C-CDA<br/>[Pregnancy Observation](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-PregnancyObservation.html)|FHIR<br/>[Pregnancy Status](https://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-observation-pregnancystatus.html)|Transform Steps| +|:----|:----|:----| +|.moodCode||The C-CDA moodCode is `EVN` which is why this maps to FHIR's Pregnancy Status rather than Pregnancy Intent. +||.code|`82810-3 (Pregnancy Status)` - C-CDA uses `ASSERTION`, but FHIR clarifies the code to be used. +|/effectiveTime/@value<br/>or<br/>/effectiveTime/low/@value<br/>or<br/>/effectiveTime/high/@value<br/>or<br/>/author/time|.effectiveDateTime|FHIR only allows a single timestamp. Send the first element from the first column with a populated timestamp.<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) +|/value|.valueCodeableConcept|*TODO ValueSet*<br/>Note: the CDA @nullFlavor of UNK maps to a coded value in the FHIR value set.<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|/entryRelationship/estimatedDateofDelivery|.hasMember|Use generic observation mapping above to create a new Observation resource from the C-CDA Date of Delivery observation, and reference it in the Pregnancy Status observation's `.hasMember` field. diff --git a/input/pagecontent/FC-social.md b/input/pagecontent/FC-social.md new file mode 100644 index 0000000..ae8e0d6 --- /dev/null +++ b/input/pagecontent/FC-social.md @@ -0,0 +1 @@ +*Coming soon...* \ No newline at end of file From 55d182005a0c4da2280a554ea606e4fccf686915 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Mon, 13 May 2024 11:30:23 -0500 Subject: [PATCH 016/112] Leave this for later --- input/pagecontent/CF-social.md | 1 - 1 file changed, 1 deletion(-) diff --git a/input/pagecontent/CF-social.md b/input/pagecontent/CF-social.md index 408be85..6c462f9 100644 --- a/input/pagecontent/CF-social.md +++ b/input/pagecontent/CF-social.md @@ -23,7 +23,6 @@ This maps to US Core version 6's Simple Observation. Previous versions of US Cor |/value[xsi:type=CD]<br/>(or CE, CV, CO, CS)|.valueCodeableConcept|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/value[xsi:type=INT]|.valueInteger| |/value[xsi:type=REAL]|.valueQuantity|Leave unit fields empty -|/author||*TODO* Additional fields, such as `.interpretationCode`, `.referenceRange`, `.performer` are not documented in C-CDA but can be mapped in the same manner as [Results](./CF-results.html). From 66f3d18dad5da989218c1a7d4b73b3bb51fd2e6d Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Tue, 14 May 2024 14:23:57 -0500 Subject: [PATCH 017/112] Update EDD to be a component --- input/pagecontent/CF-social.md | 4 +++- 1 file changed, 3 insertions(+), 1 deletion(-) diff --git a/input/pagecontent/CF-social.md b/input/pagecontent/CF-social.md index 6c462f9..3c6333c 100644 --- a/input/pagecontent/CF-social.md +++ b/input/pagecontent/CF-social.md @@ -43,4 +43,6 @@ In US Core, Pregnancy Observation was first defined in version 6. ||.code|`82810-3 (Pregnancy Status)` - C-CDA uses `ASSERTION`, but FHIR clarifies the code to be used. |/effectiveTime/@value<br/>or<br/>/effectiveTime/low/@value<br/>or<br/>/effectiveTime/high/@value<br/>or<br/>/author/time|.effectiveDateTime|FHIR only allows a single timestamp. Send the first element from the first column with a populated timestamp.<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) |/value|.valueCodeableConcept|*TODO ValueSet*<br/>Note: the CDA @nullFlavor of UNK maps to a coded value in the FHIR value set.<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| -|/entryRelationship/estimatedDateofDelivery|.hasMember|Use generic observation mapping above to create a new Observation resource from the C-CDA Date of Delivery observation, and reference it in the Pregnancy Status observation's `.hasMember` field. +|**[Estimated Date of Delivery](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-EstimatedDateofDelivery.html)**<br/>/entryRelationship/observation[code/@code="11778-8"]/value|.component.code<br/>.component.valueDateTime|Set code to `11778-8` and map value to `.valueDateTime`. + + From 9c22387eaba799af47dfa461f48f8e0cbcadaaec Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Sat, 18 May 2024 08:52:06 -0500 Subject: [PATCH 018/112] Fix link --- input/pagecontent/CF-notes.md | 2 +- 1 file changed, 1 insertion(+), 1 deletion(-) diff --git a/input/pagecontent/CF-notes.md b/input/pagecontent/CF-notes.md index f313b2f..d060c9c 100644 --- a/input/pagecontent/CF-notes.md +++ b/input/pagecontent/CF-notes.md @@ -10,7 +10,7 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea ### C-CDA to FHIR -|C-CDA¹<br/>[Note Activity](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-NoteActivity.html|FHIR<br/>[DocumentReference](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-documentreference.html)|Transform Steps| +|C-CDA¹<br/>[Note Activity](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-NoteActivity.html)<br/>[DocumentReference](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-documentreference.html)|Transform Steps| |:----|:----|:----| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| |/code|.type|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>**NOTE:** The root code in CDA is always `64109-9: Note` which matches the FHIR Binding. From a968e4d0b5955554ec46225df36df1e4615a674f Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Sat, 18 May 2024 08:52:34 -0500 Subject: [PATCH 019/112] Combine code rows --- input/pagecontent/CF-results.md | 3 +-- 1 file changed, 1 insertion(+), 2 deletions(-) diff --git a/input/pagecontent/CF-results.md b/input/pagecontent/CF-results.md index 30fcb3e..e5e8772 100644 --- a/input/pagecontent/CF-results.md +++ b/input/pagecontent/CF-results.md @@ -15,8 +15,7 @@ Observation values are generic - they can be of any CDA type in CDA, and *almost |C-CDA¹<br/>[Result Organizer](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-ResultOrganizer.html)|FHIR<br/>Diagnostic Report ([Lab](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-diagnosticreport-lab.html)) ([Reports](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-diagnosticreport-note.html))|Transform Steps| |:----|:----|:----| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| -|/code|.category|*TODO: Describe using LOINC classes to identify category* -|/code |.code|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|/code|.category<br/>&<br/>.code|*TODO: Describe using LOINC classes to identify category*<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/statusCode|.status|*TODO: ConceptMap* |/effectiveTime|.effectiveDateTime<br/>or<br/>.effectivePeriod|If low and high are identical, use effectiveDateTime. If organizer/effectiveTime is missing, use the earliest and latest observation/effectiveTime as the source of the mapping.<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) |/specimen||*TODO* From 96955aba6dc8ad070ec9d8478923a0e0de718f06 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Sat, 18 May 2024 15:10:45 -0500 Subject: [PATCH 020/112] Add closing tags --- input/pagecontent/mappingGuidance.md | 30 ++++++++++++++-------------- 1 file changed, 15 insertions(+), 15 deletions(-) diff --git a/input/pagecontent/mappingGuidance.md b/input/pagecontent/mappingGuidance.md index 5e69733..1f9f2d0 100644 --- a/input/pagecontent/mappingGuidance.md +++ b/input/pagecontent/mappingGuidance.md @@ -245,22 +245,22 @@ Note that in FHIR, `Observation.referenceRange` only contains `.low` and `.high` <div markdown="1"> {% highlight xml %} <value xsi:type="IVL_PQ"> - <high value="200" unit="mg/dL"> + <high value="200" unit="mg/dL"/> </value> {% endhighlight %} or {% highlight xml %} <value xsi:type="IVL_PQ"> - <low value="0" unit="mg/dL"> - <high value="200" unit="mg/dL"> + <low value="0" unit="mg/dL"/> + <high value="200" unit="mg/dL"/> </value> {% endhighlight %} or {% highlight xml %} <value xsi:type="IVL_PQ"> - <low nullFlavor="NINF"> - <high value="200" unit="mg/dL"> + <low nullFlavor="NINF"/> + <high value="200" unit="mg/dL"/> </value> {% endhighlight %} @@ -288,7 +288,7 @@ When `@inclusive="false"`: {% highlight xml %} <value xsi:type="IVL_PQ"> - <high value="200" unit="mg/dL" inclusive="false"> + <high value="200" unit="mg/dL" inclusive="false"/> </value> {% endhighlight %} </div> @@ -313,7 +313,7 @@ When `@inclusive="false"`: <div markdown="1"> {% highlight xml %} <value xsi:type="IVL_PQ"> - <low value="500" unit="mg/dL" inclusive="true"> + <low value="500" unit="mg/dL" inclusive="true"/> <high nullFlavor="PINF"> </value> {% endhighlight %} @@ -322,7 +322,7 @@ or {% highlight xml %} <value xsi:type="IVL_PQ"> - <low value="500" unit="mg/dL"> + <low value="500" unit="mg/dL"/> </value> {% endhighlight %} @@ -350,8 +350,8 @@ or When `@inclusive="false"`: {% highlight xml %} <value xsi:type="IVL_PQ"> - <low value="500" unit="mg/dL" inclusive="false"> - <high nullFlavor="PINF"> + <low value="500" unit="mg/dL" inclusive="false"/> + <high nullFlavor="PINF"/> </value> {% endhighlight %} @@ -359,7 +359,7 @@ or {% highlight xml %} <value xsi:type="IVL_PQ"> - <low value="500" unit="mg/dL" inclusive="false"> + <low value="500" unit="mg/dL" inclusive="false"/> </value> {% endhighlight %} </div> @@ -384,8 +384,8 @@ or <div markdown="1"> {% highlight xml %} <value xsi:type="IVL_PQ"> - <low value="200" unit="mg/dL"> - <high value="1000" unit="mg/dL"> + <low value="200" unit="mg/dL"/> + <high value="1000" unit="mg/dL"/> </value> {% endhighlight %} </div> @@ -417,8 +417,8 @@ Units can be different, as long as they are equivalent: {% highlight xml %} <value xsi:type="IVL_PQ"> - <low value="200" unit="mg/dL"> - <high value="1" unit="g/dL"> + <low value="200" unit="mg/dL"/> + <high value="1" unit="g/dL"/> </value> {% endhighlight %} </div> From 249463d5091657ec3e9d120b1a7cb95ba3bea9d6 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Tue, 28 May 2024 13:51:23 -0500 Subject: [PATCH 021/112] Add valueString to mapping --- input/pagecontent/CF-results.md | 1 + input/pagecontent/CF-social.md | 1 + 2 files changed, 2 insertions(+) diff --git a/input/pagecontent/CF-results.md b/input/pagecontent/CF-results.md index e5e8772..055853e 100644 --- a/input/pagecontent/CF-results.md +++ b/input/pagecontent/CF-results.md @@ -36,6 +36,7 @@ Observation values are generic - they can be of any CDA type in CDA, and *almost |/value[xsi:type=CD]<br/>(or CE, CV, CO, CS)|.valueCodeableConcept|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/value[xsi:type=INT]|.valueInteger| |/value[xsi:type=REAL]|.valueQuantity|Leave unit fields empty +|/value[xsi:type=ST]|.valueString| |/interpretationCode|.interpretation|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/methodCode|.method|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/targetSiteCode|.bodySite|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| diff --git a/input/pagecontent/CF-social.md b/input/pagecontent/CF-social.md index 3c6333c..d7088cb 100644 --- a/input/pagecontent/CF-social.md +++ b/input/pagecontent/CF-social.md @@ -23,6 +23,7 @@ This maps to US Core version 6's Simple Observation. Previous versions of US Cor |/value[xsi:type=CD]<br/>(or CE, CV, CO, CS)|.valueCodeableConcept|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/value[xsi:type=INT]|.valueInteger| |/value[xsi:type=REAL]|.valueQuantity|Leave unit fields empty +|/value[xsi:type=ST]|.valueString| Additional fields, such as `.interpretationCode`, `.referenceRange`, `.performer` are not documented in C-CDA but can be mapped in the same manner as [Results](./CF-results.html). From f1082f49e9dad3d78fcd57492fdb1f2aacc3ffa5 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Tue, 28 May 2024 14:02:41 -0500 Subject: [PATCH 022/112] Add note / links re US Core extensions --- input/pagecontent/CF-social.md | 7 +++++++ 1 file changed, 7 insertions(+) diff --git a/input/pagecontent/CF-social.md b/input/pagecontent/CF-social.md index d7088cb..6e7b5a2 100644 --- a/input/pagecontent/CF-social.md +++ b/input/pagecontent/CF-social.md @@ -8,6 +8,13 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea Social History is a category of several templates in C-CDA and several profiles in US Core. At a high-level, mappings between CDA `<observation>` acts and FHIR Observation resources are similar and are represented by the top table. Differences are documented on the proceeding tables. +Note that some observations in C-CDA map to extensions on the patient or elsewhere in FHIR. In these cases, a FHIR Observation should not be created; instead, the corresponding extension should be used. + +- [C-CDA Birth Sex Observation](https://hl7.org/cda/us/ccda/StructureDefinition-BirthSexObservation.html) -> [US Core Birth Sex Extension](https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-birthsex.html) +- [C-CDA Gender Identity Observation](https://hl7.org/cda/us/ccda/StructureDefinition-GenderIdentityObservation.html) -> [US Core Gender Identity Extension](https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-genderIdentity.html) +- [C-CDA Sex Observation](https://hl7.org/cda/us/ccda/StructureDefinition-SexObservation.html) -> [US Core Sex Extension](https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-sex.html) +- [C-CDA Tribal Affiliation Observation](https://hl7.org/cda/us/ccda/StructureDefinition-TribalAffiliationObservation.html) -> [US Core Tribal Affiliation Extension](https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-tribal-affiliation.html) + ### C-CDA Social History Observation to FHIR Observation This maps to US Core version 6's Simple Observation. Previous versions of US Core did not define a generic observation, but the following guidance can still be used to create a generic FHIR observation regardless of the version of US Core being targeted. From ccb2b984e06008bc071fb8d0e8f6f9dc5ef7370f Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Tue, 28 May 2024 14:05:04 -0500 Subject: [PATCH 023/112] Add SDOH note --- input/pagecontent/CF-social.md | 2 +- 1 file changed, 1 insertion(+), 1 deletion(-) diff --git a/input/pagecontent/CF-social.md b/input/pagecontent/CF-social.md index 6e7b5a2..c31f76e 100644 --- a/input/pagecontent/CF-social.md +++ b/input/pagecontent/CF-social.md @@ -21,7 +21,7 @@ This maps to US Core version 6's Simple Observation. Previous versions of US Cor |C-CDA<br/>[Social History Observation](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-SocialHistoryObservation.html)|FHIR<br/>[Simple Observation](https://hl7.org/fhir/us/core/STU6/StructureDefinition-us-core-simple-observation.html)|Transform Steps| |:----|:----|:----| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| -||.category|Set to `social-history` from [Observation Category Codes](https://build.fhir.org/ig/HL7/UTG/CodeSystem-observation-category.html) +||.category|Set to `social-history` from [Observation Category Codes](https://build.fhir.org/ig/HL7/UTG/CodeSystem-observation-category.html)<br/>Additional SDOH categories may be set as well, depending on the code of the observation. |/code |.code|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/statusCode|.status|*TODO: ConceptMap* |/effectiveTime|.effectiveDateTime<br/>or<br/>.effectivePeriod|Prefer effectiveDateTime<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) From dcb45f628d971b96fedc1dd53e6514c61612b903 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Tue, 28 May 2024 14:26:19 -0500 Subject: [PATCH 024/112] Add novel about EDD codes --- input/pagecontent/CF-social.md | 2 +- 1 file changed, 1 insertion(+), 1 deletion(-) diff --git a/input/pagecontent/CF-social.md b/input/pagecontent/CF-social.md index c31f76e..c035422 100644 --- a/input/pagecontent/CF-social.md +++ b/input/pagecontent/CF-social.md @@ -51,6 +51,6 @@ In US Core, Pregnancy Observation was first defined in version 6. ||.code|`82810-3 (Pregnancy Status)` - C-CDA uses `ASSERTION`, but FHIR clarifies the code to be used. |/effectiveTime/@value<br/>or<br/>/effectiveTime/low/@value<br/>or<br/>/effectiveTime/high/@value<br/>or<br/>/author/time|.effectiveDateTime|FHIR only allows a single timestamp. Send the first element from the first column with a populated timestamp.<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) |/value|.valueCodeableConcept|*TODO ValueSet*<br/>Note: the CDA @nullFlavor of UNK maps to a coded value in the FHIR value set.<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| -|**[Estimated Date of Delivery](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-EstimatedDateofDelivery.html)**<br/>/entryRelationship/observation[code/@code="11778-8"]/value|.component.code<br/>.component.valueDateTime|Set code to `11778-8` and map value to `.valueDateTime`. +|**[Estimated Date of Delivery](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-EstimatedDateofDelivery.html)**<br/>/entryRelationship/observation[code/@code="11778-8"]/value|.component.code<br/>.component.valueDateTime|Set code to `11778-8` and map value to `.valueDateTime`.<br/>Note that while C-CDA hard-codes this to a single value (`11778-8`), there are other, more specific, EDD LOINC codes that could be used as well (see [EDD Including Method](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.11.20.9.81/expansion)). These might be communicated as translations on the entryRelationship/observation/code, as the methodCode, or sent as entirely custom observations. Any of these codes can also reasonably be included as a component to a Pregnancy Observation to represent the estimated date of delivery. From 5756bbb60b47bed4fdeafd30278d948db2407770 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Tue, 28 May 2024 14:26:40 -0500 Subject: [PATCH 025/112] Add intention mapping; clean up nullFlavor mapping --- input/pagecontent/CF-social.md | 14 +++++++++++++- 1 file changed, 13 insertions(+), 1 deletion(-) diff --git a/input/pagecontent/CF-social.md b/input/pagecontent/CF-social.md index c035422..5edb5b1 100644 --- a/input/pagecontent/CF-social.md +++ b/input/pagecontent/CF-social.md @@ -50,7 +50,19 @@ In US Core, Pregnancy Observation was first defined in version 6. |.moodCode||The C-CDA moodCode is `EVN` which is why this maps to FHIR's Pregnancy Status rather than Pregnancy Intent. ||.code|`82810-3 (Pregnancy Status)` - C-CDA uses `ASSERTION`, but FHIR clarifies the code to be used. |/effectiveTime/@value<br/>or<br/>/effectiveTime/low/@value<br/>or<br/>/effectiveTime/high/@value<br/>or<br/>/author/time|.effectiveDateTime|FHIR only allows a single timestamp. Send the first element from the first column with a populated timestamp.<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) -|/value|.valueCodeableConcept|*TODO ValueSet*<br/>Note: the CDA @nullFlavor of UNK maps to a coded value in the FHIR value set.<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|/value|.valueCodeableConcept|Value sets are the same<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|/value/@nullFlavor=UNK|.valueCodeableConcept|Unknown becomes an actual value with system = `http://terminology.hl7.org/CodeSystem/v3-NullFlavor`. Any other nullFlavors should use a data-absent-reason extension. |**[Estimated Date of Delivery](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-EstimatedDateofDelivery.html)**<br/>/entryRelationship/observation[code/@code="11778-8"]/value|.component.code<br/>.component.valueDateTime|Set code to `11778-8` and map value to `.valueDateTime`.<br/>Note that while C-CDA hard-codes this to a single value (`11778-8`), there are other, more specific, EDD LOINC codes that could be used as well (see [EDD Including Method](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.11.20.9.81/expansion)). These might be communicated as translations on the entryRelationship/observation/code, as the methodCode, or sent as entirely custom observations. Any of these codes can also reasonably be included as a component to a Pregnancy Observation to represent the estimated date of delivery. +### C-CDA Pregnancy Intention in Next Year to FHIR Pregnancy Intent Observation +In US Core, Pregnancy Intent was first defined in version 6. + +|C-CDA<br/>[Pregnancy Intention](https://hl7.org/cda/us/ccda/StructureDefinition-PregnancyIntentionInNextYear.html)|FHIR<br/>[Pregnancy Intent](https://hl7.org/fhir/us/core/STU6/StructureDefinition-us-core-observation-pregnancyintent.html)|Transform Steps| +|:----|:----|:----| +|.moodCode||The C-CDA moodCode is `INT` which is why this maps to FHIR's Pregnancy Status rather than Pregnancy Intent. +|/code|.code|In both standards, the code is `86645-9` +|/effectiveTime/low/@value|.effectiveDateTime|FHIR only allows a single timestamp which corresponds to C-CDA's "low" +|/value|.valueCodeableConcept|Value sets are the same<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|/value/@nullFlavor=UNK|.valueCodeableConcept|Unknown becomes an actual value with system = `http://terminology.hl7.org/CodeSystem/v3-NullFlavor`. Any other nullFlavors should use a data-absent-reason extension. + From 215222345bf45b9cbb6c100a312067d13617bd12 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Tue, 28 May 2024 14:31:34 -0500 Subject: [PATCH 026/112] Fancy arrows! --- input/pagecontent/CF-social.md | 8 ++++---- 1 file changed, 4 insertions(+), 4 deletions(-) diff --git a/input/pagecontent/CF-social.md b/input/pagecontent/CF-social.md index 5edb5b1..7db68e8 100644 --- a/input/pagecontent/CF-social.md +++ b/input/pagecontent/CF-social.md @@ -10,10 +10,10 @@ Social History is a category of several templates in C-CDA and several profiles Note that some observations in C-CDA map to extensions on the patient or elsewhere in FHIR. In these cases, a FHIR Observation should not be created; instead, the corresponding extension should be used. -- [C-CDA Birth Sex Observation](https://hl7.org/cda/us/ccda/StructureDefinition-BirthSexObservation.html) -> [US Core Birth Sex Extension](https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-birthsex.html) -- [C-CDA Gender Identity Observation](https://hl7.org/cda/us/ccda/StructureDefinition-GenderIdentityObservation.html) -> [US Core Gender Identity Extension](https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-genderIdentity.html) -- [C-CDA Sex Observation](https://hl7.org/cda/us/ccda/StructureDefinition-SexObservation.html) -> [US Core Sex Extension](https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-sex.html) -- [C-CDA Tribal Affiliation Observation](https://hl7.org/cda/us/ccda/StructureDefinition-TribalAffiliationObservation.html) -> [US Core Tribal Affiliation Extension](https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-tribal-affiliation.html) +- [C-CDA Birth Sex Observation](https://hl7.org/cda/us/ccda/StructureDefinition-BirthSexObservation.html) ↔ [US Core Birth Sex Extension](https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-birthsex.html) +- [C-CDA Gender Identity Observation](https://hl7.org/cda/us/ccda/StructureDefinition-GenderIdentityObservation.html) ↔ [US Core Gender Identity Extension](https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-genderIdentity.html) +- [C-CDA Sex Observation](https://hl7.org/cda/us/ccda/StructureDefinition-SexObservation.html) ↔ [US Core Sex Extension](https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-sex.html) +- [C-CDA Tribal Affiliation Observation](https://hl7.org/cda/us/ccda/StructureDefinition-TribalAffiliationObservation.html) ↔ [US Core Tribal Affiliation Extension](https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-tribal-affiliation.html) ### C-CDA Social History Observation to FHIR Observation This maps to US Core version 6's Simple Observation. Previous versions of US Core did not define a generic observation, but the following guidance can still be used to create a generic FHIR observation regardless of the version of US Core being targeted. 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a/input/pagecontent/CF-social.md b/input/pagecontent/CF-social.md index 7db68e8..8430292 100644 --- a/input/pagecontent/CF-social.md +++ b/input/pagecontent/CF-social.md @@ -42,6 +42,10 @@ In C-CDA 3.0, the Smoking Status - MU and Tobacco Use templates were merged into |/code|.code|Prior to US Core 7, the code should be `72166-2 (Tobacco smoking status NCIS)`, but this is an extensible value set.<br/>In US Core 7, the value set remains extensible, but contains the same 4 concepts allowed in the C-CDA R3.0's Smoking Status value set. |/effectiveTime|.effectiveDateTime<br/>or<br/>.effectivePeriod|Smoking Status - MU required a timestamp; Tobacco Use required a time range; Smoking Status (3.0) combines the two templates into one and allows for either. +### Illustrative example + +{% include examplebutton.html example="CF_smoking_example" b_title = "Click on Here To See Highlighted Example" %} + ### C-CDA Pregnancy Observation to FHIR Pregnancy Status Observation In US Core, Pregnancy Observation was first defined in version 6. diff --git a/input/pagecontent/CF-vitals.md b/input/pagecontent/CF-vitals.md index 8803fba..a4968ec 100644 --- a/input/pagecontent/CF-vitals.md +++ b/input/pagecontent/CF-vitals.md @@ -37,7 +37,8 @@ C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or |/referenceRange/observationRange/value[xsi:type=ST]<br/>or<br/>/referenceRange/observationRange/text|.referenceRange.text| ### Illustrative example -... +{% include examplebutton.html example="CF_VitalsHR_example" b_title = "Click on Here To See Highlighted Example" %} + ### Links to example content ... ### Prior work and Expanded Spreadsheets From 2869400a39075d9125f1402f71adc16df5f2f482 Mon Sep 17 00:00:00 2001 From: jlyle1 <jay@lyle.net> Date: Fri, 21 Jun 2024 12:55:38 -0400 Subject: [PATCH 028/112] mod "click on here" to "click here" 6x --- input/pagecontent/CF-immunizations.md | 2 +- input/pagecontent/CF-medications.md | 2 +- input/pagecontent/CF-patient.md | 2 +- input/pagecontent/CF-problems.md | 2 +- input/pagecontent/CF-procedures.md | 2 +- input/pagecontent/CF-social.md | 2 +- input/pagecontent/CF-vitals.md | 2 +- 7 files changed, 7 insertions(+), 7 deletions(-) diff --git a/input/pagecontent/CF-immunizations.md b/input/pagecontent/CF-immunizations.md index d65228f..f5124e5 100644 --- a/input/pagecontent/CF-immunizations.md +++ b/input/pagecontent/CF-immunizations.md @@ -35,7 +35,7 @@ Mapping is from `@moodCode="EVN"` (i.e. historical) immunizations, not `INT` (fu ### Illustrative example -{% include examplebutton.html example="CF_immunization_example" b_title = "Click on Here To See Highlighted Example" %} +{% include examplebutton.html example="CF_immunization_example" b_title = "Click Here To See Highlighted Example" %} #### Links to example content diff --git a/input/pagecontent/CF-medications.md b/input/pagecontent/CF-medications.md index 2413805..7bf0500 100644 --- a/input/pagecontent/CF-medications.md +++ b/input/pagecontent/CF-medications.md @@ -41,7 +41,7 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea ### Illustrative example -{% include examplebutton.html example="CF_medication_example" b_title = "Click on Here To See Highlighted Example" %} +{% include examplebutton.html example="CF_medication_example" b_title = "Click Here To See Highlighted Example" %} #### Links to example content diff --git a/input/pagecontent/CF-patient.md b/input/pagecontent/CF-patient.md index 11d4442..aa49556 100644 --- a/input/pagecontent/CF-patient.md +++ b/input/pagecontent/CF-patient.md @@ -33,7 +33,7 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea ### Illustrative example -{% include examplebutton.html example="CF_patient_example" b_title = "Click on Here To See Highlighted Example" %} +{% include examplebutton.html example="CF_patient_example" b_title = "Click Here To See Highlighted Example" %} #### Links to example content diff --git a/input/pagecontent/CF-problems.md b/input/pagecontent/CF-problems.md index 36c2f15..ac57118 100644 --- a/input/pagecontent/CF-problems.md +++ b/input/pagecontent/CF-problems.md @@ -38,7 +38,7 @@ When authors or other provenance are recorded in the parent [Problem Concern Act ### Illustrative example -{% include examplebutton.html example="CF_problem_example" b_title = "Click on Here To See Highlighted Example" %} +{% include examplebutton.html example="CF_problem_example" b_title = "Click Here To See Highlighted Example" %} #### Links to example content diff --git a/input/pagecontent/CF-procedures.md b/input/pagecontent/CF-procedures.md index ebbfd91..23dd8ad 100644 --- a/input/pagecontent/CF-procedures.md +++ b/input/pagecontent/CF-procedures.md @@ -30,7 +30,7 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea ### Illustrative example -{% include examplebutton.html example="CF_procedure_example" b_title = "Click on Here To See Highlighted Example" %} +{% include examplebutton.html example="CF_procedure_example" b_title = "Click Here To See Highlighted Example" %} #### Links to example content diff --git a/input/pagecontent/CF-social.md b/input/pagecontent/CF-social.md index 8430292..fb7db98 100644 --- a/input/pagecontent/CF-social.md +++ b/input/pagecontent/CF-social.md @@ -44,7 +44,7 @@ In C-CDA 3.0, the Smoking Status - MU and Tobacco Use templates were merged into ### Illustrative example -{% include examplebutton.html example="CF_smoking_example" b_title = "Click on Here To See Highlighted Example" %} +{% include examplebutton.html example="CF_smoking_example" b_title = "Click Here To See Highlighted Example" %} ### C-CDA Pregnancy Observation to FHIR Pregnancy Status Observation In US Core, Pregnancy Observation was first defined in version 6. diff --git a/input/pagecontent/CF-vitals.md b/input/pagecontent/CF-vitals.md index a4968ec..19da631 100644 --- a/input/pagecontent/CF-vitals.md +++ b/input/pagecontent/CF-vitals.md @@ -37,7 +37,7 @@ C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or |/referenceRange/observationRange/value[xsi:type=ST]<br/>or<br/>/referenceRange/observationRange/text|.referenceRange.text| ### Illustrative example -{% include examplebutton.html example="CF_VitalsHR_example" b_title = "Click on Here To See Highlighted Example" %} +{% include examplebutton.html example="CF_VitalsHR_example" b_title = "Click Here To See Highlighted Example" %} ### Links to example content ... From d76a784d92513e8384095f5d9a7b34f173c78191 Mon Sep 17 00:00:00 2001 From: jlyle1 <jay@lyle.net> Date: Tue, 2 Jul 2024 11:07:13 -0400 Subject: [PATCH 029/112] added FC vitals draft --- input/pagecontent/FC-vitals.md | 41 +++++++++++++++++++++++++++++++++- 1 file changed, 40 insertions(+), 1 deletion(-) diff --git a/input/pagecontent/FC-vitals.md b/input/pagecontent/FC-vitals.md index ae8e0d6..1248c4b 100644 --- a/input/pagecontent/FC-vitals.md +++ b/input/pagecontent/FC-vitals.md @@ -1 +1,40 @@ -*Coming soon...* \ No newline at end of file +<style> +td, th { + border: 1px solid black!important; +} +</style> + +This page provides a mapping from FHIR to CDA. For the CDA to FHIR mapping, please refer to [Vitals CDA → FHIR](./CF-vitals.html). For guidance on how to read the table below, see [Reading the FHIR ↔ C-CDA Mapping Pages](./mappingGuidance.html). + +FHIR Vitals that are grouped into a panel using the memberOf property are mapped to a CDA Vital Signs Organizer. + +### FHIR Observation Panel to C-CDA Vital Signs Organizer + +|FHIR<br/>[Vital Signs Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-vital-signs.html)|C-CDA¹<br/>[Vital SignsOrganizer](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-VitalSignsOrganizer.html)|Transform Steps| +|:----|:----|:----| +|.identifier|/id|[FHIR identifier ↔ CDA id](mappingGuidance.html#fhir-identifier--cda-id)| +|.category = `vital-signs` from [Vital Signs value set](https://hl7.org/fhir/us/core/STU4/ValueSet-us-core-vital-signs.html)|| +|.code = `85353-1` [CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)||| +|.status|/statusCode|*TODO: ConceptMap* +|.effectiveDateTime|/effectiveTime|Use value +|.effectivePeriod|/effectiveTime|Use high and low <br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) +|.hasMember|component|Reference to each vital sign observation + +### FHIR Observation to C-CDA Vital Signs Observation + +|FHIR<br/>[Vital Signs Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-vital-signs.html)|C-CDA¹<br/>[Vital Sign Observation](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-VitalSignObservation.html)|Transform Steps| +|:----|:----|:----| +|.identifier|/id|[FHIR identifier ↔ CDA id](mappingGuidance.html#fhir-identifier--cda-id)| +|.code |/code|[FHIR CodeableConcept ↔ CDA coding ](mappingGuidance.html#fhir-codeableconcept--cda-coding)| +|.status|/statusCode|Set to completed +|.effectiveDateTime|/effectiveTime|Use value +|.effectivePeriod|/effectiveTime|Use high and low <br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) +|.valueQuantity|/value|If not null <br> [FHIR ↔ CDA Quantities](mappingGuidance.html#cda--fhir-quantity) +|.dataAbsentReason|/value@nullFlavor|If value is null<br>[FHIR DataAbsentReason ↔ CDA NullFlavor](ConceptMap-FC-DataAbsentReasonNullFlavor.html) +|.interpretation|/interpretationCode|[FHIR CodeableConcept ↔ CDA coding](mappingGuidance.html#fhir-codeableconcept--cda-coding)| +|.method|/methodCode|[FHIR CodeableConcept ↔ CDA coding](mappingGuidance.html#fhir-codeableconcept--cda-coding)| +|.bodySite|/targetSiteCode|[FHIR CodeableConcept ↔ CDA coding](mappingGuidance.html#fhir-codeableconcept--cda-coding)| +|||author-provenance: *TODO* + + +### Illustrative example \ No newline at end of file From f442c8b7a69603ac213d09b5d4ae3fc261b5ab8a Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Tue, 9 Jul 2024 15:07:18 -0500 Subject: [PATCH 030/112] Rename image to fix sample --- ...CF_smoker_example.png => CF_smoking_example.png} | Bin 1 file changed, 0 insertions(+), 0 deletions(-) rename input/images/{CF_smoker_example.png => CF_smoking_example.png} (100%) diff --git a/input/images/CF_smoker_example.png b/input/images/CF_smoking_example.png similarity index 100% rename from input/images/CF_smoker_example.png rename to input/images/CF_smoking_example.png From e43ccbd1f2b85d69f088acd410592f294df7dab6 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Tue, 9 Jul 2024 15:18:17 -0500 Subject: [PATCH 031/112] Add comment about telecom formatting from May 2024 connectathon --- input/pagecontent/mappingGuidance.md | 4 ++-- 1 file changed, 2 insertions(+), 2 deletions(-) diff --git a/input/pagecontent/mappingGuidance.md b/input/pagecontent/mappingGuidance.md index 1f9f2d0..71465d2 100644 --- a/input/pagecontent/mappingGuidance.md +++ b/input/pagecontent/mappingGuidance.md @@ -525,7 +525,7 @@ The mappings of name, address and telecom information are useful in many part of |CDA telecom|FHIR telecom|Transform Steps |:-----|:-----|:--------- |@use|.use|[CDA telecom use → FHIR contact point use](./ConceptMap-CF-TelecomUse.html)<br/>Note that CDA's `@use='PG'` is equivalent to FHIR's `.system='pager'`| -|@value|.system<br/>&<br/>.value|[CDA telecom value → FHIR contact point system](./ConceptMap-CF-TelecomType.html)<br/>Only include information in FHIR value which comes after the CDA system prefix| +|@value|.system<br/>&<br/>.value|[CDA telecom value → FHIR contact point system](./ConceptMap-CF-TelecomType.html)<br/>Only include information in FHIR value which comes after the CDA system prefix; other formatting may be preserved. E.g. CDA `tel:+1(555)867-5309` becomes `+1(555)867-5309` in FHIR.<br/>| #### FHIR name → CDA name ##### @@ -556,8 +556,8 @@ The mappings of name, address and telecom information are useful in many part of |FHIR telecom|CDA telecom|Comments |:-----|:-----|:--------- -|.system<br/>&<br/>.value |@value|[FHIR contact point system → CDA telecom value](./ConceptMap-FC-TelecomType.html)<br/>Insert FHIR value after the CDA system prefix mapped from FHIR system<br/>Note that FHIR's `.system='pager'` is equivalent to CDA's `@use='PG'` | |.use|@use|[FHIR contact point use → CDA use](./ConceptMap-FC-TelecomUse.html)| +|.system<br/>&<br/>.value |@value|[FHIR contact point system → CDA telecom value](./ConceptMap-FC-TelecomType.html)<br/>Insert FHIR value after the CDA system prefix mapped from FHIR system<br/>Note that FHIR's `.system='pager'` is equivalent to CDA's `@use='PG'` | ### Missing Data in C-CDA vs. FHIR #### From 58427f9a018b2b1fc74b1ecf2ceddd715a62901f Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Tue, 9 Jul 2024 15:35:42 -0500 Subject: [PATCH 032/112] Add guardian mapping from May 2024 CAT --- input/pagecontent/CF-patient.md | 4 ++++ 1 file changed, 4 insertions(+) diff --git a/input/pagecontent/CF-patient.md b/input/pagecontent/CF-patient.md index aa49556..1a4e916 100644 --- a/input/pagecontent/CF-patient.md +++ b/input/pagecontent/CF-patient.md @@ -25,6 +25,10 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea |/patientRole/patient/sdtc:raceCode|.extension:[us-core-race](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-race.html)|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>If code is in [OMB category](http://hl7.org/fhir/us/core/ValueSet/omb-race-category), use us-core-race: ombCategory; else use us-core-race: detailed.<br/>If the detailed race is under a different OMB category that the non-sdtc:raceCode element, then an additional OMB category sub-extension should be included as well.| |/patientRole/patient/ethnicGroupCode|.extension:[us-core-ethnicity](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-ethnicity.html)|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>This should be a category and map to the ombCategory sub-extension. But if it is a detailed race, then it should go in the detailed sub-extension.| |/patientRole/patient/sdtc:ethnicGroupCode|.extension:[us-core-ethnicity](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-ethnicity.html) : detailed|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>Used for detailed ethnicity| +|/patientRole/guardian/code<br/>and<br/>/patientRole/guardian/guardianPerson/sdtc:asPatientRelationship/code|.contact.relationship|First, add a fixed relationship code of `GUARD` from [v3 RoleCode](http://terminology.hl7.org/CodeSystem/v3-RoleCode) (`http://terminology.hl7.org/CodeSystem/v3-RoleCode`) to preserve the CDA guardian relationship. The map the two fields to additional relationship entries using [CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) +|/patientRole/guardian/addr|.contact.address|[CDA addr ↔ FHIR address ](mappingGuidance.html#cda-addr--fhir-address)| +|/patientRole/guardian/telecom|.contact.telecom|[CDA telecom ↔ FHIR telecom](mappingGuidance.html#cda-telecom--fhir-telecom)| +|/patientRole/guardian/guardianPerson/name|.contact.name|[CDA name ↔ FHIR name ](mappingGuidance.html#cda-name--fhir-name)| |/patientRole/patient/languageCommunication/languageCode|.communication.language|| |/patientRole/patient/languageCommunication/preferenceInd|.communication.preferred|| |/patientRole/providerOrganization|.managingOrganization| From 9ed993b60780d64255c96455fc6740564f8de987 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Tue, 9 Jul 2024 15:51:17 -0500 Subject: [PATCH 033/112] Add patient to guardian paths --- input/pagecontent/CF-patient.md | 8 ++++---- 1 file changed, 4 insertions(+), 4 deletions(-) diff --git a/input/pagecontent/CF-patient.md b/input/pagecontent/CF-patient.md index 1a4e916..f8b6d3f 100644 --- a/input/pagecontent/CF-patient.md +++ b/input/pagecontent/CF-patient.md @@ -25,10 +25,10 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea |/patientRole/patient/sdtc:raceCode|.extension:[us-core-race](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-race.html)|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>If code is in [OMB category](http://hl7.org/fhir/us/core/ValueSet/omb-race-category), use us-core-race: ombCategory; else use us-core-race: detailed.<br/>If the detailed race is under a different OMB category that the non-sdtc:raceCode element, then an additional OMB category sub-extension should be included as well.| |/patientRole/patient/ethnicGroupCode|.extension:[us-core-ethnicity](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-ethnicity.html)|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>This should be a category and map to the ombCategory sub-extension. But if it is a detailed race, then it should go in the detailed sub-extension.| |/patientRole/patient/sdtc:ethnicGroupCode|.extension:[us-core-ethnicity](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-ethnicity.html) : detailed|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>Used for detailed ethnicity| -|/patientRole/guardian/code<br/>and<br/>/patientRole/guardian/guardianPerson/sdtc:asPatientRelationship/code|.contact.relationship|First, add a fixed relationship code of `GUARD` from [v3 RoleCode](http://terminology.hl7.org/CodeSystem/v3-RoleCode) (`http://terminology.hl7.org/CodeSystem/v3-RoleCode`) to preserve the CDA guardian relationship. The map the two fields to additional relationship entries using [CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) -|/patientRole/guardian/addr|.contact.address|[CDA addr ↔ FHIR address ](mappingGuidance.html#cda-addr--fhir-address)| -|/patientRole/guardian/telecom|.contact.telecom|[CDA telecom ↔ FHIR telecom](mappingGuidance.html#cda-telecom--fhir-telecom)| -|/patientRole/guardian/guardianPerson/name|.contact.name|[CDA name ↔ FHIR name ](mappingGuidance.html#cda-name--fhir-name)| +|/patientRole/patient/guardian/code<br/>and<br/>/patientRole/patient/guardian/guardianPerson/sdtc:asPatientRelationship/code|.contact.relationship|First, add a fixed relationship code of `GUARD` from [v3 RoleCode](http://terminology.hl7.org/CodeSystem/v3-RoleCode) (`http://terminology.hl7.org/CodeSystem/v3-RoleCode`) to preserve the CDA guardian relationship. Then map the two fields to additional relationship entries using [CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) +|/patientRole/patient/guardian/addr|.contact.address|[CDA addr ↔ FHIR address ](mappingGuidance.html#cda-addr--fhir-address)| +|/patientRole/patient/guardian/telecom|.contact.telecom|[CDA telecom ↔ FHIR telecom](mappingGuidance.html#cda-telecom--fhir-telecom)| +|/patientRole/patient/guardian/guardianPerson/name|.contact.name|[CDA name ↔ FHIR name ](mappingGuidance.html#cda-name--fhir-name)| |/patientRole/patient/languageCommunication/languageCode|.communication.language|| |/patientRole/patient/languageCommunication/preferenceInd|.communication.preferred|| |/patientRole/providerOrganization|.managingOrganization| From 7de3226957358e4fd410af22204f9b3918fe684d Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Tue, 9 Jul 2024 15:52:15 -0500 Subject: [PATCH 034/112] Move patientRole to XPath instead of every row --- input/pagecontent/CF-patient.md | 44 ++++++++++++++++----------------- 1 file changed, 22 insertions(+), 22 deletions(-) diff --git a/input/pagecontent/CF-patient.md b/input/pagecontent/CF-patient.md index f8b6d3f..d02da8d 100644 --- a/input/pagecontent/CF-patient.md +++ b/input/pagecontent/CF-patient.md @@ -12,28 +12,28 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea |C-CDA¹<br/>[US Realm Header recordTarget](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-USRealmHeader.html)|FHIR<br/>[Patient](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-patient.html#profile)|Transform Steps| |:----|:----|:----| -|/patientRole/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| -|/patientRole/addr|.address|[CDA addr ↔ FHIR address ](mappingGuidance.html#cda-addr--fhir-address)| -|/patientRole/telecom|.telecom|[CDA telecom ↔ FHIR telecom](mappingGuidance.html#cda-telecom--fhir-telecom)| -|/patientRole/patient/name|.name|[CDA name ↔ FHIR name ](mappingGuidance.html#cda-name--fhir-name)| -|/patientRole/patient/administrativeGenderCode|.gender|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>[CDA administrativeGender → FHIR gender](ConceptMap-CF-AdministrativeGender.html)| -|/patientRole/patient/birthTime|.birthDate|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) <br/>**Note:** the FHIR birthDate element is less precise than the CDA birthtime element. Precision can be preserved by also using the extension [`patient-birthTime`](https://hl7.org/fhir/R4/extension-patient-birthtime.html).| -|/patientRole/patient/sdtc:deceasedInd|.deceasedBoolean|**Note:** Only one of `deceasedBoolean` or `deceasedDateTime` may exist. If both are present in CDA, use deceasedDateTime. -|/patientRole/patient/sdtc:deceasedTime|.deceasedDateTime|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) -|/patientRole/patient/maritalStatusCode|.maritalStatus|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| -|/patientRole/patient/raceCode|.extension:[us-core-race](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-race.html): ombCategory|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>This should be a category and map to the ombCategory sub-extension. But if it is a detailed race, then it should go in the detailed sub-extension.| -|/patientRole/patient/sdtc:raceCode|.extension:[us-core-race](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-race.html)|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>If code is in [OMB category](http://hl7.org/fhir/us/core/ValueSet/omb-race-category), use us-core-race: ombCategory; else use us-core-race: detailed.<br/>If the detailed race is under a different OMB category that the non-sdtc:raceCode element, then an additional OMB category sub-extension should be included as well.| -|/patientRole/patient/ethnicGroupCode|.extension:[us-core-ethnicity](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-ethnicity.html)|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>This should be a category and map to the ombCategory sub-extension. But if it is a detailed race, then it should go in the detailed sub-extension.| -|/patientRole/patient/sdtc:ethnicGroupCode|.extension:[us-core-ethnicity](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-ethnicity.html) : detailed|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>Used for detailed ethnicity| -|/patientRole/patient/guardian/code<br/>and<br/>/patientRole/patient/guardian/guardianPerson/sdtc:asPatientRelationship/code|.contact.relationship|First, add a fixed relationship code of `GUARD` from [v3 RoleCode](http://terminology.hl7.org/CodeSystem/v3-RoleCode) (`http://terminology.hl7.org/CodeSystem/v3-RoleCode`) to preserve the CDA guardian relationship. Then map the two fields to additional relationship entries using [CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) -|/patientRole/patient/guardian/addr|.contact.address|[CDA addr ↔ FHIR address ](mappingGuidance.html#cda-addr--fhir-address)| -|/patientRole/patient/guardian/telecom|.contact.telecom|[CDA telecom ↔ FHIR telecom](mappingGuidance.html#cda-telecom--fhir-telecom)| -|/patientRole/patient/guardian/guardianPerson/name|.contact.name|[CDA name ↔ FHIR name ](mappingGuidance.html#cda-name--fhir-name)| -|/patientRole/patient/languageCommunication/languageCode|.communication.language|| -|/patientRole/patient/languageCommunication/preferenceInd|.communication.preferred|| -|/patientRole/providerOrganization|.managingOrganization| - -1\. XPath abbrievated for C-CDA US Realm recordTarget as: <br/> ClinicalDocument/recordTarget/ +|/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| +|/addr|.address|[CDA addr ↔ FHIR address ](mappingGuidance.html#cda-addr--fhir-address)| +|/telecom|.telecom|[CDA telecom ↔ FHIR telecom](mappingGuidance.html#cda-telecom--fhir-telecom)| +|/patient/name|.name|[CDA name ↔ FHIR name ](mappingGuidance.html#cda-name--fhir-name)| +|/patient/administrativeGenderCode|.gender|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>[CDA administrativeGender → FHIR gender](ConceptMap-CF-AdministrativeGender.html)| +|/patient/birthTime|.birthDate|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) <br/>**Note:** the FHIR birthDate element is less precise than the CDA birthtime element. Precision can be preserved by also using the extension [`patient-birthTime`](https://hl7.org/fhir/R4/extension-patient-birthtime.html).| +|/patient/sdtc:deceasedInd|.deceasedBoolean|**Note:** Only one of `deceasedBoolean` or `deceasedDateTime` may exist. If both are present in CDA, use deceasedDateTime. +|/patient/sdtc:deceasedTime|.deceasedDateTime|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) +|/patient/maritalStatusCode|.maritalStatus|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|/patient/raceCode|.extension:[us-core-race](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-race.html): ombCategory|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>This should be a category and map to the ombCategory sub-extension. But if it is a detailed race, then it should go in the detailed sub-extension.| +|/patient/sdtc:raceCode|.extension:[us-core-race](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-race.html)|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>If code is in [OMB category](http://hl7.org/fhir/us/core/ValueSet/omb-race-category), use us-core-race: ombCategory; else use us-core-race: detailed.<br/>If the detailed race is under a different OMB category that the non-sdtc:raceCode element, then an additional OMB category sub-extension should be included as well.| +|/patient/ethnicGroupCode|.extension:[us-core-ethnicity](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-ethnicity.html)|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>This should be a category and map to the ombCategory sub-extension. But if it is a detailed race, then it should go in the detailed sub-extension.| +|/patient/sdtc:ethnicGroupCode|.extension:[us-core-ethnicity](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-ethnicity.html) : detailed|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>Used for detailed ethnicity| +|/patient/guardian/code<br/>and<br/>/patient/guardian/guardianPerson/sdtc:asPatientRelationship/code|.contact.relationship|First, add a fixed relationship code of `GUARD` from [v3 RoleCode](http://terminology.hl7.org/CodeSystem/v3-RoleCode) (`http://terminology.hl7.org/CodeSystem/v3-RoleCode`) to preserve the CDA guardian relationship. Then map the two fields to additional relationship entries using [CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) +|/patient/guardian/addr|.contact.address|[CDA addr ↔ FHIR address ](mappingGuidance.html#cda-addr--fhir-address)| +|/patient/guardian/telecom|.contact.telecom|[CDA telecom ↔ FHIR telecom](mappingGuidance.html#cda-telecom--fhir-telecom)| +|/patient/guardian/guardianPerson/name|.contact.name|[CDA name ↔ FHIR name ](mappingGuidance.html#cda-name--fhir-name)| +|/patient/languageCommunication/languageCode|.communication.language|| +|/patient/languageCommunication/preferenceInd|.communication.preferred|| +|/providerOrganization|.managingOrganization| + +1\. XPath abbrievated for C-CDA US Realm recordTarget as: <br/> ClinicalDocument/recordTarget/patientRole ### Illustrative example From eb4568f2af086c1914886184aebc56fab0c599a4 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Tue, 9 Jul 2024 15:55:09 -0500 Subject: [PATCH 035/112] Remove links to nonexistent (yet) pages --- input/pagecontent/CF-social.md | 2 -- input/pagecontent/CF-vitals.md | 1 - 2 files changed, 3 deletions(-) diff --git a/input/pagecontent/CF-social.md b/input/pagecontent/CF-social.md index fb7db98..78b184d 100644 --- a/input/pagecontent/CF-social.md +++ b/input/pagecontent/CF-social.md @@ -44,8 +44,6 @@ In C-CDA 3.0, the Smoking Status - MU and Tobacco Use templates were merged into ### Illustrative example -{% include examplebutton.html example="CF_smoking_example" b_title = "Click Here To See Highlighted Example" %} - ### C-CDA Pregnancy Observation to FHIR Pregnancy Status Observation In US Core, Pregnancy Observation was first defined in version 6. diff --git a/input/pagecontent/CF-vitals.md b/input/pagecontent/CF-vitals.md index 19da631..c79faca 100644 --- a/input/pagecontent/CF-vitals.md +++ b/input/pagecontent/CF-vitals.md @@ -37,7 +37,6 @@ C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or |/referenceRange/observationRange/value[xsi:type=ST]<br/>or<br/>/referenceRange/observationRange/text|.referenceRange.text| ### Illustrative example -{% include examplebutton.html example="CF_VitalsHR_example" b_title = "Click Here To See Highlighted Example" %} ### Links to example content ... From d6e88c279449a709bf9b693ca5aefbfe27de7ebc Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Tue, 9 Jul 2024 15:59:24 -0500 Subject: [PATCH 036/112] Add race-code text mapping --- input/pagecontent/CF-patient.md | 1 + 1 file changed, 1 insertion(+) diff --git a/input/pagecontent/CF-patient.md b/input/pagecontent/CF-patient.md index d02da8d..24f19ab 100644 --- a/input/pagecontent/CF-patient.md +++ b/input/pagecontent/CF-patient.md @@ -23,6 +23,7 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea |/patient/maritalStatusCode|.maritalStatus|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/patient/raceCode|.extension:[us-core-race](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-race.html): ombCategory|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>This should be a category and map to the ombCategory sub-extension. But if it is a detailed race, then it should go in the detailed sub-extension.| |/patient/sdtc:raceCode|.extension:[us-core-race](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-race.html)|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>If code is in [OMB category](http://hl7.org/fhir/us/core/ValueSet/omb-race-category), use us-core-race: ombCategory; else use us-core-race: detailed.<br/>If the detailed race is under a different OMB category that the non-sdtc:raceCode element, then an additional OMB category sub-extension should be included as well.| +|/patient/raceCode/originalText<br/>and<br/>/patient/sdtc:raceCode/originalText|.extension:[us-core-race](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-race.html): text|The race extension's text sub-extension is required but may only exist once. Recommendation is to comma-delimit all originalText / displayNames available, taking care to not duplicate values. |/patient/ethnicGroupCode|.extension:[us-core-ethnicity](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-ethnicity.html)|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>This should be a category and map to the ombCategory sub-extension. But if it is a detailed race, then it should go in the detailed sub-extension.| |/patient/sdtc:ethnicGroupCode|.extension:[us-core-ethnicity](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-ethnicity.html) : detailed|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>Used for detailed ethnicity| |/patient/guardian/code<br/>and<br/>/patient/guardian/guardianPerson/sdtc:asPatientRelationship/code|.contact.relationship|First, add a fixed relationship code of `GUARD` from [v3 RoleCode](http://terminology.hl7.org/CodeSystem/v3-RoleCode) (`http://terminology.hl7.org/CodeSystem/v3-RoleCode`) to preserve the CDA guardian relationship. Then map the two fields to additional relationship entries using [CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) From 316396f6aef0a13213323314f230cba77e9eb7ee Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Tue, 9 Jul 2024 16:04:07 -0500 Subject: [PATCH 037/112] Add religion --- input/pagecontent/CF-patient.md | 1 + 1 file changed, 1 insertion(+) diff --git a/input/pagecontent/CF-patient.md b/input/pagecontent/CF-patient.md index 24f19ab..a4d6771 100644 --- a/input/pagecontent/CF-patient.md +++ b/input/pagecontent/CF-patient.md @@ -21,6 +21,7 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea |/patient/sdtc:deceasedInd|.deceasedBoolean|**Note:** Only one of `deceasedBoolean` or `deceasedDateTime` may exist. If both are present in CDA, use deceasedDateTime. |/patient/sdtc:deceasedTime|.deceasedDateTime|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) |/patient/maritalStatusCode|.maritalStatus|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|/patient/religiousAffiliationCode|.extension:[patient-religion](https://hl7.org/fhir/extensions/StructureDefinition-patient-religion.html)|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) |/patient/raceCode|.extension:[us-core-race](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-race.html): ombCategory|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>This should be a category and map to the ombCategory sub-extension. But if it is a detailed race, then it should go in the detailed sub-extension.| |/patient/sdtc:raceCode|.extension:[us-core-race](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-race.html)|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>If code is in [OMB category](http://hl7.org/fhir/us/core/ValueSet/omb-race-category), use us-core-race: ombCategory; else use us-core-race: detailed.<br/>If the detailed race is under a different OMB category that the non-sdtc:raceCode element, then an additional OMB category sub-extension should be included as well.| |/patient/raceCode/originalText<br/>and<br/>/patient/sdtc:raceCode/originalText|.extension:[us-core-race](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-race.html): text|The race extension's text sub-extension is required but may only exist once. Recommendation is to comma-delimit all originalText / displayNames available, taking care to not duplicate values. From 0fa2feaa08bba5d025aa114b4f11967a8a6e0e62 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Tue, 9 Jul 2024 16:09:08 -0500 Subject: [PATCH 038/112] Add birthplaces from May 24 CAT --- input/pagecontent/CF-patient.md | 3 ++- 1 file changed, 2 insertions(+), 1 deletion(-) diff --git a/input/pagecontent/CF-patient.md b/input/pagecontent/CF-patient.md index a4d6771..f9c7a90 100644 --- a/input/pagecontent/CF-patient.md +++ b/input/pagecontent/CF-patient.md @@ -21,7 +21,7 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea |/patient/sdtc:deceasedInd|.deceasedBoolean|**Note:** Only one of `deceasedBoolean` or `deceasedDateTime` may exist. If both are present in CDA, use deceasedDateTime. |/patient/sdtc:deceasedTime|.deceasedDateTime|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) |/patient/maritalStatusCode|.maritalStatus|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| -|/patient/religiousAffiliationCode|.extension:[patient-religion](https://hl7.org/fhir/extensions/StructureDefinition-patient-religion.html)|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) +|/patient/religiousAffiliationCode|.extension:[patient-religion](https://hl7.org/fhir/extensions/StructureDefinition-patient-religion.html).valueCodeableConcept|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) |/patient/raceCode|.extension:[us-core-race](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-race.html): ombCategory|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>This should be a category and map to the ombCategory sub-extension. But if it is a detailed race, then it should go in the detailed sub-extension.| |/patient/sdtc:raceCode|.extension:[us-core-race](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-race.html)|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>If code is in [OMB category](http://hl7.org/fhir/us/core/ValueSet/omb-race-category), use us-core-race: ombCategory; else use us-core-race: detailed.<br/>If the detailed race is under a different OMB category that the non-sdtc:raceCode element, then an additional OMB category sub-extension should be included as well.| |/patient/raceCode/originalText<br/>and<br/>/patient/sdtc:raceCode/originalText|.extension:[us-core-race](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-race.html): text|The race extension's text sub-extension is required but may only exist once. Recommendation is to comma-delimit all originalText / displayNames available, taking care to not duplicate values. @@ -31,6 +31,7 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea |/patient/guardian/addr|.contact.address|[CDA addr ↔ FHIR address ](mappingGuidance.html#cda-addr--fhir-address)| |/patient/guardian/telecom|.contact.telecom|[CDA telecom ↔ FHIR telecom](mappingGuidance.html#cda-telecom--fhir-telecom)| |/patient/guardian/guardianPerson/name|.contact.name|[CDA name ↔ FHIR name ](mappingGuidance.html#cda-name--fhir-name)| +|/patient/birthPlace/place/addr|.extension:[patient-birthPlace](http://hl7.org/fhir/StructureDefinition/patient-birthPlace).valueAddress|[CDA addr ↔ FHIR address ](mappingGuidance.html#cda-addr--fhir-address)| |/patient/languageCommunication/languageCode|.communication.language|| |/patient/languageCommunication/preferenceInd|.communication.preferred|| |/providerOrganization|.managingOrganization| From 11baeb7b882702801506d374240877fa85484fab Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Tue, 9 Jul 2024 16:14:34 -0500 Subject: [PATCH 039/112] Add language fields from May 24 CAT --- input/pagecontent/CF-patient.md | 2 ++ 1 file changed, 2 insertions(+) diff --git a/input/pagecontent/CF-patient.md b/input/pagecontent/CF-patient.md index f9c7a90..e0ad512 100644 --- a/input/pagecontent/CF-patient.md +++ b/input/pagecontent/CF-patient.md @@ -34,6 +34,8 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea |/patient/birthPlace/place/addr|.extension:[patient-birthPlace](http://hl7.org/fhir/StructureDefinition/patient-birthPlace).valueAddress|[CDA addr ↔ FHIR address ](mappingGuidance.html#cda-addr--fhir-address)| |/patient/languageCommunication/languageCode|.communication.language|| |/patient/languageCommunication/preferenceInd|.communication.preferred|| +|/patient/languageCommunication/modeCode|.communication.extension:[patient-proficiency](http://hl7.org/fhir/StructureDefinition/patient-proficiency):type|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>If both modeCode and proficiencyLevelCode are set for a language, only one `patient-proficiency` extension is needed. +|/patient/languageCommunication/proficiencyLevelCode|.communication.extension:[patient-proficiency](http://hl7.org/fhir/StructureDefinition/patient-proficiency):level|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>If both modeCode and proficiencyLevelCode are set for a language, only one `patient-proficiency` extension is needed. |/providerOrganization|.managingOrganization| 1\. XPath abbrievated for C-CDA US Realm recordTarget as: <br/> ClinicalDocument/recordTarget/patientRole From 7c7bdfa38cfae027c74eba2ca5f94e36d4bd180d Mon Sep 17 00:00:00 2001 From: jlyle1 <jay@lyle.net> Date: Tue, 16 Jul 2024 16:00:02 -0400 Subject: [PATCH 040/112] Guidance on code to Coding (text) --- input/pagecontent/mappingGuidance.md | 9 +++++++++ 1 file changed, 9 insertions(+) diff --git a/input/pagecontent/mappingGuidance.md b/input/pagecontent/mappingGuidance.md index 1f9f2d0..db6934b 100644 --- a/input/pagecontent/mappingGuidance.md +++ b/input/pagecontent/mappingGuidance.md @@ -139,6 +139,15 @@ In addition to the context of the previous section, CDA often requires elements Note that C-CDA sometimes requires a code from a specific system in the root of a CD and permits others in the translation +#### FHIR Code → CDA Coding + +Both CDA and FHIR employ a hierarchy of simpler types and more complex types that re-use the simpler ones. In some cases, a simpler type on one side will map to a more complex one on the other. Where the complexity supports metadata, these maps are essentially the same as the complex-to-complex maps (Coding & CodeableConcept, above). In a few cases, a complex type supports representing a simple source where a simple target would have failed. + +|FHIR Property|CDA Target|Notes| +|:-----|:-----|:-------------| +|code|originalText|If the CDA element is mapped to a value set that has no translation for the FHIR value, the FHIR value can be placed in orginalText. This does not satisfy CDA terminology bindings, should they exist.| + + #### Mapping OID ↔ URI FHIR requires that certain terminologies use a specific uniform resource identifier (URI) while CDA always uses object identifiers (OIDs) for codeSystems. This means: From ebc04c3638ef302f3f7af109404d6a6033d5fc06 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Tue, 16 Jul 2024 16:28:45 -0500 Subject: [PATCH 041/112] Add supply order mapping --- input/pagecontent/CF-medications.md | 4 ++++ 1 file changed, 4 insertions(+) diff --git a/input/pagecontent/CF-medications.md b/input/pagecontent/CF-medications.md index 535103a..3fcd71d 100644 --- a/input/pagecontent/CF-medications.md +++ b/input/pagecontent/CF-medications.md @@ -46,6 +46,10 @@ The C-CDA Example Search site maintains a document of [Common Medication Frequen |**[Indication](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-Indication.html)**<br/>/entryRelationship[@typeCode="RSON"]/observation/value|.reasonCode|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |**[Free text sig](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-MedicationFreeTextSig.html)**<br/>/entryRelationship/substanceAdministration[code/@code="76662-6"]/text|.dosageInstruction.text|| |**[Instruction Activity](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-Instruction.html)**<br/>/entryRelationship[@typeCode="SUBJ" and @inversionInd="true"]/act|.dosageInstruction.patientInstruction<br/>.dosageInstruction.additionalInstruction|act/text or act/code/originalText can map to patientInstructions. If coded, can map to additionalInstruction. +|**[Supply Order](https://hl7.org/cda/us/ccda/StructureDefinition-MedicationSupplyOrder.html)**<br/>/entryRelationship[@typeCode="REFR"]/substanceAdministration[@moodCode="INT"]<br/>Note: moodCode=INT means supply, moodCode=EVN means dispense, which is not documented here. +|/effectiveTime/high|.dispenseRequest.period.end|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)<br/>`low` would similarly map to `start`, but only high is called out in C-CDA.| +|/repeatNumber|.dispenseRequest.numberOfRepeatsAllowed|**Caution:** in CDA, repeatNumber indicates total number of dispenses allowed. In FHIR, this field is exclusive of the original dispense. So the `numberOfRepeatsAllowed` will be one less than `repeatNumber`. +|/quantity|.dispenseRequest.quantity|https://hl7.org/cda/us/ccda/StructureDefinition-MedicationSupplyOrder.html |**[Comment Activity](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|| 1\. XPath abbrievated for C-CDA Medication Activity as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="10160-0"]/entry/substanceAdministration From e45ce74b469a12dd238fa361b5101d20106bd3a8 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Thu, 18 Jul 2024 15:57:04 -0500 Subject: [PATCH 042/112] Fix supply link/labels. Add frequency range --- input/pagecontent/CF-medications.md | 10 +++++----- 1 file changed, 5 insertions(+), 5 deletions(-) diff --git a/input/pagecontent/CF-medications.md b/input/pagecontent/CF-medications.md index 3fcd71d..5487227 100644 --- a/input/pagecontent/CF-medications.md +++ b/input/pagecontent/CF-medications.md @@ -34,7 +34,7 @@ The C-CDA Example Search site maintains a document of [Common Medication Frequen |/effectiveTime[1]/@value|.dosageInstruction.timing.event|**Constraint**: Use this when effectiveTime@value is populated<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)| |/effectiveTime[1]/low|.dosageInstruction.timing.repeat.boundsPeriod.start|**Constraint**: Use this when effectiveTime/@value is not populated<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)| |/effectiveTime[1]/high|.dosageInstruction.timing.repeat.boundsPeriod.end|**Constraint**: Use this when effectiveTime/@value is not populated<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)| -|**Periodic Frequency**<br/>/effectiveTime[operator="A" and xsi:type="PIVL_TS"]<br/>.../@institutionSpecified<br/>.../period/@value<br/>.../period/@unit|.dosageInstruction.timing.repeat.frequency<br/>.dosageInstruction.timing.repeat.period<br/>.dosageInstruction.timing.repeat.periodUnit|Compare:<br/>[C-CDA Common Medication Frequencies](http://cdasearch.hl7.org/examples/view/9588687865c0f945a326364a9449321690c7a7ef) and <br/>[FHIR Timing Data Type](http://hl7.org/fhir/R4/datatypes.html#Timing) +|**Periodic Frequency**<br/>/effectiveTime[operator="A" and xsi:type="PIVL_TS"]<br/>.../@institutionSpecified<br/>.../period/@value<br/>.../period/@unit|.dosageInstruction.timing.repeat.frequency<br/>.dosageInstruction.timing.repeat.period<br/>.dosageInstruction.timing.repeat.periodUnit|Compare:<br/>[C-CDA Common Medication Frequencies](http://cdasearch.hl7.org/examples/view/9588687865c0f945a326364a9449321690c7a7ef) and <br/>[FHIR Timing Data Type](http://hl7.org/fhir/R4/datatypes.html#Timing) to determine whether `frequency` or `period` should be used.<br/>If CDA `period` contains `low` and `high` (e.g. a range like 4-6 hours or 3-4 times a day), map `low` the same as `@value` (e.g. to `repeat.period` or `repeat.frequency`) and map `high` to `repeat.periodMax` or `repeat.frequencyMax` depending on whether it is a frequency or period. |**Event-Based Timing**<br/>/effectiveTime[operator="A" and xsi:type="EIVL_TS"]<br/>.../event/@code<br/>.../offset|.dosageInstruction.timing.repeat.when<br/>.dosageInstruction.timing.repeat.offset|@code vocabulary matches .when<br/>CDA offset must be converted to minutes for FHIR |/routeCode|.dosageInstruction.route|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/doseQuantity|.dosageInstruction.doseAndRate.doseQuantity|[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity)| @@ -46,10 +46,10 @@ The C-CDA Example Search site maintains a document of [Common Medication Frequen |**[Indication](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-Indication.html)**<br/>/entryRelationship[@typeCode="RSON"]/observation/value|.reasonCode|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |**[Free text sig](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-MedicationFreeTextSig.html)**<br/>/entryRelationship/substanceAdministration[code/@code="76662-6"]/text|.dosageInstruction.text|| |**[Instruction Activity](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-Instruction.html)**<br/>/entryRelationship[@typeCode="SUBJ" and @inversionInd="true"]/act|.dosageInstruction.patientInstruction<br/>.dosageInstruction.additionalInstruction|act/text or act/code/originalText can map to patientInstructions. If coded, can map to additionalInstruction. -|**[Supply Order](https://hl7.org/cda/us/ccda/StructureDefinition-MedicationSupplyOrder.html)**<br/>/entryRelationship[@typeCode="REFR"]/substanceAdministration[@moodCode="INT"]<br/>Note: moodCode=INT means supply, moodCode=EVN means dispense, which is not documented here. -|/effectiveTime/high|.dispenseRequest.period.end|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)<br/>`low` would similarly map to `start`, but only high is called out in C-CDA.| -|/repeatNumber|.dispenseRequest.numberOfRepeatsAllowed|**Caution:** in CDA, repeatNumber indicates total number of dispenses allowed. In FHIR, this field is exclusive of the original dispense. So the `numberOfRepeatsAllowed` will be one less than `repeatNumber`. -|/quantity|.dispenseRequest.quantity|https://hl7.org/cda/us/ccda/StructureDefinition-MedicationSupplyOrder.html +|**[Supply Order](https://hl7.org/cda/us/ccda/StructureDefinition-MedicationSupplyOrder.html)**<br/>/entryRelationship[@typeCode="REFR"]/substanceAdministration[@moodCode="INT"]||Note: moodCode=INT means supply, moodCode=EVN means dispense, which is not documented here. +|../effectiveTime/high|.dispenseRequest.period.end|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)<br/>`low` would similarly map to `start`, but only high is called out in C-CDA.| +|../repeatNumber|.dispenseRequest.numberOfRepeatsAllowed|**Caution:** in CDA, repeatNumber indicates total number of dispenses allowed. In FHIR, this field is exclusive of the original dispense. So the `numberOfRepeatsAllowed` will be one less than `repeatNumber`. +|../quantity|.dispenseRequest.quantity|[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity) |**[Comment Activity](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|| 1\. XPath abbrievated for C-CDA Medication Activity as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="10160-0"]/entry/substanceAdministration From 99d7aaf64f34f024f8d4328fed5e32d61c00f883 Mon Sep 17 00:00:00 2001 From: jlyle1 <jay@lyle.net> Date: Sun, 21 Jul 2024 16:17:28 -0400 Subject: [PATCH 043/112] loinc code typo --- input/pagecontent/CF-notes.md | 2 +- 1 file changed, 1 insertion(+), 1 deletion(-) diff --git a/input/pagecontent/CF-notes.md b/input/pagecontent/CF-notes.md index d060c9c..7194ed8 100644 --- a/input/pagecontent/CF-notes.md +++ b/input/pagecontent/CF-notes.md @@ -13,7 +13,7 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea |C-CDA¹<br/>[Note Activity](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-NoteActivity.html)<br/>[DocumentReference](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-documentreference.html)|Transform Steps| |:----|:----|:----| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| -|/code|.type|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>**NOTE:** The root code in CDA is always `64109-9: Note` which matches the FHIR Binding. +|/code|.type|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>**NOTE:** The root code in CDA is always `34109-9: Note` which matches the FHIR Binding. |/text/@mediaType<br/>&<br/>/text/text()|.attachment.contentType<br/>&<br/>.attachment.data|If @mediaType is present, then representation should = B64, and the inner-text contents are embedded base64-encoded data. In this case, the mediaType and base64-encoded data map 1:1 to attachment.contentType and .data. |/text/reference/@value|.attachment.contentType<br/>&<br/>.attachment.data|Convert the narrative element referenced by @value following [Narrative Text](mappingGuidance.html#narrative-text) guidance and use `application/xhtml+xml` as the contentType.<br/>If the narrative has minimal markup (i.e. only `<content>` and `<paragraph>` elements which can be converted to line breaks), it can be converted to `text/plain`.<br/>To send the raw CDA narrative without converting, use `application/cda+xml`, but this is less useful to receivers. |/effectiveTime|.context.period|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) From be4b289702193cc73ef803e77253c658008e6f64 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Mon, 22 Jul 2024 09:02:30 -0500 Subject: [PATCH 044/112] Typos / content cleanup on new pages --- input/pagecontent/CF-notes.md | 2 +- input/pagecontent/CF-results.md | 2 +- input/pagecontent/CF-social.md | 2 -- input/pagecontent/CF-vitals.md | 6 +++--- 4 files changed, 5 insertions(+), 7 deletions(-) diff --git a/input/pagecontent/CF-notes.md b/input/pagecontent/CF-notes.md index 7194ed8..acc218d 100644 --- a/input/pagecontent/CF-notes.md +++ b/input/pagecontent/CF-notes.md @@ -6,7 +6,7 @@ td, th { This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, please refer to [Notes FHIR → CDA](./FC-notes.html). For guidance on how to read the table below, see [Reading the C-CDA ↔ FHIR Mapping Pages](./mappingGuidance.html). -... +Clinical Notes may appear in their own section or as an entry in any open section. They are identified by an `<act>` with a `<code>` value of `34109-9`. ### C-CDA to FHIR diff --git a/input/pagecontent/CF-results.md b/input/pagecontent/CF-results.md index 055853e..58d1864 100644 --- a/input/pagecontent/CF-results.md +++ b/input/pagecontent/CF-results.md @@ -40,7 +40,7 @@ Observation values are generic - they can be of any CDA type in CDA, and *almost |/interpretationCode|.interpretation|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/methodCode|.method|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/targetSiteCode|.bodySite|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| -|/author||*TODO* +|/author|**[Provenance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-provenance.html)**|[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| |/referenceRange/observationRange/interpretationCode|**Not Supported**|FHIR expects reference ranges to be "normal" ranges. If C-CDA includes multiple reference ranges, only map the one with interpretationCode = `"N"`. |/referenceRange/observationRange/value[xsi:type=IVL_PQ]|.referenceRange.low<br/>&<br/>.referenceRange.high| |/referenceRange/observationRange/value[xsi:type=ST]<br/>or<br/>/referenceRange/observationRange/text|.referenceRange.text| diff --git a/input/pagecontent/CF-social.md b/input/pagecontent/CF-social.md index 78b184d..7db68e8 100644 --- a/input/pagecontent/CF-social.md +++ b/input/pagecontent/CF-social.md @@ -42,8 +42,6 @@ In C-CDA 3.0, the Smoking Status - MU and Tobacco Use templates were merged into |/code|.code|Prior to US Core 7, the code should be `72166-2 (Tobacco smoking status NCIS)`, but this is an extensible value set.<br/>In US Core 7, the value set remains extensible, but contains the same 4 concepts allowed in the C-CDA R3.0's Smoking Status value set. |/effectiveTime|.effectiveDateTime<br/>or<br/>.effectivePeriod|Smoking Status - MU required a timestamp; Tobacco Use required a time range; Smoking Status (3.0) combines the two templates into one and allows for either. -### Illustrative example - ### C-CDA Pregnancy Observation to FHIR Pregnancy Status Observation In US Core, Pregnancy Observation was first defined in version 6. diff --git a/input/pagecontent/CF-vitals.md b/input/pagecontent/CF-vitals.md index c79faca..6936ca0 100644 --- a/input/pagecontent/CF-vitals.md +++ b/input/pagecontent/CF-vitals.md @@ -27,17 +27,17 @@ C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or ||.category|Set to `vital-signs` from [Vital Signs value set](https://hl7.org/fhir/us/core/STU4/ValueSet-us-core-vital-signs.html) |/code |.code|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/effectiveTime|.effectiveDateTime<br/>or<br/>.effectivePeriod|Prefer effectiveDateTime<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) -|value|.valueQuantity|CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity) +|value|.valueQuantity|[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity) |/interpretationCode|.interpretation|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/methodCode|.method|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/targetSiteCode|.bodySite|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/author||*TODO* -|/referenceRange/observationRange/interpretationCode|**Not Supported**|FHIR expects reference ranges to be "normal" ranges. If C-CDA includes multiple reference ranges, only map the one with interpretationCode = `"N"`. +|/referenceRange/observationRange/interpretationCode|**Not Supported**|[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity)<br/>FHIR expects reference ranges to be "normal" ranges. If C-CDA includes multiple reference ranges, only map the one with interpretationCode = `"N"`. |/referenceRange/observationRange/value[xsi:type=IVL_PQ]|.referenceRange.low<br/>&<br/>.referenceRange.high| |/referenceRange/observationRange/value[xsi:type=ST]<br/>or<br/>/referenceRange/observationRange/text|.referenceRange.text| ### Illustrative example - +... ### Links to example content ... ### Prior work and Expanded Spreadsheets From 8c2672f17c188e261832cb93bba725905510798d Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Tue, 13 Aug 2024 15:38:14 -0500 Subject: [PATCH 045/112] Add supporting observation --- input/pagecontent/CF-problems.md | 1 + 1 file changed, 1 insertion(+) diff --git a/input/pagecontent/CF-problems.md b/input/pagecontent/CF-problems.md index ac57118..ddde570 100644 --- a/input/pagecontent/CF-problems.md +++ b/input/pagecontent/CF-problems.md @@ -29,6 +29,7 @@ Note that C-CDA includes a Concern wrapper act from which status may be read; mo |**[Problem Status](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-ProblemStatus.html)**<br/>/entryRelationship/observation[code/@code="33999-4"]/value|.clinicalStatus|[CDA Problem Status Observation value → FHIR clinicalStatus](./ConceptMap-CF-ProblemStatus.html)| |**[Date of Diagnosis](https://www.hl7.org/ccdasearch/templates/2.16.840.1.113883.10.20.22.4.502.html)**<br/>/entryRelationship/act[code/@code="77975-1"]/effectiveTime|.extension:[assertedDate](http://hl7.org/fhir/StructureDefinition/condition-assertedDate)|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)<br/>See **[US CORE Condition](https://hl7.org/fhir/us/core/StructureDefinition-us-core-condition-problems-health-concerns.html#mandatory-and-must-support-data-elements)** for additional guidance| |**[Comment Activity](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|| +|**Supporting Observations (e.g. [Assessment Scale Observation](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-AssessmentScaleObservation.html))**<br/>/entryRelationship[@typeCode=SPRT]/observation|.evidence.detail|Create an Observation resource, mapping fields like `id`, `code`, `effectiveTime`, `value` similar to [Results](CF-results.html). If the CDA observation is an SDOH observation, use the [US Core Observation Screening Assessment](https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-observation-screening-assessment.html) profile. 1\. XPath abbrievated for C-CDA Problem Concern act as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="11450-4"]/entry/act/ From 764caed872e680e181a634851c086e483623662c Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Tue, 13 Aug 2024 15:42:47 -0500 Subject: [PATCH 046/112] Add Age Observation --- input/pagecontent/CF-problems.md | 3 ++- 1 file changed, 2 insertions(+), 1 deletion(-) diff --git a/input/pagecontent/CF-problems.md b/input/pagecontent/CF-problems.md index ddde570..83f8ae3 100644 --- a/input/pagecontent/CF-problems.md +++ b/input/pagecontent/CF-problems.md @@ -29,7 +29,8 @@ Note that C-CDA includes a Concern wrapper act from which status may be read; mo |**[Problem Status](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-ProblemStatus.html)**<br/>/entryRelationship/observation[code/@code="33999-4"]/value|.clinicalStatus|[CDA Problem Status Observation value → FHIR clinicalStatus](./ConceptMap-CF-ProblemStatus.html)| |**[Date of Diagnosis](https://www.hl7.org/ccdasearch/templates/2.16.840.1.113883.10.20.22.4.502.html)**<br/>/entryRelationship/act[code/@code="77975-1"]/effectiveTime|.extension:[assertedDate](http://hl7.org/fhir/StructureDefinition/condition-assertedDate)|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)<br/>See **[US CORE Condition](https://hl7.org/fhir/us/core/StructureDefinition-us-core-condition-problems-health-concerns.html#mandatory-and-must-support-data-elements)** for additional guidance| |**[Comment Activity](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|| -|**Supporting Observations (e.g. [Assessment Scale Observation](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-AssessmentScaleObservation.html))**<br/>/entryRelationship[@typeCode=SPRT]/observation|.evidence.detail|Create an Observation resource, mapping fields like `id`, `code`, `effectiveTime`, `value` similar to [Results](CF-results.html). If the CDA observation is an SDOH observation, use the [US Core Observation Screening Assessment](https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-observation-screening-assessment.html) profile. +|**[Age Observation]()**<br/>/entryRelationship[@typeCode="SUBJ" and @inversionInd="true"]/observation[code/@code="445518008"]/value|.onsetAge|**CAUTION:** Only one of `onsetAge` or `onsetDateTime` may be present.<br/>[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity) +|**Supporting Observations (e.g. [Assessment Scale Observation](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-AssessmentScaleObservation.html))**<br/>/entryRelationship[@typeCode="SPRT"]/observation|.evidence.detail|Create an Observation resource, mapping fields like `id`, `code`, `effectiveTime`, `value` similar to [Results](CF-results.html). If the CDA observation is an SDOH observation, use the [US Core Observation Screening Assessment](https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-observation-screening-assessment.html) profile. 1\. XPath abbrievated for C-CDA Problem Concern act as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="11450-4"]/entry/act/ From a3b5b812eaa65d144a5d8c017438e97fd6541599 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Mon, 26 Aug 2024 08:40:45 -0500 Subject: [PATCH 047/112] Fix some spelling --- input/pagecontent/CF-allergies.md | 6 +++--- input/pagecontent/CF-problems.md | 4 ++-- 2 files changed, 5 insertions(+), 5 deletions(-) diff --git a/input/pagecontent/CF-allergies.md b/input/pagecontent/CF-allergies.md index 7a44eab..89b3d68 100644 --- a/input/pagecontent/CF-allergies.md +++ b/input/pagecontent/CF-allergies.md @@ -7,7 +7,7 @@ td, th { This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, please refer to [Allergies FHIR → CDA](./FC-allergies.html). For guidance on how to read the table below, see [Reading the C-CDA ↔ FHIR Mapping Pages](./mappingGuidance.html) -**Uncommon use case:** Multiple C-CDA Allergy Intolerance observations inside a single Allery Concern act should map to separate and distinct FHIR AllergyIntolerance resources. The C-CDA Companion Guide ([see 5.2.7.1](https://www.hl7.org/implement/standards/product_brief.cfm?product_id=447)) actively discourages the practice of multiple osbervations insice a single act. It may occur, however, since Allergy Concern act allows for multiple Allergy Intolerance observations in C-CDA. Lossless transformations may not be possible without the use of extensions ([see 3.1 of this guide](./mappingBackground.html)). +**Uncommon use case:** Multiple C-CDA Allergy Intolerance observations inside a single Allergy Concern act should map to separate and distinct FHIR AllergyIntolerance resources. The C-CDA Companion Guide ([see 5.2.7.1](https://www.hl7.org/implement/standards/product_brief.cfm?product_id=447)) actively discourages the practice of multiple observations inside a single act. It may occur, however, since Allergy Concern act allows for multiple Allergy Intolerance observations in C-CDA. Lossless transformations may not be possible without the use of extensions ([see 3.1 of this guide](./mappingBackground.html)). <br /> ### C-CDA to FHIR @@ -31,9 +31,9 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea |**[Comment Activity](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text³|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|| -1\. XPath abbrievated for C-CDA Allergy Concern act as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="48765-2"]/entry/act/ +1\. XPath abbreviated for C-CDA Allergy Concern act as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="48765-2"]/entry/act/ -2\. XPath abbrievated for C-CDA Allergy Inteolerance observation as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="48765-2"]/entry/act/entryRelationship[@typeCode="SUBJ"]/observation +2\. XPath abbreviated for C-CDA Allergy Intolerance observation as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="48765-2"]/entry/act/entryRelationship[@typeCode="SUBJ"]/observation 3\. Note that these entryRelationships will also have inversionInd="true" in CDA diff --git a/input/pagecontent/CF-problems.md b/input/pagecontent/CF-problems.md index 83f8ae3..c595e51 100644 --- a/input/pagecontent/CF-problems.md +++ b/input/pagecontent/CF-problems.md @@ -32,9 +32,9 @@ Note that C-CDA includes a Concern wrapper act from which status may be read; mo |**[Age Observation]()**<br/>/entryRelationship[@typeCode="SUBJ" and @inversionInd="true"]/observation[code/@code="445518008"]/value|.onsetAge|**CAUTION:** Only one of `onsetAge` or `onsetDateTime` may be present.<br/>[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity) |**Supporting Observations (e.g. [Assessment Scale Observation](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-AssessmentScaleObservation.html))**<br/>/entryRelationship[@typeCode="SPRT"]/observation|.evidence.detail|Create an Observation resource, mapping fields like `id`, `code`, `effectiveTime`, `value` similar to [Results](CF-results.html). If the CDA observation is an SDOH observation, use the [US Core Observation Screening Assessment](https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-observation-screening-assessment.html) profile. -1\. XPath abbrievated for C-CDA Problem Concern act as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="11450-4"]/entry/act/ +1\. XPath abbreviated for C-CDA Problem Concern act as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="11450-4"]/entry/act/ -2\. XPath abbrievated for C-CDA Problem Observation as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="11450-4"]/entry/act/entryRelationship[@typeCode="SUBJ"]/observation/ +2\. XPath abbreviated for C-CDA Problem Observation as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="11450-4"]/entry/act/entryRelationship[@typeCode="SUBJ"]/observation/ When authors or other provenance are recorded in the parent [Problem Concern Act](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-ProblemConcernAct.html), it is recommended that those data be mapped to the FHIR Condition. From 2130dcec64c90a7adb7cbc2a71d2c0a316c69003 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Sat, 21 Sep 2024 11:16:41 -0500 Subject: [PATCH 048/112] Add approachSiteCode --- input/pagecontent/CF-medications.md | 1 + 1 file changed, 1 insertion(+) diff --git a/input/pagecontent/CF-medications.md b/input/pagecontent/CF-medications.md index 5487227..08e57dd 100644 --- a/input/pagecontent/CF-medications.md +++ b/input/pagecontent/CF-medications.md @@ -37,6 +37,7 @@ The C-CDA Example Search site maintains a document of [Common Medication Frequen |**Periodic Frequency**<br/>/effectiveTime[operator="A" and xsi:type="PIVL_TS"]<br/>.../@institutionSpecified<br/>.../period/@value<br/>.../period/@unit|.dosageInstruction.timing.repeat.frequency<br/>.dosageInstruction.timing.repeat.period<br/>.dosageInstruction.timing.repeat.periodUnit|Compare:<br/>[C-CDA Common Medication Frequencies](http://cdasearch.hl7.org/examples/view/9588687865c0f945a326364a9449321690c7a7ef) and <br/>[FHIR Timing Data Type](http://hl7.org/fhir/R4/datatypes.html#Timing) to determine whether `frequency` or `period` should be used.<br/>If CDA `period` contains `low` and `high` (e.g. a range like 4-6 hours or 3-4 times a day), map `low` the same as `@value` (e.g. to `repeat.period` or `repeat.frequency`) and map `high` to `repeat.periodMax` or `repeat.frequencyMax` depending on whether it is a frequency or period. |**Event-Based Timing**<br/>/effectiveTime[operator="A" and xsi:type="EIVL_TS"]<br/>.../event/@code<br/>.../offset|.dosageInstruction.timing.repeat.when<br/>.dosageInstruction.timing.repeat.offset|@code vocabulary matches .when<br/>CDA offset must be converted to minutes for FHIR |/routeCode|.dosageInstruction.route|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|/approachSiteCode|.site|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/doseQuantity|.dosageInstruction.doseAndRate.doseQuantity|[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity)| |/rateQuantity|.dosageInstruction.doseAndRate.rateQuantity|[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity)| |/consumable/manufacturedProduct/manufacturedMaterial/code|.medicationCodeableConcept|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| From 111707d9134064fcba496e9c5e6f381ce0830b40 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Sat, 21 Sep 2024 12:05:31 -0500 Subject: [PATCH 049/112] Add maxDoseQuantity --- input/pagecontent/CF-medications.md | 4 +++- 1 file changed, 3 insertions(+), 1 deletion(-) diff --git a/input/pagecontent/CF-medications.md b/input/pagecontent/CF-medications.md index 08e57dd..01e620c 100644 --- a/input/pagecontent/CF-medications.md +++ b/input/pagecontent/CF-medications.md @@ -37,9 +37,11 @@ The C-CDA Example Search site maintains a document of [Common Medication Frequen |**Periodic Frequency**<br/>/effectiveTime[operator="A" and xsi:type="PIVL_TS"]<br/>.../@institutionSpecified<br/>.../period/@value<br/>.../period/@unit|.dosageInstruction.timing.repeat.frequency<br/>.dosageInstruction.timing.repeat.period<br/>.dosageInstruction.timing.repeat.periodUnit|Compare:<br/>[C-CDA Common Medication Frequencies](http://cdasearch.hl7.org/examples/view/9588687865c0f945a326364a9449321690c7a7ef) and <br/>[FHIR Timing Data Type](http://hl7.org/fhir/R4/datatypes.html#Timing) to determine whether `frequency` or `period` should be used.<br/>If CDA `period` contains `low` and `high` (e.g. a range like 4-6 hours or 3-4 times a day), map `low` the same as `@value` (e.g. to `repeat.period` or `repeat.frequency`) and map `high` to `repeat.periodMax` or `repeat.frequencyMax` depending on whether it is a frequency or period. |**Event-Based Timing**<br/>/effectiveTime[operator="A" and xsi:type="EIVL_TS"]<br/>.../event/@code<br/>.../offset|.dosageInstruction.timing.repeat.when<br/>.dosageInstruction.timing.repeat.offset|@code vocabulary matches .when<br/>CDA offset must be converted to minutes for FHIR |/routeCode|.dosageInstruction.route|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| -|/approachSiteCode|.site|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|/approachSiteCode|.dosageInstruction.site|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/doseQuantity|.dosageInstruction.doseAndRate.doseQuantity|[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity)| |/rateQuantity|.dosageInstruction.doseAndRate.rateQuantity|[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity)| +|/maxDoseQuantity/numerator|.dosageInstruction.maxDosePerPeriod.numerator||[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity)| +|/maxDoseQuantity/denominator|.dosageInstruction.maxDosePerPeriod.denominator||[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity)| |/consumable/manufacturedProduct/manufacturedMaterial/code|.medicationCodeableConcept|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/author|.requester<br/>&<br/>**[Provenance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-procedure.html)**|[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| |/author/time|.authoredOn|Earliest, if more than one.<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)| From 41a9828a077e432469537c2243c824fbeab667be Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Sat, 21 Sep 2024 13:59:22 -0500 Subject: [PATCH 050/112] Add new table for Medication mapping --- input/pagecontent/CF-medications.md | 22 +++++++++++++++++----- 1 file changed, 17 insertions(+), 5 deletions(-) diff --git a/input/pagecontent/CF-medications.md b/input/pagecontent/CF-medications.md index 01e620c..2742d11 100644 --- a/input/pagecontent/CF-medications.md +++ b/input/pagecontent/CF-medications.md @@ -23,7 +23,7 @@ The second `<effectiveTime>` represents the frequency and contains the attribute The C-CDA Example Search site maintains a document of [Common Medication Frequencies](http://cdasearch.hl7.org/examples/view/9588687865c0f945a326364a9449321690c7a7ef) which can be cross-referenced with a similar table in FHIR's [Timing Data Type](http://hl7.org/fhir/R4/datatypes.html#Timing) to properly map CDA frequencies to FHIR timing values. -### C-CDA to FHIR +### C-CDA to FHIR (MedicationRequest) |C-CDA¹<br>[Medication Activity substanceAdministration](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-MedicationActivity.html)|FHIR<br>[MedicationRequest](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-medicationrequest.html)|Transform Steps| |:----|:----|:----| @@ -40,12 +40,14 @@ The C-CDA Example Search site maintains a document of [Common Medication Frequen |/approachSiteCode|.dosageInstruction.site|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/doseQuantity|.dosageInstruction.doseAndRate.doseQuantity|[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity)| |/rateQuantity|.dosageInstruction.doseAndRate.rateQuantity|[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity)| -|/maxDoseQuantity/numerator|.dosageInstruction.maxDosePerPeriod.numerator||[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity)| -|/maxDoseQuantity/denominator|.dosageInstruction.maxDosePerPeriod.denominator||[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity)| -|/consumable/manufacturedProduct/manufacturedMaterial/code|.medicationCodeableConcept|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|/maxDoseQuantity/numerator|.dosageInstruction.maxDosePerPeriod.numerator|[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity)| +|/maxDoseQuantity/denominator|.dosageInstruction.maxDosePerPeriod.denominator|[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity)| +|/administrationUnitCode|Medication.form|[See below](#c-cda-to-fhir-medication) +|/consumable/manufacturedProduct/manufacturedMaterial/code|.medicationCodeableConcept<br/>OR<br/>.medicationReference|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>Only one of these fields may be populated. When generating a Medication resource ([see below](#c-cda-to-fhir-medication)), use the medicationReference field.| +|/consumable/manufacturedProduct/manufacturerOrganization|Medication.manufacturer|[See below](#c-cda-to-fhir-medication) |/author|.requester<br/>&<br/>**[Provenance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-procedure.html)**|[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| |/author/time|.authoredOn|Earliest, if more than one.<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)| -|/precondition|.asNeededBoolean = true|The presence of a precondition element indicates asNeededBoolean should be true.<br/>More complex maps may be possible with .asNeededCodeableConcept.| +|**[Drug Vehicle](https://hl7.org/cda/us/ccda/StructureDefinition-DrugVehicle.html)**<br/>/participant[@typeCode="COV"]/playingEntity/code|Medication.ingredient|[See below](#c-cda-to-fhir-medication) |**[Indication](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-Indication.html)**<br/>/entryRelationship[@typeCode="RSON"]/observation/value|.reasonCode|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |**[Free text sig](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-MedicationFreeTextSig.html)**<br/>/entryRelationship/substanceAdministration[code/@code="76662-6"]/text|.dosageInstruction.text|| |**[Instruction Activity](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-Instruction.html)**<br/>/entryRelationship[@typeCode="SUBJ" and @inversionInd="true"]/act|.dosageInstruction.patientInstruction<br/>.dosageInstruction.additionalInstruction|act/text or act/code/originalText can map to patientInstructions. If coded, can map to additionalInstruction. @@ -54,9 +56,19 @@ The C-CDA Example Search site maintains a document of [Common Medication Frequen |../repeatNumber|.dispenseRequest.numberOfRepeatsAllowed|**Caution:** in CDA, repeatNumber indicates total number of dispenses allowed. In FHIR, this field is exclusive of the original dispense. So the `numberOfRepeatsAllowed` will be one less than `repeatNumber`. |../quantity|.dispenseRequest.quantity|[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity) |**[Comment Activity](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|| +|/precondition|.asNeededBoolean = true|The presence of a precondition element indicates asNeededBoolean should be true.<br/>More complex maps may be possible with .asNeededCodeableConcept.| 1\. XPath abbrievated for C-CDA Medication Activity as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="10160-0"]/entry/substanceAdministration +### C-CDA to FHIR (Medication) +MedicationRequest (and other resources) may represent the medication as a simple CodeableConcept. But when additional information about the medication needs to be conveyed, a Medication resource should be created instead and referenced by the MedicationRequest resource. Implementers may also opt to always create Medication resources. + +|C-CDA¹<br>[Medication Activity substanceAdministration](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-MedicationActivity.html)|FHIR<br>[Medication](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-medication.html)|Transform Steps| +|:----|:----|:----| +|/administrationUnitCode|.form|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) +|/consumable/manufacturedProduct/manufacturedMaterial/code|.code|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|/consumable/manufacturedProduct/manufacturerOrganization|**[Organization](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-organization.html)**<br/>.manufacturer| +|**[Drug Vehicle](https://hl7.org/cda/us/ccda/StructureDefinition-DrugVehicle.html)**<br/>/participant[@typeCode="COV"]/playingEntity/code|.ingredient.itemCodeableConcept|Set `.isActive = false`<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) ### Illustrative example From 0bf8b84dbaaff135a04400073fd80f7f97fb571b Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Sun, 22 Sep 2024 09:05:15 -0500 Subject: [PATCH 051/112] recorded -> recordedDate --- input/pagecontent/CF-allergies.md | 4 ++-- 1 file changed, 2 insertions(+), 2 deletions(-) diff --git a/input/pagecontent/CF-allergies.md b/input/pagecontent/CF-allergies.md index 89b3d68..d6c3930 100644 --- a/input/pagecontent/CF-allergies.md +++ b/input/pagecontent/CF-allergies.md @@ -21,7 +21,7 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea |/effectiveTime/low|.onsetDateTime|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)<br/>effectiveTime/high should not be mapped within onset (DateTime or Period)| |/value|.type<br/>&<br/>.category|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>[CDA value → FHIR type](ConceptMap-CF-AllergyIntoleranceType.html) <br/> [CDA value → FHIR category](./ConceptMap-CF-AllergyIntoleranceCategory.html)| |/author|.recorder<br/>&<br/>**[Provenance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-provenance.html)**|**Constraint:** Only map single CDA author to FHIR recorder<br/>[Guidance on CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| -|/author/time|.recorded|**Constraint:** Only map earliest author/time <br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)| +|/author/time|.recordedDate|**Constraint:** Only map earliest author/time <br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)| |/participant/participantRole/playingEntity/code|.code|**Constraint:** When CDA negation is absent or false<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/participant/participantRole/playingEntity/code<br/>&<br/>/value|.code|**Constraint:** When CDA negation is true and nullFlavor is used in playingEntity/code<br/>[CDA No known allergy → FHIR code](ConceptMap-CF-NoKnownAllergies.html)<br/> When negation is true and playingEntity/code is populated, use equivalent negated concept (e.g. map latex substance to no known latex allergy [1003774007, SNOMED CT]) if available. If not, use the [substanceExposureRisk extension](https://hl7.org/fhir/extensions/StructureDefinition-allergyintolerance-substanceExposureRisk.html), placing the substance in the substance sub-extension and setting the exposureRisk sub-extension to `no-known-reaction-risk`. Note that when using this extension, the AllergyIntolerance resource will not be a conformant US Core AllergyIntolerance since the extension prohibits the required .code element.| |**[Status](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-AllergyStatusObservation.html)**<br/>/entryRelationship/observation[code/@code="33999-4"]/value³|.clinicalStatus|[CDA Allergy Status Observation value → FHIR clinicalStatus](./ConceptMap-CF-AllergyStatus.html) @@ -37,7 +37,7 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea 3\. Note that these entryRelationships will also have inversionInd="true" in CDA -When authors or other provenance are recorded in the parent [Allergy Concern Act](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-AllergyConcernAct.html), it is recommended that those data be mapped to the FHIR AllergyIntolerance. +When authors or other provenance are recorded in the parentƒ [Allergy Concern Act](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-AllergyConcernAct.html), it is recommended that those data be mapped to the FHIR AllergyIntolerance. ### Illustrative example From 81ec26a11a066dcd0301f9854b726667822a0147 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Sun, 22 Sep 2024 10:25:11 -0500 Subject: [PATCH 052/112] Move PQ link down to value --- input/pagecontent/CF-vitals.md | 4 ++-- 1 file changed, 2 insertions(+), 2 deletions(-) diff --git a/input/pagecontent/CF-vitals.md b/input/pagecontent/CF-vitals.md index 6936ca0..8f3e943 100644 --- a/input/pagecontent/CF-vitals.md +++ b/input/pagecontent/CF-vitals.md @@ -32,8 +32,8 @@ C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or |/methodCode|.method|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/targetSiteCode|.bodySite|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/author||*TODO* -|/referenceRange/observationRange/interpretationCode|**Not Supported**|[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity)<br/>FHIR expects reference ranges to be "normal" ranges. If C-CDA includes multiple reference ranges, only map the one with interpretationCode = `"N"`. -|/referenceRange/observationRange/value[xsi:type=IVL_PQ]|.referenceRange.low<br/>&<br/>.referenceRange.high| +|/referenceRange/observationRange/interpretationCode|**Not Supported**|FHIR expects reference ranges to be "normal" ranges. If C-CDA includes multiple reference ranges, only map the one with interpretationCode = `"N"`. +|/referenceRange/observationRange/value[xsi:type=IVL_PQ]|.referenceRange.low<br/>&<br/>.referenceRange.high|[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity) |/referenceRange/observationRange/value[xsi:type=ST]<br/>or<br/>/referenceRange/observationRange/text|.referenceRange.text| ### Illustrative example From 0b92050748f12f28d4a1184f6d55bf8da134cef5 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Sun, 22 Sep 2024 10:54:00 -0500 Subject: [PATCH 053/112] Map author to performer (follow meds/imm model) --- input/pagecontent/CF-vitals.md | 2 +- 1 file changed, 1 insertion(+), 1 deletion(-) diff --git a/input/pagecontent/CF-vitals.md b/input/pagecontent/CF-vitals.md index 8f3e943..e2f7d00 100644 --- a/input/pagecontent/CF-vitals.md +++ b/input/pagecontent/CF-vitals.md @@ -31,7 +31,7 @@ C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or |/interpretationCode|.interpretation|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/methodCode|.method|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/targetSiteCode|.bodySite|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| -|/author||*TODO* +|/author|.performer<br/>&<br/>**[Provenance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-procedure.html)**|[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| |/referenceRange/observationRange/interpretationCode|**Not Supported**|FHIR expects reference ranges to be "normal" ranges. If C-CDA includes multiple reference ranges, only map the one with interpretationCode = `"N"`. |/referenceRange/observationRange/value[xsi:type=IVL_PQ]|.referenceRange.low<br/>&<br/>.referenceRange.high|[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity) |/referenceRange/observationRange/value[xsi:type=ST]<br/>or<br/>/referenceRange/observationRange/text|.referenceRange.text| From d25b68d782b1656e7250a9ac1d0c3997348f2917 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Sun, 22 Sep 2024 12:37:51 -0500 Subject: [PATCH 054/112] Add BP & PulseOx special cases to vitals --- input/pagecontent/CF-vitals.md | 27 ++++++++++++++++++++------- 1 file changed, 20 insertions(+), 7 deletions(-) diff --git a/input/pagecontent/CF-vitals.md b/input/pagecontent/CF-vitals.md index e2f7d00..0c0dcb8 100644 --- a/input/pagecontent/CF-vitals.md +++ b/input/pagecontent/CF-vitals.md @@ -15,26 +15,39 @@ C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| ||.category|Set to `vital-signs` from [Vital Signs value set](https://hl7.org/fhir/us/core/STU4/ValueSet-us-core-vital-signs.html) ||.code|Set to `85353-1` [CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| -|/statusCode|.status|*TODO: ConceptMap* +|/statusCode|.status|`final` (C-CDA is fixed to `completed`) |/effectiveTime|.effectiveDateTime<br/>or<br/>.effectivePeriod|If low and high are identical, use effectiveDateTime. If organizer/effectiveTime is missing, use the earliest and latest observation/effectiveTime as the source of the mapping.<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) ||.hasMember|Reference to each vital sign observation mapped from CDA ### C-CDA Vital Signs Observation to FHIR Observation -|C-CDA¹<br/>[Vital Sign Observation](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-VitalSignObservation.html)|FHIR<br/>[Vital Signs Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-vital-signs.html)|Transform Steps| +|C-CDA¹<br/>[Vital Sign Observation](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-VitalSignObservation.html)|FHIR<br/>[Vital Signs Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-vital-signs.html)|Transform Steps<br/>Note: US Core defines separate profiles for individual vitals such as [weight](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-body-weight.html), [heart rate](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-heart-rate.html), etc.| |:----|:----|:----| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| ||.category|Set to `vital-signs` from [Vital Signs value set](https://hl7.org/fhir/us/core/STU4/ValueSet-us-core-vital-signs.html) -|/code |.code|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|/code |.code²|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/effectiveTime|.effectiveDateTime<br/>or<br/>.effectivePeriod|Prefer effectiveDateTime<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) -|value|.valueQuantity|[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity) -|/interpretationCode|.interpretation|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|value|.valueQuantity²|[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity) +|/interpretationCode|.interpretation²|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/methodCode|.method|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/targetSiteCode|.bodySite|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/author|.performer<br/>&<br/>**[Provenance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-procedure.html)**|[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| |/referenceRange/observationRange/interpretationCode|**Not Supported**|FHIR expects reference ranges to be "normal" ranges. If C-CDA includes multiple reference ranges, only map the one with interpretationCode = `"N"`. -|/referenceRange/observationRange/value[xsi:type=IVL_PQ]|.referenceRange.low<br/>&<br/>.referenceRange.high|[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity) -|/referenceRange/observationRange/value[xsi:type=ST]<br/>or<br/>/referenceRange/observationRange/text|.referenceRange.text| +|/referenceRange/observationRange/value[xsi:type=IVL_PQ]|.referenceRange.low²<br/>&<br/>.referenceRange.high²|[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity) +|/referenceRange/observationRange/value[xsi:type=ST]<br/>or<br/>/referenceRange/observationRange/text|.referenceRange.text²| + +1\. XPath abbreviated for C-CDA Vital Signs Observation as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="8716-3"]/entry/organizer/entryRelationship/component + +2\. Some C-CDA observations need special handling when converting to FHIR. When recording the following vitals, the value, interpretation, and referenceRange should be placed in a `.component` element within a parent Observation. + +**[Blood Pressure](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-blood-pressure.html)** (LOINC codes `8480-6` - systolic & `8462-4` - diastolic) +- Set `Observation.code` to `85354-9` (Blood Pressure Panel) and create 2 components for the systolic and diastolic readings. Both components are required. +- Do not send `Observation.valueQuantity` + +**[Pulse Oximetry](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-pulse-oximetry.html)** (LOINC codes `3150-0` - Inhaled Oxygen Concentration & `3151-8` - Inhaled Oxygen Flow Rate) +- `Observation.code` should contain two coding values: `59408-5` & `2708-6` +- Observation.valueQuantity represents the Oxygen saturation (e.g. `98%`) +- Create individual components for `3150-0` - Inhaled Oxygen Concentration & `3151-8` - Inhaled Oxygen Flow Rate ### Illustrative example ... From 986e428838caba2d99ca3c7df235b077d22a49ce Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Sun, 22 Sep 2024 12:38:28 -0500 Subject: [PATCH 055/112] Clean up Encounter Dx --- input/pagecontent/CF-encounters.md | 2 +- 1 file changed, 1 insertion(+), 1 deletion(-) diff --git a/input/pagecontent/CF-encounters.md b/input/pagecontent/CF-encounters.md index 94cf7f2..519d86a 100644 --- a/input/pagecontent/CF-encounters.md +++ b/input/pagecontent/CF-encounters.md @@ -25,7 +25,7 @@ Encounter Activities in the Encounters Section (or elsewhere in the document, su |/performer/sdtc:functionCode <sup>(b)</sup>|.participant.type|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) |/participant[@typeCode="LOC"] <sup>(b)</sup><br/>/location <sup>(h)</sup>|.location |**[Indication](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-Indication.html)** <sup>(b)</sup><br/>/entryRelationship[@typeCode="RSON"]/observation|.reasonCode<br/>or<br/>.reasonReference|If the id of the indication references a problem in the document that has been converted to a FHIR resource, populate .reasonReference with a reference to that resource. Otherwise, map observation/value to .reasonCode.<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) -|**[Encounter Diagnosis](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-EncounterDiagnosis.html)** <sup>(b)</sup><br/>/entryRelationship/act[code/@code="29308-4"]/observation|.diagnosis.condition|Map similar to [CDA → FHIR Problems](./CF-problems.html).<br/>*TODO: Rename to FHIR Conditions, add a note on that page about where it's coming from; update the category code.* +|**[Encounter Diagnosis](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-EncounterDiagnosis.html)** <sup>(b)</sup><br/>/entryRelationship/act[code/@code="29308-4"]/observation|**[Encounter Diagnosis](https://hl7.org/fhir/us/core/StructureDefinition-us-core-condition-encounter-diagnosis.html)**<br/>&<br/>.diagnosis.condition|The observation maps identically to [CDA → FHIR Problems](./CF-problems.html).<br/>Since this is an encounter diagnosis, the `Observation.category` should be set to `encounter-diagnosis`. ### Illustrative example From 8af2056d0b9bc52147dbb4304104d8a967c66deb Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Tue, 24 Sep 2024 08:32:17 -0500 Subject: [PATCH 056/112] Start draft of participations --- input/hl7.fhir.us.ccda.xml | 5 +++ input/pagecontent/CF-participations.md | 51 ++++++++++++++++++++++++++ 2 files changed, 56 insertions(+) create mode 100644 input/pagecontent/CF-participations.md diff --git a/input/hl7.fhir.us.ccda.xml b/input/hl7.fhir.us.ccda.xml index 9036707..6365bbe 100644 --- a/input/hl7.fhir.us.ccda.xml +++ b/input/hl7.fhir.us.ccda.xml @@ -831,6 +831,11 @@ <title value="C-CDA to FHIR Patient"/> <generation value="markdown"/> </page> + <page> + <nameUrl value="CF-participations.html"/> + <title value="C-CDA to FHIR Participations"/> + <generation value="markdown"/> + </page> <page> <nameUrl value="CF-allergies.html"/> <title value="C-CDA to FHIR Allergies"/> diff --git a/input/pagecontent/CF-participations.md b/input/pagecontent/CF-participations.md new file mode 100644 index 0000000..7b3ad79 --- /dev/null +++ b/input/pagecontent/CF-participations.md @@ -0,0 +1,51 @@ +<style> +td, th { + border: 1px solid black!important; +} +</style> + +CDA defines participants in a number of elements, but the structure is often similar. These represent people (usually providers), organizations, and in some cases devices, locations, or some combination of all of the above. + +The FHIR equivalent of these fields are most commonly Practitioner, Organization, and PractitionerRole resources. Occasionally RelatedPerson, Device, or Location may be appropriate targets of CDA participants as well. + +The following table shows the common and unique fields of each CDA participation type. Since all (except Participant) are just specific flavors of participation, they can all be mapped to FHIR fairly similarly. For Participant mapping, the `@typeCode` and `@classCode` attributes are key in determining the type of FHIR resource to create. + +|[Author](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-Author.html)<br/>(Non-Device)|[Data Enterer](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-DataEnterer.html)|[Informant](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-Informant.html)|[Performer](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-Performer2.html) / <br/>[Performer (Service Event)](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-Performer1.html)|[Participant](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-Participant1.html)<br/>(ClinicalDocument)|[Participant](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-Participant2.html)<br/>(Everywhere Else)| +|:----|:----|:----|:----|:----|:----| +|`@typeCode=AUT`|`@typeCode=ENT`|`@typeCode=INF`|`@typeCode=PRF`|@typeCode|@typeCode +|functionCode|||sdtc:functionCode<br/>(no sdtc: in ServiceEvent)|functionCode|sdtc:functionCode +|time|time||time|time|time +||||modeCode (not in serviceEvent)||awarenessCode +|**assignedAuthor**|**assignedEntity**|**assignedEntity**<br/>or<br/>**relatedEntity**|**assignedEntity**|**associatedEntity**|**participantRole** +|`/@classCode=ASSIGNED`|`/@classCode=ASSIGNED`|/@classCode<br/>(assignedEntity = `ASSIGNED`)|/`@classCode=ASSIGNED`|/@classCode|/@classCode +|/id|/id|/id (not in related)|/id|/id|/id +|/code|/code|/code|/code|/code|/code +|/addr|/addr|/addr|/addr|/addr|/addr +|/telecom|/telecom|/telecom|/telecom|/telecom|/telecom +|||/effectiveTime (only in related) +||/sdtc:patient/id|/sdtc:patient/id (not in related)|/sdtc:patient/id +|/**assignedPerson**|/**assignedPerson**|/**assignedPerson**<br/>or<br/>/**relatedPerson**|/**assignedPerson**|/**associatedPerson**|/**playingEntity** +|//`@classCode=PSN`|//`@classCode=PSN`|//`@classCode=PSN`|//`@classCode=PSN`|//`@classCode=PSN`|//@classCode +|//name|//name|//name|//name|//name|//name +|//sdtc:desc|//sdtc:desc|//sdtc:desc|//sdtc:desc|//sdtc:desc|//desc +|//asPatientRelationship/code|//asPatientRelationship/code|//asPatientRelationship/code|//asPatientRelationship/code|//asPatientRelationship/code +||||||//quantity +||||||//sdtc:birthTime +|/**representedOrganization**|/**representedOrganization**|/**representedOrganization**<br/>(not in related)|/**representedOrganization**|/**scopingOrganization**|/**scopingEntity** +|/`@classCode=ORG`|/`@classCode=ORG`|/`@classCode=ORG`|/`@classCode=ORG`|/`@classCode=ORG`|//@classCode +|//id|//id|//id|//id|//id|//id +|//name|//name|//name|//name|//name|//desc +|//telecom|//telecom|//telecom|//telecom|//telecom +|//addr|//addr|//addr|//addr|//addr +|//standardIndustryClassCode|//standardIndustryClassCode|//standardIndustryClassCode|//standardIndustryClassCode|//standardIndustryClassCode|//code +|//asOrganizationPartOf (recursive)|//asOrganizationPartOf (recursive)|//asOrganizationPartOf (recursive)|//asOrganizationPartOf (recursive)|//asOrganizationPartOf + +The general process for creating FHIR resources from CDA Participations is as follows: + +- If the device element is populated (Author and Participation), create a **Device** resource +- If the relatedPerson element is present (Informant only) or Participant/@typeCode indicates a non-clinical Person, create a **RelatedPerson** resource +- If the @typeCode (Participant only) indicates a physical location, create a **Location** resource +- If there is no person element present and only an organization element is present, create an **Organization** resource. +- If there is both a person element and either an organization or a person/code element, create a **PractitionerRole** and **Practitioner** resource. If there is an organization, also create an **Organization** resource. + +*TODO: Tables for each of the above* \ No newline at end of file From 97d0f61c8ddf8a4a3c85de0249afc72b807a59db Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Wed, 25 Sep 2024 11:22:28 -0500 Subject: [PATCH 057/112] Finish tables and mapping guidance --- input/pagecontent/CF-index.md | 1 + input/pagecontent/CF-participations.md | 65 +++++++++++++++++++++++--- 2 files changed, 60 insertions(+), 6 deletions(-) diff --git a/input/pagecontent/CF-index.md b/input/pagecontent/CF-index.md index 2a6d04a..092e259 100644 --- a/input/pagecontent/CF-index.md +++ b/input/pagecontent/CF-index.md @@ -13,6 +13,7 @@ - [Immunizations](CF-immunizations.html) - [Medications](CF-medications.html) - [Notes](CF-notes.html) +- [Participation](CF-participations.html) (Including Author, DataEnterer, Informant, Performer, Participant) - [Patient](CF-patient.html) - [Problems](CF-problems.html) - [Procedures](CF-procedures.html) diff --git a/input/pagecontent/CF-participations.md b/input/pagecontent/CF-participations.md index 7b3ad79..3a7fe83 100644 --- a/input/pagecontent/CF-participations.md +++ b/input/pagecontent/CF-participations.md @@ -8,6 +8,8 @@ CDA defines participants in a number of elements, but the structure is often sim The FHIR equivalent of these fields are most commonly Practitioner, Organization, and PractitionerRole resources. Occasionally RelatedPerson, Device, or Location may be appropriate targets of CDA participants as well. +### Comparison of CDA Participant elements + The following table shows the common and unique fields of each CDA participation type. Since all (except Participant) are just specific flavors of participation, they can all be mapped to FHIR fairly similarly. For Participant mapping, the `@typeCode` and `@classCode` attributes are key in determining the type of FHIR resource to create. |[Author](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-Author.html)<br/>(Non-Device)|[Data Enterer](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-DataEnterer.html)|[Informant](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-Informant.html)|[Performer](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-Performer2.html) / <br/>[Performer (Service Event)](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-Performer1.html)|[Participant](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-Participant1.html)<br/>(ClinicalDocument)|[Participant](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-Participant2.html)<br/>(Everywhere Else)| @@ -29,6 +31,7 @@ The following table shows the common and unique fields of each CDA participation |//name|//name|//name|//name|//name|//name |//sdtc:desc|//sdtc:desc|//sdtc:desc|//sdtc:desc|//sdtc:desc|//desc |//asPatientRelationship/code|//asPatientRelationship/code|//asPatientRelationship/code|//asPatientRelationship/code|//asPatientRelationship/code +||||||//code ||||||//quantity ||||||//sdtc:birthTime |/**representedOrganization**|/**representedOrganization**|/**representedOrganization**<br/>(not in related)|/**representedOrganization**|/**scopingOrganization**|/**scopingEntity** @@ -40,12 +43,62 @@ The following table shows the common and unique fields of each CDA participation |//standardIndustryClassCode|//standardIndustryClassCode|//standardIndustryClassCode|//standardIndustryClassCode|//standardIndustryClassCode|//code |//asOrganizationPartOf (recursive)|//asOrganizationPartOf (recursive)|//asOrganizationPartOf (recursive)|//asOrganizationPartOf (recursive)|//asOrganizationPartOf +### Mapping to different FHIR resource types + The general process for creating FHIR resources from CDA Participations is as follows: -- If the device element is populated (Author and Participation), create a **Device** resource -- If the relatedPerson element is present (Informant only) or Participant/@typeCode indicates a non-clinical Person, create a **RelatedPerson** resource -- If the @typeCode (Participant only) indicates a physical location, create a **Location** resource -- If there is no person element present and only an organization element is present, create an **Organization** resource. -- If there is both a person element and either an organization or a person/code element, create a **PractitionerRole** and **Practitioner** resource. If there is an organization, also create an **Organization** resource. +- If the device element is populated (Author and Participation), create a **[Device](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-implantable-device.html)** resource +- If the relatedPerson element is present (Informant only), the `<asPatientRelationship>` element is present, or Participant/@typeCode indicates a non-clinical Person, create a **[RelatedPerson](https://hl7.org/fhir/us/core/StructureDefinition-us-core-relatedperson.html)** resource. Note that RelatedPerson has no Organization component, so if CDA conveys an organization, an additional Person resource may need to be created with a `level4` link to RelatedPerson. +- If the @typeCode (Participant only) indicates a physical location, create a **[Location](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-location.html)** resource. +- If there is no person element present and only an organization element is present, create an **[Organization](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-organization.html)** resource. +- If there is both a person element and either an organization or a person/code element (see below for more details), create a **[PractitionerRole](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-practitionerrole.html)** and **[Practitioner](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-practitioner.html)** resource. If there is an organization, also create an **[Organization](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-organization.html)** resource. + +In some cases a specific FHIR resource type may not be allowed (for example, a `.recorder` that can reference Practitioner or PractitionerRole but not Device). Implementers should be aware of requirements and make adjustments accordingly. + +### Mapping functionCode & time +In most cases the `<functionCode>` and `<time>` properties correspond to fields in the resource that is referencing the practitioner. For example, Encounter.participant.individual points to Practitioner, while CDA's `<functionCode>` would map to Encounter.participant.type. Likewise, `<time>` often maps to fields like `recorded` or `assertedDate`. + +### Mapping id +Though the `<id>` element in CDA is recorded at the role level, it is used to represent the id of the person, not their role. For example, clinicians' NPI's are recorded here. For this reason, the `<id>` should always be mapped to Practitioner.identifier or RelatedPerson.identifier, not to PractitionerRole.identifier + +Note that this is different than the `<id>` underneath `<representedOrganization>` or `<scopingOrganization>` which maps to the identifier in an Organization resource. + +### Mapping code +The `<code>` element in CDA is ambiguous and mapping to FHIR often depends on context and/or the coding system used. Common mappings to FHIR locations include: + +- **PractitionerRole.code** - role the participant is playing +- **PractitionerRole.specialty** - specific specialty of the provider +- **RelatedPerson.relationship** - when talking about a non-provider (though `<asPatientRelationship>/<code>` is a more appropriate location, it is a recently-added extension and not commonly populated) +- **Practitioner**.qualification.code - uncommon; this is more commonly found in name/suffix + +Additionally, if there is a `<representedOrganization>` or `<scopingOrganization>` with *only* a `<standardIndustryClassCode>` populated, this could also indicate specialty. + +### Practitioner vs ParticipantRole +When there is information about a person AND an organization, the PractitionerRole resource should be created to represent the role that person plays at that organization. + +Additionally, if `<code>` corresponds to role code or specialty, the PractitionerRole resource is the only way to convey this information. + +### CDA to FHIR Organization +Note when the only field populated is `<standardIndustryClassCode>`, the Organization resource can be omitted and simply populate the PractitionerRole.specialty. + +|CDA [Organization](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-Organization.html)|CDA [Participant/scopingEntity](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-Entity.html)<br/>(Only when `@classCode` = `ORG` or a similar class)|FHIR [Organization](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-organization.html)|Transform Steps| +|:----|:----|:---|:---| +|/id|/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| +|/name|/desc|.name|This is just a string in FHIR +|/telecom|/telecom|.telecom|[CDA id ↔ FHIR telecom](mappingGuidance.html#cda-telecom--fhir-telecom)| +|/addr|/addr|.address|[CDA id ↔ FHIR address](mappingGuidance.html##cda-addr--fhir-address)| +|/standardIndustryClassCode|/code|.type|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) +|/asOrganizationPartOf|/asOrganizationPartOf|.partOf|Recursive Organization reference + +### CDA to FHIR Practitioner -*TODO: Tables for each of the above* \ No newline at end of file +|[AssignedAuthor](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-AssignedAuthor.html)<br/>[AssignedEntity](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-AssignedEntity.html)<br/>[AssociatedEntity](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-AssociatedEntity.html)<br/>[ParticipantRole](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-ParticipantRole.html)|[Practitioner](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-practitioner.html)|Transform Steps| +|:----|:----|:----| +|/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| +|/code||[See Mapping code](#mapping-code)| +|/addr|.address|[CDA id ↔ FHIR address](mappingGuidance.html##cda-addr--fhir-address)| +|/telecom|.telecom|[CDA id ↔ FHIR telecom](mappingGuidance.html#cda-telecom--fhir-telecom)| +|**[Person](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-Person.html)<br/>[Playing entity](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-PlayingEntity.html)**||Person is the CDA data type for `<assignedPerson>` and `<associatedPerson>`.| +|//name|.name|[CDA name ↔ FHIR name](mappingGuidance.html#cda-name--fhir-name)| +|//name/suffix|.qualification.code|If the suffix contains a qualifier like PhD, CNP, etc.| +|//desc|.qualification.code<br/>or<br/>.text|Only map to qualifier if desc contains a qualifier. From dd5ba411020977fc1a729b9b9b0f162f8ed53604 Mon Sep 17 00:00:00 2001 From: jlyle1 <jay@lyle.net> Date: Wed, 25 Sep 2024 21:59:13 -0400 Subject: [PATCH 058/112] added encounter status concept map --- FHIR-us-ccda.xml | 11 + _gencontinuous.bat | 2 + _gencontinuous.sh | 2 + _genonce.sh | 2 + _updatePublisher.bat | 219 ++++++++++++++++++ _updatePublisher.sh | 53 ++++- input/maps/ConceptMap-CF-EncounterStatus.json | 142 ++++++++++++ input/pagecontent/conceptMaps.md | 1 + 8 files changed, 420 insertions(+), 12 deletions(-) create mode 100644 _gencontinuous.bat create mode 100644 _gencontinuous.sh create mode 100644 _updatePublisher.bat create mode 100644 input/maps/ConceptMap-CF-EncounterStatus.json diff --git a/FHIR-us-ccda.xml b/FHIR-us-ccda.xml index 5d8b9b1..a15875e 100644 --- a/FHIR-us-ccda.xml +++ b/FHIR-us-ccda.xml @@ -26,6 +26,7 @@ <artifact id="ConceptMap/CF-AddressUse" key="ConceptMap-CF-AddressUse" name="C-CDA to FHIR Address Use"/> <artifact id="ConceptMap/CF-AdministrativeGender" key="ConceptMap-CF-AdministrativeGender" name="C-CDA to FHIR Adminmistrative Gender"/> <artifact id="ConceptMap/CF-AllergyStatus" key="ConceptMap-CF-AllergyStatus" name="C-CDA to FHIR Allergy Status"/> +<artifact id="ConceptMap/CF-EncounterStatus" key="ConceptMap-CF-EncounterStatus" name="C-CDA to FHIR Encounter Status"/> <artifact id="ConceptMap/CF-ImmunizationStatus" key="ConceptMap-CF-ImmunizationStatus" name="C-CDA to FHIR Immunization Status"/> <artifact id="ConceptMap/CF-MedicationStatus" key="ConceptMap-CF-MedicationStatus" name="C-CDA to FHIR Medication Status"/> <artifact id="ConceptMap/CF-NameUse" key="ConceptMap-CF-NameUse" name="C-CDA to FHIR NameUse"/> @@ -160,19 +161,29 @@ <page key="artifacts" name="Artifacts Summary"/> <page key="background" name="Background"/> <page key="CF-allergies" name="C-CDA to FHIR Allergies"/> +<page key="CF-encounters" name="C-CDA to FHIR Encounters"/> <page key="CF-immunizations" name="C-CDA to FHIR Immunizations"/> <page key="CF-medications" name="C-CDA to FHIR Medications"/> +<page key="CF-notes" name="C-CDA to FHIR Notes"/> <page key="CF-patient" name="C-CDA to FHIR Patient"/> <page key="CF-problems" name="C-CDA to FHIR Problems"/> <page key="CF-procedures" name="C-CDA to FHIR Procedures"/> +<page key="CF-results" name="C-CDA to FHIR Results"/> +<page key="CF-social" name="C-CDA to FHIR Social History"/> +<page key="CF-vitals" name="C-CDA to FHIR Vital Signs"/> <page key="CF-index" name="C-CDA → FHIR Index"/> <page key="downloads" name="Downloads"/> <page key="FC-allergies" name="FHIR to C-CDA Allergies"/> +<page key="FC-encounters" name="FHIR to C-CDA Encounters"/> <page key="FC-immunizations" name="FHIR to C-CDA Immunizations"/> <page key="FC-medications" name="FHIR to C-CDA Medications"/> +<page key="FC-medications" name="FHIR to C-CDA Medications"/> <page key="FC-patient" name="FHIR to C-CDA Patient"/> <page key="FC-problems" name="FHIR to C-CDA Problems"/> <page key="FC-procedures" name="FHIR to C-CDA Procedures"/> +<page key="FC-results" name="FHIR to C-CDA Results"/> +<page key="FC-social" name="FHIR to C-CDA Social History"/> +<page key="FC-vitals" name="FHIR to C-CDA Vital Signs"/> <page key="FC-index" name="FHIR → C-CDA Index"/> <page deprecated="true" key="Guidance" name="Guidance"/> <page key="index" name="Home Page"/> diff --git a/_gencontinuous.bat b/_gencontinuous.bat new file mode 100644 index 0000000..ca2867a --- /dev/null +++ b/_gencontinuous.bat @@ -0,0 +1,2 @@ +@ECHO OFF +CALL ./_genonce.bat -watch \ No newline at end of file diff --git a/_gencontinuous.sh b/_gencontinuous.sh new file mode 100644 index 0000000..b9ac593 --- /dev/null +++ b/_gencontinuous.sh @@ -0,0 +1,2 @@ +#!/bin/bash +./_genonce.sh -watch diff --git a/_genonce.sh b/_genonce.sh index 38efcb4..4f981f0 100755 --- a/_genonce.sh +++ b/_genonce.sh @@ -14,6 +14,8 @@ fi echo "$txoption" +export JAVA_TOOL_OPTIONS="$JAVA_TOOL_OPTIONS -Dfile.encoding=UTF-8" + publisher=$input_cache_path/$publisher_jar if test -f "$publisher"; then java -jar $publisher -ig . $txoption $* diff --git a/_updatePublisher.bat b/_updatePublisher.bat new file mode 100644 index 0000000..67aebf5 --- /dev/null +++ b/_updatePublisher.bat @@ -0,0 +1,219 @@ +@ECHO OFF + +SETLOCAL + +SET dlurl=https://github.com/HL7/fhir-ig-publisher/releases/latest/download/publisher.jar +SET publisher_jar=publisher.jar +SET input_cache_path=%CD%\input-cache\ +SET skipPrompts=false + +SET scriptdlroot=https://raw.githubusercontent.com/HL7/ig-publisher-scripts/main +SET update_bat_url=%scriptdlroot%/_updatePublisher.bat +SET gen_bat_url=%scriptdlroot%/_genonce.bat +SET gencont_bat_url=%scriptdlroot%/_gencontinuous.bat +SET gencont_sh_url=%scriptdlroot%/_gencontinuous.sh +SET gen_sh_url=%scriptdlroot%/_genonce.sh +SET update_sh_url=%scriptdlroot%/_updatePublisher.sh + +IF "%~1"=="/f" SET skipPrompts=y + + +ECHO. +ECHO Checking internet connection... +PING tx.fhir.org -4 -n 1 -w 1000 | FINDSTR TTL && GOTO isonline +ECHO We're offline, nothing to do... +GOTO end + +:isonline +ECHO We're online + + +:processflags +SET ARG=%1 +IF DEFINED ARG ( + IF "%ARG%"=="-f" SET FORCE=true + IF "%ARG%"=="--force" SET FORCE=true + SHIFT + GOTO processflags +) + +FOR %%x IN ("%CD%") DO SET upper_path=%%~dpx + +ECHO. +IF NOT EXIST "%input_cache_path%%publisher_jar%" ( + IF NOT EXIST "%upper_path%%publisher_jar%" ( + SET jarlocation="%input_cache_path%%publisher_jar%" + SET jarlocationname=Input Cache + ECHO IG Publisher is not yet in input-cache or parent folder. + REM we don't use jarlocation below because it will be empty because we're in a bracketed if statement + GOTO create + ) ELSE ( + ECHO IG Publisher FOUND in parent folder + SET jarlocation="%upper_path%%publisher_jar%" + SET jarlocationname=Parent folder + GOTO upgrade + ) +) ELSE ( + ECHO IG Publisher FOUND in input-cache + SET jarlocation="%input_cache_path%%publisher_jar%" + SET jarlocationname=Input Cache + GOTO upgrade +) + +:create +IF DEFINED FORCE ( + MKDIR "%input_cache_path%" 2> NUL + GOTO download +) + +IF "%skipPrompts%"=="y" ( + SET create=Y +) ELSE ( + SET /p create="Ok? (Y/N) " +) +IF /I "%create%"=="Y" ( + ECHO Will place publisher jar here: %input_cache_path%%publisher_jar% + MKDIR "%input_cache_path%" 2> NUL + GOTO download +) +GOTO done + +:upgrade +IF "%skipPrompts%"=="y" ( + SET overwrite=Y +) ELSE ( + SET /p overwrite="Overwrite %jarlocation%? (Y/N) " +) + +IF /I "%overwrite%"=="Y" ( + GOTO download +) +GOTO done + +:download +ECHO Downloading most recent publisher to %jarlocationname% - it's ~100 MB, so this may take a bit + +FOR /f "tokens=4-5 delims=. " %%i IN ('ver') DO SET VERSION=%%i.%%j +IF "%version%" == "10.0" GOTO win10 +IF "%version%" == "6.3" GOTO win8.1 +IF "%version%" == "6.2" GOTO win8 +IF "%version%" == "6.1" GOTO win7 +IF "%version%" == "6.0" GOTO vista + +ECHO Unrecognized version: %version% +GOTO done + +:win10 +CALL POWERSHELL -command if ('System.Net.WebClient' -as [type]) {(new-object System.Net.WebClient).DownloadFile(\"%dlurl%\",\"%jarlocation%\") } else { Invoke-WebRequest -Uri "%dlurl%" -Outfile "%jarlocation%" } + +GOTO done + +:win7 +rem this may be triggering the antivirus - bitsadmin.exe is a known threat +rem CALL bitsadmin /transfer GetPublisher /download /priority normal "%dlurl%" "%jarlocation%" + +rem this didn't work in win 10 +rem CALL Start-BitsTransfer /priority normal "%dlurl%" "%jarlocation%" + +rem this should work - untested +call (New-Object Net.WebClient).DownloadFile('%dlurl%', '%jarlocation%') +GOTO done + +:win8.1 +:win8 +:vista +GOTO done + + + +:done + + + + +ECHO. +ECHO Updating scripts +IF "%skipPrompts%"=="y" ( + SET updateScripts=Y +) ELSE ( + SET /p updateScripts="Update scripts? (Y/N) " +) +IF /I "%updateScripts%"=="Y" ( + GOTO scripts +) +GOTO end + + +:scripts + +REM Download all batch files (and this one with a new name) + +SETLOCAL DisableDelayedExpansion + + + +:dl_script_1 +ECHO Updating _updatePublisher.sh +call POWERSHELL -command if ('System.Net.WebClient' -as [type]) {(new-object System.Net.WebClient).DownloadFile(\"%update_sh_url%\",\"_updatePublisher.new.sh\") } else { Invoke-WebRequest -Uri "%update_sh_url%" -Outfile "_updatePublisher.new.sh" } +if %ERRORLEVEL% == 0 goto upd_script_1 +echo "Errors encountered during download: %errorlevel%" +goto dl_script_2 +:upd_script_1 +start copy /y "_updatePublisher.new.sh" "_updatePublisher.sh" ^&^& del "_updatePublisher.new.sh" ^&^& exit + + +:dl_script_2 +ECHO Updating _genonce.bat +call POWERSHELL -command if ('System.Net.WebClient' -as [type]) {(new-object System.Net.WebClient).DownloadFile(\"%gen_bat_url%\",\"_genonce.new.bat\") } else { Invoke-WebRequest -Uri "%gen_bat_url%" -Outfile "_genonce.bat" } +if %ERRORLEVEL% == 0 goto upd_script_2 +echo "Errors encountered during download: %errorlevel%" +goto dl_script_3 +:upd_script_2 +start copy /y "_genonce.new.bat" "_genonce.bat" ^&^& del "_genonce.new.bat" ^&^& exit + +:dl_script_3 +ECHO Updating _gencontinuous.bat +call POWERSHELL -command if ('System.Net.WebClient' -as [type]) {(new-object System.Net.WebClient).DownloadFile(\"%gencont_bat_url%\",\"_gencontinuous.new.bat\") } else { Invoke-WebRequest -Uri "%gencont_bat_url%" -Outfile "_gencontinuous.bat" } +if %ERRORLEVEL% == 0 goto upd_script_3 +echo "Errors encountered during download: %errorlevel%" +goto dl_script_4 +:upd_script_3 +start copy /y "_gencontinuous.new.bat" "_gencontinuous.bat" ^&^& del "_gencontinuous.new.bat" ^&^& exit + + +:dl_script_4 +ECHO Updating _genonce.sh +call POWERSHELL -command if ('System.Net.WebClient' -as [type]) {(new-object System.Net.WebClient).DownloadFile(\"%gen_sh_url%\",\"_genonce.new.sh\") } else { Invoke-WebRequest -Uri "%gen_sh_url%" -Outfile "_genonce.sh" } +if %ERRORLEVEL% == 0 goto upd_script_4 +echo "Errors encountered during download: %errorlevel%" +goto dl_script_5 +:upd_script_4 +start copy /y "_genonce.new.sh" "_genonce.sh" ^&^& del "_genonce.new.sh" ^&^& exit + +:dl_script_5 +ECHO Updating _gencontinuous.sh +call POWERSHELL -command if ('System.Net.WebClient' -as [type]) {(new-object System.Net.WebClient).DownloadFile(\"%gencont_sh_url%\",\"_gencontinuous.new.sh\") } else { Invoke-WebRequest -Uri "%gencont_sh_url%" -Outfile "_gencontinuous.sh" } +if %ERRORLEVEL% == 0 goto upd_script_5 +echo "Errors encountered during download: %errorlevel%" +goto dl_script_6 +:upd_script_5 +start copy /y "_gencontinuous.new.sh" "_gencontinuous.sh" ^&^& del "_gencontinuous.new.sh" ^&^& exit + + + +:dl_script_6 +ECHO Updating _updatePublisher.bat +call POWERSHELL -command if ('System.Net.WebClient' -as [type]) {(new-object System.Net.WebClient).DownloadFile(\"%update_bat_url%\",\"_updatePublisher.new.bat\") } else { Invoke-WebRequest -Uri "%update_bat_url%" -Outfile "_updatePublisher.new.bat" } +if %ERRORLEVEL% == 0 goto upd_script_6 +echo "Errors encountered during download: %errorlevel%" +goto end +:upd_script_6 +start copy /y "_updatePublisher.new.bat" "_updatePublisher.bat" ^&^& del "_updatePublisher.new.bat" ^&^& exit + + +:end + + +IF "%skipPrompts%"=="true" ( + PAUSE +) diff --git a/_updatePublisher.sh b/_updatePublisher.sh index a817ce3..0f9ecbe 100755 --- a/_updatePublisher.sh +++ b/_updatePublisher.sh @@ -25,18 +25,13 @@ while [ "$#" -gt 0 ]; do case $1 in -f|--force) FORCE=true ;; -y|--yes) skipPrompts=true ; FORCE=true ;; - -s|--skip) skipPrompts=true ;; *) echo "Unknown parameter passed: $1. Exiting"; exit 1 ;; esac shift done echo "Checking internet connection" -case "$OSTYPE" in - linux-gnu* ) ping tx.fhir.org -4 -c 1 -w 1000 >/dev/null ;; - darwin* ) ping tx.fhir.org -c 1 >/dev/null ;; - *) echo "unknown: $OSTYPE"; exit 1 ;; -esac +curl -sSf tx.fhir.org > /dev/null if [ $? -ne 0 ] ; then echo "Offline (or the terminology server is down), unable to update. Exiting" @@ -44,11 +39,11 @@ if [ $? -ne 0 ] ; then fi if [ ! -d "$input_cache_path" ] ; then - if [ $skipPrompts != true ]; then + if [ $FORCE != true ]; then echo "$input_cache_path does not exist" message="create it?" read -r -p "$message" response - else + else response=y fi fi @@ -90,14 +85,48 @@ if [[ $skipPrompts == false ]]; then fi read -r -p "$message" response else - if [[ $FORCE == true ]]; then - response=y - fi + response=y fi -if [[ $response =~ ^[yY].*$ ]]; then +if [[ $skipPrompts == true ]] || [[ $response =~ ^[yY].*$ ]]; then echo "Downloading most recent publisher to $jarlocationname - it's ~100 MB, so this may take a bit" curl -L $dlurl -o "$jarlocation" --create-dirs else echo cancelled publisher update fi + +if [[ $skipPrompts != true ]]; then + message="Update scripts? (enter 'y' or 'Y' to continue, any other key to cancel)?" + read -r -p "$message" response + fi + +if [[ $skipPrompts == true ]] || [[ $response =~ ^[yY].*$ ]]; then + echo "Downloading most recent scripts " + + curl -L $update_bat_url -o /tmp/_updatePublisher.new + cp /tmp/_updatePublisher.new _updatePublisher.bat + rm /tmp/_updatePublisher.new + + curl -L $gen_bat_url -o /tmp/_genonce.new + cp /tmp/_genonce.new _genonce.bat + rm /tmp/_genonce.new + + curl -L $gencont_bat_url -o /tmp/_gencontinuous.new + cp /tmp/_gencontinuous.new _gencontinuous.bat + rm /tmp/_gencontinuous.new + + curl -L $gencont_sh_url -o /tmp/_gencontinuous.new + cp /tmp/_gencontinuous.new _gencontinuous.sh + chmod +x _gencontinuous.sh + rm /tmp/_gencontinuous.new + + curl -L $gen_sh_url -o /tmp/_genonce.new + cp /tmp/_genonce.new _genonce.sh + chmod +x _genonce.sh + rm /tmp/_genonce.new + + curl -L $update_sh_url -o /tmp/_updatePublisher.new + cp /tmp/_updatePublisher.new _updatePublisher.sh + chmod +x _updatePublisher.sh + rm /tmp/_updatePublisher.new +fi diff --git a/input/maps/ConceptMap-CF-EncounterStatus.json b/input/maps/ConceptMap-CF-EncounterStatus.json new file mode 100644 index 0000000..2fb3d56 --- /dev/null +++ b/input/maps/ConceptMap-CF-EncounterStatus.json @@ -0,0 +1,142 @@ +{ + "resourceType" : "ConceptMap", + "id" : "CF-EncounterStatus", + "extension" : [ + { + "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg", + "valueCode" : "cgp" + } + ], + "url" : "http://hl7.org/fhir/us/ccda/ConceptMap/CF-EncounterStatus", + "version" : "1.2.0", + "name" : "CCDAtoFHIREncounterStatus", + "title" : "C-CDA to FHIR Encounter Status", + "status" : "active", + "experimental" : false, + "date" : "2024-09-22T17:40:28+00:00", + "publisher" : "HL7 International / Cross-Group Projects", + "contact" : [ + { + "name" : "HL7 International / Cross-Group Projects", + "telecom" : [ + { + "system" : "url", + "value" : "http://www.hl7.org/Special/committees/cgp" + } + ] + } + ], + "description" : "C-CDA to FHIR Encounter Status", + "jurisdiction" : [ + { + "coding" : [ + { + "system" : "urn:iso:std:iso:3166", + "code" : "US" + } + ] + } + ], + "sourceUri" : "http://terminology.hl7.org/CodeSystem/v3-ActStatus", + "targetUri" : "http://hl7.org/fhir/encounter-status", + "group" : [ + { + "source" : "http://terminology.hl7.org/CodeSystem/v3-ActStatus", + "target" : "http://hl7.org/fhir/encounter-status", + "element" : [ + { + "code" : "aborted", + "display" : "Aborted", + "target" : [ + { + "code" : "unknown", + "display" : "Unknown", + "equivalence" : "wider", + "comment" : "Semantically this could be 'finished', but that might imply completion." + } + ] + }, + { + "code" : "active", + "display" : "Active", + "target" : [ + { + "code" : "in-progress", + "display" : "In-progress", + "equivalence" : "equal" + } + ] + }, + { + "code" : "cancelled", + "display" : "Cancelled", + "target" : [ + { + "code" : "cancelled", + "display" : "Cancelled", + "equivalence" : "equal" + } + ] + }, + { + "code" : "completed", + "display" : "Completed", + "target" : [ + { + "code" : "finished", + "display" : "Finished", + "equivalence" : "equal" + } + ] + }, + { + "code" : "held", + "display" : "Held", + "target" : [ + { + "code" : "planned", + "display" : "Planned", + "equivalence" : "wider", + "comment" : "Held encounters have been planned, but intent to execute has been suspended." + } + ] + }, + { + "code" : "new", + "display" : "New", + "target" : [ + { + "code" : "unknown", + "display" : "Unknown", + "equivalence" : "wider", + "comment" : "This is not Planned, because New encounters have been planned but may or may not have been started. 'Planned' encounters in FHIR have not been started." + } + ] + }, + { + "code" : "suspended", + "display" : "Suspended", + "target" : [ + { + "code" : "on-leave", + "display" : "On-leave", + "equivalence" : "narrower", + "comment" : "Suspended encounters have been started, but intent to execute has been temporarily stopped. On-leave is a special case of this circumstance." + } + ] + }, + { + "code" : "nullified", + "display" : "Nullified", + "target" : [ + { + "code" : "entered-in-error", + "display" : "Entered-in-error", + "equivalence" : "equal" + } + ] + } + ] + } + ] +} \ No newline at end of file diff --git a/input/pagecontent/conceptMaps.md b/input/pagecontent/conceptMaps.md index 8adee1b..75664ee 100644 --- a/input/pagecontent/conceptMaps.md +++ b/input/pagecontent/conceptMaps.md @@ -13,6 +13,7 @@ Shown below are terminology mappings for use in moving from CDA → FHIR. Entry - [Allergy Intolerance Observation value (CDA) → AllergyIntolerance category (FHIR)](./ConceptMap-CF-AllergyIntoleranceCategory.html) - [Allergy Status Observation (CDA) → AllergyIntolerance clinicalStatus (FHIR)](./ConceptMap-CF-AllergyStatus.html) - [Criticality value (CDA) → criticality (FHIR)](./ConceptMap-CF-Criticality.html) +- [Encounter status (CDA) → Encounter status (FHIR)](./ConceptMap-CF-EncounterStatus.html) - [Immunization Activity statusCode (CDA) → Immunization status (FHIR)](./ConceptMap-CF-ImmunizationStatus.html) - [Immunization Refusal Reason (CDA) → Immunization statusReason (FHIR)](./ConceptMap-CF-ImmunizationRefusal.html) - [Medication Activity statusCode (CDA) → MedicationRequest status (FHIR)](./ConceptMap-CF-MedicationStatus.html) From ae9fbfe4982fe290970ee4e3c6a6d80352d596e3 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Thu, 26 Sep 2024 10:34:42 -0500 Subject: [PATCH 059/112] Link to new encounter status concept map --- input/pagecontent/CF-encounters.md | 2 +- 1 file changed, 1 insertion(+), 1 deletion(-) diff --git a/input/pagecontent/CF-encounters.md b/input/pagecontent/CF-encounters.md index 519d86a..b87758a 100644 --- a/input/pagecontent/CF-encounters.md +++ b/input/pagecontent/CF-encounters.md @@ -16,7 +16,7 @@ Encounter Activities in the Encounters Section (or elsewhere in the document, su |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| |/code |.class|Only the V3 ActCode system, which may be present in the root element or any `<translation>`.<br/>Other code systems may map to V3 ActCode (for example CPT codes 99211-99215 map to `AMB`, 99221-99223 to `IMP`, 99281-99285 to `EMER`, etc), but if this mapping is not possible, use the [Data Absent Reason](http://hl7.org/fhir/StructureDefinition/data-absent-reason) extension.| |/code|.type|The remaining codes besides V3 ActCode<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) -|/statusCode <sup>(b)</sup>|.status|*TODO: ActStatus to Encounter Status ConceptMap*<br/>**Note:** statusCode is optional in C-CDA. If missing, fallback to effectiveTime mapping. +|/statusCode <sup>(b)</sup>|.status|[CDA → FHIR encounter status](ConceptMap-CF-EncounterStatus.html)<br/>**Note:** statusCode is optional in C-CDA. If missing, fallback to effectiveTime mapping. |/effectiveTime|.status|If effectiveTime is a single timestamp or contains a high, status = `"finished"`.<br/>If low is present and high is missing, the status may be `"in-progress"` but implementers may choose to evaluate historical values as `"finished"` or `"unknown"` if appropriate. |/effectiveTime/@value<br/>/effectiveTime/low/@value|.period.start|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) |/effectiveTime/high/@value|.period.end From 46e9003bcc85122e46384cc673e4f75c82cbb496 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Thu, 26 Sep 2024 10:34:51 -0500 Subject: [PATCH 060/112] Small typo/cleanup --- input/pagecontent/CF-participations.md | 2 +- 1 file changed, 1 insertion(+), 1 deletion(-) diff --git a/input/pagecontent/CF-participations.md b/input/pagecontent/CF-participations.md index 3a7fe83..d039b2e 100644 --- a/input/pagecontent/CF-participations.md +++ b/input/pagecontent/CF-participations.md @@ -98,7 +98,7 @@ Note when the only field populated is `<standardIndustryClassCode>`, the Organiz |/code||[See Mapping code](#mapping-code)| |/addr|.address|[CDA id ↔ FHIR address](mappingGuidance.html##cda-addr--fhir-address)| |/telecom|.telecom|[CDA id ↔ FHIR telecom](mappingGuidance.html#cda-telecom--fhir-telecom)| -|**[Person](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-Person.html)<br/>[Playing entity](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-PlayingEntity.html)**||Person is the CDA data type for `<assignedPerson>` and `<associatedPerson>`.| +|**[Person](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-Person.html)<br/>[PlayingEntity](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-PlayingEntity.html)**||Person is the CDA data type for `<assignedPerson>` and `<associatedPerson>`.| |//name|.name|[CDA name ↔ FHIR name](mappingGuidance.html#cda-name--fhir-name)| |//name/suffix|.qualification.code|If the suffix contains a qualifier like PhD, CNP, etc.| |//desc|.qualification.code<br/>or<br/>.text|Only map to qualifier if desc contains a qualifier. From 78122493e81c418174c4c63fb30014a77c81f28d Mon Sep 17 00:00:00 2001 From: jlyle1 <jay@lyle.net> Date: Mon, 30 Sep 2024 14:19:41 -0400 Subject: [PATCH 061/112] added text about missing maps --- input/pagecontent/mappingGuidance.md | 4 ++++ 1 file changed, 4 insertions(+) diff --git a/input/pagecontent/mappingGuidance.md b/input/pagecontent/mappingGuidance.md index 7207d3a..e77c531 100644 --- a/input/pagecontent/mappingGuidance.md +++ b/input/pagecontent/mappingGuidance.md @@ -27,6 +27,10 @@ Examples for C-CDA to FHIR transforms are provided based on a consensus of vario The highlighted output images were created using an [open source tool for C-CDA ↔ FHIR Mapping](https://github.com/jddamore/cda-fhir-compare) developed as part of this project. +#### Missing Maps + +If you have data in an input artifact that is defined in the source specification and for which no map is specified here, that means that this team did not find a target for which we could build consensus. In most cases, this means that the data is unusual enough that the target specification did not address it (e.g., treatments for allergy reactions, which would probably be reported in the Problems or Procedures section rather than the Allergies section). In these cases, the team felt that converging on one design from the many solution possible patterns was not an optimal investment of resources. If readers identify elements for which this seems insufficient, they should comment. + ### CDA id ↔ FHIR identifier Identifiers in both FHIR and CDA can divide the identifier value from its namespace: FHIR as the identifier.system and CDA as the id.root. In many cases, this correspondence works well. From bf20b730af787c51d23cc73f935dfe1d0cc92241 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Mon, 14 Oct 2024 08:47:08 -0500 Subject: [PATCH 062/112] Update CF Notes mapping table --- input/pagecontent/CF-notes.md | 13 +++++++------ 1 file changed, 7 insertions(+), 6 deletions(-) diff --git a/input/pagecontent/CF-notes.md b/input/pagecontent/CF-notes.md index acc218d..9864a75 100644 --- a/input/pagecontent/CF-notes.md +++ b/input/pagecontent/CF-notes.md @@ -4,23 +4,24 @@ td, th { } </style> -This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, please refer to [Notes FHIR → CDA](./FC-notes.html). For guidance on how to read the table below, see [Reading the C-CDA ↔ FHIR Mapping Pages](./mappingGuidance.html). +This page provides a mapping from CDA to FHIR. <!-- For the FHIR to CDA mapping, please refer to [Notes FHIR → CDA](./FC-notes.html). --> For guidance on how to read the table below, see [Reading the C-CDA ↔ FHIR Mapping Pages](./mappingGuidance.html). Clinical Notes may appear in their own section or as an entry in any open section. They are identified by an `<act>` with a `<code>` value of `34109-9`. ### C-CDA to FHIR -|C-CDA¹<br/>[Note Activity](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-NoteActivity.html)<br/>[DocumentReference](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-documentreference.html)|Transform Steps| +|C-CDA¹<br/>[Note Activity](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-NoteActivity.html)|[DocumentReference](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-documentreference.html)|Transform Steps| |:----|:----|:----| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| -|/code|.type|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>**NOTE:** The root code in CDA is always `34109-9: Note` which matches the FHIR Binding. +|/code/translation|.type|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>**NOTE:** The root code in C-CDA is always `34109-9: Note`. A more specific code may be sent in translation which should be sent as the DocumentReference.type. If there is no translation, however, `34109-9` may be sent as the type. +||.category|Set to `clinical-note`. |/text/@mediaType<br/>&<br/>/text/text()|.attachment.contentType<br/>&<br/>.attachment.data|If @mediaType is present, then representation should = B64, and the inner-text contents are embedded base64-encoded data. In this case, the mediaType and base64-encoded data map 1:1 to attachment.contentType and .data. |/text/reference/@value|.attachment.contentType<br/>&<br/>.attachment.data|Convert the narrative element referenced by @value following [Narrative Text](mappingGuidance.html#narrative-text) guidance and use `application/xhtml+xml` as the contentType.<br/>If the narrative has minimal markup (i.e. only `<content>` and `<paragraph>` elements which can be converted to line breaks), it can be converted to `text/plain`.<br/>To send the raw CDA narrative without converting, use `application/cda+xml`, but this is less useful to receivers. |/effectiveTime|.context.period|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) -|/author|.author +|/author|.author|[C-CDA → FHIR Participation](CF-participations.html) |/author/time|.date|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) -|/entryRelationship[@typeCode=COMP]/encounter<br/>or<br/>Parent `<encounter>` element<br/>or<br/>`<encompassingEncounter>`|.context.encounter|C-CDA requires an encounter for notes, but allows for context conduction. If the Note Activity is in an entryRelationship chain that includes an Encounter Activity, use that. Otherwise, if the document contains an `<encompassingEncounter>`, that is the encounter for the note. -|/reference/externalDocument/id|.relatesTo.target|*TODO: Appropriate?* +|/entryRelationship[@typeCode=COMP]/encounter<br/>or<br/>Parent `<encounter>` element<br/>or<br/>`<encompassingEncounter>`|.context.encounter|C-CDA requires an encounter for notes, but allows for context conduction. If the Note Activity is in an entryRelationship chain that includes an Encounter Activity, use that. Otherwise, if the document contains an `<encompassingEncounter>`, that is the encounter for the note.<br/>[CDA → FHIR Encounters](CF-encounters.html) +|/reference/externalDocument/id|.relatesTo.target.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| From e2f4cde475a34da9407bf9dba31b0332a8014716 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Mon, 14 Oct 2024 08:50:23 -0500 Subject: [PATCH 063/112] Remove CF -> FC links until those pages have content --- input/pagecontent/CF-encounters.md | 2 +- input/pagecontent/CF-results.md | 2 +- input/pagecontent/CF-social.md | 2 +- input/pagecontent/FC-index.md | 1 + 4 files changed, 4 insertions(+), 3 deletions(-) diff --git a/input/pagecontent/CF-encounters.md b/input/pagecontent/CF-encounters.md index b87758a..2fa5d91 100644 --- a/input/pagecontent/CF-encounters.md +++ b/input/pagecontent/CF-encounters.md @@ -4,7 +4,7 @@ td, th { } </style> -This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, please refer to [Encounters FHIR → CDA](./FC-encounters.html). For guidance on how to read the table below, see [Reading the C-CDA ↔ FHIR Mapping Pages](./mappingGuidance.html). +This page provides a mapping from CDA to FHIR. <!-- For the FHIR to CDA mapping, please refer to [Encounters FHIR → CDA](./FC-encounters.html). --> For guidance on how to read the table below, see [Reading the C-CDA ↔ FHIR Mapping Pages](./mappingGuidance.html). Encounter Activities in the Encounters Section (or elsewhere in the document, such as `<entryReference>` on Clinical Notes) correspond FHIR Encounter resources. If the document itself contains a `componentOf/encompassingEncounter`, this should also be converted to a FHIR Encounter resource. In all cases, when the same encounter is referenced multiple times (such as the `encompassingEncounter` and an Encounter Activity in the Encounters Section containing the same `<id>`), it should be converted to the same FHIR resource. diff --git a/input/pagecontent/CF-results.md b/input/pagecontent/CF-results.md index 58d1864..f9df42d 100644 --- a/input/pagecontent/CF-results.md +++ b/input/pagecontent/CF-results.md @@ -4,7 +4,7 @@ td, th { } </style> -This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, please refer to [Results FHIR → CDA](./FC-results.html). For guidance on how to read the table below, see [Reading the C-CDA ↔ FHIR Mapping Pages](./mappingGuidance.html). +This page provides a mapping from CDA to FHIR. <!-- For the FHIR to CDA mapping, please refer to [Results FHIR → CDA](./FC-results.html). --> For guidance on how to read the table below, see [Reading the C-CDA ↔ FHIR Mapping Pages](./mappingGuidance.html). Results in C-CDA are collected into `<organizer>` elements containing one or more result `<observation>` element. This corresponds to one FHIR DiagnosticReport for the `<organizer>` which multiple `.result` references to FHIR Observation resources, one for each CDA `<observation>`. diff --git a/input/pagecontent/CF-social.md b/input/pagecontent/CF-social.md index 7db68e8..49e5c64 100644 --- a/input/pagecontent/CF-social.md +++ b/input/pagecontent/CF-social.md @@ -4,7 +4,7 @@ td, th { } </style> -This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, please refer to [Results FHIR → CDA](./FC-results.html). For guidance on how to read the table below, see [Reading the C-CDA ↔ FHIR Mapping Pages](./mappingGuidance.html). +This page provides a mapping from CDA to FHIR. <!-- For the FHIR to CDA mapping, please refer to [Results FHIR → CDA](./FC-results.html). --> For guidance on how to read the table below, see [Reading the C-CDA ↔ FHIR Mapping Pages](./mappingGuidance.html). Social History is a category of several templates in C-CDA and several profiles in US Core. At a high-level, mappings between CDA `<observation>` acts and FHIR Observation resources are similar and are represented by the top table. Differences are documented on the proceeding tables. diff --git a/input/pagecontent/FC-index.md b/input/pagecontent/FC-index.md index 3c3fa2c..8e47623 100644 --- a/input/pagecontent/FC-index.md +++ b/input/pagecontent/FC-index.md @@ -13,5 +13,6 @@ - [Patient](FC-patient.html) - [Problems](FC-problems.html) - [Procedures](FC-procedures.html) +- [Vitals](FC-vitals.html) Please refer to [mapping background](mappingBackground.html) for more information how maps were selected and developed. From ec5a4f14a9e7866e22c7ff67b80dbc8f6430747d Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Mon, 14 Oct 2024 08:57:50 -0500 Subject: [PATCH 064/112] Fix broken internal links --- input/pagecontent/CF-participations.md | 4 ++-- input/pagecontent/FC-vitals.md | 4 ++-- 2 files changed, 4 insertions(+), 4 deletions(-) diff --git a/input/pagecontent/CF-participations.md b/input/pagecontent/CF-participations.md index d039b2e..ce12114 100644 --- a/input/pagecontent/CF-participations.md +++ b/input/pagecontent/CF-participations.md @@ -86,7 +86,7 @@ Note when the only field populated is `<standardIndustryClassCode>`, the Organiz |/id|/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| |/name|/desc|.name|This is just a string in FHIR |/telecom|/telecom|.telecom|[CDA id ↔ FHIR telecom](mappingGuidance.html#cda-telecom--fhir-telecom)| -|/addr|/addr|.address|[CDA id ↔ FHIR address](mappingGuidance.html##cda-addr--fhir-address)| +|/addr|/addr|.address|[CDA id ↔ FHIR address](mappingGuidance.html#cda-addr--fhir-address)| |/standardIndustryClassCode|/code|.type|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) |/asOrganizationPartOf|/asOrganizationPartOf|.partOf|Recursive Organization reference @@ -96,7 +96,7 @@ Note when the only field populated is `<standardIndustryClassCode>`, the Organiz |:----|:----|:----| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| |/code||[See Mapping code](#mapping-code)| -|/addr|.address|[CDA id ↔ FHIR address](mappingGuidance.html##cda-addr--fhir-address)| +|/addr|.address|[CDA id ↔ FHIR address](mappingGuidance.html#cda-addr--fhir-address)| |/telecom|.telecom|[CDA id ↔ FHIR telecom](mappingGuidance.html#cda-telecom--fhir-telecom)| |**[Person](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-Person.html)<br/>[PlayingEntity](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-PlayingEntity.html)**||Person is the CDA data type for `<assignedPerson>` and `<associatedPerson>`.| |//name|.name|[CDA name ↔ FHIR name](mappingGuidance.html#cda-name--fhir-name)| diff --git a/input/pagecontent/FC-vitals.md b/input/pagecontent/FC-vitals.md index 1248c4b..2348aa5 100644 --- a/input/pagecontent/FC-vitals.md +++ b/input/pagecontent/FC-vitals.md @@ -12,7 +12,7 @@ FHIR Vitals that are grouped into a panel using the memberOf property are mapped |FHIR<br/>[Vital Signs Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-vital-signs.html)|C-CDA¹<br/>[Vital SignsOrganizer](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-VitalSignsOrganizer.html)|Transform Steps| |:----|:----|:----| -|.identifier|/id|[FHIR identifier ↔ CDA id](mappingGuidance.html#fhir-identifier--cda-id)| +|.identifier|/id|[FHIR identifier ↔ CDA id](mappingGuidance.html#cda-id--fhir-identifier)| |.category = `vital-signs` from [Vital Signs value set](https://hl7.org/fhir/us/core/STU4/ValueSet-us-core-vital-signs.html)|| |.code = `85353-1` [CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)||| |.status|/statusCode|*TODO: ConceptMap* @@ -24,7 +24,7 @@ FHIR Vitals that are grouped into a panel using the memberOf property are mapped |FHIR<br/>[Vital Signs Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-vital-signs.html)|C-CDA¹<br/>[Vital Sign Observation](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-VitalSignObservation.html)|Transform Steps| |:----|:----|:----| -|.identifier|/id|[FHIR identifier ↔ CDA id](mappingGuidance.html#fhir-identifier--cda-id)| +|.identifier|/id|[FHIR identifier ↔ CDA id](mappingGuidance.html#cda-id--fhir-identifier)| |.code |/code|[FHIR CodeableConcept ↔ CDA coding ](mappingGuidance.html#fhir-codeableconcept--cda-coding)| |.status|/statusCode|Set to completed |.effectiveDateTime|/effectiveTime|Use value From 18d61409adee286f7897aeb90253d430e72718e0 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Mon, 14 Oct 2024 09:06:47 -0500 Subject: [PATCH 065/112] Fix EncounterStatus concept map codes / displays --- input/maps/ConceptMap-CF-EncounterStatus.json | 8 ++++---- 1 file changed, 4 insertions(+), 4 deletions(-) diff --git a/input/maps/ConceptMap-CF-EncounterStatus.json b/input/maps/ConceptMap-CF-EncounterStatus.json index 2fb3d56..d92c606 100644 --- a/input/maps/ConceptMap-CF-EncounterStatus.json +++ b/input/maps/ConceptMap-CF-EncounterStatus.json @@ -62,7 +62,7 @@ "target" : [ { "code" : "in-progress", - "display" : "In-progress", + "display" : "In Progress", "equivalence" : "equal" } ] @@ -118,8 +118,8 @@ "display" : "Suspended", "target" : [ { - "code" : "on-leave", - "display" : "On-leave", + "code" : "onleave", + "display" : "On Leave", "equivalence" : "narrower", "comment" : "Suspended encounters have been started, but intent to execute has been temporarily stopped. On-leave is a special case of this circumstance." } @@ -131,7 +131,7 @@ "target" : [ { "code" : "entered-in-error", - "display" : "Entered-in-error", + "display" : "Entered in Error", "equivalence" : "equal" } ] From 8f49bfd48cbe7646d2a67473d26fbc38d354e870 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Mon, 14 Oct 2024 09:07:37 -0500 Subject: [PATCH 066/112] Update links from C-CDA 2024Jan ballot to published 3.0 URL --- input/pagecontent/CF-allergies.md | 16 ++++++++-------- input/pagecontent/CF-encounters.md | 6 +++--- input/pagecontent/CF-immunizations.md | 8 ++++---- input/pagecontent/CF-medications.md | 12 ++++++------ input/pagecontent/CF-notes.md | 2 +- input/pagecontent/CF-patient.md | 2 +- input/pagecontent/CF-problems.md | 12 ++++++------ input/pagecontent/CF-procedures.md | 8 ++++---- input/pagecontent/CF-results.md | 4 ++-- input/pagecontent/CF-social.md | 8 ++++---- input/pagecontent/CF-vitals.md | 4 ++-- input/pagecontent/FC-allergies.md | 12 ++++++------ input/pagecontent/FC-immunizations.md | 14 +++++++------- input/pagecontent/FC-medications.md | 10 +++++----- input/pagecontent/FC-patient.md | 2 +- input/pagecontent/FC-problems.md | 8 ++++---- input/pagecontent/FC-procedures.md | 10 +++++----- input/pagecontent/FC-vitals.md | 4 ++-- input/pagecontent/mappingBackground.md | 2 +- input/pagecontent/mappingGuidance.md | 6 +++--- 20 files changed, 75 insertions(+), 75 deletions(-) diff --git a/input/pagecontent/CF-allergies.md b/input/pagecontent/CF-allergies.md index d6c3930..8b19cbb 100644 --- a/input/pagecontent/CF-allergies.md +++ b/input/pagecontent/CF-allergies.md @@ -12,10 +12,10 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea <br /> ### C-CDA to FHIR -| C-CDA¹ <br/>[Allergy Concern act](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-AllergyConcernAct.html)| FHIR <br/>[AllergyIntolerance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-allergyintolerance.html)|Transform Steps & Notes| +| C-CDA¹ <br/>[Allergy Concern act](https://hl7.org/cda/us/ccda/StructureDefinition-AllergyConcernAct.html)| FHIR <br/>[AllergyIntolerance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-allergyintolerance.html)|Transform Steps & Notes| |:-------|:------|:---------| |/statusCode|.clinicalStatus|For more information on how status is managed in Allergy Concern Act wrapper, refer to [C-CDA guidance, see 5.2.7.1](https://www.hl7.org/implement/standards/product_brief.cfm?product_id=447)<br/>Also see Status entryRelationship mapping below| -| All of the following are a **[Allergy Intolerance observation](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-AllergyIntoleranceObservation.html)** nested inside the **[Allergy Concern act](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-AllergyConcernAct.html)**. Each observation should become a distinct FHIR **[AllergyIntolerance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-allergyintolerance.html)** resource.<br/>Include /entryRelationship[@typeCode="SUBJ"]/observation prefix to rows below²| +| All of the following are a **[Allergy Intolerance observation](https://hl7.org/cda/us/ccda/StructureDefinition-AllergyIntoleranceObservation.html)** nested inside the **[Allergy Concern act](https://hl7.org/cda/us/ccda/StructureDefinition-AllergyConcernAct.html)**. Each observation should become a distinct FHIR **[AllergyIntolerance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-allergyintolerance.html)** resource.<br/>Include /entryRelationship[@typeCode="SUBJ"]/observation prefix to rows below²| |/@negationInd||See constraints under /participant |/id|.identifier| [CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| |/effectiveTime/low|.onsetDateTime|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)<br/>effectiveTime/high should not be mapped within onset (DateTime or Period)| @@ -24,11 +24,11 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea |/author/time|.recordedDate|**Constraint:** Only map earliest author/time <br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)| |/participant/participantRole/playingEntity/code|.code|**Constraint:** When CDA negation is absent or false<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/participant/participantRole/playingEntity/code<br/>&<br/>/value|.code|**Constraint:** When CDA negation is true and nullFlavor is used in playingEntity/code<br/>[CDA No known allergy → FHIR code](ConceptMap-CF-NoKnownAllergies.html)<br/> When negation is true and playingEntity/code is populated, use equivalent negated concept (e.g. map latex substance to no known latex allergy [1003774007, SNOMED CT]) if available. If not, use the [substanceExposureRisk extension](https://hl7.org/fhir/extensions/StructureDefinition-allergyintolerance-substanceExposureRisk.html), placing the substance in the substance sub-extension and setting the exposureRisk sub-extension to `no-known-reaction-risk`. Note that when using this extension, the AllergyIntolerance resource will not be a conformant US Core AllergyIntolerance since the extension prohibits the required .code element.| -|**[Status](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-AllergyStatusObservation.html)**<br/>/entryRelationship/observation[code/@code="33999-4"]/value³|.clinicalStatus|[CDA Allergy Status Observation value → FHIR clinicalStatus](./ConceptMap-CF-AllergyStatus.html) -|**[Reaction](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-ReactionObservation.html)**<br/>/entryRelationship[@typeCode="MFST"]/observation/value³|.reaction.manifestation|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>Both use SNOMED clinical findings with minor valueSet definition differences -|**[Severity](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-SeverityObservation.html)** (nested inside Reaction)<br/>/entryRelationship[@typeCode="MFST"]/observation/entryRelationship/observation[code/@code="SEV"]/value³|.reaction.severity|[CDA Severity value → FHIR Severity](./ConceptMap-CF-Severity.html)<br/>**Note:** CDA documents should not assign severity at the Allergy level.<br/><br/>In cases where CDA assigns severity only to the Allergy rather than the reaction, map the severity to FHIR reaction severity, even if there are more than one. This means assuming that the same severity applies to all child reactions.<br/><br/>If severity is assigned at both levels, the reaction level should be used. -|**[Criticality](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-CriticalityObservation.html)**<br/>/entryRelationship/observation[code/@code="82606-5"]/value³|.criticality|[CDA Criticality value → FHIR Criticality](./ConceptMap-CF-Criticality.html) -|**[Comment Activity](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text³|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|| +|**[Status](https://hl7.org/cda/us/ccda/StructureDefinition-AllergyStatusObservation.html)**<br/>/entryRelationship/observation[code/@code="33999-4"]/value³|.clinicalStatus|[CDA Allergy Status Observation value → FHIR clinicalStatus](./ConceptMap-CF-AllergyStatus.html) +|**[Reaction](https://hl7.org/cda/us/ccda/StructureDefinition-ReactionObservation.html)**<br/>/entryRelationship[@typeCode="MFST"]/observation/value³|.reaction.manifestation|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>Both use SNOMED clinical findings with minor valueSet definition differences +|**[Severity](https://hl7.org/cda/us/ccda/StructureDefinition-SeverityObservation.html)** (nested inside Reaction)<br/>/entryRelationship[@typeCode="MFST"]/observation/entryRelationship/observation[code/@code="SEV"]/value³|.reaction.severity|[CDA Severity value → FHIR Severity](./ConceptMap-CF-Severity.html)<br/>**Note:** CDA documents should not assign severity at the Allergy level.<br/><br/>In cases where CDA assigns severity only to the Allergy rather than the reaction, map the severity to FHIR reaction severity, even if there are more than one. This means assuming that the same severity applies to all child reactions.<br/><br/>If severity is assigned at both levels, the reaction level should be used. +|**[Criticality](https://hl7.org/cda/us/ccda/StructureDefinition-CriticalityObservation.html)**<br/>/entryRelationship/observation[code/@code="82606-5"]/value³|.criticality|[CDA Criticality value → FHIR Criticality](./ConceptMap-CF-Criticality.html) +|**[Comment Activity](https://hl7.org/cda/us/ccda/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text³|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|| 1\. XPath abbreviated for C-CDA Allergy Concern act as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="48765-2"]/entry/act/ @@ -37,7 +37,7 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea 3\. Note that these entryRelationships will also have inversionInd="true" in CDA -When authors or other provenance are recorded in the parentƒ [Allergy Concern Act](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-AllergyConcernAct.html), it is recommended that those data be mapped to the FHIR AllergyIntolerance. +When authors or other provenance are recorded in the parentƒ [Allergy Concern Act](https://hl7.org/cda/us/ccda/StructureDefinition-AllergyConcernAct.html), it is recommended that those data be mapped to the FHIR AllergyIntolerance. ### Illustrative example diff --git a/input/pagecontent/CF-encounters.md b/input/pagecontent/CF-encounters.md index 2fa5d91..400ff44 100644 --- a/input/pagecontent/CF-encounters.md +++ b/input/pagecontent/CF-encounters.md @@ -11,7 +11,7 @@ Encounter Activities in the Encounters Section (or elsewhere in the document, su ### C-CDA Encounter to FHIR <sup>(b)</sup> - indicates element is only present in Encounter Activity in the body of the document<br/><sup>(h)</sup> - indicates element is only present in EncompassingEncounter in the header of the document -|C-CDA¹<br/>[Encounter Activity](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-EncounterActivity.html) or [EncompassingEncounter](https://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-EncompassingEncounter.html)|FHIR<br/>[Encounter](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-encounter.html)|Transform Steps| +|C-CDA¹<br/>[Encounter Activity](https://hl7.org/cda/us/ccda/StructureDefinition-EncounterActivity.html) or [EncompassingEncounter](https://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-EncompassingEncounter.html)|FHIR<br/>[Encounter](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-encounter.html)|Transform Steps| |:----|:----|:----| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| |/code |.class|Only the V3 ActCode system, which may be present in the root element or any `<translation>`.<br/>Other code systems may map to V3 ActCode (for example CPT codes 99211-99215 map to `AMB`, 99221-99223 to `IMP`, 99281-99285 to `EMER`, etc), but if this mapping is not possible, use the [Data Absent Reason](http://hl7.org/fhir/StructureDefinition/data-absent-reason) extension.| @@ -24,8 +24,8 @@ Encounter Activities in the Encounters Section (or elsewhere in the document, su |/performer <sup>(b)</sup><br/>/encounterParticipant <sup>(h)</sup>|.participant|*TODO: Mapping Guidance for general performers (Participant vs ParticipantRole vs Organization)* |/performer/sdtc:functionCode <sup>(b)</sup>|.participant.type|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) |/participant[@typeCode="LOC"] <sup>(b)</sup><br/>/location <sup>(h)</sup>|.location -|**[Indication](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-Indication.html)** <sup>(b)</sup><br/>/entryRelationship[@typeCode="RSON"]/observation|.reasonCode<br/>or<br/>.reasonReference|If the id of the indication references a problem in the document that has been converted to a FHIR resource, populate .reasonReference with a reference to that resource. Otherwise, map observation/value to .reasonCode.<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) -|**[Encounter Diagnosis](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-EncounterDiagnosis.html)** <sup>(b)</sup><br/>/entryRelationship/act[code/@code="29308-4"]/observation|**[Encounter Diagnosis](https://hl7.org/fhir/us/core/StructureDefinition-us-core-condition-encounter-diagnosis.html)**<br/>&<br/>.diagnosis.condition|The observation maps identically to [CDA → FHIR Problems](./CF-problems.html).<br/>Since this is an encounter diagnosis, the `Observation.category` should be set to `encounter-diagnosis`. +|**[Indication](https://hl7.org/cda/us/ccda/StructureDefinition-Indication.html)** <sup>(b)</sup><br/>/entryRelationship[@typeCode="RSON"]/observation|.reasonCode<br/>or<br/>.reasonReference|If the id of the indication references a problem in the document that has been converted to a FHIR resource, populate .reasonReference with a reference to that resource. Otherwise, map observation/value to .reasonCode.<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) +|**[Encounter Diagnosis](https://hl7.org/cda/us/ccda/StructureDefinition-EncounterDiagnosis.html)** <sup>(b)</sup><br/>/entryRelationship/act[code/@code="29308-4"]/observation|**[Encounter Diagnosis](https://hl7.org/fhir/us/core/StructureDefinition-us-core-condition-encounter-diagnosis.html)**<br/>&<br/>.diagnosis.condition|The observation maps identically to [CDA → FHIR Problems](./CF-problems.html).<br/>Since this is an encounter diagnosis, the `Observation.category` should be set to `encounter-diagnosis`. ### Illustrative example diff --git a/input/pagecontent/CF-immunizations.md b/input/pagecontent/CF-immunizations.md index d020ba8..7613c30 100644 --- a/input/pagecontent/CF-immunizations.md +++ b/input/pagecontent/CF-immunizations.md @@ -12,7 +12,7 @@ Mapping is from `@moodCode="EVN"` (i.e. historical) immunizations, not `INT` (fu <br /> ### C-CDA to FHIR -|C-CDA¹<br/>[Immunization Activity substanceAdministration](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-ImmunizationActivity.html)|FHIR<br/>[Immunization](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-immunization.html#profile)|Transform Steps| +|C-CDA¹<br/>[Immunization Activity substanceAdministration](https://hl7.org/cda/us/ccda/StructureDefinition-ImmunizationActivity.html)|FHIR<br/>[Immunization](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-immunization.html#profile)|Transform Steps| |:----|:----|:----| |/@negationInd="true"||Set ```.status="not-done"``` when @negationInd="true"| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| @@ -29,10 +29,10 @@ Mapping is from `@moodCode="EVN"` (i.e. historical) immunizations, not `INT` (fu |/author|**[Provenance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-provenance.html)**|[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| |/author/time|.recorded|Earliest, if more than one.<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) |/performer|.performer|Set ```performer.function="AP"``` -|**[Immunization Refusal Reason](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-ImmunizationRefusalReason.html)**<br/>/entryRelationship[@typeCode="RSON"]²/observation/code<br/>(only if code is from ValueSet [No Immunization Reason](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.1.11.19717/expansion/Latest))|.statusReason|[CDA refusal → FHIR statusReason](ConceptMap-CF-ImmunizationRefusal.html)<br/>Indicates the reason the immunization event was **not** performed. This is generally only used for the status of "not-done".| +|**[Immunization Refusal Reason](https://hl7.org/cda/us/ccda/StructureDefinition-ImmunizationRefusalReason.html)**<br/>/entryRelationship[@typeCode="RSON"]²/observation/code<br/>(only if code is from ValueSet [No Immunization Reason](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.1.11.19717/expansion/Latest))|.statusReason|[CDA refusal → FHIR statusReason](ConceptMap-CF-ImmunizationRefusal.html)<br/>Indicates the reason the immunization event was **not** performed. This is generally only used for the status of "not-done".| |**[Indication](http://hl7.org/cda/stds/ccda/draft1/StructureDefinition-2.16.840.1.113883.10.20.22.4.19.html)**<br/>/entryRelationship[@typeCode="RSON"]²/observation/value<br/>(only if observation/code is from ValueSet [Problem Type](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.88.12.3221.7.2/expansion/Latest))|.reasonCode|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| -|**[Reaction](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-ReactionObservation.html)**<br/>/entryRelationship[@typeCode="MFST"]/observation/value|.reaction|It is recommended that reaction observation value be mapped to reaction detail (Observation) valueCodeable concept. Comments are welcome on how this may be best implemented. -|**[Comment Activity](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|| +|**[Reaction](https://hl7.org/cda/us/ccda/StructureDefinition-ReactionObservation.html)**<br/>/entryRelationship[@typeCode="MFST"]/observation/value|.reaction|It is recommended that reaction observation value be mapped to reaction detail (Observation) valueCodeable concept. Comments are welcome on how this may be best implemented. +|**[Comment Activity](https://hl7.org/cda/us/ccda/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|| 1\. XPath abbrievated for C-CDA Immunization Activity as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="11369-6"]/entry/substanceAdministration<br/> diff --git a/input/pagecontent/CF-medications.md b/input/pagecontent/CF-medications.md index 2742d11..ddc131c 100644 --- a/input/pagecontent/CF-medications.md +++ b/input/pagecontent/CF-medications.md @@ -25,7 +25,7 @@ The C-CDA Example Search site maintains a document of [Common Medication Frequen ### C-CDA to FHIR (MedicationRequest) -|C-CDA¹<br>[Medication Activity substanceAdministration](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-MedicationActivity.html)|FHIR<br>[MedicationRequest](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-medicationrequest.html)|Transform Steps| +|C-CDA¹<br>[Medication Activity substanceAdministration](https://hl7.org/cda/us/ccda/StructureDefinition-MedicationActivity.html)|FHIR<br>[MedicationRequest](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-medicationrequest.html)|Transform Steps| |:----|:----|:----| |/@negationInd="true"|set .doNotPerform=true|| |@moodCode|.intent|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) <br/>[Mood to intent](ConceptMap-CF-MedActivityMood.html)| @@ -48,14 +48,14 @@ The C-CDA Example Search site maintains a document of [Common Medication Frequen |/author|.requester<br/>&<br/>**[Provenance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-procedure.html)**|[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| |/author/time|.authoredOn|Earliest, if more than one.<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)| |**[Drug Vehicle](https://hl7.org/cda/us/ccda/StructureDefinition-DrugVehicle.html)**<br/>/participant[@typeCode="COV"]/playingEntity/code|Medication.ingredient|[See below](#c-cda-to-fhir-medication) -|**[Indication](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-Indication.html)**<br/>/entryRelationship[@typeCode="RSON"]/observation/value|.reasonCode|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| -|**[Free text sig](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-MedicationFreeTextSig.html)**<br/>/entryRelationship/substanceAdministration[code/@code="76662-6"]/text|.dosageInstruction.text|| -|**[Instruction Activity](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-Instruction.html)**<br/>/entryRelationship[@typeCode="SUBJ" and @inversionInd="true"]/act|.dosageInstruction.patientInstruction<br/>.dosageInstruction.additionalInstruction|act/text or act/code/originalText can map to patientInstructions. If coded, can map to additionalInstruction. +|**[Indication](https://hl7.org/cda/us/ccda/StructureDefinition-Indication.html)**<br/>/entryRelationship[@typeCode="RSON"]/observation/value|.reasonCode|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|**[Free text sig](https://hl7.org/cda/us/ccda/StructureDefinition-MedicationFreeTextSig.html)**<br/>/entryRelationship/substanceAdministration[code/@code="76662-6"]/text|.dosageInstruction.text|| +|**[Instruction Activity](https://hl7.org/cda/us/ccda/StructureDefinition-Instruction.html)**<br/>/entryRelationship[@typeCode="SUBJ" and @inversionInd="true"]/act|.dosageInstruction.patientInstruction<br/>.dosageInstruction.additionalInstruction|act/text or act/code/originalText can map to patientInstructions. If coded, can map to additionalInstruction. |**[Supply Order](https://hl7.org/cda/us/ccda/StructureDefinition-MedicationSupplyOrder.html)**<br/>/entryRelationship[@typeCode="REFR"]/substanceAdministration[@moodCode="INT"]||Note: moodCode=INT means supply, moodCode=EVN means dispense, which is not documented here. |../effectiveTime/high|.dispenseRequest.period.end|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)<br/>`low` would similarly map to `start`, but only high is called out in C-CDA.| |../repeatNumber|.dispenseRequest.numberOfRepeatsAllowed|**Caution:** in CDA, repeatNumber indicates total number of dispenses allowed. In FHIR, this field is exclusive of the original dispense. So the `numberOfRepeatsAllowed` will be one less than `repeatNumber`. |../quantity|.dispenseRequest.quantity|[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity) -|**[Comment Activity](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|| +|**[Comment Activity](https://hl7.org/cda/us/ccda/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|| |/precondition|.asNeededBoolean = true|The presence of a precondition element indicates asNeededBoolean should be true.<br/>More complex maps may be possible with .asNeededCodeableConcept.| 1\. XPath abbrievated for C-CDA Medication Activity as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="10160-0"]/entry/substanceAdministration @@ -63,7 +63,7 @@ The C-CDA Example Search site maintains a document of [Common Medication Frequen ### C-CDA to FHIR (Medication) MedicationRequest (and other resources) may represent the medication as a simple CodeableConcept. But when additional information about the medication needs to be conveyed, a Medication resource should be created instead and referenced by the MedicationRequest resource. Implementers may also opt to always create Medication resources. -|C-CDA¹<br>[Medication Activity substanceAdministration](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-MedicationActivity.html)|FHIR<br>[Medication](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-medication.html)|Transform Steps| +|C-CDA¹<br>[Medication Activity substanceAdministration](https://hl7.org/cda/us/ccda/StructureDefinition-MedicationActivity.html)|FHIR<br>[Medication](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-medication.html)|Transform Steps| |:----|:----|:----| |/administrationUnitCode|.form|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) |/consumable/manufacturedProduct/manufacturedMaterial/code|.code|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| diff --git a/input/pagecontent/CF-notes.md b/input/pagecontent/CF-notes.md index 9864a75..7c5323a 100644 --- a/input/pagecontent/CF-notes.md +++ b/input/pagecontent/CF-notes.md @@ -10,7 +10,7 @@ Clinical Notes may appear in their own section or as an entry in any open sectio ### C-CDA to FHIR -|C-CDA¹<br/>[Note Activity](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-NoteActivity.html)|[DocumentReference](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-documentreference.html)|Transform Steps| +|C-CDA¹<br/>[Note Activity](https://hl7.org/cda/us/ccda/StructureDefinition-NoteActivity.html)|[DocumentReference](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-documentreference.html)|Transform Steps| |:----|:----|:----| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| |/code/translation|.type|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>**NOTE:** The root code in C-CDA is always `34109-9: Note`. A more specific code may be sent in translation which should be sent as the DocumentReference.type. If there is no translation, however, `34109-9` may be sent as the type. diff --git a/input/pagecontent/CF-patient.md b/input/pagecontent/CF-patient.md index e0ad512..23619bd 100644 --- a/input/pagecontent/CF-patient.md +++ b/input/pagecontent/CF-patient.md @@ -10,7 +10,7 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea <br /> ### C-CDA to FHIR -|C-CDA¹<br/>[US Realm Header recordTarget](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-USRealmHeader.html)|FHIR<br/>[Patient](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-patient.html#profile)|Transform Steps| +|C-CDA¹<br/>[US Realm Header recordTarget](https://hl7.org/cda/us/ccda/StructureDefinition-USRealmHeader.html)|FHIR<br/>[Patient](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-patient.html#profile)|Transform Steps| |:----|:----|:----| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| |/addr|.address|[CDA addr ↔ FHIR address ](mappingGuidance.html#cda-addr--fhir-address)| diff --git a/input/pagecontent/CF-problems.md b/input/pagecontent/CF-problems.md index c595e51..e6d93d7 100644 --- a/input/pagecontent/CF-problems.md +++ b/input/pagecontent/CF-problems.md @@ -13,11 +13,11 @@ Note that C-CDA includes a Concern wrapper act from which status may be read; mo <br /> ### C-CDA to FHIR -|C-CDA¹<br/>[Problem Concern Act](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-ProblemConcernAct.html)|FHIR<br/>[Condition and Health Concern](https://hl7.org/fhir/us/core/StructureDefinition-us-core-condition-problems-health-concerns.html)|Transform Steps| +|C-CDA¹<br/>[Problem Concern Act](https://hl7.org/cda/us/ccda/StructureDefinition-ProblemConcernAct.html)|FHIR<br/>[Condition and Health Concern](https://hl7.org/fhir/us/core/StructureDefinition-us-core-condition-problems-health-concerns.html)|Transform Steps| |:----|:----|:----| |From the parent section, use code@code|.category|[CDA section → FHIR category](ConceptMap-CF-ProblemCategory.html)<br/>**Note:** The section of a Problem Observation affects its FHIR category.| |/statusCode|.clinicalStatus|/statusCode → .clinicalStatus is to be used only if the C-CDA Problem Status Observation (see below) is missing.<br/>For more information on how status is managed in Problem Concern Act wrapper, refer to [C-CDA guidance, see 5.2.6.1](https://www.hl7.org/implement/standards/product_brief.cfm?product_id=447)<br/> [Concern Status → Condition Clinical Status](ConceptMap-CF-ConditionClinicalStatus.html) -|All of the following are a [Problem observation](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-ProblemObservation.html) nested inside the [Problem Concern act](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-ProblemConcernAct.html). Each observation should become a distinct FHIR Condition resource. <br/>/entryRelationship[@typeCode="SUBJ"]/observation prefix to rows below²||| +|All of the following are a [Problem observation](https://hl7.org/cda/us/ccda/StructureDefinition-ProblemObservation.html) nested inside the [Problem Concern act](https://hl7.org/cda/us/ccda/StructureDefinition-ProblemConcernAct.html). Each observation should become a distinct FHIR Condition resource. <br/>/entryRelationship[@typeCode="SUBJ"]/observation prefix to rows below²||| |/@negationInd=true|set .verificationStatus="refuted" or adjust .code for negated concept| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| |/code |.category|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| @@ -26,17 +26,17 @@ Note that C-CDA includes a Concern wrapper act from which status may be read; mo |/value|.code|**Constraint:** When CDA negation is absent or false<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/author|.recorder<br/>&<br/>**[Provenance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-procedure.html)**|.recorder should be authoritative (latest) author if there are multiple<br/>[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| |/author/time|.recordedDate|Earliest, if more than one<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) -|**[Problem Status](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-ProblemStatus.html)**<br/>/entryRelationship/observation[code/@code="33999-4"]/value|.clinicalStatus|[CDA Problem Status Observation value → FHIR clinicalStatus](./ConceptMap-CF-ProblemStatus.html)| +|**[Problem Status](https://hl7.org/cda/us/ccda/StructureDefinition-ProblemStatus.html)**<br/>/entryRelationship/observation[code/@code="33999-4"]/value|.clinicalStatus|[CDA Problem Status Observation value → FHIR clinicalStatus](./ConceptMap-CF-ProblemStatus.html)| |**[Date of Diagnosis](https://www.hl7.org/ccdasearch/templates/2.16.840.1.113883.10.20.22.4.502.html)**<br/>/entryRelationship/act[code/@code="77975-1"]/effectiveTime|.extension:[assertedDate](http://hl7.org/fhir/StructureDefinition/condition-assertedDate)|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)<br/>See **[US CORE Condition](https://hl7.org/fhir/us/core/StructureDefinition-us-core-condition-problems-health-concerns.html#mandatory-and-must-support-data-elements)** for additional guidance| -|**[Comment Activity](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|| +|**[Comment Activity](https://hl7.org/cda/us/ccda/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|| |**[Age Observation]()**<br/>/entryRelationship[@typeCode="SUBJ" and @inversionInd="true"]/observation[code/@code="445518008"]/value|.onsetAge|**CAUTION:** Only one of `onsetAge` or `onsetDateTime` may be present.<br/>[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity) -|**Supporting Observations (e.g. [Assessment Scale Observation](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-AssessmentScaleObservation.html))**<br/>/entryRelationship[@typeCode="SPRT"]/observation|.evidence.detail|Create an Observation resource, mapping fields like `id`, `code`, `effectiveTime`, `value` similar to [Results](CF-results.html). If the CDA observation is an SDOH observation, use the [US Core Observation Screening Assessment](https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-observation-screening-assessment.html) profile. +|**Supporting Observations (e.g. [Assessment Scale Observation](https://hl7.org/cda/us/ccda/StructureDefinition-AssessmentScaleObservation.html))**<br/>/entryRelationship[@typeCode="SPRT"]/observation|.evidence.detail|Create an Observation resource, mapping fields like `id`, `code`, `effectiveTime`, `value` similar to [Results](CF-results.html). If the CDA observation is an SDOH observation, use the [US Core Observation Screening Assessment](https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-observation-screening-assessment.html) profile. 1\. XPath abbreviated for C-CDA Problem Concern act as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="11450-4"]/entry/act/ 2\. XPath abbreviated for C-CDA Problem Observation as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="11450-4"]/entry/act/entryRelationship[@typeCode="SUBJ"]/observation/ -When authors or other provenance are recorded in the parent [Problem Concern Act](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-ProblemConcernAct.html), it is recommended that those data be mapped to the FHIR Condition. +When authors or other provenance are recorded in the parent [Problem Concern Act](https://hl7.org/cda/us/ccda/StructureDefinition-ProblemConcernAct.html), it is recommended that those data be mapped to the FHIR Condition. ### Illustrative example diff --git a/input/pagecontent/CF-procedures.md b/input/pagecontent/CF-procedures.md index e59e971..41aae89 100644 --- a/input/pagecontent/CF-procedures.md +++ b/input/pagecontent/CF-procedures.md @@ -13,7 +13,7 @@ C-CDA 2.1 describes three templates for Procedures: Procedure Activity Act, Proc <br /> ### C-CDA to FHIR -|C-CDA¹<br/>[Procedure Activity procedure](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-ProcedureActivityProcedure.html)|FHIR<br/>[Procedure](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-procedure.html)|Transform Steps| +|C-CDA¹<br/>[Procedure Activity procedure](https://hl7.org/cda/us/ccda/StructureDefinition-ProcedureActivityProcedure.html)|FHIR<br/>[Procedure](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-procedure.html)|Transform Steps| |:----|:----|:----| |/@negationInd="true"|set status="not-done"|| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| @@ -25,9 +25,9 @@ C-CDA 2.1 describes three templates for Procedures: Procedure Activity Act, Proc |/targetSiteCode|.bodySite|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/author|.recorder<br/>&<br/>**[Provenance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-procedure.html)**|<br/>[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance) <br/>If a latest author can be identified, map to .recorder.<br/>Any author with a time can be put in Provenance.| |/performer/assignedEntity|.performer.actor|May map to Practitioner, PractitionerRole, or Organization<br/>onBehalfOf should not be used when actor is a Practitioner or PractitionerRole | -|**[Service Delivery Location](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-ServiceDeliveryLocation.html)**<br/>/participant[@typeCode="LOC"]/participantRole|.location|| -|**[Indication](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-Indication.html)**<br/>/entryRelationship[@typeCode="RSON"]/observation/value|.reasonCode|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| -|**[Comment Activity](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note| +|**[Service Delivery Location](https://hl7.org/cda/us/ccda/StructureDefinition-ServiceDeliveryLocation.html)**<br/>/participant[@typeCode="LOC"]/participantRole|.location|| +|**[Indication](https://hl7.org/cda/us/ccda/StructureDefinition-Indication.html)**<br/>/entryRelationship[@typeCode="RSON"]/observation/value|.reasonCode|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|**[Comment Activity](https://hl7.org/cda/us/ccda/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note| 1\. XPath abbrievated for C-CDA Procedure as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="47519-4"]/entry/procedure diff --git a/input/pagecontent/CF-results.md b/input/pagecontent/CF-results.md index f9df42d..8d11d60 100644 --- a/input/pagecontent/CF-results.md +++ b/input/pagecontent/CF-results.md @@ -12,7 +12,7 @@ Observation values are generic - they can be of any CDA type in CDA, and *almost ### C-CDA Organizer to FHIR Diagnostic Report -|C-CDA¹<br/>[Result Organizer](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-ResultOrganizer.html)|FHIR<br/>Diagnostic Report ([Lab](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-diagnosticreport-lab.html)) ([Reports](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-diagnosticreport-note.html))|Transform Steps| +|C-CDA¹<br/>[Result Organizer](https://hl7.org/cda/us/ccda/StructureDefinition-ResultOrganizer.html)|FHIR<br/>Diagnostic Report ([Lab](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-diagnosticreport-lab.html)) ([Reports](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-diagnosticreport-note.html))|Transform Steps| |:----|:----|:----| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| |/code|.category<br/>&<br/>.code|*TODO: Describe using LOINC classes to identify category*<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| @@ -24,7 +24,7 @@ Observation values are generic - they can be of any CDA type in CDA, and *almost ### C-CDA Observation to FHIR Observation -|C-CDA¹<br/>[Result Observation](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-ResultObservation.html)|FHIR<br/>[Lab Result Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-observation-lab.html)|Transform Steps| +|C-CDA¹<br/>[Result Observation](https://hl7.org/cda/us/ccda/StructureDefinition-ResultObservation.html)|FHIR<br/>[Lab Result Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-observation-lab.html)|Transform Steps| |:----|:----|:----| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| |(parent organizer)|.category|Use category from DiagnosticReport or map /code to a category similarly diff --git a/input/pagecontent/CF-social.md b/input/pagecontent/CF-social.md index 49e5c64..03e7684 100644 --- a/input/pagecontent/CF-social.md +++ b/input/pagecontent/CF-social.md @@ -18,7 +18,7 @@ Note that some observations in C-CDA map to extensions on the patient or elsewhe ### C-CDA Social History Observation to FHIR Observation This maps to US Core version 6's Simple Observation. Previous versions of US Core did not define a generic observation, but the following guidance can still be used to create a generic FHIR observation regardless of the version of US Core being targeted. -|C-CDA<br/>[Social History Observation](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-SocialHistoryObservation.html)|FHIR<br/>[Simple Observation](https://hl7.org/fhir/us/core/STU6/StructureDefinition-us-core-simple-observation.html)|Transform Steps| +|C-CDA<br/>[Social History Observation](https://hl7.org/cda/us/ccda/StructureDefinition-SocialHistoryObservation.html)|FHIR<br/>[Simple Observation](https://hl7.org/fhir/us/core/STU6/StructureDefinition-us-core-simple-observation.html)|Transform Steps| |:----|:----|:----| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| ||.category|Set to `social-history` from [Observation Category Codes](https://build.fhir.org/ig/HL7/UTG/CodeSystem-observation-category.html)<br/>Additional SDOH categories may be set as well, depending on the code of the observation. @@ -37,7 +37,7 @@ Additional fields, such as `.interpretationCode`, `.referenceRange`, `.performer ### C-CDA Smoking Status / Tobacco Use to FHIR Observation In C-CDA 3.0, the Smoking Status - MU and Tobacco Use templates were merged into a single template to better match US Core's Smoking Status template. -|C-CDA<br/>[Smoking Status - MU](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-SmokingStatusMeaningfulUse.html) (Deprecated)<br/>[Tobacco Use](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-TobaccoUse.html) (Decprecated)<br/>[Smoking Status](https://build.fhir.org/ig/HL7/CDA-ccda/StructureDefinition-SmokingStatus.html) (C-CDA 3.0)²|FHIR<br/>[Smoking Status Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-smokingstatus.html)|Transform Steps| +|C-CDA<br/>[Smoking Status - MU](https://hl7.org/cda/us/ccda/StructureDefinition-SmokingStatusMeaningfulUse.html) (Deprecated)<br/>[Tobacco Use](https://hl7.org/cda/us/ccda/StructureDefinition-TobaccoUse.html) (Decprecated)<br/>[Smoking Status](https://build.fhir.org/ig/HL7/CDA-ccda/StructureDefinition-SmokingStatus.html) (C-CDA 3.0)²|FHIR<br/>[Smoking Status Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-smokingstatus.html)|Transform Steps| |:----|:----|:----| |/code|.code|Prior to US Core 7, the code should be `72166-2 (Tobacco smoking status NCIS)`, but this is an extensible value set.<br/>In US Core 7, the value set remains extensible, but contains the same 4 concepts allowed in the C-CDA R3.0's Smoking Status value set. |/effectiveTime|.effectiveDateTime<br/>or<br/>.effectivePeriod|Smoking Status - MU required a timestamp; Tobacco Use required a time range; Smoking Status (3.0) combines the two templates into one and allows for either. @@ -45,14 +45,14 @@ In C-CDA 3.0, the Smoking Status - MU and Tobacco Use templates were merged into ### C-CDA Pregnancy Observation to FHIR Pregnancy Status Observation In US Core, Pregnancy Observation was first defined in version 6. -|C-CDA<br/>[Pregnancy Observation](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-PregnancyObservation.html)|FHIR<br/>[Pregnancy Status](https://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-observation-pregnancystatus.html)|Transform Steps| +|C-CDA<br/>[Pregnancy Observation](https://hl7.org/cda/us/ccda/StructureDefinition-PregnancyObservation.html)|FHIR<br/>[Pregnancy Status](https://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-observation-pregnancystatus.html)|Transform Steps| |:----|:----|:----| |.moodCode||The C-CDA moodCode is `EVN` which is why this maps to FHIR's Pregnancy Status rather than Pregnancy Intent. ||.code|`82810-3 (Pregnancy Status)` - C-CDA uses `ASSERTION`, but FHIR clarifies the code to be used. |/effectiveTime/@value<br/>or<br/>/effectiveTime/low/@value<br/>or<br/>/effectiveTime/high/@value<br/>or<br/>/author/time|.effectiveDateTime|FHIR only allows a single timestamp. Send the first element from the first column with a populated timestamp.<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) |/value|.valueCodeableConcept|Value sets are the same<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/value/@nullFlavor=UNK|.valueCodeableConcept|Unknown becomes an actual value with system = `http://terminology.hl7.org/CodeSystem/v3-NullFlavor`. Any other nullFlavors should use a data-absent-reason extension. -|**[Estimated Date of Delivery](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-EstimatedDateofDelivery.html)**<br/>/entryRelationship/observation[code/@code="11778-8"]/value|.component.code<br/>.component.valueDateTime|Set code to `11778-8` and map value to `.valueDateTime`.<br/>Note that while C-CDA hard-codes this to a single value (`11778-8`), there are other, more specific, EDD LOINC codes that could be used as well (see [EDD Including Method](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.11.20.9.81/expansion)). These might be communicated as translations on the entryRelationship/observation/code, as the methodCode, or sent as entirely custom observations. Any of these codes can also reasonably be included as a component to a Pregnancy Observation to represent the estimated date of delivery. +|**[Estimated Date of Delivery](https://hl7.org/cda/us/ccda/StructureDefinition-EstimatedDateofDelivery.html)**<br/>/entryRelationship/observation[code/@code="11778-8"]/value|.component.code<br/>.component.valueDateTime|Set code to `11778-8` and map value to `.valueDateTime`.<br/>Note that while C-CDA hard-codes this to a single value (`11778-8`), there are other, more specific, EDD LOINC codes that could be used as well (see [EDD Including Method](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.11.20.9.81/expansion)). These might be communicated as translations on the entryRelationship/observation/code, as the methodCode, or sent as entirely custom observations. Any of these codes can also reasonably be included as a component to a Pregnancy Observation to represent the estimated date of delivery. ### C-CDA Pregnancy Intention in Next Year to FHIR Pregnancy Intent Observation In US Core, Pregnancy Intent was first defined in version 6. diff --git a/input/pagecontent/CF-vitals.md b/input/pagecontent/CF-vitals.md index 0c0dcb8..8dd777a 100644 --- a/input/pagecontent/CF-vitals.md +++ b/input/pagecontent/CF-vitals.md @@ -10,7 +10,7 @@ C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or ### C-CDA Vital Signs Organizer to FHIR Observation Panel -|C-CDA¹<br/>[Vital SignsOrganizer](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-VitalSignsOrganizer.html)|FHIR<br/>[Vital Signs Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-vital-signs.html)|Transform Steps| +|C-CDA¹<br/>[Vital SignsOrganizer](https://hl7.org/cda/us/ccda/StructureDefinition-VitalSignsOrganizer.html)|FHIR<br/>[Vital Signs Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-vital-signs.html)|Transform Steps| |:----|:----|:----| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| ||.category|Set to `vital-signs` from [Vital Signs value set](https://hl7.org/fhir/us/core/STU4/ValueSet-us-core-vital-signs.html) @@ -21,7 +21,7 @@ C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or ### C-CDA Vital Signs Observation to FHIR Observation -|C-CDA¹<br/>[Vital Sign Observation](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-VitalSignObservation.html)|FHIR<br/>[Vital Signs Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-vital-signs.html)|Transform Steps<br/>Note: US Core defines separate profiles for individual vitals such as [weight](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-body-weight.html), [heart rate](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-heart-rate.html), etc.| +|C-CDA¹<br/>[Vital Sign Observation](https://hl7.org/cda/us/ccda/StructureDefinition-VitalSignObservation.html)|FHIR<br/>[Vital Signs Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-vital-signs.html)|Transform Steps<br/>Note: US Core defines separate profiles for individual vitals such as [weight](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-body-weight.html), [heart rate](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-heart-rate.html), etc.| |:----|:----|:----| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| ||.category|Set to `vital-signs` from [Vital Signs value set](https://hl7.org/fhir/us/core/STU4/ValueSet-us-core-vital-signs.html) diff --git a/input/pagecontent/FC-allergies.md b/input/pagecontent/FC-allergies.md index c05428c..a45f526 100644 --- a/input/pagecontent/FC-allergies.md +++ b/input/pagecontent/FC-allergies.md @@ -18,12 +18,12 @@ This page provides a mapping from FHIR to CDA. For the CDA to FHIR mapping, plea ### FHIR to C-CDA -|FHIR<br/>[AllergyIntolerance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-allergyintolerance.html#profile)|C-CDA¹<br/>[Allergy Intolerance observation](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-AllergyIntoleranceObservation.html)|Transform Steps| +|FHIR<br/>[AllergyIntolerance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-allergyintolerance.html#profile)|C-CDA¹<br/>[Allergy Intolerance observation](https://hl7.org/cda/us/ccda/StructureDefinition-AllergyIntoleranceObservation.html)|Transform Steps| |:----|:----|:----| |.identifier|/id|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| -|.clinicalStatus|(act parent to observation) ../../statusCode <br/>&<br />**[Allergy Status](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-AllergyStatusObservation.html)**<br/>/entryRelationship/observation[code/@code="33999-4"]/value|[FHIR clinicalStatus → CDA Allergy Status Observation value](./ConceptMap-FC-AllergyStatus.html)<br/>For more information on how status is managed in Allergy Concern Act wrapper, refer to [C-CDA guidance, see 5.2.7.1](https://www.hl7.org/implement/standards/product_brief.cfm?product_id=447)| +|.clinicalStatus|(act parent to observation) ../../statusCode <br/>&<br />**[Allergy Status](https://hl7.org/cda/us/ccda/StructureDefinition-AllergyStatusObservation.html)**<br/>/entryRelationship/observation[code/@code="33999-4"]/value|[FHIR clinicalStatus → CDA Allergy Status Observation value](./ConceptMap-FC-AllergyStatus.html)<br/>For more information on how status is managed in Allergy Concern Act wrapper, refer to [C-CDA guidance, see 5.2.7.1](https://www.hl7.org/implement/standards/product_brief.cfm?product_id=447)| |.type<br/>&<br/>.category|/value|[FHIR type → CDA value](ConceptMap-FC-AllergyIntoleranceType.html)<br/>[FHIR category → CDA value](ConceptMap-FC-AllergyIntoleranceCategory.html)| -|.criticality|**[Criticality](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-CriticalityObservation.html)**<br/>/entryRelationship/observation[code/@code="82606-5"]/value|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>[FHIR criticality → CDA Criticality value](ConceptMap-FC-Criticality.html)| +|.criticality|**[Criticality](https://hl7.org/cda/us/ccda/StructureDefinition-CriticalityObservation.html)**<br/>/entryRelationship/observation[code/@code="82606-5"]/value|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>[FHIR criticality → CDA Criticality value](ConceptMap-FC-Criticality.html)| |.code|/participant/participantRole/playingEntity/code|**Constraint**: When FHIR concept is not a negated concept<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |.code|/participant/participantRole/playingEntity/code or /value<br/>&<br/>set @negationInd="true"|**Constraint**: When FHIR concept represents general negated concept (e.g. no known allergy)<br/>[FHIR code → CDA No Known Allergy](ConceptMap-FC-NoKnownAllergies.html)<br/>In case where a specific refutation is coded (no latex allergy), use text or a mapped concept.| |.encounter|/entryRelationship[@typeCode="REFR"]/act/id|| @@ -31,10 +31,10 @@ This page provides a mapping from FHIR to CDA. For the CDA to FHIR mapping, plea |.onsetPeriod.start|/effectiveTime/low|effectiveTime/high should not be mapped from onsetPeriod| |.recordedDate|/assignedAuthor/time|These are not necessarily the same author| |.recorder|/assignedAuthor|[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)<br/>Time and author are not necessarily the same| -|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|**[Comment Activity](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|| -|.reaction.manifestation|**[Reaction](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-ReactionObservation.html)**<br/>/entryRelationship[@typeCode="MFST"]/observation/value|Both use SNOMED clinical findings with minor valueSet definition differences +|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|**[Comment Activity](https://hl7.org/cda/us/ccda/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|| +|.reaction.manifestation|**[Reaction](https://hl7.org/cda/us/ccda/StructureDefinition-ReactionObservation.html)**<br/>/entryRelationship[@typeCode="MFST"]/observation/value|Both use SNOMED clinical findings with minor valueSet definition differences |.reaction.onset|/effectiveTime/low|Constraint: This should only be used in event that AlleryIntolerance.onset was not available| -|.reaction.severity|**[Severity](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-SeverityObservation.html)**<br/>/entryRelationship[@typeCode="MFST"]/observation/entryRelationship/observation[code/@code="SEV"]/value|[FHIR severity → CDA severity value ](ConceptMap-FC-Criticality.html)<br/>This should be nested in CDA within the respective allergic reaction observation| +|.reaction.severity|**[Severity](https://hl7.org/cda/us/ccda/StructureDefinition-SeverityObservation.html)**<br/>/entryRelationship[@typeCode="MFST"]/observation/entryRelationship/observation[code/@code="SEV"]/value|[FHIR severity → CDA severity value ](ConceptMap-FC-Criticality.html)<br/>This should be nested in CDA within the respective allergic reaction observation| 1\. XPath abbrievated for C-CDA Allergy Intolerance as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="48765-2"]/entry/act/entryRelationship/observation diff --git a/input/pagecontent/FC-immunizations.md b/input/pagecontent/FC-immunizations.md index 0812551..c33910f 100644 --- a/input/pagecontent/FC-immunizations.md +++ b/input/pagecontent/FC-immunizations.md @@ -17,13 +17,13 @@ This page provides a mapping from FHIR to CDA. For the CDA to FHIR mapping, plea ### FHIR to C-CDA -|FHIR<br/>[Immunization](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-immunization.html#profile)|C-CDA¹<br/>[Immunization Activity substanceAdministration](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-ImmunizationActivity.html)|Transform Steps| +|FHIR<br/>[Immunization](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-immunization.html#profile)|C-CDA¹<br/>[Immunization Activity substanceAdministration](https://hl7.org/cda/us/ccda/StructureDefinition-ImmunizationActivity.html)|Transform Steps| |:----|:----|:----| ||/@moodCode="EVN"|All FHIR Immunizations should be set to "EVN" moodCode |.identifier|/id|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| |.status|/statusCode|**Constraint** when .status.value="not-done"<br/>Set negationInd to true in CDA observation| |.status|/statusCode|**Constraint** all other values of .status<br/>[FHIR status → CDA statusCode](ConceptMap-FC-ImmunizationStatus.html)| -|.statusReason|**[Immunization Refusal Reason](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-ImmunizationRefusalReason.html)**<br/>/entryRelationship[@typeCode="RSON"]/observation/code|[FHIR statusReason → CDA refusal](ConceptMap-FC-ImmunizationRefusal.html)| +|.statusReason|**[Immunization Refusal Reason](https://hl7.org/cda/us/ccda/StructureDefinition-ImmunizationRefusalReason.html)**<br/>/entryRelationship[@typeCode="RSON"]/observation/code|[FHIR statusReason → CDA refusal](ConceptMap-FC-ImmunizationRefusal.html)| |.vaccineCode|/consumable/manufacturedProduct/manufacturedMaterial/code|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |.primarySource||This element has no target in CDA |.occurrenceDateTime|/effectiveTime/@value|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)| @@ -33,13 +33,13 @@ This page provides a mapping from FHIR to CDA. For the CDA to FHIR mapping, plea |.route|/routeCode|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |.doseQuantity|/doseQuantity|[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity)| |.performer.actor|/performer|**Constraint** when .performer.function="AP"<br/>[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| -|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|**[Comment Activity](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|| -|.reasonCode|**[Indication](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-Indication.html)**<br/>/entryRelationship[@typeCode="RSON"]/observation/value|| +|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|**[Comment Activity](https://hl7.org/cda/us/ccda/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|| +|.reasonCode|**[Indication](https://hl7.org/cda/us/ccda/StructureDefinition-Indication.html)**<br/>/entryRelationship[@typeCode="RSON"]/observation/value|| |.education.documentType|reference/ExternalDocument/code|| |.education.reference|/reference/ExternalDocument/id|| -|.reaction.id<br/><br/>|**[Reaction](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-ReactionObservation.html)**<br/>/entryRelationship[@typeCode="MFST"]/observation/id|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| -|.reaction.date|/**[Reaction](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-ReactionObservation.html)**<br/>/entryRelationship[@typeCode="MFST"]/observation/effectiveTime|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)| -|.reaction.detail.valueCodeableConcept|**[Reaction](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-ReactionObservation.html)**<br/>/entryRelationship[@typeCode="MFST"]/observation/value|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|.reaction.id<br/><br/>|**[Reaction](https://hl7.org/cda/us/ccda/StructureDefinition-ReactionObservation.html)**<br/>/entryRelationship[@typeCode="MFST"]/observation/id|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| +|.reaction.date|/**[Reaction](https://hl7.org/cda/us/ccda/StructureDefinition-ReactionObservation.html)**<br/>/entryRelationship[@typeCode="MFST"]/observation/effectiveTime|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)| +|.reaction.detail.valueCodeableConcept|**[Reaction](https://hl7.org/cda/us/ccda/StructureDefinition-ReactionObservation.html)**<br/>/entryRelationship[@typeCode="MFST"]/observation/value|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |.doseNumber[x].doseNumberPositiveInt|/repeatNumber|| 1\. XPath abbrievated for C-CDA Immunization Activity as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="11369-6"]/entry/substanceAdministration diff --git a/input/pagecontent/FC-medications.md b/input/pagecontent/FC-medications.md index d5f72e4..1fdb39d 100644 --- a/input/pagecontent/FC-medications.md +++ b/input/pagecontent/FC-medications.md @@ -19,7 +19,7 @@ See guidance on timing mappings on [Medications CDA → FHIR](./CF-medications.h ### FHIR to C-CDA -|FHIR<br>[MedicationRequest](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-medicationrequest.html)|C-CDA¹<br>[Medication Activity substanceAdministration](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-MedicationActivity.html)|Transform Steps| +|FHIR<br>[MedicationRequest](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-medicationrequest.html)|C-CDA¹<br>[Medication Activity substanceAdministration](https://hl7.org/cda/us/ccda/StructureDefinition-MedicationActivity.html)|Transform Steps| |:----|:----|:----| |.identifier|/id|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| |.status|/status|[FHIR status → CDA statusCode](ConceptMap-FC-MedicationStatus.html)| @@ -30,10 +30,10 @@ See guidance on timing mappings on [Medications CDA → FHIR](./CF-medications.h |.authoredOn|/author/time|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)| |.requester|/assignedAuthor|[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| |.performer|/performer|[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| -|.reasonCode|**[Indication](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-Indication.html)**<br/>/entryRelationship[@typeCode="RSON"]/observation/value|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| -|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|**[Comment Activity](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|| -|.dosageInstruction.text<br/>&<br/>.dosageInstruction.patientInstruction|**[Free text sig](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-MedicationFreeTextSig.html)**<br/>/entryRelationship/substanceAdministration[code/@code="76662-6"]/text|| -|.dosageInstruction.additionalInstruction|**[Instruction](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-Instruction.html)**<br/>/entryRelationship[@typeCode="SUBJ"]/act/code|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|.reasonCode|**[Indication](https://hl7.org/cda/us/ccda/StructureDefinition-Indication.html)**<br/>/entryRelationship[@typeCode="RSON"]/observation/value|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|**[Comment Activity](https://hl7.org/cda/us/ccda/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|| +|.dosageInstruction.text<br/>&<br/>.dosageInstruction.patientInstruction|**[Free text sig](https://hl7.org/cda/us/ccda/StructureDefinition-MedicationFreeTextSig.html)**<br/>/entryRelationship/substanceAdministration[code/@code="76662-6"]/text|| +|.dosageInstruction.additionalInstruction|**[Instruction](https://hl7.org/cda/us/ccda/StructureDefinition-Instruction.html)**<br/>/entryRelationship[@typeCode="SUBJ"]/act/code|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |.dosageInstruction.timing.repeat.boundsPeriod.start|effectiveTime[1]/low|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)<br/>**Note:** in XPath, `[1]` is the first instance; there is no `[0]` in XPath.| |.dosageInstruction.timing.repeat.boundsPeriod.end|effectiveTime[1]/high|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)| |.dosageInstruction.timing.repeat.frequency<br/>&<br/>.dosageInstruction.timing.repeat.period<br/>&<br/>.dosageInstruction.timing.repeat.periodUnit<br/>|/effectiveTime[2]/...<br/>/@operator='A'<br/>/@xsi:type='PIVL_TS'<br/>/@institutionSpecified<br/>/period|Compare:<br/>[C-CDA Common Medication Frequencies](http://cdasearch.hl7.org/examples/view/9588687865c0f945a326364a9449321690c7a7ef) and <br/>[FHIR Timing Data Type](http://hl7.org/fhir/R4/datatypes.html#Timing)| diff --git a/input/pagecontent/FC-patient.md b/input/pagecontent/FC-patient.md index 856f6e8..d89be8a 100644 --- a/input/pagecontent/FC-patient.md +++ b/input/pagecontent/FC-patient.md @@ -17,7 +17,7 @@ This page provides a mapping from FHIR to CDA. For the CDA to FHIR mapping, plea ### FHIR to C-CDA -|FHIR<br/>[Patient](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-patient.html#profile)|C-CDA¹<br/>[US Realm Header recordTarget](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-USRealmHeader.html)|Transform Steps| +|FHIR<br/>[Patient](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-patient.html#profile)|C-CDA¹<br/>[US Realm Header recordTarget](https://hl7.org/cda/us/ccda/StructureDefinition-USRealmHeader.html)|Transform Steps| |:----|:----|:----| |.extension.extension (race)<br/>url=http://hl7.org/fhir/us/core/STU4/StructureDefinition/us-core-race|/patientRole/patient/raceCode<br/>&<br/>/patientRole/patient/sdtc:raceCode|only one ombCategory extension goes in raceCode; other values go in sdtc:raceCode| |.extension.extension (ethnicity)<br/>url=http://hl7.org/fhir/us/core/STU4/StructureDefinition/us-core-ethnicity|/patientRole/patient/ethnicGroupCode<br/>&<br/>/patientRole/patient/sdtc:ethnicGroupCode|only one ombCategory extension goes in ethnicGroupCode; other values go in sdtc:ethnicGroupCode| diff --git a/input/pagecontent/FC-problems.md b/input/pagecontent/FC-problems.md index c508360..958d666 100644 --- a/input/pagecontent/FC-problems.md +++ b/input/pagecontent/FC-problems.md @@ -17,11 +17,11 @@ This page provides a mapping from FHIR to CDA. For the CDA to FHIR mapping, plea ### FHIR to C-CDA -|FHIR<br/>[Condition and Health Concern](https://hl7.org/fhir/us/core/StructureDefinition-us-core-condition-problems-health-concerns.html)|C-CDA¹<br/>[Problem observation](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-ProblemObservation.html)|Transform Steps| +|FHIR<br/>[Condition and Health Concern](https://hl7.org/fhir/us/core/StructureDefinition-us-core-condition-problems-health-concerns.html)|C-CDA¹<br/>[Problem observation](https://hl7.org/cda/us/ccda/StructureDefinition-ProblemObservation.html)|Transform Steps| |:----|:----|:----| |.identifier|/id|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| -|.clinicalStatus|(act parent to observation) ../../statusCode<br/>&<br/>**[Problem Status](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-ProblemStatus.html)**<br/>/entryRelationship/observation[code/@code="33999-4"]/value|[FHIR clinicalStatus → CDA Problem Status Observation value](./ConceptMap-FC-ProblemStatus.html)<br/>For more information on how status is managed in Problem Concern Act wrapper, refer to [C-CDA guidance, see 5.2.6.1](https://www.hl7.org/implement/standards/product_brief.cfm?product_id=447)| -|.category|/code<br/>This also affects the C-CDA document section:<br/>**[Problems](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-ProblemSection.html)**<br/>**[Health Concerns](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-HealthConcernsSection.html)**<br/>**[Encounters](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-EncountersSection.html)**|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>[FHIR category → CDA section](ConceptMap-FC-ProblemCategory.html)| +|.clinicalStatus|(act parent to observation) ../../statusCode<br/>&<br/>**[Problem Status](https://hl7.org/cda/us/ccda/StructureDefinition-ProblemStatus.html)**<br/>/entryRelationship/observation[code/@code="33999-4"]/value|[FHIR clinicalStatus → CDA Problem Status Observation value](./ConceptMap-FC-ProblemStatus.html)<br/>For more information on how status is managed in Problem Concern Act wrapper, refer to [C-CDA guidance, see 5.2.6.1](https://www.hl7.org/implement/standards/product_brief.cfm?product_id=447)| +|.category|/code<br/>This also affects the C-CDA document section:<br/>**[Problems](https://hl7.org/cda/us/ccda/StructureDefinition-ProblemSection.html)**<br/>**[Health Concerns](https://hl7.org/cda/us/ccda/StructureDefinition-HealthConcernsSection.html)**<br/>**[Encounters](https://hl7.org/cda/us/ccda/StructureDefinition-EncountersSection.html)**|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>[FHIR category → CDA section](ConceptMap-FC-ProblemCategory.html)| |.code|/value|**Constraint**: When FHIR concept does not represent negated concept<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |.code|/value<br/>&<br/>set @negationInd="true"|**Constraint**: When FHIR concept represents negated concept| |.onsetDateTime|/effectiveTime/low|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)| @@ -30,7 +30,7 @@ This page provides a mapping from FHIR to CDA. For the CDA to FHIR mapping, plea |.recordedDate|**[Date of Diagnosis](https://www.hl7.org/ccdasearch/templates/2.16.840.1.113883.10.20.22.4.502.html)**<br/>entryRelationship/act[code/@code="77975-1"]/effectiveTime<br/>&<br/>/assignedAuthor/time|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)| |.recorder|/assignedAuthor|[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| |.asserter|/informant|[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| -|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|**[Comment Activity](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-CommentActivity.html)**<br/>entryRelationship/act[code/@code="48767-8"]/text|| +|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|**[Comment Activity](https://hl7.org/cda/us/ccda/StructureDefinition-CommentActivity.html)**<br/>entryRelationship/act[code/@code="48767-8"]/text|| 1\. XPath abbrievated for C-CDA Problem observation as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="11450-4"]/entry/act/entryRelationship/observation diff --git a/input/pagecontent/FC-procedures.md b/input/pagecontent/FC-procedures.md index 79438e6..cb4f0a7 100644 --- a/input/pagecontent/FC-procedures.md +++ b/input/pagecontent/FC-procedures.md @@ -16,11 +16,11 @@ td, th { This page provides a mapping from FHIR to CDA. For the CDA to FHIR mapping, please refer to [Procedures CDA → FHIR](./CF-procedures.html). For guidance on how to read the table below, see [Reading the C-CDA ↔ FHIR Mapping Pages](./mappingGuidance.html). <br/> #### Note on template selection -It also specifies a template for “all interventional, non-interventional, surgical, diagnostic, or therapeutic procedures or treatments pertinent to the patient historically at the time the document is generated." For this reason, we recommend mapping [FHIR Procedures](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-procedure.html) to [Procedure Activity Procedure](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-ProcedureActivityProcedure.html) when using the C-CDA R3/E1 guide for the targeted C-CDA, while guidance on mapping to the other templates when generating an older version C-CDA will be forthcoming. +It also specifies a template for “all interventional, non-interventional, surgical, diagnostic, or therapeutic procedures or treatments pertinent to the patient historically at the time the document is generated." For this reason, we recommend mapping [FHIR Procedures](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-procedure.html) to [Procedure Activity Procedure](https://hl7.org/cda/us/ccda/StructureDefinition-ProcedureActivityProcedure.html) when using the C-CDA R3/E1 guide for the targeted C-CDA, while guidance on mapping to the other templates when generating an older version C-CDA will be forthcoming. ### FHIR to C-CDA -|FHIR<br/>[Procedure](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-procedure.html)|C-CDA¹<br/>[Procedure Activity procedure](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-ProcedureActivityProcedure.html)|Transform Steps| +|FHIR<br/>[Procedure](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-procedure.html)|C-CDA¹<br/>[Procedure Activity procedure](https://hl7.org/cda/us/ccda/StructureDefinition-ProcedureActivityProcedure.html)|Transform Steps| |:----|:----|:----| |.identifier|/id|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| |.status|/statusCode|[FHIR status → CDA statusCode](./ConceptMap-FC-ProcedureStatus.html)| @@ -30,10 +30,10 @@ It also specifies a template for “all interventional, non-interventional, surg |.performedPeriod.end|/effectiveTime/high|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)| |.performer.actor|/performer|[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| |.performer.onBehalfOf|/perfomer/assignedEntity/representedOrganization|[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| -|.location|**[Service Delivery Location](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-ServiceDeliveryLocation.html)**<br/>/participant[@typeCode="LOC"]<br/>/participantRole|| -|.reasonCode|**[Indication](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-Indication.html)**<br/>/entryRelationship[@typeCode="RSON"]<br/>/observation/value|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|.location|**[Service Delivery Location](https://hl7.org/cda/us/ccda/StructureDefinition-ServiceDeliveryLocation.html)**<br/>/participant[@typeCode="LOC"]<br/>/participantRole|| +|.reasonCode|**[Indication](https://hl7.org/cda/us/ccda/StructureDefinition-Indication.html)**<br/>/entryRelationship[@typeCode="RSON"]<br/>/observation/value|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |.bodySite|/targetSiteCode|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| -|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|**[Comment Activity](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-CommentActivity.html)**<br/>entryRelationship/act[code@code="48767-8"]/entryRelationship/act/text|| +|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|**[Comment Activity](https://hl7.org/cda/us/ccda/StructureDefinition-CommentActivity.html)**<br/>entryRelationship/act[code@code="48767-8"]/entryRelationship/act/text|| 1\. XPath abbrievated for C-CDA Procedure as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="47519-4"]/entry/procedure diff --git a/input/pagecontent/FC-vitals.md b/input/pagecontent/FC-vitals.md index 2348aa5..a20e638 100644 --- a/input/pagecontent/FC-vitals.md +++ b/input/pagecontent/FC-vitals.md @@ -10,7 +10,7 @@ FHIR Vitals that are grouped into a panel using the memberOf property are mapped ### FHIR Observation Panel to C-CDA Vital Signs Organizer -|FHIR<br/>[Vital Signs Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-vital-signs.html)|C-CDA¹<br/>[Vital SignsOrganizer](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-VitalSignsOrganizer.html)|Transform Steps| +|FHIR<br/>[Vital Signs Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-vital-signs.html)|C-CDA¹<br/>[Vital SignsOrganizer](https://hl7.org/cda/us/ccda/StructureDefinition-VitalSignsOrganizer.html)|Transform Steps| |:----|:----|:----| |.identifier|/id|[FHIR identifier ↔ CDA id](mappingGuidance.html#cda-id--fhir-identifier)| |.category = `vital-signs` from [Vital Signs value set](https://hl7.org/fhir/us/core/STU4/ValueSet-us-core-vital-signs.html)|| @@ -22,7 +22,7 @@ FHIR Vitals that are grouped into a panel using the memberOf property are mapped ### FHIR Observation to C-CDA Vital Signs Observation -|FHIR<br/>[Vital Signs Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-vital-signs.html)|C-CDA¹<br/>[Vital Sign Observation](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-VitalSignObservation.html)|Transform Steps| +|FHIR<br/>[Vital Signs Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-vital-signs.html)|C-CDA¹<br/>[Vital Sign Observation](https://hl7.org/cda/us/ccda/StructureDefinition-VitalSignObservation.html)|Transform Steps| |:----|:----|:----| |.identifier|/id|[FHIR identifier ↔ CDA id](mappingGuidance.html#cda-id--fhir-identifier)| |.code |/code|[FHIR CodeableConcept ↔ CDA coding ](mappingGuidance.html#fhir-codeableconcept--cda-coding)| diff --git a/input/pagecontent/mappingBackground.md b/input/pagecontent/mappingBackground.md index 7363d4c..573bbb7 100644 --- a/input/pagecontent/mappingBackground.md +++ b/input/pagecontent/mappingBackground.md @@ -1,4 +1,4 @@ -[Consolidated Clinical Document Architecture (C-CDA)](https://hl7.org/cda/us/ccda/2024Jan/) and [Fast Healthcare Interoperability Resources (FHIR) US Core](http://hl7.org/fhir/us/core/STU4/) are two of the most common standards for exchanging clinical data in the United States. This [project's](https://confluence.hl7.org/display/CGP/C-CDA+to+and+from+US+Core+Mapping) goals are to establish HL7 mapping transformation guidance to provide clarity and consistency in translating data between C-CDA and FHIR and between FHIR and C-CDA. +[Consolidated Clinical Document Architecture (C-CDA)](https://hl7.org/cda/us/ccda/) and [Fast Healthcare Interoperability Resources (FHIR) US Core](http://hl7.org/fhir/us/core/STU4/) are two of the most common standards for exchanging clinical data in the United States. This [project's](https://confluence.hl7.org/display/CGP/C-CDA+to+and+from+US+Core+Mapping) goals are to establish HL7 mapping transformation guidance to provide clarity and consistency in translating data between C-CDA and FHIR and between FHIR and C-CDA. In our first publication, we focused on the subset of domains that are recognized as the most exchangeable concepts in the industry. This first publication is limited to Problems, Allergies, Medications, Immunizations, Procedures, and Patient (PAMI+) domains. Acknowledging the various stages of maturity for each domain, we included the entire work for these concepts. This project was scoped independently of the document-level profiles developed in earlier versions of this guide. diff --git a/input/pagecontent/mappingGuidance.md b/input/pagecontent/mappingGuidance.md index e77c531..4763b15 100644 --- a/input/pagecontent/mappingGuidance.md +++ b/input/pagecontent/mappingGuidance.md @@ -8,9 +8,9 @@ td, th { #### How to Read Mapping Tables and Transform Steps? -The header row of the mapping table provides links to the respective profiles in FHIR (e.g. **[US Core AllergyIntolerance](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-allergyintolerance.html)**) and templates in C-CDA (e.g. **[Allergy Intolerance observation](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-AllergyIntoleranceObservation.html)**)and specifies the "base" that each of the rows will build on. All FHIR elements use a simplified dot notation and the CDA elements use simplified slash notation. Always use the underlying standards, provided via header row links, to ensure conformance when building FHIR resources or C-CDA clinical documents. +The header row of the mapping table provides links to the respective profiles in FHIR (e.g. **[US Core AllergyIntolerance](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-allergyintolerance.html)**) and templates in C-CDA (e.g. **[Allergy Intolerance observation](https://hl7.org/cda/us/ccda/StructureDefinition-AllergyIntoleranceObservation.html)**)and specifies the "base" that each of the rows will build on. All FHIR elements use a simplified dot notation and the CDA elements use simplified slash notation. Always use the underlying standards, provided via header row links, to ensure conformance when building FHIR resources or C-CDA clinical documents. -Rather than repeating cardinality, conformance, and other criteria from FHIR Resources or a C-CDA templates defined outside this implementaiton guide, external references are shown in tables as bold hyperlinks (e.g. **[US Core Patient](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-patient.html)** or **[C-CDA US Realm Header](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-USRealmHeader.html)**). Unbolded links refer to guidance contained within this guide (e.g. [CDA ↔ FHIR Name, Address, and Telecom mapping](mappingGuidance.html#name-address-telecom)). When criteria for selecting XML elements from C-CDA is required, you will see **[XPath](https://en.wikipedia.org/wiki/XPath)** notation with the respective criteria within brackets (e.g. /entryRelationship[@typeCode="MSFT"]). +Rather than repeating cardinality, conformance, and other criteria from FHIR Resources or a C-CDA templates defined outside this implementaiton guide, external references are shown in tables as bold hyperlinks (e.g. **[US Core Patient](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-patient.html)** or **[C-CDA US Realm Header](https://hl7.org/cda/us/ccda/StructureDefinition-USRealmHeader.html)**). Unbolded links refer to guidance contained within this guide (e.g. [CDA ↔ FHIR Name, Address, and Telecom mapping](mappingGuidance.html#name-address-telecom)). When criteria for selecting XML elements from C-CDA is required, you will see **[XPath](https://en.wikipedia.org/wiki/XPath)** notation with the respective criteria within brackets (e.g. /entryRelationship[@typeCode="MSFT"]). The "Transform Steps" column of the table will provide guidance for mapping content between C-CDA and FHIR, those steps will be listed in the following order: @@ -575,7 +575,7 @@ The mappings of name, address and telecom information are useful in many part of ### Missing Data in C-CDA vs. FHIR #### CDA and FHIR address missing data and null usage in different ways: -- The use of nullFlavor in CDA is explained in depth in Volume 1 of the [C-CDA Implementation Guide](https://hl7.org/cda/us/ccda/2024Jan/generalguidance.html#unknown-and-no-known-information) and in the [C-CDA Companion Guide](https://www.hl7.org/implement/standards/product_brief.cfm?product_id=447). +- The use of nullFlavor in CDA is explained in depth in Volume 1 of the [C-CDA Implementation Guide](https://hl7.org/cda/us/ccda/generalguidance.html#unknown-and-no-known-information) and in the [C-CDA Companion Guide](https://www.hl7.org/implement/standards/product_brief.cfm?product_id=447). - The use of the data absent reason extension is explained in depth in the [US Core Implementation Guide](https://hl7.org/fhir/us/core/STU4/general-guidance.html#missing-data) and also in the [base extension](http://hl7.org/fhir/extension-data-absent-reason.html). In this publication, we include a mapping between missing data concepts. **Importantly, it should be noted that several mappings include non-equivalence (wider or narrower or unsupported) and that each standard may allow data elements to be omitted while the other requires**. Feedback to improve implementer guidance is welcome on the handling of missing data between C-CDA and FHIR: From 1aa4b072b12964439211512ad6e4bec7b2add1f8 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Mon, 14 Oct 2024 15:05:18 -0500 Subject: [PATCH 067/112] Update C-CDA links to 3.0 version directly (since "latest" could change) --- input/pagecontent/CF-allergies.md | 16 ++++++++-------- input/pagecontent/CF-encounters.md | 6 +++--- input/pagecontent/CF-immunizations.md | 10 +++++----- input/pagecontent/CF-medications.md | 18 +++++++++--------- input/pagecontent/CF-notes.md | 2 +- input/pagecontent/CF-patient.md | 2 +- input/pagecontent/CF-problems.md | 12 ++++++------ input/pagecontent/CF-procedures.md | 8 ++++---- input/pagecontent/CF-results.md | 4 ++-- input/pagecontent/CF-social.md | 18 +++++++++--------- input/pagecontent/CF-vitals.md | 4 ++-- input/pagecontent/FC-allergies.md | 12 ++++++------ input/pagecontent/FC-immunizations.md | 14 +++++++------- input/pagecontent/FC-medications.md | 10 +++++----- input/pagecontent/FC-patient.md | 2 +- input/pagecontent/FC-problems.md | 8 ++++---- input/pagecontent/FC-procedures.md | 10 +++++----- input/pagecontent/FC-vitals.md | 4 ++-- input/pagecontent/index.md | 2 +- input/pagecontent/mappingGuidance.md | 4 ++-- 20 files changed, 83 insertions(+), 83 deletions(-) diff --git a/input/pagecontent/CF-allergies.md b/input/pagecontent/CF-allergies.md index 8b19cbb..cba2026 100644 --- a/input/pagecontent/CF-allergies.md +++ b/input/pagecontent/CF-allergies.md @@ -12,10 +12,10 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea <br /> ### C-CDA to FHIR -| C-CDA¹ <br/>[Allergy Concern act](https://hl7.org/cda/us/ccda/StructureDefinition-AllergyConcernAct.html)| FHIR <br/>[AllergyIntolerance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-allergyintolerance.html)|Transform Steps & Notes| +| C-CDA¹ <br/>[Allergy Concern act](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-AllergyConcernAct.html)| FHIR <br/>[AllergyIntolerance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-allergyintolerance.html)|Transform Steps & Notes| |:-------|:------|:---------| |/statusCode|.clinicalStatus|For more information on how status is managed in Allergy Concern Act wrapper, refer to [C-CDA guidance, see 5.2.7.1](https://www.hl7.org/implement/standards/product_brief.cfm?product_id=447)<br/>Also see Status entryRelationship mapping below| -| All of the following are a **[Allergy Intolerance observation](https://hl7.org/cda/us/ccda/StructureDefinition-AllergyIntoleranceObservation.html)** nested inside the **[Allergy Concern act](https://hl7.org/cda/us/ccda/StructureDefinition-AllergyConcernAct.html)**. Each observation should become a distinct FHIR **[AllergyIntolerance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-allergyintolerance.html)** resource.<br/>Include /entryRelationship[@typeCode="SUBJ"]/observation prefix to rows below²| +| All of the following are a **[Allergy Intolerance observation](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-AllergyIntoleranceObservation.html)** nested inside the **[Allergy Concern act](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-AllergyConcernAct.html)**. Each observation should become a distinct FHIR **[AllergyIntolerance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-allergyintolerance.html)** resource.<br/>Include /entryRelationship[@typeCode="SUBJ"]/observation prefix to rows below²| |/@negationInd||See constraints under /participant |/id|.identifier| [CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| |/effectiveTime/low|.onsetDateTime|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)<br/>effectiveTime/high should not be mapped within onset (DateTime or Period)| @@ -24,11 +24,11 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea |/author/time|.recordedDate|**Constraint:** Only map earliest author/time <br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)| |/participant/participantRole/playingEntity/code|.code|**Constraint:** When CDA negation is absent or false<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/participant/participantRole/playingEntity/code<br/>&<br/>/value|.code|**Constraint:** When CDA negation is true and nullFlavor is used in playingEntity/code<br/>[CDA No known allergy → FHIR code](ConceptMap-CF-NoKnownAllergies.html)<br/> When negation is true and playingEntity/code is populated, use equivalent negated concept (e.g. map latex substance to no known latex allergy [1003774007, SNOMED CT]) if available. If not, use the [substanceExposureRisk extension](https://hl7.org/fhir/extensions/StructureDefinition-allergyintolerance-substanceExposureRisk.html), placing the substance in the substance sub-extension and setting the exposureRisk sub-extension to `no-known-reaction-risk`. Note that when using this extension, the AllergyIntolerance resource will not be a conformant US Core AllergyIntolerance since the extension prohibits the required .code element.| -|**[Status](https://hl7.org/cda/us/ccda/StructureDefinition-AllergyStatusObservation.html)**<br/>/entryRelationship/observation[code/@code="33999-4"]/value³|.clinicalStatus|[CDA Allergy Status Observation value → FHIR clinicalStatus](./ConceptMap-CF-AllergyStatus.html) -|**[Reaction](https://hl7.org/cda/us/ccda/StructureDefinition-ReactionObservation.html)**<br/>/entryRelationship[@typeCode="MFST"]/observation/value³|.reaction.manifestation|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>Both use SNOMED clinical findings with minor valueSet definition differences -|**[Severity](https://hl7.org/cda/us/ccda/StructureDefinition-SeverityObservation.html)** (nested inside Reaction)<br/>/entryRelationship[@typeCode="MFST"]/observation/entryRelationship/observation[code/@code="SEV"]/value³|.reaction.severity|[CDA Severity value → FHIR Severity](./ConceptMap-CF-Severity.html)<br/>**Note:** CDA documents should not assign severity at the Allergy level.<br/><br/>In cases where CDA assigns severity only to the Allergy rather than the reaction, map the severity to FHIR reaction severity, even if there are more than one. This means assuming that the same severity applies to all child reactions.<br/><br/>If severity is assigned at both levels, the reaction level should be used. -|**[Criticality](https://hl7.org/cda/us/ccda/StructureDefinition-CriticalityObservation.html)**<br/>/entryRelationship/observation[code/@code="82606-5"]/value³|.criticality|[CDA Criticality value → FHIR Criticality](./ConceptMap-CF-Criticality.html) -|**[Comment Activity](https://hl7.org/cda/us/ccda/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text³|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|| +|**[Status](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-AllergyStatusObservation.html)**<br/>/entryRelationship/observation[code/@code="33999-4"]/value³|.clinicalStatus|[CDA Allergy Status Observation value → FHIR clinicalStatus](./ConceptMap-CF-AllergyStatus.html) +|**[Reaction](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ReactionObservation.html)**<br/>/entryRelationship[@typeCode="MFST"]/observation/value³|.reaction.manifestation|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>Both use SNOMED clinical findings with minor valueSet definition differences +|**[Severity](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-SeverityObservation.html)** (nested inside Reaction)<br/>/entryRelationship[@typeCode="MFST"]/observation/entryRelationship/observation[code/@code="SEV"]/value³|.reaction.severity|[CDA Severity value → FHIR Severity](./ConceptMap-CF-Severity.html)<br/>**Note:** CDA documents should not assign severity at the Allergy level.<br/><br/>In cases where CDA assigns severity only to the Allergy rather than the reaction, map the severity to FHIR reaction severity, even if there are more than one. This means assuming that the same severity applies to all child reactions.<br/><br/>If severity is assigned at both levels, the reaction level should be used. +|**[Criticality](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-CriticalityObservation.html)**<br/>/entryRelationship/observation[code/@code="82606-5"]/value³|.criticality|[CDA Criticality value → FHIR Criticality](./ConceptMap-CF-Criticality.html) +|**[Comment Activity](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text³|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|| 1\. XPath abbreviated for C-CDA Allergy Concern act as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="48765-2"]/entry/act/ @@ -37,7 +37,7 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea 3\. Note that these entryRelationships will also have inversionInd="true" in CDA -When authors or other provenance are recorded in the parentƒ [Allergy Concern Act](https://hl7.org/cda/us/ccda/StructureDefinition-AllergyConcernAct.html), it is recommended that those data be mapped to the FHIR AllergyIntolerance. +When authors or other provenance are recorded in the parentƒ [Allergy Concern Act](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-AllergyConcernAct.html), it is recommended that those data be mapped to the FHIR AllergyIntolerance. ### Illustrative example diff --git a/input/pagecontent/CF-encounters.md b/input/pagecontent/CF-encounters.md index 400ff44..3ad87f8 100644 --- a/input/pagecontent/CF-encounters.md +++ b/input/pagecontent/CF-encounters.md @@ -11,7 +11,7 @@ Encounter Activities in the Encounters Section (or elsewhere in the document, su ### C-CDA Encounter to FHIR <sup>(b)</sup> - indicates element is only present in Encounter Activity in the body of the document<br/><sup>(h)</sup> - indicates element is only present in EncompassingEncounter in the header of the document -|C-CDA¹<br/>[Encounter Activity](https://hl7.org/cda/us/ccda/StructureDefinition-EncounterActivity.html) or [EncompassingEncounter](https://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-EncompassingEncounter.html)|FHIR<br/>[Encounter](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-encounter.html)|Transform Steps| +|C-CDA¹<br/>[Encounter Activity](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-EncounterActivity.html) or [EncompassingEncounter](https://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-EncompassingEncounter.html)|FHIR<br/>[Encounter](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-encounter.html)|Transform Steps| |:----|:----|:----| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| |/code |.class|Only the V3 ActCode system, which may be present in the root element or any `<translation>`.<br/>Other code systems may map to V3 ActCode (for example CPT codes 99211-99215 map to `AMB`, 99221-99223 to `IMP`, 99281-99285 to `EMER`, etc), but if this mapping is not possible, use the [Data Absent Reason](http://hl7.org/fhir/StructureDefinition/data-absent-reason) extension.| @@ -24,8 +24,8 @@ Encounter Activities in the Encounters Section (or elsewhere in the document, su |/performer <sup>(b)</sup><br/>/encounterParticipant <sup>(h)</sup>|.participant|*TODO: Mapping Guidance for general performers (Participant vs ParticipantRole vs Organization)* |/performer/sdtc:functionCode <sup>(b)</sup>|.participant.type|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) |/participant[@typeCode="LOC"] <sup>(b)</sup><br/>/location <sup>(h)</sup>|.location -|**[Indication](https://hl7.org/cda/us/ccda/StructureDefinition-Indication.html)** <sup>(b)</sup><br/>/entryRelationship[@typeCode="RSON"]/observation|.reasonCode<br/>or<br/>.reasonReference|If the id of the indication references a problem in the document that has been converted to a FHIR resource, populate .reasonReference with a reference to that resource. Otherwise, map observation/value to .reasonCode.<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) -|**[Encounter Diagnosis](https://hl7.org/cda/us/ccda/StructureDefinition-EncounterDiagnosis.html)** <sup>(b)</sup><br/>/entryRelationship/act[code/@code="29308-4"]/observation|**[Encounter Diagnosis](https://hl7.org/fhir/us/core/StructureDefinition-us-core-condition-encounter-diagnosis.html)**<br/>&<br/>.diagnosis.condition|The observation maps identically to [CDA → FHIR Problems](./CF-problems.html).<br/>Since this is an encounter diagnosis, the `Observation.category` should be set to `encounter-diagnosis`. +|**[Indication](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-Indication.html)** <sup>(b)</sup><br/>/entryRelationship[@typeCode="RSON"]/observation|.reasonCode<br/>or<br/>.reasonReference|If the id of the indication references a problem in the document that has been converted to a FHIR resource, populate .reasonReference with a reference to that resource. Otherwise, map observation/value to .reasonCode.<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) +|**[Encounter Diagnosis](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-EncounterDiagnosis.html)** <sup>(b)</sup><br/>/entryRelationship/act[code/@code="29308-4"]/observation|**[Encounter Diagnosis](https://hl7.org/fhir/us/core/StructureDefinition-us-core-condition-encounter-diagnosis.html)**<br/>&<br/>.diagnosis.condition|The observation maps identically to [CDA → FHIR Problems](./CF-problems.html).<br/>Since this is an encounter diagnosis, the `Observation.category` should be set to `encounter-diagnosis`. ### Illustrative example diff --git a/input/pagecontent/CF-immunizations.md b/input/pagecontent/CF-immunizations.md index 7613c30..6472c6a 100644 --- a/input/pagecontent/CF-immunizations.md +++ b/input/pagecontent/CF-immunizations.md @@ -12,7 +12,7 @@ Mapping is from `@moodCode="EVN"` (i.e. historical) immunizations, not `INT` (fu <br /> ### C-CDA to FHIR -|C-CDA¹<br/>[Immunization Activity substanceAdministration](https://hl7.org/cda/us/ccda/StructureDefinition-ImmunizationActivity.html)|FHIR<br/>[Immunization](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-immunization.html#profile)|Transform Steps| +|C-CDA¹<br/>[Immunization Activity substanceAdministration](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ImmunizationActivity.html)|FHIR<br/>[Immunization](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-immunization.html#profile)|Transform Steps| |:----|:----|:----| |/@negationInd="true"||Set ```.status="not-done"``` when @negationInd="true"| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| @@ -29,10 +29,10 @@ Mapping is from `@moodCode="EVN"` (i.e. historical) immunizations, not `INT` (fu |/author|**[Provenance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-provenance.html)**|[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| |/author/time|.recorded|Earliest, if more than one.<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) |/performer|.performer|Set ```performer.function="AP"``` -|**[Immunization Refusal Reason](https://hl7.org/cda/us/ccda/StructureDefinition-ImmunizationRefusalReason.html)**<br/>/entryRelationship[@typeCode="RSON"]²/observation/code<br/>(only if code is from ValueSet [No Immunization Reason](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.1.11.19717/expansion/Latest))|.statusReason|[CDA refusal → FHIR statusReason](ConceptMap-CF-ImmunizationRefusal.html)<br/>Indicates the reason the immunization event was **not** performed. This is generally only used for the status of "not-done".| -|**[Indication](http://hl7.org/cda/stds/ccda/draft1/StructureDefinition-2.16.840.1.113883.10.20.22.4.19.html)**<br/>/entryRelationship[@typeCode="RSON"]²/observation/value<br/>(only if observation/code is from ValueSet [Problem Type](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.88.12.3221.7.2/expansion/Latest))|.reasonCode|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| -|**[Reaction](https://hl7.org/cda/us/ccda/StructureDefinition-ReactionObservation.html)**<br/>/entryRelationship[@typeCode="MFST"]/observation/value|.reaction|It is recommended that reaction observation value be mapped to reaction detail (Observation) valueCodeable concept. Comments are welcome on how this may be best implemented. -|**[Comment Activity](https://hl7.org/cda/us/ccda/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|| +|**[Immunization Refusal Reason](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ImmunizationRefusalReason.html)**<br/>/entryRelationship[@typeCode="RSON"]²/observation/code<br/>(only if code is from ValueSet [No Immunization Reason](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.1.11.19717/expansion/Latest))|.statusReason|[CDA refusal → FHIR statusReason](ConceptMap-CF-ImmunizationRefusal.html)<br/>Indicates the reason the immunization event was **not** performed. This is generally only used for the status of "not-done".| +|**[Indication](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-Indication.html)**<br/>/entryRelationship[@typeCode="RSON"]²/observation/value<br/>(only if observation/code is from ValueSet [Problem Type](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.88.12.3221.7.2/expansion/Latest))|.reasonCode|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|**[Reaction](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ReactionObservation.html)**<br/>/entryRelationship[@typeCode="MFST"]/observation/value|.reaction|It is recommended that reaction observation value be mapped to reaction detail (Observation) valueCodeable concept. Comments are welcome on how this may be best implemented. +|**[Comment Activity](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|| 1\. XPath abbrievated for C-CDA Immunization Activity as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="11369-6"]/entry/substanceAdministration<br/> diff --git a/input/pagecontent/CF-medications.md b/input/pagecontent/CF-medications.md index ddc131c..5542f40 100644 --- a/input/pagecontent/CF-medications.md +++ b/input/pagecontent/CF-medications.md @@ -25,7 +25,7 @@ The C-CDA Example Search site maintains a document of [Common Medication Frequen ### C-CDA to FHIR (MedicationRequest) -|C-CDA¹<br>[Medication Activity substanceAdministration](https://hl7.org/cda/us/ccda/StructureDefinition-MedicationActivity.html)|FHIR<br>[MedicationRequest](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-medicationrequest.html)|Transform Steps| +|C-CDA¹<br>[Medication Activity substanceAdministration](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-MedicationActivity.html)|FHIR<br>[MedicationRequest](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-medicationrequest.html)|Transform Steps| |:----|:----|:----| |/@negationInd="true"|set .doNotPerform=true|| |@moodCode|.intent|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) <br/>[Mood to intent](ConceptMap-CF-MedActivityMood.html)| @@ -47,15 +47,15 @@ The C-CDA Example Search site maintains a document of [Common Medication Frequen |/consumable/manufacturedProduct/manufacturerOrganization|Medication.manufacturer|[See below](#c-cda-to-fhir-medication) |/author|.requester<br/>&<br/>**[Provenance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-procedure.html)**|[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| |/author/time|.authoredOn|Earliest, if more than one.<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)| -|**[Drug Vehicle](https://hl7.org/cda/us/ccda/StructureDefinition-DrugVehicle.html)**<br/>/participant[@typeCode="COV"]/playingEntity/code|Medication.ingredient|[See below](#c-cda-to-fhir-medication) -|**[Indication](https://hl7.org/cda/us/ccda/StructureDefinition-Indication.html)**<br/>/entryRelationship[@typeCode="RSON"]/observation/value|.reasonCode|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| -|**[Free text sig](https://hl7.org/cda/us/ccda/StructureDefinition-MedicationFreeTextSig.html)**<br/>/entryRelationship/substanceAdministration[code/@code="76662-6"]/text|.dosageInstruction.text|| -|**[Instruction Activity](https://hl7.org/cda/us/ccda/StructureDefinition-Instruction.html)**<br/>/entryRelationship[@typeCode="SUBJ" and @inversionInd="true"]/act|.dosageInstruction.patientInstruction<br/>.dosageInstruction.additionalInstruction|act/text or act/code/originalText can map to patientInstructions. If coded, can map to additionalInstruction. -|**[Supply Order](https://hl7.org/cda/us/ccda/StructureDefinition-MedicationSupplyOrder.html)**<br/>/entryRelationship[@typeCode="REFR"]/substanceAdministration[@moodCode="INT"]||Note: moodCode=INT means supply, moodCode=EVN means dispense, which is not documented here. +|**[Drug Vehicle](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-DrugVehicle.html)**<br/>/participant[@typeCode="COV"]/playingEntity/code|Medication.ingredient|[See below](#c-cda-to-fhir-medication) +|**[Indication](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-Indication.html)**<br/>/entryRelationship[@typeCode="RSON"]/observation/value|.reasonCode|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|**[Free text sig](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-MedicationFreeTextSig.html)**<br/>/entryRelationship/substanceAdministration[code/@code="76662-6"]/text|.dosageInstruction.text|| +|**[Instruction Activity](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-Instruction.html)**<br/>/entryRelationship[@typeCode="SUBJ" and @inversionInd="true"]/act|.dosageInstruction.patientInstruction<br/>.dosageInstruction.additionalInstruction|act/text or act/code/originalText can map to patientInstructions. If coded, can map to additionalInstruction. +|**[Supply Order](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-MedicationSupplyOrder.html)**<br/>/entryRelationship[@typeCode="REFR"]/substanceAdministration[@moodCode="INT"]||Note: moodCode=INT means supply, moodCode=EVN means dispense, which is not documented here. |../effectiveTime/high|.dispenseRequest.period.end|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)<br/>`low` would similarly map to `start`, but only high is called out in C-CDA.| |../repeatNumber|.dispenseRequest.numberOfRepeatsAllowed|**Caution:** in CDA, repeatNumber indicates total number of dispenses allowed. In FHIR, this field is exclusive of the original dispense. So the `numberOfRepeatsAllowed` will be one less than `repeatNumber`. |../quantity|.dispenseRequest.quantity|[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity) -|**[Comment Activity](https://hl7.org/cda/us/ccda/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|| +|**[Comment Activity](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|| |/precondition|.asNeededBoolean = true|The presence of a precondition element indicates asNeededBoolean should be true.<br/>More complex maps may be possible with .asNeededCodeableConcept.| 1\. XPath abbrievated for C-CDA Medication Activity as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="10160-0"]/entry/substanceAdministration @@ -63,12 +63,12 @@ The C-CDA Example Search site maintains a document of [Common Medication Frequen ### C-CDA to FHIR (Medication) MedicationRequest (and other resources) may represent the medication as a simple CodeableConcept. But when additional information about the medication needs to be conveyed, a Medication resource should be created instead and referenced by the MedicationRequest resource. Implementers may also opt to always create Medication resources. -|C-CDA¹<br>[Medication Activity substanceAdministration](https://hl7.org/cda/us/ccda/StructureDefinition-MedicationActivity.html)|FHIR<br>[Medication](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-medication.html)|Transform Steps| +|C-CDA¹<br>[Medication Activity substanceAdministration](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-MedicationActivity.html)|FHIR<br>[Medication](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-medication.html)|Transform Steps| |:----|:----|:----| |/administrationUnitCode|.form|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) |/consumable/manufacturedProduct/manufacturedMaterial/code|.code|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/consumable/manufacturedProduct/manufacturerOrganization|**[Organization](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-organization.html)**<br/>.manufacturer| -|**[Drug Vehicle](https://hl7.org/cda/us/ccda/StructureDefinition-DrugVehicle.html)**<br/>/participant[@typeCode="COV"]/playingEntity/code|.ingredient.itemCodeableConcept|Set `.isActive = false`<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) +|**[Drug Vehicle](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-DrugVehicle.html)**<br/>/participant[@typeCode="COV"]/playingEntity/code|.ingredient.itemCodeableConcept|Set `.isActive = false`<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) ### Illustrative example diff --git a/input/pagecontent/CF-notes.md b/input/pagecontent/CF-notes.md index 7c5323a..c17c80c 100644 --- a/input/pagecontent/CF-notes.md +++ b/input/pagecontent/CF-notes.md @@ -10,7 +10,7 @@ Clinical Notes may appear in their own section or as an entry in any open sectio ### C-CDA to FHIR -|C-CDA¹<br/>[Note Activity](https://hl7.org/cda/us/ccda/StructureDefinition-NoteActivity.html)|[DocumentReference](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-documentreference.html)|Transform Steps| +|C-CDA¹<br/>[Note Activity](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-NoteActivity.html)|[DocumentReference](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-documentreference.html)|Transform Steps| |:----|:----|:----| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| |/code/translation|.type|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>**NOTE:** The root code in C-CDA is always `34109-9: Note`. A more specific code may be sent in translation which should be sent as the DocumentReference.type. If there is no translation, however, `34109-9` may be sent as the type. diff --git a/input/pagecontent/CF-patient.md b/input/pagecontent/CF-patient.md index 23619bd..16bfb22 100644 --- a/input/pagecontent/CF-patient.md +++ b/input/pagecontent/CF-patient.md @@ -10,7 +10,7 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea <br /> ### C-CDA to FHIR -|C-CDA¹<br/>[US Realm Header recordTarget](https://hl7.org/cda/us/ccda/StructureDefinition-USRealmHeader.html)|FHIR<br/>[Patient](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-patient.html#profile)|Transform Steps| +|C-CDA¹<br/>[US Realm Header recordTarget](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-USRealmHeader.html)|FHIR<br/>[Patient](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-patient.html#profile)|Transform Steps| |:----|:----|:----| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| |/addr|.address|[CDA addr ↔ FHIR address ](mappingGuidance.html#cda-addr--fhir-address)| diff --git a/input/pagecontent/CF-problems.md b/input/pagecontent/CF-problems.md index e6d93d7..280bbbe 100644 --- a/input/pagecontent/CF-problems.md +++ b/input/pagecontent/CF-problems.md @@ -13,11 +13,11 @@ Note that C-CDA includes a Concern wrapper act from which status may be read; mo <br /> ### C-CDA to FHIR -|C-CDA¹<br/>[Problem Concern Act](https://hl7.org/cda/us/ccda/StructureDefinition-ProblemConcernAct.html)|FHIR<br/>[Condition and Health Concern](https://hl7.org/fhir/us/core/StructureDefinition-us-core-condition-problems-health-concerns.html)|Transform Steps| +|C-CDA¹<br/>[Problem Concern Act](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ProblemConcernAct.html)|FHIR<br/>[Condition and Health Concern](https://hl7.org/fhir/us/core/StructureDefinition-us-core-condition-problems-health-concerns.html)|Transform Steps| |:----|:----|:----| |From the parent section, use code@code|.category|[CDA section → FHIR category](ConceptMap-CF-ProblemCategory.html)<br/>**Note:** The section of a Problem Observation affects its FHIR category.| |/statusCode|.clinicalStatus|/statusCode → .clinicalStatus is to be used only if the C-CDA Problem Status Observation (see below) is missing.<br/>For more information on how status is managed in Problem Concern Act wrapper, refer to [C-CDA guidance, see 5.2.6.1](https://www.hl7.org/implement/standards/product_brief.cfm?product_id=447)<br/> [Concern Status → Condition Clinical Status](ConceptMap-CF-ConditionClinicalStatus.html) -|All of the following are a [Problem observation](https://hl7.org/cda/us/ccda/StructureDefinition-ProblemObservation.html) nested inside the [Problem Concern act](https://hl7.org/cda/us/ccda/StructureDefinition-ProblemConcernAct.html). Each observation should become a distinct FHIR Condition resource. <br/>/entryRelationship[@typeCode="SUBJ"]/observation prefix to rows below²||| +|All of the following are a [Problem observation](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ProblemObservation.html) nested inside the [Problem Concern act](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ProblemConcernAct.html). Each observation should become a distinct FHIR Condition resource. <br/>/entryRelationship[@typeCode="SUBJ"]/observation prefix to rows below²||| |/@negationInd=true|set .verificationStatus="refuted" or adjust .code for negated concept| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| |/code |.category|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| @@ -26,17 +26,17 @@ Note that C-CDA includes a Concern wrapper act from which status may be read; mo |/value|.code|**Constraint:** When CDA negation is absent or false<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/author|.recorder<br/>&<br/>**[Provenance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-procedure.html)**|.recorder should be authoritative (latest) author if there are multiple<br/>[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| |/author/time|.recordedDate|Earliest, if more than one<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) -|**[Problem Status](https://hl7.org/cda/us/ccda/StructureDefinition-ProblemStatus.html)**<br/>/entryRelationship/observation[code/@code="33999-4"]/value|.clinicalStatus|[CDA Problem Status Observation value → FHIR clinicalStatus](./ConceptMap-CF-ProblemStatus.html)| +|**[Problem Status](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ProblemStatus.html)**<br/>/entryRelationship/observation[code/@code="33999-4"]/value|.clinicalStatus|[CDA Problem Status Observation value → FHIR clinicalStatus](./ConceptMap-CF-ProblemStatus.html)| |**[Date of Diagnosis](https://www.hl7.org/ccdasearch/templates/2.16.840.1.113883.10.20.22.4.502.html)**<br/>/entryRelationship/act[code/@code="77975-1"]/effectiveTime|.extension:[assertedDate](http://hl7.org/fhir/StructureDefinition/condition-assertedDate)|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)<br/>See **[US CORE Condition](https://hl7.org/fhir/us/core/StructureDefinition-us-core-condition-problems-health-concerns.html#mandatory-and-must-support-data-elements)** for additional guidance| -|**[Comment Activity](https://hl7.org/cda/us/ccda/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|| +|**[Comment Activity](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|| |**[Age Observation]()**<br/>/entryRelationship[@typeCode="SUBJ" and @inversionInd="true"]/observation[code/@code="445518008"]/value|.onsetAge|**CAUTION:** Only one of `onsetAge` or `onsetDateTime` may be present.<br/>[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity) -|**Supporting Observations (e.g. [Assessment Scale Observation](https://hl7.org/cda/us/ccda/StructureDefinition-AssessmentScaleObservation.html))**<br/>/entryRelationship[@typeCode="SPRT"]/observation|.evidence.detail|Create an Observation resource, mapping fields like `id`, `code`, `effectiveTime`, `value` similar to [Results](CF-results.html). If the CDA observation is an SDOH observation, use the [US Core Observation Screening Assessment](https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-observation-screening-assessment.html) profile. +|**Supporting Observations (e.g. [Assessment Scale Observation](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-AssessmentScaleObservation.html))**<br/>/entryRelationship[@typeCode="SPRT"]/observation|.evidence.detail|Create an Observation resource, mapping fields like `id`, `code`, `effectiveTime`, `value` similar to [Results](CF-results.html). If the CDA observation is an SDOH observation, use the [US Core Observation Screening Assessment](https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-observation-screening-assessment.html) profile. 1\. XPath abbreviated for C-CDA Problem Concern act as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="11450-4"]/entry/act/ 2\. XPath abbreviated for C-CDA Problem Observation as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="11450-4"]/entry/act/entryRelationship[@typeCode="SUBJ"]/observation/ -When authors or other provenance are recorded in the parent [Problem Concern Act](https://hl7.org/cda/us/ccda/StructureDefinition-ProblemConcernAct.html), it is recommended that those data be mapped to the FHIR Condition. +When authors or other provenance are recorded in the parent [Problem Concern Act](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ProblemConcernAct.html), it is recommended that those data be mapped to the FHIR Condition. ### Illustrative example diff --git a/input/pagecontent/CF-procedures.md b/input/pagecontent/CF-procedures.md index 41aae89..3200ff9 100644 --- a/input/pagecontent/CF-procedures.md +++ b/input/pagecontent/CF-procedures.md @@ -13,7 +13,7 @@ C-CDA 2.1 describes three templates for Procedures: Procedure Activity Act, Proc <br /> ### C-CDA to FHIR -|C-CDA¹<br/>[Procedure Activity procedure](https://hl7.org/cda/us/ccda/StructureDefinition-ProcedureActivityProcedure.html)|FHIR<br/>[Procedure](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-procedure.html)|Transform Steps| +|C-CDA¹<br/>[Procedure Activity procedure](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ProcedureActivityProcedure.html)|FHIR<br/>[Procedure](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-procedure.html)|Transform Steps| |:----|:----|:----| |/@negationInd="true"|set status="not-done"|| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| @@ -25,9 +25,9 @@ C-CDA 2.1 describes three templates for Procedures: Procedure Activity Act, Proc |/targetSiteCode|.bodySite|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/author|.recorder<br/>&<br/>**[Provenance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-procedure.html)**|<br/>[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance) <br/>If a latest author can be identified, map to .recorder.<br/>Any author with a time can be put in Provenance.| |/performer/assignedEntity|.performer.actor|May map to Practitioner, PractitionerRole, or Organization<br/>onBehalfOf should not be used when actor is a Practitioner or PractitionerRole | -|**[Service Delivery Location](https://hl7.org/cda/us/ccda/StructureDefinition-ServiceDeliveryLocation.html)**<br/>/participant[@typeCode="LOC"]/participantRole|.location|| -|**[Indication](https://hl7.org/cda/us/ccda/StructureDefinition-Indication.html)**<br/>/entryRelationship[@typeCode="RSON"]/observation/value|.reasonCode|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| -|**[Comment Activity](https://hl7.org/cda/us/ccda/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note| +|**[Service Delivery Location](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ServiceDeliveryLocation.html)**<br/>/participant[@typeCode="LOC"]/participantRole|.location|| +|**[Indication](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-Indication.html)**<br/>/entryRelationship[@typeCode="RSON"]/observation/value|.reasonCode|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|**[Comment Activity](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note| 1\. XPath abbrievated for C-CDA Procedure as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="47519-4"]/entry/procedure diff --git a/input/pagecontent/CF-results.md b/input/pagecontent/CF-results.md index 8d11d60..6eae8d2 100644 --- a/input/pagecontent/CF-results.md +++ b/input/pagecontent/CF-results.md @@ -12,7 +12,7 @@ Observation values are generic - they can be of any CDA type in CDA, and *almost ### C-CDA Organizer to FHIR Diagnostic Report -|C-CDA¹<br/>[Result Organizer](https://hl7.org/cda/us/ccda/StructureDefinition-ResultOrganizer.html)|FHIR<br/>Diagnostic Report ([Lab](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-diagnosticreport-lab.html)) ([Reports](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-diagnosticreport-note.html))|Transform Steps| +|C-CDA¹<br/>[Result Organizer](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ResultOrganizer.html)|FHIR<br/>Diagnostic Report ([Lab](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-diagnosticreport-lab.html)) ([Reports](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-diagnosticreport-note.html))|Transform Steps| |:----|:----|:----| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| |/code|.category<br/>&<br/>.code|*TODO: Describe using LOINC classes to identify category*<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| @@ -24,7 +24,7 @@ Observation values are generic - they can be of any CDA type in CDA, and *almost ### C-CDA Observation to FHIR Observation -|C-CDA¹<br/>[Result Observation](https://hl7.org/cda/us/ccda/StructureDefinition-ResultObservation.html)|FHIR<br/>[Lab Result Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-observation-lab.html)|Transform Steps| +|C-CDA¹<br/>[Result Observation](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ResultObservation.html)|FHIR<br/>[Lab Result Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-observation-lab.html)|Transform Steps| |:----|:----|:----| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| |(parent organizer)|.category|Use category from DiagnosticReport or map /code to a category similarly diff --git a/input/pagecontent/CF-social.md b/input/pagecontent/CF-social.md index 03e7684..6789ff1 100644 --- a/input/pagecontent/CF-social.md +++ b/input/pagecontent/CF-social.md @@ -10,15 +10,15 @@ Social History is a category of several templates in C-CDA and several profiles Note that some observations in C-CDA map to extensions on the patient or elsewhere in FHIR. In these cases, a FHIR Observation should not be created; instead, the corresponding extension should be used. -- [C-CDA Birth Sex Observation](https://hl7.org/cda/us/ccda/StructureDefinition-BirthSexObservation.html) ↔ [US Core Birth Sex Extension](https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-birthsex.html) -- [C-CDA Gender Identity Observation](https://hl7.org/cda/us/ccda/StructureDefinition-GenderIdentityObservation.html) ↔ [US Core Gender Identity Extension](https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-genderIdentity.html) -- [C-CDA Sex Observation](https://hl7.org/cda/us/ccda/StructureDefinition-SexObservation.html) ↔ [US Core Sex Extension](https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-sex.html) -- [C-CDA Tribal Affiliation Observation](https://hl7.org/cda/us/ccda/StructureDefinition-TribalAffiliationObservation.html) ↔ [US Core Tribal Affiliation Extension](https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-tribal-affiliation.html) +- [C-CDA Birth Sex Observation](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-BirthSexObservation.html) ↔ [US Core Birth Sex Extension](https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-birthsex.html) +- [C-CDA Gender Identity Observation](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-GenderIdentityObservation.html) ↔ [US Core Gender Identity Extension](https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-genderIdentity.html) +- [C-CDA Sex Observation](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-SexObservation.html) ↔ [US Core Sex Extension](https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-sex.html) +- [C-CDA Tribal Affiliation Observation](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-TribalAffiliationObservation.html) ↔ [US Core Tribal Affiliation Extension](https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-tribal-affiliation.html) ### C-CDA Social History Observation to FHIR Observation This maps to US Core version 6's Simple Observation. Previous versions of US Core did not define a generic observation, but the following guidance can still be used to create a generic FHIR observation regardless of the version of US Core being targeted. -|C-CDA<br/>[Social History Observation](https://hl7.org/cda/us/ccda/StructureDefinition-SocialHistoryObservation.html)|FHIR<br/>[Simple Observation](https://hl7.org/fhir/us/core/STU6/StructureDefinition-us-core-simple-observation.html)|Transform Steps| +|C-CDA<br/>[Social History Observation](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-SocialHistoryObservation.html)|FHIR<br/>[Simple Observation](https://hl7.org/fhir/us/core/STU6/StructureDefinition-us-core-simple-observation.html)|Transform Steps| |:----|:----|:----| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| ||.category|Set to `social-history` from [Observation Category Codes](https://build.fhir.org/ig/HL7/UTG/CodeSystem-observation-category.html)<br/>Additional SDOH categories may be set as well, depending on the code of the observation. @@ -37,7 +37,7 @@ Additional fields, such as `.interpretationCode`, `.referenceRange`, `.performer ### C-CDA Smoking Status / Tobacco Use to FHIR Observation In C-CDA 3.0, the Smoking Status - MU and Tobacco Use templates were merged into a single template to better match US Core's Smoking Status template. -|C-CDA<br/>[Smoking Status - MU](https://hl7.org/cda/us/ccda/StructureDefinition-SmokingStatusMeaningfulUse.html) (Deprecated)<br/>[Tobacco Use](https://hl7.org/cda/us/ccda/StructureDefinition-TobaccoUse.html) (Decprecated)<br/>[Smoking Status](https://build.fhir.org/ig/HL7/CDA-ccda/StructureDefinition-SmokingStatus.html) (C-CDA 3.0)²|FHIR<br/>[Smoking Status Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-smokingstatus.html)|Transform Steps| +|C-CDA<br/>[Smoking Status - MU](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-SmokingStatusMeaningfulUse.html) (Deprecated)<br/>[Tobacco Use](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-TobaccoUse.html) (Decprecated)<br/>[Smoking Status](https://build.fhir.org/ig/HL7/CDA-ccda/StructureDefinition-SmokingStatus.html) (C-CDA 3.0)²|FHIR<br/>[Smoking Status Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-smokingstatus.html)|Transform Steps| |:----|:----|:----| |/code|.code|Prior to US Core 7, the code should be `72166-2 (Tobacco smoking status NCIS)`, but this is an extensible value set.<br/>In US Core 7, the value set remains extensible, but contains the same 4 concepts allowed in the C-CDA R3.0's Smoking Status value set. |/effectiveTime|.effectiveDateTime<br/>or<br/>.effectivePeriod|Smoking Status - MU required a timestamp; Tobacco Use required a time range; Smoking Status (3.0) combines the two templates into one and allows for either. @@ -45,19 +45,19 @@ In C-CDA 3.0, the Smoking Status - MU and Tobacco Use templates were merged into ### C-CDA Pregnancy Observation to FHIR Pregnancy Status Observation In US Core, Pregnancy Observation was first defined in version 6. -|C-CDA<br/>[Pregnancy Observation](https://hl7.org/cda/us/ccda/StructureDefinition-PregnancyObservation.html)|FHIR<br/>[Pregnancy Status](https://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-observation-pregnancystatus.html)|Transform Steps| +|C-CDA<br/>[Pregnancy Observation](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-PregnancyObservation.html)|FHIR<br/>[Pregnancy Status](https://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-observation-pregnancystatus.html)|Transform Steps| |:----|:----|:----| |.moodCode||The C-CDA moodCode is `EVN` which is why this maps to FHIR's Pregnancy Status rather than Pregnancy Intent. ||.code|`82810-3 (Pregnancy Status)` - C-CDA uses `ASSERTION`, but FHIR clarifies the code to be used. |/effectiveTime/@value<br/>or<br/>/effectiveTime/low/@value<br/>or<br/>/effectiveTime/high/@value<br/>or<br/>/author/time|.effectiveDateTime|FHIR only allows a single timestamp. Send the first element from the first column with a populated timestamp.<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) |/value|.valueCodeableConcept|Value sets are the same<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/value/@nullFlavor=UNK|.valueCodeableConcept|Unknown becomes an actual value with system = `http://terminology.hl7.org/CodeSystem/v3-NullFlavor`. Any other nullFlavors should use a data-absent-reason extension. -|**[Estimated Date of Delivery](https://hl7.org/cda/us/ccda/StructureDefinition-EstimatedDateofDelivery.html)**<br/>/entryRelationship/observation[code/@code="11778-8"]/value|.component.code<br/>.component.valueDateTime|Set code to `11778-8` and map value to `.valueDateTime`.<br/>Note that while C-CDA hard-codes this to a single value (`11778-8`), there are other, more specific, EDD LOINC codes that could be used as well (see [EDD Including Method](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.11.20.9.81/expansion)). These might be communicated as translations on the entryRelationship/observation/code, as the methodCode, or sent as entirely custom observations. Any of these codes can also reasonably be included as a component to a Pregnancy Observation to represent the estimated date of delivery. +|**[Estimated Date of Delivery](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-EstimatedDateofDelivery.html)**<br/>/entryRelationship/observation[code/@code="11778-8"]/value|.component.code<br/>.component.valueDateTime|Set code to `11778-8` and map value to `.valueDateTime`.<br/>Note that while C-CDA hard-codes this to a single value (`11778-8`), there are other, more specific, EDD LOINC codes that could be used as well (see [EDD Including Method](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.11.20.9.81/expansion)). These might be communicated as translations on the entryRelationship/observation/code, as the methodCode, or sent as entirely custom observations. Any of these codes can also reasonably be included as a component to a Pregnancy Observation to represent the estimated date of delivery. ### C-CDA Pregnancy Intention in Next Year to FHIR Pregnancy Intent Observation In US Core, Pregnancy Intent was first defined in version 6. -|C-CDA<br/>[Pregnancy Intention](https://hl7.org/cda/us/ccda/StructureDefinition-PregnancyIntentionInNextYear.html)|FHIR<br/>[Pregnancy Intent](https://hl7.org/fhir/us/core/STU6/StructureDefinition-us-core-observation-pregnancyintent.html)|Transform Steps| +|C-CDA<br/>[Pregnancy Intention](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-PregnancyIntentionInNextYear.html)|FHIR<br/>[Pregnancy Intent](https://hl7.org/fhir/us/core/STU6/StructureDefinition-us-core-observation-pregnancyintent.html)|Transform Steps| |:----|:----|:----| |.moodCode||The C-CDA moodCode is `INT` which is why this maps to FHIR's Pregnancy Status rather than Pregnancy Intent. |/code|.code|In both standards, the code is `86645-9` diff --git a/input/pagecontent/CF-vitals.md b/input/pagecontent/CF-vitals.md index 8dd777a..d4693c0 100644 --- a/input/pagecontent/CF-vitals.md +++ b/input/pagecontent/CF-vitals.md @@ -10,7 +10,7 @@ C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or ### C-CDA Vital Signs Organizer to FHIR Observation Panel -|C-CDA¹<br/>[Vital SignsOrganizer](https://hl7.org/cda/us/ccda/StructureDefinition-VitalSignsOrganizer.html)|FHIR<br/>[Vital Signs Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-vital-signs.html)|Transform Steps| +|C-CDA¹<br/>[Vital SignsOrganizer](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-VitalSignsOrganizer.html)|FHIR<br/>[Vital Signs Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-vital-signs.html)|Transform Steps| |:----|:----|:----| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| ||.category|Set to `vital-signs` from [Vital Signs value set](https://hl7.org/fhir/us/core/STU4/ValueSet-us-core-vital-signs.html) @@ -21,7 +21,7 @@ C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or ### C-CDA Vital Signs Observation to FHIR Observation -|C-CDA¹<br/>[Vital Sign Observation](https://hl7.org/cda/us/ccda/StructureDefinition-VitalSignObservation.html)|FHIR<br/>[Vital Signs Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-vital-signs.html)|Transform Steps<br/>Note: US Core defines separate profiles for individual vitals such as [weight](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-body-weight.html), [heart rate](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-heart-rate.html), etc.| +|C-CDA¹<br/>[Vital Sign Observation](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-VitalSignObservation.html)|FHIR<br/>[Vital Signs Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-vital-signs.html)|Transform Steps<br/>Note: US Core defines separate profiles for individual vitals such as [weight](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-body-weight.html), [heart rate](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-heart-rate.html), etc.| |:----|:----|:----| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| ||.category|Set to `vital-signs` from [Vital Signs value set](https://hl7.org/fhir/us/core/STU4/ValueSet-us-core-vital-signs.html) diff --git a/input/pagecontent/FC-allergies.md b/input/pagecontent/FC-allergies.md index a45f526..9e0443f 100644 --- a/input/pagecontent/FC-allergies.md +++ b/input/pagecontent/FC-allergies.md @@ -18,12 +18,12 @@ This page provides a mapping from FHIR to CDA. For the CDA to FHIR mapping, plea ### FHIR to C-CDA -|FHIR<br/>[AllergyIntolerance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-allergyintolerance.html#profile)|C-CDA¹<br/>[Allergy Intolerance observation](https://hl7.org/cda/us/ccda/StructureDefinition-AllergyIntoleranceObservation.html)|Transform Steps| +|FHIR<br/>[AllergyIntolerance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-allergyintolerance.html#profile)|C-CDA¹<br/>[Allergy Intolerance observation](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-AllergyIntoleranceObservation.html)|Transform Steps| |:----|:----|:----| |.identifier|/id|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| -|.clinicalStatus|(act parent to observation) ../../statusCode <br/>&<br />**[Allergy Status](https://hl7.org/cda/us/ccda/StructureDefinition-AllergyStatusObservation.html)**<br/>/entryRelationship/observation[code/@code="33999-4"]/value|[FHIR clinicalStatus → CDA Allergy Status Observation value](./ConceptMap-FC-AllergyStatus.html)<br/>For more information on how status is managed in Allergy Concern Act wrapper, refer to [C-CDA guidance, see 5.2.7.1](https://www.hl7.org/implement/standards/product_brief.cfm?product_id=447)| +|.clinicalStatus|(act parent to observation) ../../statusCode <br/>&<br />**[Allergy Status](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-AllergyStatusObservation.html)**<br/>/entryRelationship/observation[code/@code="33999-4"]/value|[FHIR clinicalStatus → CDA Allergy Status Observation value](./ConceptMap-FC-AllergyStatus.html)<br/>For more information on how status is managed in Allergy Concern Act wrapper, refer to [C-CDA guidance, see 5.2.7.1](https://www.hl7.org/implement/standards/product_brief.cfm?product_id=447)| |.type<br/>&<br/>.category|/value|[FHIR type → CDA value](ConceptMap-FC-AllergyIntoleranceType.html)<br/>[FHIR category → CDA value](ConceptMap-FC-AllergyIntoleranceCategory.html)| -|.criticality|**[Criticality](https://hl7.org/cda/us/ccda/StructureDefinition-CriticalityObservation.html)**<br/>/entryRelationship/observation[code/@code="82606-5"]/value|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>[FHIR criticality → CDA Criticality value](ConceptMap-FC-Criticality.html)| +|.criticality|**[Criticality](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-CriticalityObservation.html)**<br/>/entryRelationship/observation[code/@code="82606-5"]/value|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>[FHIR criticality → CDA Criticality value](ConceptMap-FC-Criticality.html)| |.code|/participant/participantRole/playingEntity/code|**Constraint**: When FHIR concept is not a negated concept<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |.code|/participant/participantRole/playingEntity/code or /value<br/>&<br/>set @negationInd="true"|**Constraint**: When FHIR concept represents general negated concept (e.g. no known allergy)<br/>[FHIR code → CDA No Known Allergy](ConceptMap-FC-NoKnownAllergies.html)<br/>In case where a specific refutation is coded (no latex allergy), use text or a mapped concept.| |.encounter|/entryRelationship[@typeCode="REFR"]/act/id|| @@ -31,10 +31,10 @@ This page provides a mapping from FHIR to CDA. For the CDA to FHIR mapping, plea |.onsetPeriod.start|/effectiveTime/low|effectiveTime/high should not be mapped from onsetPeriod| |.recordedDate|/assignedAuthor/time|These are not necessarily the same author| |.recorder|/assignedAuthor|[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)<br/>Time and author are not necessarily the same| -|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|**[Comment Activity](https://hl7.org/cda/us/ccda/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|| -|.reaction.manifestation|**[Reaction](https://hl7.org/cda/us/ccda/StructureDefinition-ReactionObservation.html)**<br/>/entryRelationship[@typeCode="MFST"]/observation/value|Both use SNOMED clinical findings with minor valueSet definition differences +|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|**[Comment Activity](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|| +|.reaction.manifestation|**[Reaction](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ReactionObservation.html)**<br/>/entryRelationship[@typeCode="MFST"]/observation/value|Both use SNOMED clinical findings with minor valueSet definition differences |.reaction.onset|/effectiveTime/low|Constraint: This should only be used in event that AlleryIntolerance.onset was not available| -|.reaction.severity|**[Severity](https://hl7.org/cda/us/ccda/StructureDefinition-SeverityObservation.html)**<br/>/entryRelationship[@typeCode="MFST"]/observation/entryRelationship/observation[code/@code="SEV"]/value|[FHIR severity → CDA severity value ](ConceptMap-FC-Criticality.html)<br/>This should be nested in CDA within the respective allergic reaction observation| +|.reaction.severity|**[Severity](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-SeverityObservation.html)**<br/>/entryRelationship[@typeCode="MFST"]/observation/entryRelationship/observation[code/@code="SEV"]/value|[FHIR severity → CDA severity value ](ConceptMap-FC-Criticality.html)<br/>This should be nested in CDA within the respective allergic reaction observation| 1\. XPath abbrievated for C-CDA Allergy Intolerance as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="48765-2"]/entry/act/entryRelationship/observation diff --git a/input/pagecontent/FC-immunizations.md b/input/pagecontent/FC-immunizations.md index c33910f..93275b0 100644 --- a/input/pagecontent/FC-immunizations.md +++ b/input/pagecontent/FC-immunizations.md @@ -17,13 +17,13 @@ This page provides a mapping from FHIR to CDA. For the CDA to FHIR mapping, plea ### FHIR to C-CDA -|FHIR<br/>[Immunization](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-immunization.html#profile)|C-CDA¹<br/>[Immunization Activity substanceAdministration](https://hl7.org/cda/us/ccda/StructureDefinition-ImmunizationActivity.html)|Transform Steps| +|FHIR<br/>[Immunization](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-immunization.html#profile)|C-CDA¹<br/>[Immunization Activity substanceAdministration](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ImmunizationActivity.html)|Transform Steps| |:----|:----|:----| ||/@moodCode="EVN"|All FHIR Immunizations should be set to "EVN" moodCode |.identifier|/id|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| |.status|/statusCode|**Constraint** when .status.value="not-done"<br/>Set negationInd to true in CDA observation| |.status|/statusCode|**Constraint** all other values of .status<br/>[FHIR status → CDA statusCode](ConceptMap-FC-ImmunizationStatus.html)| -|.statusReason|**[Immunization Refusal Reason](https://hl7.org/cda/us/ccda/StructureDefinition-ImmunizationRefusalReason.html)**<br/>/entryRelationship[@typeCode="RSON"]/observation/code|[FHIR statusReason → CDA refusal](ConceptMap-FC-ImmunizationRefusal.html)| +|.statusReason|**[Immunization Refusal Reason](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ImmunizationRefusalReason.html)**<br/>/entryRelationship[@typeCode="RSON"]/observation/code|[FHIR statusReason → CDA refusal](ConceptMap-FC-ImmunizationRefusal.html)| |.vaccineCode|/consumable/manufacturedProduct/manufacturedMaterial/code|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |.primarySource||This element has no target in CDA |.occurrenceDateTime|/effectiveTime/@value|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)| @@ -33,13 +33,13 @@ This page provides a mapping from FHIR to CDA. For the CDA to FHIR mapping, plea |.route|/routeCode|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |.doseQuantity|/doseQuantity|[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity)| |.performer.actor|/performer|**Constraint** when .performer.function="AP"<br/>[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| -|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|**[Comment Activity](https://hl7.org/cda/us/ccda/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|| -|.reasonCode|**[Indication](https://hl7.org/cda/us/ccda/StructureDefinition-Indication.html)**<br/>/entryRelationship[@typeCode="RSON"]/observation/value|| +|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|**[Comment Activity](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|| +|.reasonCode|**[Indication](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-Indication.html)**<br/>/entryRelationship[@typeCode="RSON"]/observation/value|| |.education.documentType|reference/ExternalDocument/code|| |.education.reference|/reference/ExternalDocument/id|| -|.reaction.id<br/><br/>|**[Reaction](https://hl7.org/cda/us/ccda/StructureDefinition-ReactionObservation.html)**<br/>/entryRelationship[@typeCode="MFST"]/observation/id|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| -|.reaction.date|/**[Reaction](https://hl7.org/cda/us/ccda/StructureDefinition-ReactionObservation.html)**<br/>/entryRelationship[@typeCode="MFST"]/observation/effectiveTime|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)| -|.reaction.detail.valueCodeableConcept|**[Reaction](https://hl7.org/cda/us/ccda/StructureDefinition-ReactionObservation.html)**<br/>/entryRelationship[@typeCode="MFST"]/observation/value|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|.reaction.id<br/><br/>|**[Reaction](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ReactionObservation.html)**<br/>/entryRelationship[@typeCode="MFST"]/observation/id|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| +|.reaction.date|/**[Reaction](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ReactionObservation.html)**<br/>/entryRelationship[@typeCode="MFST"]/observation/effectiveTime|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)| +|.reaction.detail.valueCodeableConcept|**[Reaction](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ReactionObservation.html)**<br/>/entryRelationship[@typeCode="MFST"]/observation/value|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |.doseNumber[x].doseNumberPositiveInt|/repeatNumber|| 1\. XPath abbrievated for C-CDA Immunization Activity as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="11369-6"]/entry/substanceAdministration diff --git a/input/pagecontent/FC-medications.md b/input/pagecontent/FC-medications.md index 1fdb39d..97672cf 100644 --- a/input/pagecontent/FC-medications.md +++ b/input/pagecontent/FC-medications.md @@ -19,7 +19,7 @@ See guidance on timing mappings on [Medications CDA → FHIR](./CF-medications.h ### FHIR to C-CDA -|FHIR<br>[MedicationRequest](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-medicationrequest.html)|C-CDA¹<br>[Medication Activity substanceAdministration](https://hl7.org/cda/us/ccda/StructureDefinition-MedicationActivity.html)|Transform Steps| +|FHIR<br>[MedicationRequest](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-medicationrequest.html)|C-CDA¹<br>[Medication Activity substanceAdministration](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-MedicationActivity.html)|Transform Steps| |:----|:----|:----| |.identifier|/id|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| |.status|/status|[FHIR status → CDA statusCode](ConceptMap-FC-MedicationStatus.html)| @@ -30,10 +30,10 @@ See guidance on timing mappings on [Medications CDA → FHIR](./CF-medications.h |.authoredOn|/author/time|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)| |.requester|/assignedAuthor|[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| |.performer|/performer|[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| -|.reasonCode|**[Indication](https://hl7.org/cda/us/ccda/StructureDefinition-Indication.html)**<br/>/entryRelationship[@typeCode="RSON"]/observation/value|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| -|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|**[Comment Activity](https://hl7.org/cda/us/ccda/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|| -|.dosageInstruction.text<br/>&<br/>.dosageInstruction.patientInstruction|**[Free text sig](https://hl7.org/cda/us/ccda/StructureDefinition-MedicationFreeTextSig.html)**<br/>/entryRelationship/substanceAdministration[code/@code="76662-6"]/text|| -|.dosageInstruction.additionalInstruction|**[Instruction](https://hl7.org/cda/us/ccda/StructureDefinition-Instruction.html)**<br/>/entryRelationship[@typeCode="SUBJ"]/act/code|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|.reasonCode|**[Indication](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-Indication.html)**<br/>/entryRelationship[@typeCode="RSON"]/observation/value|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|**[Comment Activity](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|| +|.dosageInstruction.text<br/>&<br/>.dosageInstruction.patientInstruction|**[Free text sig](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-MedicationFreeTextSig.html)**<br/>/entryRelationship/substanceAdministration[code/@code="76662-6"]/text|| +|.dosageInstruction.additionalInstruction|**[Instruction](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-Instruction.html)**<br/>/entryRelationship[@typeCode="SUBJ"]/act/code|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |.dosageInstruction.timing.repeat.boundsPeriod.start|effectiveTime[1]/low|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)<br/>**Note:** in XPath, `[1]` is the first instance; there is no `[0]` in XPath.| |.dosageInstruction.timing.repeat.boundsPeriod.end|effectiveTime[1]/high|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)| |.dosageInstruction.timing.repeat.frequency<br/>&<br/>.dosageInstruction.timing.repeat.period<br/>&<br/>.dosageInstruction.timing.repeat.periodUnit<br/>|/effectiveTime[2]/...<br/>/@operator='A'<br/>/@xsi:type='PIVL_TS'<br/>/@institutionSpecified<br/>/period|Compare:<br/>[C-CDA Common Medication Frequencies](http://cdasearch.hl7.org/examples/view/9588687865c0f945a326364a9449321690c7a7ef) and <br/>[FHIR Timing Data Type](http://hl7.org/fhir/R4/datatypes.html#Timing)| diff --git a/input/pagecontent/FC-patient.md b/input/pagecontent/FC-patient.md index d89be8a..7e6a508 100644 --- a/input/pagecontent/FC-patient.md +++ b/input/pagecontent/FC-patient.md @@ -17,7 +17,7 @@ This page provides a mapping from FHIR to CDA. For the CDA to FHIR mapping, plea ### FHIR to C-CDA -|FHIR<br/>[Patient](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-patient.html#profile)|C-CDA¹<br/>[US Realm Header recordTarget](https://hl7.org/cda/us/ccda/StructureDefinition-USRealmHeader.html)|Transform Steps| +|FHIR<br/>[Patient](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-patient.html#profile)|C-CDA¹<br/>[US Realm Header recordTarget](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-USRealmHeader.html)|Transform Steps| |:----|:----|:----| |.extension.extension (race)<br/>url=http://hl7.org/fhir/us/core/STU4/StructureDefinition/us-core-race|/patientRole/patient/raceCode<br/>&<br/>/patientRole/patient/sdtc:raceCode|only one ombCategory extension goes in raceCode; other values go in sdtc:raceCode| |.extension.extension (ethnicity)<br/>url=http://hl7.org/fhir/us/core/STU4/StructureDefinition/us-core-ethnicity|/patientRole/patient/ethnicGroupCode<br/>&<br/>/patientRole/patient/sdtc:ethnicGroupCode|only one ombCategory extension goes in ethnicGroupCode; other values go in sdtc:ethnicGroupCode| diff --git a/input/pagecontent/FC-problems.md b/input/pagecontent/FC-problems.md index 958d666..bd44bc1 100644 --- a/input/pagecontent/FC-problems.md +++ b/input/pagecontent/FC-problems.md @@ -17,11 +17,11 @@ This page provides a mapping from FHIR to CDA. For the CDA to FHIR mapping, plea ### FHIR to C-CDA -|FHIR<br/>[Condition and Health Concern](https://hl7.org/fhir/us/core/StructureDefinition-us-core-condition-problems-health-concerns.html)|C-CDA¹<br/>[Problem observation](https://hl7.org/cda/us/ccda/StructureDefinition-ProblemObservation.html)|Transform Steps| +|FHIR<br/>[Condition and Health Concern](https://hl7.org/fhir/us/core/StructureDefinition-us-core-condition-problems-health-concerns.html)|C-CDA¹<br/>[Problem observation](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ProblemObservation.html)|Transform Steps| |:----|:----|:----| |.identifier|/id|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| -|.clinicalStatus|(act parent to observation) ../../statusCode<br/>&<br/>**[Problem Status](https://hl7.org/cda/us/ccda/StructureDefinition-ProblemStatus.html)**<br/>/entryRelationship/observation[code/@code="33999-4"]/value|[FHIR clinicalStatus → CDA Problem Status Observation value](./ConceptMap-FC-ProblemStatus.html)<br/>For more information on how status is managed in Problem Concern Act wrapper, refer to [C-CDA guidance, see 5.2.6.1](https://www.hl7.org/implement/standards/product_brief.cfm?product_id=447)| -|.category|/code<br/>This also affects the C-CDA document section:<br/>**[Problems](https://hl7.org/cda/us/ccda/StructureDefinition-ProblemSection.html)**<br/>**[Health Concerns](https://hl7.org/cda/us/ccda/StructureDefinition-HealthConcernsSection.html)**<br/>**[Encounters](https://hl7.org/cda/us/ccda/StructureDefinition-EncountersSection.html)**|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>[FHIR category → CDA section](ConceptMap-FC-ProblemCategory.html)| +|.clinicalStatus|(act parent to observation) ../../statusCode<br/>&<br/>**[Problem Status](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ProblemStatus.html)**<br/>/entryRelationship/observation[code/@code="33999-4"]/value|[FHIR clinicalStatus → CDA Problem Status Observation value](./ConceptMap-FC-ProblemStatus.html)<br/>For more information on how status is managed in Problem Concern Act wrapper, refer to [C-CDA guidance, see 5.2.6.1](https://www.hl7.org/implement/standards/product_brief.cfm?product_id=447)| +|.category|/code<br/>This also affects the C-CDA document section:<br/>**[Problems](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ProblemSection.html)**<br/>**[Health Concerns](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-HealthConcernsSection.html)**<br/>**[Encounters](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-EncountersSection.html)**|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>[FHIR category → CDA section](ConceptMap-FC-ProblemCategory.html)| |.code|/value|**Constraint**: When FHIR concept does not represent negated concept<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |.code|/value<br/>&<br/>set @negationInd="true"|**Constraint**: When FHIR concept represents negated concept| |.onsetDateTime|/effectiveTime/low|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)| @@ -30,7 +30,7 @@ This page provides a mapping from FHIR to CDA. For the CDA to FHIR mapping, plea |.recordedDate|**[Date of Diagnosis](https://www.hl7.org/ccdasearch/templates/2.16.840.1.113883.10.20.22.4.502.html)**<br/>entryRelationship/act[code/@code="77975-1"]/effectiveTime<br/>&<br/>/assignedAuthor/time|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)| |.recorder|/assignedAuthor|[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| |.asserter|/informant|[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| -|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|**[Comment Activity](https://hl7.org/cda/us/ccda/StructureDefinition-CommentActivity.html)**<br/>entryRelationship/act[code/@code="48767-8"]/text|| +|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|**[Comment Activity](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-CommentActivity.html)**<br/>entryRelationship/act[code/@code="48767-8"]/text|| 1\. XPath abbrievated for C-CDA Problem observation as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="11450-4"]/entry/act/entryRelationship/observation diff --git a/input/pagecontent/FC-procedures.md b/input/pagecontent/FC-procedures.md index cb4f0a7..847887e 100644 --- a/input/pagecontent/FC-procedures.md +++ b/input/pagecontent/FC-procedures.md @@ -16,11 +16,11 @@ td, th { This page provides a mapping from FHIR to CDA. For the CDA to FHIR mapping, please refer to [Procedures CDA → FHIR](./CF-procedures.html). For guidance on how to read the table below, see [Reading the C-CDA ↔ FHIR Mapping Pages](./mappingGuidance.html). <br/> #### Note on template selection -It also specifies a template for “all interventional, non-interventional, surgical, diagnostic, or therapeutic procedures or treatments pertinent to the patient historically at the time the document is generated." For this reason, we recommend mapping [FHIR Procedures](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-procedure.html) to [Procedure Activity Procedure](https://hl7.org/cda/us/ccda/StructureDefinition-ProcedureActivityProcedure.html) when using the C-CDA R3/E1 guide for the targeted C-CDA, while guidance on mapping to the other templates when generating an older version C-CDA will be forthcoming. +It also specifies a template for “all interventional, non-interventional, surgical, diagnostic, or therapeutic procedures or treatments pertinent to the patient historically at the time the document is generated." For this reason, we recommend mapping [FHIR Procedures](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-procedure.html) to [Procedure Activity Procedure](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ProcedureActivityProcedure.html) when using the C-CDA R3/E1 guide for the targeted C-CDA, while guidance on mapping to the other templates when generating an older version C-CDA will be forthcoming. ### FHIR to C-CDA -|FHIR<br/>[Procedure](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-procedure.html)|C-CDA¹<br/>[Procedure Activity procedure](https://hl7.org/cda/us/ccda/StructureDefinition-ProcedureActivityProcedure.html)|Transform Steps| +|FHIR<br/>[Procedure](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-procedure.html)|C-CDA¹<br/>[Procedure Activity procedure](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ProcedureActivityProcedure.html)|Transform Steps| |:----|:----|:----| |.identifier|/id|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| |.status|/statusCode|[FHIR status → CDA statusCode](./ConceptMap-FC-ProcedureStatus.html)| @@ -30,10 +30,10 @@ It also specifies a template for “all interventional, non-interventional, surg |.performedPeriod.end|/effectiveTime/high|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)| |.performer.actor|/performer|[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| |.performer.onBehalfOf|/perfomer/assignedEntity/representedOrganization|[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| -|.location|**[Service Delivery Location](https://hl7.org/cda/us/ccda/StructureDefinition-ServiceDeliveryLocation.html)**<br/>/participant[@typeCode="LOC"]<br/>/participantRole|| -|.reasonCode|**[Indication](https://hl7.org/cda/us/ccda/StructureDefinition-Indication.html)**<br/>/entryRelationship[@typeCode="RSON"]<br/>/observation/value|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|.location|**[Service Delivery Location](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ServiceDeliveryLocation.html)**<br/>/participant[@typeCode="LOC"]<br/>/participantRole|| +|.reasonCode|**[Indication](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-Indication.html)**<br/>/entryRelationship[@typeCode="RSON"]<br/>/observation/value|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |.bodySite|/targetSiteCode|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| -|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|**[Comment Activity](https://hl7.org/cda/us/ccda/StructureDefinition-CommentActivity.html)**<br/>entryRelationship/act[code@code="48767-8"]/entryRelationship/act/text|| +|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|**[Comment Activity](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-CommentActivity.html)**<br/>entryRelationship/act[code@code="48767-8"]/entryRelationship/act/text|| 1\. XPath abbrievated for C-CDA Procedure as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="47519-4"]/entry/procedure diff --git a/input/pagecontent/FC-vitals.md b/input/pagecontent/FC-vitals.md index a20e638..ce25f2e 100644 --- a/input/pagecontent/FC-vitals.md +++ b/input/pagecontent/FC-vitals.md @@ -10,7 +10,7 @@ FHIR Vitals that are grouped into a panel using the memberOf property are mapped ### FHIR Observation Panel to C-CDA Vital Signs Organizer -|FHIR<br/>[Vital Signs Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-vital-signs.html)|C-CDA¹<br/>[Vital SignsOrganizer](https://hl7.org/cda/us/ccda/StructureDefinition-VitalSignsOrganizer.html)|Transform Steps| +|FHIR<br/>[Vital Signs Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-vital-signs.html)|C-CDA¹<br/>[Vital SignsOrganizer](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-VitalSignsOrganizer.html)|Transform Steps| |:----|:----|:----| |.identifier|/id|[FHIR identifier ↔ CDA id](mappingGuidance.html#cda-id--fhir-identifier)| |.category = `vital-signs` from [Vital Signs value set](https://hl7.org/fhir/us/core/STU4/ValueSet-us-core-vital-signs.html)|| @@ -22,7 +22,7 @@ FHIR Vitals that are grouped into a panel using the memberOf property are mapped ### FHIR Observation to C-CDA Vital Signs Observation -|FHIR<br/>[Vital Signs Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-vital-signs.html)|C-CDA¹<br/>[Vital Sign Observation](https://hl7.org/cda/us/ccda/StructureDefinition-VitalSignObservation.html)|Transform Steps| +|FHIR<br/>[Vital Signs Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-vital-signs.html)|C-CDA¹<br/>[Vital Sign Observation](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-VitalSignObservation.html)|Transform Steps| |:----|:----|:----| |.identifier|/id|[FHIR identifier ↔ CDA id](mappingGuidance.html#cda-id--fhir-identifier)| |.code |/code|[FHIR CodeableConcept ↔ CDA coding ](mappingGuidance.html#fhir-codeableconcept--cda-coding)| diff --git a/input/pagecontent/index.md b/input/pagecontent/index.md index 6fa69df..3e4fd98 100644 --- a/input/pagecontent/index.md +++ b/input/pagecontent/index.md @@ -16,7 +16,7 @@ This first stage of the project defines all the C-CDA document-level profiles on Any coded data used by sections will be represented using relevant U.S. Core FHIR profiles where they exist. FHIR profiles defined by other work groups or unconstrained FHIR resources may also be referenced if no appropriate US Core Profile exist. -For further information see the [pdf-based C-CDA specification](http://www.hl7.org/implement/standards/product_brief.cfm?product_id=492), [StructureDefinition C-CDA specification](http://hl7.org/cda/stds/ccda/draft1/), [original project scope](https://confluence.hl7.org/pages/viewpage.action?pageId=76158360) and [mapping project scope](https://jira.hl7.org/browse/PSS-1811). +For further information see the [pdf-based C-CDA specification](http://www.hl7.org/implement/standards/product_brief.cfm?product_id=492), [StructureDefinition C-CDA specification](https://hl7.org/cda/us/ccda/3.0.0/), [original project scope](https://confluence.hl7.org/pages/viewpage.action?pageId=76158360) and [mapping project scope](https://jira.hl7.org/browse/PSS-1811). ### Authors (Composition Profiles, Extensions and CapabilityStatement ) diff --git a/input/pagecontent/mappingGuidance.md b/input/pagecontent/mappingGuidance.md index 4763b15..3f23ddc 100644 --- a/input/pagecontent/mappingGuidance.md +++ b/input/pagecontent/mappingGuidance.md @@ -8,9 +8,9 @@ td, th { #### How to Read Mapping Tables and Transform Steps? -The header row of the mapping table provides links to the respective profiles in FHIR (e.g. **[US Core AllergyIntolerance](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-allergyintolerance.html)**) and templates in C-CDA (e.g. **[Allergy Intolerance observation](https://hl7.org/cda/us/ccda/StructureDefinition-AllergyIntoleranceObservation.html)**)and specifies the "base" that each of the rows will build on. All FHIR elements use a simplified dot notation and the CDA elements use simplified slash notation. Always use the underlying standards, provided via header row links, to ensure conformance when building FHIR resources or C-CDA clinical documents. +The header row of the mapping table provides links to the respective profiles in FHIR (e.g. **[US Core AllergyIntolerance](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-allergyintolerance.html)**) and templates in C-CDA (e.g. **[Allergy Intolerance observation](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-AllergyIntoleranceObservation.html)**)and specifies the "base" that each of the rows will build on. All FHIR elements use a simplified dot notation and the CDA elements use simplified slash notation. Always use the underlying standards, provided via header row links, to ensure conformance when building FHIR resources or C-CDA clinical documents. -Rather than repeating cardinality, conformance, and other criteria from FHIR Resources or a C-CDA templates defined outside this implementaiton guide, external references are shown in tables as bold hyperlinks (e.g. **[US Core Patient](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-patient.html)** or **[C-CDA US Realm Header](https://hl7.org/cda/us/ccda/StructureDefinition-USRealmHeader.html)**). Unbolded links refer to guidance contained within this guide (e.g. [CDA ↔ FHIR Name, Address, and Telecom mapping](mappingGuidance.html#name-address-telecom)). When criteria for selecting XML elements from C-CDA is required, you will see **[XPath](https://en.wikipedia.org/wiki/XPath)** notation with the respective criteria within brackets (e.g. /entryRelationship[@typeCode="MSFT"]). +Rather than repeating cardinality, conformance, and other criteria from FHIR Resources or a C-CDA templates defined outside this implementaiton guide, external references are shown in tables as bold hyperlinks (e.g. **[US Core Patient](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-patient.html)** or **[C-CDA US Realm Header](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-USRealmHeader.html)**). Unbolded links refer to guidance contained within this guide (e.g. [CDA ↔ FHIR Name, Address, and Telecom mapping](mappingGuidance.html#name-address-telecom)). When criteria for selecting XML elements from C-CDA is required, you will see **[XPath](https://en.wikipedia.org/wiki/XPath)** notation with the respective criteria within brackets (e.g. /entryRelationship[@typeCode="MSFT"]). The "Transform Steps" column of the table will provide guidance for mapping content between C-CDA and FHIR, those steps will be listed in the following order: From ba5570c2dd97e7413ea2712a9254d8fd48062b14 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Mon, 14 Oct 2024 15:49:01 -0500 Subject: [PATCH 068/112] Draft change log --- input/hl7.fhir.us.ccda.xml | 5 ++++ input/includes/menu.xml | 3 ++ input/pagecontent/mappingChangelog.md | 41 +++++++++++++++++++++++++++ 3 files changed, 49 insertions(+) create mode 100644 input/pagecontent/mappingChangelog.md diff --git a/input/hl7.fhir.us.ccda.xml b/input/hl7.fhir.us.ccda.xml index 6365bbe..94c59d4 100644 --- a/input/hl7.fhir.us.ccda.xml +++ b/input/hl7.fhir.us.ccda.xml @@ -952,6 +952,11 @@ <title value="Terminology Maps (Concept Maps)"/> <generation value="markdown"/> </page> + <page> + <nameUrl value="mappingChangelog.html"/> + <title value="Change Log"/> + <generation value="markdown"/> + </page> <page> <nameUrl value="mappingIssues.html"/> <title value="Known Issues"/> diff --git a/input/includes/menu.xml b/input/includes/menu.xml index c5fa711..8dee585 100644 --- a/input/includes/menu.xml +++ b/input/includes/menu.xml @@ -24,6 +24,9 @@ <li> <a href="conceptMaps.html">Terminology Maps</a> </li> + <li> + <a href="mappingChangeLog.html">Change Log</a> + </li> <li> <a href="mappingIssues.html">Known Issues</a> </li> diff --git a/input/pagecontent/mappingChangelog.md b/input/pagecontent/mappingChangelog.md new file mode 100644 index 0000000..c11356e --- /dev/null +++ b/input/pagecontent/mappingChangelog.md @@ -0,0 +1,41 @@ +### 1.3.0 (Current STU Ballot) +Though feedback is welcome on any part of the IG, only changed content may be voted upon during an STU ballot. The following is a high-level list of changes since version 1.2.0 STU1. + +**New Resources / Guidance** +- [C-CDA → FHIR Encounters](CF-encounters.html) +- [C-CDA → FHIR Notes](CF-notes.html) +- [C-CDA → FHIR Participation](CF-participations.html) +- [C-CDA → FHIR Results](CF-results.html) +- [C-CDA → FHIR Social History](CF-social.html) +- [C-CDA → FHIR Vitals](CF-vitals.html) +- [FHIR → Notes](FC-notes.html) +- [GeneralGuidance](mappingGuidance.html) + - [Missing Maps](mappingGuidance.html#missing-maps) + - [FHIR Code → CDA Coding](mappingGuidance.html#fhir-code--cda-coding) + - [Ranges of Physical Quantities](mappingGuidance.html#ranges-of-physical-quantities) + +**Updated Mappings** + +During the 2023 & 2024 connectathons, several mappings were enhanced. These updates addressed gaps for fields required by C-CDA or USCDI and included non-controversial mappings. For guidance on handling unmapped fields, refer to the [Missing Maps](mappingGuidance.html#missing-maps) section. +- [C-CDA → FHIR Medications](CF-medications.html) - Added `approachSiteCode`, `maxDoseQuantity`, `manufacturer`, `Drug Vehicle`, and`Supply`. +- [C-CDA → FHIR Patient](CF-patient.html) - Added guidance for `raceCode/originalText` as well as mappings for `guardian`, `languageCommunication/modeCode`, and `languageCommunication/proficiencyLevelCode`. +- [C-CDA → Probelms](CF-problems.html) - Added `Age Observation` and `Supporting Observations (e.g. Assessment Scale Observation)`. + +### 1.2.0 STU 1 (First Mapping Ballot) +- Mapping Background +- Bidirectional mappings for the following content: + - Allergies + - Immunizations + - Medications + - Patient + - Problems + - Procedures +- Structural Guidance + - Identifiers + - Time/Dates + - Coding/CodeableConcept + - Quantity + - Provenance (high-level) + - Name/Address/Telecom + - Missing Data + - Narrative Text \ No newline at end of file From 4c724ab941e9cf1e106c6210f1a59553fc4fe223 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Mon, 14 Oct 2024 15:50:17 -0500 Subject: [PATCH 069/112] Undo the bad display now that THO has fixed theirs. --- input/maps/ConceptMap-FC-TelecomUse.xml | 2 +- 1 file changed, 1 insertion(+), 1 deletion(-) diff --git a/input/maps/ConceptMap-FC-TelecomUse.xml b/input/maps/ConceptMap-FC-TelecomUse.xml index 251452d..1c1546d 100644 --- a/input/maps/ConceptMap-FC-TelecomUse.xml +++ b/input/maps/ConceptMap-FC-TelecomUse.xml @@ -81,7 +81,7 @@ <display value="Mobile"/> <target> <code value="MC"/> - <display value="mobile contact)"/> + <display value="mobile contact"/> <equivalence value="equivalent"/> </target> </element> From 3d8fd5e28f66f8a4aef5d15d8ceaaac258ef7c0a Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Mon, 14 Oct 2024 15:52:29 -0500 Subject: [PATCH 070/112] Remove ignored warnings that no longer occur --- input/ignoreWarnings.txt | 29 ----------------------------- 1 file changed, 29 deletions(-) diff --git a/input/ignoreWarnings.txt b/input/ignoreWarnings.txt index 83c7ddc..2772f35 100644 --- a/input/ignoreWarnings.txt +++ b/input/ignoreWarnings.txt @@ -8,34 +8,5 @@ A definition for CodeSystem 'urn:oid:2.16.840.1.113883.3.247.1.1' could not be f Unknown Code '486' in the system% -# LOINC Imaging Document Codes value set marked as incomplete (and also too large), but has all (6343) codes from 2022-07 release of http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.12009.10.2.5 -INFORMATION: ValueSet/1.3.6.1.4.1.12009.10.2.5: ValueSet.compose.include[0]: The value set include has too many codes to validate (6,342), so each individual code has not been checked -INFORMATION: ValueSet.where(id = '1.3.6.1.4.1.12009.10.2.5'): The value set expansion is too large, and only a subset has been displayed - - -# Draft, trial-use and external reference elements in examples prior to 2023 ballot -Reference to draft CodeSystem http://terminology.hl7.org/CodeSystem/organization-type|0.1.0 -Reference to draft CodeSystem http://terminology.hl7.org/CodeSystem/condition-category|0.5.0 - - # Missing performers in examples prior to 2023 ballot Best Practice Recommendation: In general, all observations should have a performer - - -# Publisher is adding these modifier extensions - https://chat.fhir.org/#narrow/stream/179252-IG-creation/topic/Regression.20in.20ConceptMap -The modifier extension http://hl7.org/fhir/1.0/StructureDefinition/extension-ConceptMap.element.target.equivalence from FHIR version 1.0 is not allowed to be used at this point (allowed = e:ConceptMap.element.target; this element is [[BackboneElement, ConceptMap.group.element.target]; this is a warning since contexts may be renamed between FHIR versions) - - -# Publisher is not checking all SNOMED/LOINC codes in ConceptMap -Source Code System http://snomed.info/sct doesn't have all content (content = not-present), so the source codes cannot be checked -Target Code System http://snomed.info/sct doesn't have all content (content = not-present), so the target codes cannot be checked -Source Code System http://loinc.org doesn't have all content (content = not-present), so the source codes cannot be checked -Target Code System http://loinc.org doesn't have all content (content = not-present), so the target codes cannot be checked - - -# Poor / Buggy Displays from AddressUse Code System -WARNING: ConceptMap/CF-TelecomUse: ConceptMap.group[0].element[7].code: The source display 'mobile contact' for the code 'http://terminology.hl7.org/CodeSystem/v3-AddressUse|2.1.0#MC' is not valid. Possible displays: 'mobile contact)' - - -# Deprecated extension is still needed in R4 -The extension http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber|5.1.0-cibuild is deprecated \ No newline at end of file From c52f536c8d54bcbb0543132331a1d6bac0c182e2 Mon Sep 17 00:00:00 2001 From: jlyle1 <jay@lyle.net> Date: Thu, 17 Oct 2024 12:54:08 -0400 Subject: [PATCH 071/112] added guidance on LOINC lookup for categories --- input/pagecontent/CF-results.md | 5 ++++- 1 file changed, 4 insertions(+), 1 deletion(-) diff --git a/input/pagecontent/CF-results.md b/input/pagecontent/CF-results.md index 58d1864..1bfd8a1 100644 --- a/input/pagecontent/CF-results.md +++ b/input/pagecontent/CF-results.md @@ -15,7 +15,10 @@ Observation values are generic - they can be of any CDA type in CDA, and *almost |C-CDA¹<br/>[Result Organizer](https://hl7.org/cda/us/ccda/2024Jan/StructureDefinition-ResultOrganizer.html)|FHIR<br/>Diagnostic Report ([Lab](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-diagnosticreport-lab.html)) ([Reports](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-diagnosticreport-note.html))|Transform Steps| |:----|:----|:----| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| -|/code|.category<br/>&<br/>.code|*TODO: Describe using LOINC classes to identify category*<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|/code|.category<br/>&<br/>.code|*TODO: Describe using LOINC classes to identify category*<br/> +If LOINC, look up code class with {endpoint}CodeSystem/$lookup?system=http://loinc.org&code={code}&&property=CLASSTYPE<br/> +1=Laboratory class (laboratory); 2=Clinical class (clinical-test); 3=Claims attachments (not mapped); 4=Surveys (survey)<br/> +[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/statusCode|.status|*TODO: ConceptMap* |/effectiveTime|.effectiveDateTime<br/>or<br/>.effectivePeriod|If low and high are identical, use effectiveDateTime. If organizer/effectiveTime is missing, use the earliest and latest observation/effectiveTime as the source of the mapping.<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) |/specimen||*TODO* From 9d0ab49382a131facf143a7990fb18a514edf68f Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Thu, 17 Oct 2024 14:12:45 -0500 Subject: [PATCH 072/112] Fix changelog / menu --- input/includes/menu.xml | 2 +- input/pagecontent/mappingChangelog.md | 2 +- 2 files changed, 2 insertions(+), 2 deletions(-) diff --git a/input/includes/menu.xml b/input/includes/menu.xml index 8dee585..b6ca240 100644 --- a/input/includes/menu.xml +++ b/input/includes/menu.xml @@ -25,7 +25,7 @@ <a href="conceptMaps.html">Terminology Maps</a> </li> <li> - <a href="mappingChangeLog.html">Change Log</a> + <a href="mappingChangelog.html">Change Log</a> </li> <li> <a href="mappingIssues.html">Known Issues</a> diff --git a/input/pagecontent/mappingChangelog.md b/input/pagecontent/mappingChangelog.md index c11356e..6d1a3ef 100644 --- a/input/pagecontent/mappingChangelog.md +++ b/input/pagecontent/mappingChangelog.md @@ -8,7 +8,7 @@ Though feedback is welcome on any part of the IG, only changed content may be vo - [C-CDA → FHIR Results](CF-results.html) - [C-CDA → FHIR Social History](CF-social.html) - [C-CDA → FHIR Vitals](CF-vitals.html) -- [FHIR → Notes](FC-notes.html) +- [FHIR → C-CDA Vitals](FC-vitals.html) - [GeneralGuidance](mappingGuidance.html) - [Missing Maps](mappingGuidance.html#missing-maps) - [FHIR Code → CDA Coding](mappingGuidance.html#fhir-code--cda-coding) From 6ce9abc98ab0b2eea36cff154b2c863d86a8a749 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Thu, 17 Oct 2024 14:18:23 -0500 Subject: [PATCH 073/112] Fix broken results table; update LOINC mapping after call --- input/pagecontent/CF-results.md | 9 +++------ 1 file changed, 3 insertions(+), 6 deletions(-) diff --git a/input/pagecontent/CF-results.md b/input/pagecontent/CF-results.md index 8155ae8..8ff7ac2 100644 --- a/input/pagecontent/CF-results.md +++ b/input/pagecontent/CF-results.md @@ -15,14 +15,11 @@ Observation values are generic - they can be of any CDA type in CDA, and *almost |C-CDA¹<br/>[Result Organizer](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ResultOrganizer.html)|FHIR<br/>Diagnostic Report ([Lab](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-diagnosticreport-lab.html)) ([Reports](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-diagnosticreport-note.html))|Transform Steps| |:----|:----|:----| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| -|/code|.category<br/>&<br/>.code|*TODO: Describe using LOINC classes to identify category*<br/> -If LOINC, look up code class with {endpoint}CodeSystem/$lookup?system=http://loinc.org&code={code}&&property=CLASSTYPE<br/> -1=Laboratory class (laboratory); 2=Clinical class (clinical-test); 3=Claims attachments (not mapped); 4=Surveys (survey)<br/> -[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|/code|.code<br/>&<br/>.category|Map to code using [CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept).<br/>Category (and target FHIR Profile) may be identified by looking up a LOINC code's CLASSTYPE (see process in next table).<br/>Alternatively, an extension for `<sdtc:category>` is being developed for CDA Organizer which, if present, will map directly to this field. |/statusCode|.status|*TODO: ConceptMap* |/effectiveTime|.effectiveDateTime<br/>or<br/>.effectivePeriod|If low and high are identical, use effectiveDateTime. If organizer/effectiveTime is missing, use the earliest and latest observation/effectiveTime as the source of the mapping.<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) |/specimen||*TODO* -|/author||*TODO* +|/author|**[Provenance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-provenance.html)**|[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| |/component/observation|.result|See following table ### C-CDA Observation to FHIR Observation @@ -30,7 +27,7 @@ If LOINC, look up code class with {endpoint}CodeSystem/$lookup?system=http://loi |C-CDA¹<br/>[Result Observation](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ResultObservation.html)|FHIR<br/>[Lab Result Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-observation-lab.html)|Transform Steps| |:----|:----|:----| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| -|(parent organizer)|.category|Use category from DiagnosticReport or map /code to a category similarly +||.category|If the code is LOINC, the category can be inferred from the LOINC code CLASSTYPE. Query a FHIR server via `{endpoint}CodeSystem/$lookup?system=http://loinc.org&code={code}&&property=CLASSTYPE` and set the category according to the CLASSTYPE property:<br/>1=Laboratory class (laboratory); 2=Clinical class (clinical-test); 3=Claims attachments (not mapped); 4=Surveys (survey) |/code |.code|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/statusCode|.status|*TODO: ConceptMap* |/effectiveTime|.effectiveDateTime<br/>or<br/>.effectivePeriod|Prefer effectiveDateTime<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) From 87c9bfddd70e32080b844b912aa253883740b2e8 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Thu, 17 Oct 2024 15:32:58 -0500 Subject: [PATCH 074/112] Add specimen --- input/pagecontent/CF-results.md | 21 +++++++++++++++++++-- 1 file changed, 19 insertions(+), 2 deletions(-) diff --git a/input/pagecontent/CF-results.md b/input/pagecontent/CF-results.md index 8ff7ac2..9e5e03a 100644 --- a/input/pagecontent/CF-results.md +++ b/input/pagecontent/CF-results.md @@ -18,9 +18,10 @@ Observation values are generic - they can be of any CDA type in CDA, and *almost |/code|.code<br/>&<br/>.category|Map to code using [CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept).<br/>Category (and target FHIR Profile) may be identified by looking up a LOINC code's CLASSTYPE (see process in next table).<br/>Alternatively, an extension for `<sdtc:category>` is being developed for CDA Organizer which, if present, will map directly to this field. |/statusCode|.status|*TODO: ConceptMap* |/effectiveTime|.effectiveDateTime<br/>or<br/>.effectivePeriod|If low and high are identical, use effectiveDateTime. If organizer/effectiveTime is missing, use the earliest and latest observation/effectiveTime as the source of the mapping.<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) -|/specimen||*TODO* +|/specimen|.specimen|[See below](#c-cda-specimen-to-fhir-specimen) |/author|**[Provenance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-provenance.html)**|[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| -|/component/observation|.result|See following table +|**[Result Observation](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ResultObservation.html)**<br/>/component/observation|.result|See following table +|**[Specimen Collection Procedure](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-SpecimenCollectionProcedure.html)**<br/>/component/procedure[code/@code=17636008]|.specimen|[See below](#c-cda-specimen-to-fhir-specimen) ### C-CDA Observation to FHIR Observation @@ -40,11 +41,27 @@ Observation values are generic - they can be of any CDA type in CDA, and *almost |/interpretationCode|.interpretation|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/methodCode|.method|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/targetSiteCode|.bodySite|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|/specimen|.specimen|[See below](#c-cda-specimen-to-fhir-specimen) |/author|**[Provenance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-provenance.html)**|[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| |/referenceRange/observationRange/interpretationCode|**Not Supported**|FHIR expects reference ranges to be "normal" ranges. If C-CDA includes multiple reference ranges, only map the one with interpretationCode = `"N"`. |/referenceRange/observationRange/value[xsi:type=IVL_PQ]|.referenceRange.low<br/>&<br/>.referenceRange.high| |/referenceRange/observationRange/value[xsi:type=ST]<br/>or<br/>/referenceRange/observationRange/text|.referenceRange.text| +### C-CDA Specimen to FHIR Specimen + +The CDA [Specimen](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-Specimen.html) class may be present on either a Result Organizer or a Result Observation. If present on the organizer, the FHIR Specimen resource can be attached to the DiagnosticReport as well as each of the child Observation resources. If present only on a C-CDA Results Observation, it should only be attached at the FHIR Observation level. + +C-CDA also defines a [Specimen Collection Procedure](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-SpecimenCollectionProcedure.html) which can be present in the Result Organizer. The information in this procedure can be combined with information from the Specimen class and attached to the FHIR DiagnosticReport and Observation resources. + +|CDA<br/>[Specimen](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-Specimen.html)|FHIR<br/>[Specimen](https://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-specimen.html)|Transform Steps| +|:----|:----|:----| +|/specimenRole/id|.identifier<br/>or<br/>.accessionIdentifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| +|/specimenRole/specimenPlayingEntity/code|.type|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|/specimenRole/specimenPlayingEntity/name|.type.text|If there is no `<code>`. If code already exists, name may also go in `.note` +|/specimenRole/specimenPlayingEntity/quantity|.collection.quantity|[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity)| +|/specimenRole/specimenPlayingEntity/desc|.note| +|**C-CDA [Specimen Collection Procedure](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-SpecimenCollectionProcedure.html)**<br/>/targetSiteCode|.collection.bodySite|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|**C-CDA [Specimen Condtion Observation](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-SpecimenConditionObservation.html)**<br/>/value|.condition|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| ### Illustrative example ... From 35bc8473ae99b416999667556c47f2aab1f0ce85 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Thu, 17 Oct 2024 16:16:37 -0500 Subject: [PATCH 075/112] Create examples for Blood Pressure and PulseOx --- input/pagecontent/CF-vitals.md | 250 ++++++++++++++++++++++++++++++++- 1 file changed, 247 insertions(+), 3 deletions(-) diff --git a/input/pagecontent/CF-vitals.md b/input/pagecontent/CF-vitals.md index d4693c0..33f414f 100644 --- a/input/pagecontent/CF-vitals.md +++ b/input/pagecontent/CF-vitals.md @@ -40,14 +40,258 @@ C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or 2\. Some C-CDA observations need special handling when converting to FHIR. When recording the following vitals, the value, interpretation, and referenceRange should be placed in a `.component` element within a parent Observation. -**[Blood Pressure](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-blood-pressure.html)** (LOINC codes `8480-6` - systolic & `8462-4` - diastolic) +**[Blood Pressure](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-blood-pressure.html)** (C-CDA observations with codes `8480-6` - systolic & `8462-4` - diastolic) - Set `Observation.code` to `85354-9` (Blood Pressure Panel) and create 2 components for the systolic and diastolic readings. Both components are required. - Do not send `Observation.valueQuantity` -**[Pulse Oximetry](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-pulse-oximetry.html)** (LOINC codes `3150-0` - Inhaled Oxygen Concentration & `3151-8` - Inhaled Oxygen Flow Rate) +**[Pulse Oximetry](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-pulse-oximetry.html)** (C-CDA observations with codes `3150-0` - Inhaled Oxygen Concentration, `3151-8` - Inhaled Oxygen Flow Rate, `59408-5` - Oxygen saturation in Arterial blood by Pulse oximetry, or `2708-6` - Oxygen saturation in Arterial blood) - `Observation.code` should contain two coding values: `59408-5` & `2708-6` - Observation.valueQuantity represents the Oxygen saturation (e.g. `98%`) -- Create individual components for `3150-0` - Inhaled Oxygen Concentration & `3151-8` - Inhaled Oxygen Flow Rate +- Create individual components for `3150-0` - Inhaled Oxygen Concentration & `3151-8` - Inhaled Oxygen Flow Rate (only if values exist) + +<table> +<tr><th>C-CDA Blood Pressure Example</th><th>FHIR Blood Pressure Example</th></tr> +<tr><td> +<div markdown="1"> +{% highlight xml %} +<organizer> + <!-- C-CDA Vital Signs Organizer --> + <templateId + root="2.16.840.1.113883.10.20.22.4.26" + extension="2015-08-01" /> + <id root="..." /> + <code + code="46680005" + codeSystem="2.16.840.1.113883.6.96" + codeSystemName="SNOMED CT" + displayName="Vital Signs" /> + <statusCode code="completed" /> + <!-- effectiveTime, author, etc stripped --> + <component> + <observation> + <!-- C-CDA Vital Signs Observation --> + <templateId + root="2.16.840.1.113883.10.20.22.4.27" + extension="2014-06-09" /> + <id root="..." /> + <code + code="8480-6" + codeSystem="2.16.840.1.113883.6.1" + codeSystemName="LOINC" + displayName="Systolic blood pressure" /> + <statusCode code="completed" /> + <value xsi:type="PQ" + value="115" + unit="mm[Hg]" /> + </observation> + <observation> + <!-- C-CDA Vital Signs Observation --> + <templateId + root="2.16.840.1.113883.10.20.22.4.27" + extension="2014-06-09" /> + <id root="..." /> + <code + code="8462-4" + codeSystem="2.16.840.1.113883.6.1" + codeSystemName="LOINC" + displayName="Diastolic blood pressure" /> + <value xsi:type="PQ" value="75" unit="mm[Hg]" /> + </observation> + </component> +</organizer> +{% endhighlight %} +</div> + +</td><td> +<div markdown="1"> +{% highlight json %} +{ + "resourceType" : "Observation", + "status" : "final", + "category" : [{ + "coding" : [{ + "system" : "http://terminology.hl7.org/CodeSystem/observation-category", + "code" : "vital-signs", + }], + }], + "code" : { + "coding" : [{ + "system" : "http://loinc.org", + "code" : "85354-9", + "display" : "Blood pressure panel with all children optional" + }] + }, + // no valueQuantity + "component" : [{ + "code" : { + "coding" : [{ + "system" : "http://loinc.org", + "code" : "8480-6", + "display" : "Systolic blood pressure" + }], + "text" : "Systolic blood pressure" + }, + "valueQuantity" : { + "value" : 115, + "unit" : "mmHg", + "system" : "http://unitsofmeasure.org", + "code" : "mm[Hg]" + } + }, + { + "code" : { + "coding" : [{ + "system" : "http://loinc.org", + "code" : "8462-4", + "display" : "Diastolic blood pressure" + }], + "text" : "Diastolic blood pressure" + }, + "valueQuantity" : { + "value" : 75, + "unit" : "mmHg", + "system" : "http://unitsofmeasure.org", + "code" : "mm[Hg]" + } + }] +} +{% endhighlight %} +</div> +</td></tr> +<tr><th>C-CDA Pulse Oximetry Observations</th><th>FHIR Pulse Oximetry Observation</th></tr> +<tr><td> +<div markdown="1"> +{% highlight xml %} +<organizer> + <!-- C-CDA Vital Signs Organizer --> + <templateId + root="2.16.840.1.113883.10.20.22.4.26" + extension="2015-08-01" /> + <id root="..." /> + <code + code="46680005" + codeSystem="2.16.840.1.113883.6.96" + codeSystemName="SNOMED CT" + displayName="Vital Signs" /> + <statusCode code="completed" /> + <!-- effectiveTime, author, etc stripped --> + <component> + <observation> + <!-- C-CDA Vital Signs Observation --> + <templateId + root="2.16.840.1.113883.10.20.22.4.27" + extension="2014-06-09" /> + <id root="..." /> + <code + code="2708-6" + codeSystem="2.16.840.1.113883.6.1" + codeSystemName="LOINC" + displayName="Oxygen saturation" /> + <value xsi:type="PQ" + value="98" + unit="%" /> + </observation> + <observation> + <!-- C-CDA Vital Signs Observation --> + <templateId + root="2.16.840.1.113883.10.20.22.4.27" + extension="2014-06-09" /> + <id root="..." /> + <code + code="3151-8" + codeSystem="2.16.840.1.113883.6.1" + codeSystemName="LOINC" + displayName="Inhaled Oxygen Flow Rate" /> + <value xsi:type="PQ" + value="6" + unit="L/min" /> + </observation> + <observation> + <!-- C-CDA Vital Signs Observation --> + <templateId + root="2.16.840.1.113883.10.20.22.4.27" + extension="2014-06-09" /> + <id root="..." /> + <code + code="3150-0" + codeSystem="2.16.840.1.113883.6.1" + codeSystemName="LOINC" + displayName="Inhaled Oxygen Concentration" /> + <value xsi:type="PQ" + value="35" + unit="%" /> + </observation> + </component> +</organizer> +{% endhighlight %} +</div> + +</td><td> +<div markdown="1"> +{% highlight json %} +{ + "resourceType" : "Observation", + "status" : "final", + "category" : [{ + "coding" : [{ + "system" : "http://terminology.hl7.org/CodeSystem/observation-category", + "code" : "vital-signs", + }], + }], + "code" : { + "coding" : [{ + "system" : "http://loinc.org", + "code" : "2708-6", + "display" : "Oxygen saturation in Arterial blood" + }, + { + "system" : "http://loinc.org", + "code" : "59408-5", + "display" : "Oxygen saturation in Arterial blood by Pulse oximetry" + }] + }, + "valueQuantity" : { + "value" : 98, + "unit" : "%", + "system" : "http://unitsofmeasure.org", + "code" : "%" + }, + "component" : [{ + "code" : { + "coding" : [{ + "system" : "http://loinc.org", + "code" : "3151-8", + "display" : "Inhaled oxygen flow rate" + }] + }, + "valueQuantity" : { + "value" : 6, + "unit" : "liters/min", + "system" : "http://unitsofmeasure.org", + "code" : "L/min" + } + }, + { + "code" : { + "coding" : [{ + "system" : "http://loinc.org", + "code" : "3150-0", + "display" : "Inhaled Oxygen Concentration" + }] + }, + "valueQuantity" : { + "value" : 35, + "unit" : "%", + "system" : "http://unitsofmeasure.org", + "code" : "%" + } + }] +} +{% endhighlight %} +</div> +</td></tr> +</table> + ### Illustrative example ... From 41387780cf234570705f67720d64d02756d03c32 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Thu, 17 Oct 2024 19:47:17 -0500 Subject: [PATCH 076/112] Fix some improper XML --- input/pagecontent/CF-vitals.md | 10 ++++++++-- 1 file changed, 8 insertions(+), 2 deletions(-) diff --git a/input/pagecontent/CF-vitals.md b/input/pagecontent/CF-vitals.md index 33f414f..b45d381 100644 --- a/input/pagecontent/CF-vitals.md +++ b/input/pagecontent/CF-vitals.md @@ -84,6 +84,8 @@ C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or value="115" unit="mm[Hg]" /> </observation> + </component> + <component> <observation> <!-- C-CDA Vital Signs Observation --> <templateId @@ -111,8 +113,8 @@ C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or "category" : [{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/observation-category", - "code" : "vital-signs", - }], + "code" : "vital-signs" + }] }], "code" : { "coding" : [{ @@ -191,6 +193,8 @@ C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or value="98" unit="%" /> </observation> + </component> + <component> <observation> <!-- C-CDA Vital Signs Observation --> <templateId @@ -206,6 +210,8 @@ C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or value="6" unit="L/min" /> </observation> + </component> + <component> <observation> <!-- C-CDA Vital Signs Observation --> <templateId From d6ce2390ac1e707edc511c8a4591bd15b4e483a7 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Fri, 18 Oct 2024 10:12:30 -0500 Subject: [PATCH 077/112] Build-in the highlighting --- input/images/colors.css | 128 ++++++++++++++++ input/pagecontent/CF-vitals.md | 257 ++++++++++++++++++++++++++++++++- 2 files changed, 378 insertions(+), 7 deletions(-) create mode 100644 input/images/colors.css diff --git a/input/images/colors.css b/input/images/colors.css new file mode 100644 index 0000000..43099b8 --- /dev/null +++ b/input/images/colors.css @@ -0,0 +1,128 @@ +td, th { + border: 1px solid black!important; +} + +.codeArea { + font-family: 'Courier New', Courier, monospace; + white-space: pre; + background: #f5f2f0; /* FHIR prism template */ + border: 1px solid #ccc; + border-radius: 4px; +} + +.comment { + color: #999; +} +.field { + color: #2f6f9f; +} +.attrib { + color: #690; +} +.value { + color: #d44950; +} + +mark span{ + color: black !important; +} + +.color10 { + background-color: #ffff00ff; +} +.color11 { + background-color: #7cfc00ff; +} +.color12 { + background-color: #00ffffff; +} +.color13 { + background-color: #ffc0cbff; +} +.color14 { + background-color: #87cefaff; +} +.color15 { + background-color: #c0c0c0ff; +} +.color16 { + background-color: #eee8aaff; +} +.color17 { + background-color: #ffa500ff; +} +.color18 { + background-color: #ffd700ff; +} +.color19 { + background-color: #9acd32ff; +} +.color20 { + background-color: #1e90ffff; +} +.color21 { + background-color: #deb887ff; +} +.color22{ + background-color: #dda0ddff; +} +.color23 { + background-color: #ff6347ff; +} +.color24 { + background-color: #b8860bff; +} +.color25 { + background-color: #808080ff; +} +.color26 { + background-color: #2e8b57ff; +} +.color27 { + background-color: #4682b4ff; +} +.color28 { + background-color: #808000ff; +} +.color29 { + background-color: #5f9ea0ff; +} +.color30 { + background-color: #ba55d3ff; +} +.color31 { + background-color: #d3d3d3ff; +} +.color32 { + background-color: #d2691eff; +} +.color33 { + background-color: #ffe4c4ff; +} +.color34 { + background-color: #ff7f50ff; +} +.color35 { + background-color: #98fb98ff; +} +.color36 { + background-color: #ff00ffff; +} +.color37 { + background-color: #778899ff; +} +.color38 { + background-color: #ff4500ff; +} +.color39 { + background-color: #20b2aaff; +} +.color40 { + background-color: #9370dbff; +} +.color41 { + background-color: #ff8c00ff; +} +.color42 { + background-color: #ff0000ff; +} \ No newline at end of file diff --git a/input/pagecontent/CF-vitals.md b/input/pagecontent/CF-vitals.md index b45d381..fbd2b76 100644 --- a/input/pagecontent/CF-vitals.md +++ b/input/pagecontent/CF-vitals.md @@ -1,10 +1,7 @@ -<style> -td, th { - border: 1px solid black!important; -} -</style> +<link rel="stylesheet" href="colors.css"> -This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, please refer to [Vitals FHIR → CDA](./FC-vitals.html). For guidance on how to read the table below, see [Reading the C-CDA ↔ FHIR Mapping Pages](./mappingGuidance.html). +This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, please refer to [Vitals FHIR → CDA](./FC-vitals.html). For guidance on how to read the table +below, see [Reading the C-CDA ↔ FHIR Mapping Pages](./mappingGuidance.html). C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or more vitals readings together. This has been mapped to an additional FHIR Observation for the panel of vital signs. This panel contains a `.hasMember` field which references each observation mapped from the original C-CDA Vital Signs Organizer. @@ -163,6 +160,7 @@ C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or <tr><th>C-CDA Pulse Oximetry Observations</th><th>FHIR Pulse Oximetry Observation</th></tr> <tr><td> <div markdown="1"> + {% highlight xml %} <organizer> <!-- C-CDA Vital Signs Organizer --> @@ -300,7 +298,252 @@ C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or ### Illustrative example -... + +(Main example still coming - just experimenting with new fancy-highlighter here; compare with auto-formatted XML/JSON above) + +<table> +<tr><th>C-CDA Blood Pressure (Codes & Values Only)</th><th>FHIR Blood Pressure</th></tr> +<tr><td> +<div id="cda" class="border codeArea"><<span class="field">organizer</span>> + <span class="comment"><!-- C-CDA Vital Signs Organizer --></span> + <<span class="field">templateId</span> + <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.26"</span> + <span class="attrib">extension=</span><span class="value">"2015-08-01"</span> /> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"..."</span> /> + <<span class="field">code</span> + <span class="attrib">code=</span><span class="value">"<mark class="color10">46680005</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"2.16.840.1.113883.6.96"</span> + <span class="attrib">codeSystemName=</span><span class="value">"SNOMED CT"</span> + displayName=<mark class="color10"><span class="value">"Vital Signs"</span></mark> /> + <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"completed"</span> /> + <span class="comment"><!-- effectiveTime, author, etc stripped --></span> + <<span class="field">component</span>> + <<span class="field">observation</span>> + <span class="comment"><!-- C-CDA Vital Signs Observation --></span> + <<span class="field">templateId</span> + <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.27"</span> + <span class="attrib">extension=</span><span class="value">"2014-06-09"</span> /> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"..."</span> /> + <<span class="field">code</span> + <span class="attrib">code=</span><span class="value">"<mark class="color11">8480-6</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color12">2.16.840.1.113883.6.1</mark>"</span> + <span class="attrib">codeSystemName=</span><span class="value">"<mark class="color12">LOINC</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color13">Systolic blood pressure</mark>"</span> /> + <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"completed"</span> /> + <<span class="field">value</span> <span class="attrib">xsi:type=</span><span class="value">"PQ"</span> + value=<mark class="color14"><span class="value">"115"</span></mark> + <span class="attrib">unit=</span><span class="value">"<mark class="color15">mm[Hg]</mark>"</span> /> + </<span class="field">observation</span>> + </<span class="field">component</span>> + <<span class="field">component</span>> + <<span class="field">observation</span>> + <span class="comment"><!-- C-CDA Vital Signs Observation --></span> + <<span class="field">templateId</span> + <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.27"</span> + <span class="attrib">extension=</span><span class="value">"2014-06-09"</span> /> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"..."</span> /> + <<span class="field">code</span> + <span class="attrib">code=</span><span class="value">"<mark class="color16">8462-4</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color12">2.16.840.1.113883.6.1</mark>"</span> + <span class="attrib">codeSystemName=</span><span class="value">"<mark class="color12">LOINC</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color17">Diastolic blood pressure</mark>"</span> /> + <<span class="field">value</span> <span class="attrib">xsi:type=</span><span class="value">"PQ"</span> value=<mark class="color18"><span class="value">"75"</span></mark> <span class="attrib">unit=</span><span class="value">"<mark class="color15">mm[Hg]</mark>"</span> /> + </<span class="field">observation</span>> + </<span class="field">component</span>> +</<span class="field">organizer</span>></div> +</td><td> +<div id="fhir" class="border codeArea">{ + "<span class="field">resourceType</span>" : "<span class="value">Observation</span>", + "<span class="field">status</span>" : "<span class="value">final</span>", + "<span class="field">category</span>" : [{ + "<span class="field">coding</span>" : [{ + "<span class="field">system</span>" : "<span class="value">http://terminology.hl7.org/CodeSystem/observation-category</span>", + "<span class="field">code</span>" : "<span class="value"><mark class="color10">vital-signs</mark></span>" + }] + }], + "<span class="field">code</span>" : { + "<span class="field">coding</span>" : [{ + "<span class="field">system</span>" : "<span class="value"><mark class="color12">http://loinc.org</mark></span>", + "<span class="field">code</span>" : "<span class="value">85354-9</span>", + "<span class="field">display</span>" : "<span class="value">Blood pressure panel with all children optional</span>" + }] + }, + "<span class="field">component</span>" : [{ + "<span class="field">code</span>" : { + "<span class="field">coding</span>" : [{ + "<span class="field">system</span>" : "<span class="value"><mark class="color12">http://loinc.org</mark></span>", + "<span class="field">code</span>" : "<span class="value"><mark class="color11">8480-6</mark></span>", + "<span class="field">display</span>" : "<span class="value"><mark class="color13">Systolic blood pressure</mark></span>" + }], + "<span class="field">text</span>" : "<span class="value"><mark class="color13">Systolic blood pressure</mark></span>" + }, + "<span class="field">valueQuantity</span>" : { + "<span class="field">value</span>" : <mark class="color14">115,</mark> + "<span class="field">unit</span>" : "<span class="value">mmHg</span>", + "<span class="field">system</span>" : "<span class="value">http://unitsofmeasure.org</span>", + "<span class="field">code</span>" : "<span class="value"><mark class="color15">mm[Hg]</mark></span>" + } + }, + { + "<span class="field">code</span>" : { + "<span class="field">coding</span>" : [{ + "<span class="field">system</span>" : "<span class="value"><mark class="color12">http://loinc.org</mark></span>", + "<span class="field">code</span>" : "<span class="value"><mark class="color16">8462-4</mark></span>", + "<span class="field">display</span>" : "<span class="value"><mark class="color17">Diastolic blood pressure</mark></span>" + }], + "<span class="field">text</span>" : "<span class="value"><mark class="color17">Diastolic blood pressure</mark></span>" + }, + "<span class="field">valueQuantity</span>" : { + "<span class="field">value</span>" : <mark class="color18">75,</mark> + "<span class="field">unit</span>" : "<span class="value">mmHg</span>", + "<span class="field">system</span>" : "<span class="value">http://unitsofmeasure.org</span>", + "<span class="field">code</span>" : "<span class="value"><mark class="color15">mm[Hg]</mark></span>" + } + }] +}</div> +</td></tr> + + +<tr><th>C-CDA Pulse Oximetry (Codes & Values Only)</th><th>FHIR Pulse Oximetry</th></tr> +<tr><td> +<div id="cda" class="border codeArea"><<span class="field">organizer</span>> + <span class="comment"><!-- C-CDA Vital Signs Organizer --></span> + <<span class="field">templateId</span> + <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.26"</span> + <span class="attrib">extension=</span><span class="value">"2015-08-01"</span> /> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"..."</span> /> + <<span class="field">code</span> + <span class="attrib">code=</span><span class="value">"<mark class="color10">46680005</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"2.16.840.1.113883.6.96"</span> + <span class="attrib">codeSystemName=</span><span class="value">"SNOMED CT"</span> + displayName=<mark class="color10"><span class="value">"Vital Signs"</span></mark> /> + <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"completed"</span> /> + <span class="comment"><!-- effectiveTime, author, etc stripped --></span> + <<span class="field">component</span>> + <<span class="field">observation</span>> + <span class="comment"><!-- C-CDA Vital Signs Observation --></span> + <<span class="field">templateId</span> + <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.27"</span> + <span class="attrib">extension=</span><span class="value">"2014-06-09"</span> /> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"..."</span> /> + <<span class="field">code</span> + <span class="attrib">code=</span><span class="value">"<mark class="color11">2708-6</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color12">2.16.840.1.113883.6.1</mark>"</span> + <span class="attrib">codeSystemName=</span><span class="value">"<mark class="color12">LOINC</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"Oxygen saturation"</span> /> + <<span class="field">value</span> <span class="attrib">xsi:type=</span><span class="value">"PQ"</span> + value=<mark class="color13"><span class="value">"98"</span></mark> + unit=<mark class="color14"><span class="value">"%"</span></mark> /> + </<span class="field">observation</span>> + <<span class="field">observation</span>> + <span class="comment"><!-- C-CDA Vital Signs Observation --></span> + <<span class="field">templateId</span> + <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.27"</span> + <span class="attrib">extension=</span><span class="value">"2014-06-09"</span> /> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"..."</span> /> + <<span class="field">code</span> + <span class="attrib">code=</span><span class="value">"<mark class="color15">3151-8</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color12">2.16.840.1.113883.6.1</mark>"</span> + <span class="attrib">codeSystemName=</span><span class="value">"<mark class="color12">LOINC</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"Inhaled Oxygen Flow Rate"</span> /> + <<span class="field">value</span> <span class="attrib">xsi:type=</span><span class="value">"PQ"</span> + value=<mark class="color16"><span class="value">"6"</span></mark> + <span class="attrib">unit=</span><span class="value">"<mark class="color17">L/min</mark>"</span> /> + </<span class="field">observation</span>> + <<span class="field">observation</span>> + <span class="comment"><!-- C-CDA Vital Signs Observation --></span> + <<span class="field">templateId</span> + <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.27"</span> + <span class="attrib">extension=</span><span class="value">"2014-06-09"</span> /> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"..."</span> /> + <<span class="field">code</span> + <span class="attrib">code=</span><span class="value">"<mark class="color18">3150-0</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color12">2.16.840.1.113883.6.1</mark>"</span> + <span class="attrib">codeSystemName=</span><span class="value">"<mark class="color12">LOINC</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color19">Inhaled Oxygen Concentration</mark>"</span> /> + <<span class="field">value</span> <span class="attrib">xsi:type=</span><span class="value">"PQ"</span> + value=<mark class="color20"><span class="value">"35"</span></mark> + unit=<mark class="color14"><span class="value">"%"</span></mark> /> + </<span class="field">observation</span>> + </<span class="field">component</span>> +</<span class="field">organizer</span>></div> + +</td><td> +<div id="fhir" class="border codeArea">{ + "<span class="field">resourceType</span>": "<span class="value">Observation</span>", + "<span class="field">status</span>": "<span class="value">final</span>", + "<span class="field">category</span>": [ + { + "<span class="field">coding</span>": [ + { + "<span class="field">system</span>": "<span class="value">http://terminology.hl7.org/CodeSystem/observation-category</span>", + "<span class="field">code</span>": "<span class="value"><mark class="color10">vital-signs</mark></span>" + } + ] + } + ], + "<span class="field">code</span>": { + "<span class="field">coding</span>": [ + { + "<span class="field">system</span>": "<span class="value"><mark class="color12">http://loinc.org</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color11">2708-6</mark></span>", + "<span class="field">display</span>": "<span class="value">Oxygen saturation in Arterial blood</span>" + }, + { + "<span class="field">system</span>": "<span class="value"><mark class="color12">http://loinc.org</mark></span>", + "<span class="field">code</span>": "<span class="value">59408-5</span>", + "<span class="field">display</span>": "<span class="value">Oxygen saturation in Arterial blood by Pulse oximetry</span>" + } + ] + }, + "<span class="field">valueQuantity</span>": { + "<span class="field">value</span>": <mark class="color13">98,</mark> + "<span class="field">unit</span>": <mark class="color14">"%"</mark>, + "<span class="field">system</span>": "<span class="value">http://unitsofmeasure.org</span>", + "<span class="field">code</span>": <mark class="color14">"%"</mark> + }, + "<span class="field">component</span>": [ + { + "<span class="field">code</span>": { + "<span class="field">coding</span>": [ + { + "<span class="field">system</span>": "<span class="value"><mark class="color12">http://loinc.org</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color15">3151-8</mark></span>", + "<span class="field">display</span>": "<span class="value">Inhaled oxygen flow rate</span>" + } + ] + }, + "<span class="field">valueQuantity</span>": { + "<span class="field">value</span>": <mark class="color16">6,</mark> + "<span class="field">unit</span>": "<span class="value">liters/min</span>", + "<span class="field">system</span>": "<span class="value">http://unitsofmeasure.org</span>", + "<span class="field">code</span>": "<span class="value"><mark class="color17">L/min</mark></span>" + } + }, + { + "<span class="field">code</span>": { + "<span class="field">coding</span>": [ + { + "<span class="field">system</span>": "<span class="value"><mark class="color12">http://loinc.org</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color18">3150-0</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color19">Inhaled Oxygen Concentration</mark></span>" + } + ] + }, + "<span class="field">valueQuantity</span>": { + "<span class="field">value</span>": <mark class="color20">35,</mark> + "<span class="field">unit</span>": <mark class="color14">"%"</mark>, + "<span class="field">system</span>": "<span class="value">http://unitsofmeasure.org</span>", + "<span class="field">code</span>": <mark class="color14">"%"</mark> + } + } + ] +}</div> +</td></tr> +</table> + + + ### Links to example content ... ### Prior work and Expanded Spreadsheets From c235e4410a405c50d11e7730b2168fd55387cb83 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Fri, 18 Oct 2024 10:26:08 -0500 Subject: [PATCH 078/112] Fix the formatting of short attributes --- input/pagecontent/CF-vitals.md | 126 +++++++++++++++------------------ 1 file changed, 57 insertions(+), 69 deletions(-) diff --git a/input/pagecontent/CF-vitals.md b/input/pagecontent/CF-vitals.md index fbd2b76..91a2ca4 100644 --- a/input/pagecontent/CF-vitals.md +++ b/input/pagecontent/CF-vitals.md @@ -304,7 +304,7 @@ C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or <table> <tr><th>C-CDA Blood Pressure (Codes & Values Only)</th><th>FHIR Blood Pressure</th></tr> <tr><td> -<div id="cda" class="border codeArea"><<span class="field">organizer</span>> +<div class="border codeArea"><<span class="field">organizer</span>> <span class="comment"><!-- C-CDA Vital Signs Organizer --></span> <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.26"</span> @@ -314,7 +314,7 @@ C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or <span class="attrib">code=</span><span class="value">"<mark class="color10">46680005</mark>"</span> <span class="attrib">codeSystem=</span><span class="value">"2.16.840.1.113883.6.96"</span> <span class="attrib">codeSystemName=</span><span class="value">"SNOMED CT"</span> - displayName=<mark class="color10"><span class="value">"Vital Signs"</span></mark> /> + <span class="attrib">displayName=</span><mark class="color10"><span class="value">"Vital Signs"</span></mark> /> <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"completed"</span> /> <span class="comment"><!-- effectiveTime, author, etc stripped --></span> <<span class="field">component</span>> @@ -331,7 +331,7 @@ C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or <span class="attrib">displayName=</span><span class="value">"<mark class="color13">Systolic blood pressure</mark>"</span> /> <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"completed"</span> /> <<span class="field">value</span> <span class="attrib">xsi:type=</span><span class="value">"PQ"</span> - value=<mark class="color14"><span class="value">"115"</span></mark> + <span class="attrib">value=</span><mark class="color14"><span class="value">"115"</span></mark> <span class="attrib">unit=</span><span class="value">"<mark class="color15">mm[Hg]</mark>"</span> /> </<span class="field">observation</span>> </<span class="field">component</span>> @@ -347,12 +347,12 @@ C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or <span class="attrib">codeSystem=</span><span class="value">"<mark class="color12">2.16.840.1.113883.6.1</mark>"</span> <span class="attrib">codeSystemName=</span><span class="value">"<mark class="color12">LOINC</mark>"</span> <span class="attrib">displayName=</span><span class="value">"<mark class="color17">Diastolic blood pressure</mark>"</span> /> - <<span class="field">value</span> <span class="attrib">xsi:type=</span><span class="value">"PQ"</span> value=<mark class="color18"><span class="value">"75"</span></mark> <span class="attrib">unit=</span><span class="value">"<mark class="color15">mm[Hg]</mark>"</span> /> + <<span class="field">value</span> <span class="attrib">xsi:type=</span><span class="value">"PQ"</span> <span class="attrib">value=</span><mark class="color18"><span class="value">"75"</span></mark> <span class="attrib">unit=</span><span class="value">"<mark class="color15">mm[Hg]</mark>"</span> /> </<span class="field">observation</span>> </<span class="field">component</span>> </<span class="field">organizer</span>></div> </td><td> -<div id="fhir" class="border codeArea">{ +<div class="border codeArea">{ "<span class="field">resourceType</span>" : "<span class="value">Observation</span>", "<span class="field">status</span>" : "<span class="value">final</span>", "<span class="field">category</span>" : [{ @@ -406,7 +406,7 @@ C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or <tr><th>C-CDA Pulse Oximetry (Codes & Values Only)</th><th>FHIR Pulse Oximetry</th></tr> <tr><td> -<div id="cda" class="border codeArea"><<span class="field">organizer</span>> +<div class="border codeArea"><<span class="field">organizer</span>> <span class="comment"><!-- C-CDA Vital Signs Organizer --></span> <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.26"</span> @@ -416,7 +416,7 @@ C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or <span class="attrib">code=</span><span class="value">"<mark class="color10">46680005</mark>"</span> <span class="attrib">codeSystem=</span><span class="value">"2.16.840.1.113883.6.96"</span> <span class="attrib">codeSystemName=</span><span class="value">"SNOMED CT"</span> - displayName=<mark class="color10"><span class="value">"Vital Signs"</span></mark> /> + <span class="attrib">displayName=</span><mark class="color10"><span class="value">"Vital Signs"</span></mark> /> <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"completed"</span> /> <span class="comment"><!-- effectiveTime, author, etc stripped --></span> <<span class="field">component</span>> @@ -432,8 +432,8 @@ C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or <span class="attrib">codeSystemName=</span><span class="value">"<mark class="color12">LOINC</mark>"</span> <span class="attrib">displayName=</span><span class="value">"Oxygen saturation"</span> /> <<span class="field">value</span> <span class="attrib">xsi:type=</span><span class="value">"PQ"</span> - value=<mark class="color13"><span class="value">"98"</span></mark> - unit=<mark class="color14"><span class="value">"%"</span></mark> /> + <span class="attrib">value=</span><mark class="color13"><span class="value">"98"</span></mark> + <span class="attrib">unit=</span><mark class="color14"><span class="value">"%"</span></mark> /> </<span class="field">observation</span>> <<span class="field">observation</span>> <span class="comment"><!-- C-CDA Vital Signs Observation --></span> @@ -447,7 +447,7 @@ C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or <span class="attrib">codeSystemName=</span><span class="value">"<mark class="color12">LOINC</mark>"</span> <span class="attrib">displayName=</span><span class="value">"Inhaled Oxygen Flow Rate"</span> /> <<span class="field">value</span> <span class="attrib">xsi:type=</span><span class="value">"PQ"</span> - value=<mark class="color16"><span class="value">"6"</span></mark> + <span class="attrib">value=</span><mark class="color16"><span class="value">"6"</span></mark> <span class="attrib">unit=</span><span class="value">"<mark class="color17">L/min</mark>"</span> /> </<span class="field">observation</span>> <<span class="field">observation</span>> @@ -462,39 +462,33 @@ C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or <span class="attrib">codeSystemName=</span><span class="value">"<mark class="color12">LOINC</mark>"</span> <span class="attrib">displayName=</span><span class="value">"<mark class="color19">Inhaled Oxygen Concentration</mark>"</span> /> <<span class="field">value</span> <span class="attrib">xsi:type=</span><span class="value">"PQ"</span> - value=<mark class="color20"><span class="value">"35"</span></mark> - unit=<mark class="color14"><span class="value">"%"</span></mark> /> + <span class="attrib">value=</span><mark class="color20"><span class="value">"35"</span></mark> + <span class="attrib">unit=</span><mark class="color14"><span class="value">"%"</span></mark> /> </<span class="field">observation</span>> </<span class="field">component</span>> </<span class="field">organizer</span>></div> </td><td> -<div id="fhir" class="border codeArea">{ +<div class="border codeArea">{ "<span class="field">resourceType</span>": "<span class="value">Observation</span>", "<span class="field">status</span>": "<span class="value">final</span>", - "<span class="field">category</span>": [ - { - "<span class="field">coding</span>": [ - { - "<span class="field">system</span>": "<span class="value">http://terminology.hl7.org/CodeSystem/observation-category</span>", - "<span class="field">code</span>": "<span class="value"><mark class="color10">vital-signs</mark></span>" - } - ] - } - ], + "<span class="field">category</span>": [{ + "<span class="field">coding</span>": [{ + "<span class="field">system</span>": "<span class="value">http://terminology.hl7.org/CodeSystem/observation-category</span>", + "<span class="field">code</span>": "<span class="value"><mark class="color10">vital-signs</mark></span>" + }] + }], "<span class="field">code</span>": { - "<span class="field">coding</span>": [ - { - "<span class="field">system</span>": "<span class="value"><mark class="color12">http://loinc.org</mark></span>", - "<span class="field">code</span>": "<span class="value"><mark class="color11">2708-6</mark></span>", - "<span class="field">display</span>": "<span class="value">Oxygen saturation in Arterial blood</span>" - }, - { - "<span class="field">system</span>": "<span class="value"><mark class="color12">http://loinc.org</mark></span>", - "<span class="field">code</span>": "<span class="value">59408-5</span>", - "<span class="field">display</span>": "<span class="value">Oxygen saturation in Arterial blood by Pulse oximetry</span>" - } - ] + "<span class="field">coding</span>": [{ + "<span class="field">system</span>": "<span class="value"><mark class="color12">http://loinc.org</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color11">2708-6</mark></span>", + "<span class="field">display</span>": "<span class="value">Oxygen saturation in Arterial blood</span>" + }, + { + "<span class="field">system</span>": "<span class="value"><mark class="color12">http://loinc.org</mark></span>", + "<span class="field">code</span>": "<span class="value">59408-5</span>", + "<span class="field">display</span>": "<span class="value">Oxygen saturation in Arterial blood by Pulse oximetry</span>" + }] }, "<span class="field">valueQuantity</span>": { "<span class="field">value</span>": <mark class="color13">98,</mark> @@ -502,42 +496,36 @@ C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or "<span class="field">system</span>": "<span class="value">http://unitsofmeasure.org</span>", "<span class="field">code</span>": <mark class="color14">"%"</mark> }, - "<span class="field">component</span>": [ - { - "<span class="field">code</span>": { - "<span class="field">coding</span>": [ - { - "<span class="field">system</span>": "<span class="value"><mark class="color12">http://loinc.org</mark></span>", - "<span class="field">code</span>": "<span class="value"><mark class="color15">3151-8</mark></span>", - "<span class="field">display</span>": "<span class="value">Inhaled oxygen flow rate</span>" - } - ] - }, - "<span class="field">valueQuantity</span>": { - "<span class="field">value</span>": <mark class="color16">6,</mark> - "<span class="field">unit</span>": "<span class="value">liters/min</span>", - "<span class="field">system</span>": "<span class="value">http://unitsofmeasure.org</span>", - "<span class="field">code</span>": "<span class="value"><mark class="color17">L/min</mark></span>" - } + "<span class="field">component</span>": [{ + "<span class="field">code</span>": { + "<span class="field">coding</span>": [{ + "<span class="field">system</span>": "<span class="value"><mark class="color12">http://loinc.org</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color15">3151-8</mark></span>", + "<span class="field">display</span>": "<span class="value">Inhaled oxygen flow rate</span>" + }] }, - { - "<span class="field">code</span>": { - "<span class="field">coding</span>": [ - { - "<span class="field">system</span>": "<span class="value"><mark class="color12">http://loinc.org</mark></span>", - "<span class="field">code</span>": "<span class="value"><mark class="color18">3150-0</mark></span>", - "<span class="field">display</span>": "<span class="value"><mark class="color19">Inhaled Oxygen Concentration</mark></span>" - } - ] - }, - "<span class="field">valueQuantity</span>": { - "<span class="field">value</span>": <mark class="color20">35,</mark> - "<span class="field">unit</span>": <mark class="color14">"%"</mark>, - "<span class="field">system</span>": "<span class="value">http://unitsofmeasure.org</span>", - "<span class="field">code</span>": <mark class="color14">"%"</mark> - } + "<span class="field">valueQuantity</span>": { + "<span class="field">value</span>": <mark class="color16">6,</mark> + "<span class="field">unit</span>": "<span class="value">liters/min</span>", + "<span class="field">system</span>": "<span class="value">http://unitsofmeasure.org</span>", + "<span class="field">code</span>": "<span class="value"><mark class="color17">L/min</mark></span>" + } + }, + { + "<span class="field">code</span>": { + "<span class="field">coding</span>": [{ + "<span class="field">system</span>": "<span class="value"><mark class="color12">http://loinc.org</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color18">3150-0</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color19">Inhaled Oxygen Concentration</mark></span>" + }] + }, + "<span class="field">valueQuantity</span>": { + "<span class="field">value</span>": <mark class="color20">35,</mark> + "<span class="field">unit</span>": <mark class="color14">"%"</mark>, + "<span class="field">system</span>": "<span class="value">http://unitsofmeasure.org</span>", + "<span class="field">code</span>": <mark class="color14">"%"</mark> } - ] + }] }</div> </td></tr> </table> From 6ee93f106ff787148b1efca9ac91040c27bb89b6 Mon Sep 17 00:00:00 2001 From: jlyle1 <jay@lyle.net> Date: Mon, 21 Oct 2024 12:54:09 -0400 Subject: [PATCH 079/112] added concept map for result status CF --- FHIR-us-ccda.xml | 3 + input/maps/ConceptMap-CF-ResultStatus.xml | 89 +++++++++++++++++++++++ input/pagecontent/CF-results.md | 4 +- 3 files changed, 94 insertions(+), 2 deletions(-) create mode 100644 input/maps/ConceptMap-CF-ResultStatus.xml diff --git a/FHIR-us-ccda.xml b/FHIR-us-ccda.xml index a15875e..4538d2b 100644 --- a/FHIR-us-ccda.xml +++ b/FHIR-us-ccda.xml @@ -37,6 +37,7 @@ <artifact id="ConceptMap/CF-Criticality" key="ConceptMap-CF-Criticality" name="CCDA Criticality to FHIR Criticality"/> <artifact id="ConceptMap/CF-MedActivityMood" key="ConceptMap-CF-MedActivityMood" name="CCDA Medication Activity Mood to FHIR MedicationRequest.intent"/> <artifact id="ConceptMap/CF-ConditionClinicalStatus" key="ConceptMap-CF-ConditionClinicalStatus" name="CCDA Problem Concern Status to FHIR Condition Clinical Status"/> +<artifact id="ConceptMap/CF-ResultStatus" key="ConceptMap-CF-ResultStatus" name="CCDA ResultStatus to FHIR ResultStatus"/> <artifact id="CapabilityStatement/CcdaOnFhirClient" key="CapabilityStatement-CcdaOnFhirClient" name="CCDA on FHIR Client"/> <artifact id="CapabilityStatement/CcdaOnFhirServer" key="CapabilityStatement-CcdaOnFhirServer" name="CCDA on FHIR Server"/> <artifact id="ConceptMap/CF-AllergyIntoleranceCategory" key="ConceptMap-CF-AllergyIntoleranceCategory" name="CCDA to FHIR Allergy Intolerance Category"/> @@ -165,6 +166,7 @@ <page key="CF-immunizations" name="C-CDA to FHIR Immunizations"/> <page key="CF-medications" name="C-CDA to FHIR Medications"/> <page key="CF-notes" name="C-CDA to FHIR Notes"/> +<page key="CF-participations" name="C-CDA to FHIR Participations"/> <page key="CF-patient" name="C-CDA to FHIR Patient"/> <page key="CF-problems" name="C-CDA to FHIR Problems"/> <page key="CF-procedures" name="C-CDA to FHIR Procedures"/> @@ -172,6 +174,7 @@ <page key="CF-social" name="C-CDA to FHIR Social History"/> <page key="CF-vitals" name="C-CDA to FHIR Vital Signs"/> <page key="CF-index" name="C-CDA → FHIR Index"/> +<page key="mappingChangelog" name="Change Log"/> <page key="downloads" name="Downloads"/> <page key="FC-allergies" name="FHIR to C-CDA Allergies"/> <page key="FC-encounters" name="FHIR to C-CDA Encounters"/> diff --git a/input/maps/ConceptMap-CF-ResultStatus.xml b/input/maps/ConceptMap-CF-ResultStatus.xml new file mode 100644 index 0000000..53b0628 --- /dev/null +++ b/input/maps/ConceptMap-CF-ResultStatus.xml @@ -0,0 +1,89 @@ +<ConceptMap xmlns="http://hl7.org/fhir" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"> + <id value="CF-ResultStatus"/> + <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"> + <valueCode value="cgp" /> + </extension> + <url value="http://hl7.org/fhir/us/ccda/ConceptMap/CF-ResultStatus"/> + <version value="4.0.1"/> + <name value="CCDAtoFHIRResultStatus"/> + <title value="CCDA ResultStatus to FHIR ResultStatus"/> + <status value="active"/> + <experimental value="false"/> + <publisher value="HL7 International"/> + <description value="C-CDA ResultStatus to FHIR ResultStatus"/> + <contact> + <name value="HL7 International"/> + <telecom> + <system value="phone"/> + <value value="+1 734 677 7777"/> + </telecom> + <telecom> + <system value="fax"/> + <value value="+1 734 677 6622"/> + </telecom> + <telecom> + <system value="email"/> + <value value="info@hl7.org"/> + </telecom> + </contact> + <sourceUri value="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.11.20.9.39"/> + <targetUri value="http://hl7.org/fhir/ValueSet/observation-status"/> + <group> + <source value="http://terminology.hl7.org/CodeSystem/2.16.840.1.113883.5.14"/> + <target value="http://hl7.org/fhir/observation-status"/> + <element> + <code value="aborted"/> + <display value="aborted"/> + <target> + <code value="cancelled"/> + <display value="Cancelled"/> + <equivalence value="wider"/> + </target> + </element> + <element> + <code value="active"/> + <display value="active"/> + <target> + <code value="registered"/> + <display value="Registered"/> + <equivalence value="inexact"/> + </target> + </element> + <element> + <code value="cancelled"/> + <display value="cancelled"/> + <target> + <code value="cancelled"/> + <display value="Cancelled"/> + <equivalence value="wider"/> + </target> + </element> + <element> + <code value="completed"/> + <display value="completed"/> + <target> + <code value="final"/> + <display value="Final"/> + <equivalence value="equal"/> + </target> + </element> + <element> + <code value="held"/> + <display value="held"/> + <target> + <code value="registered"/> + <display value="Registered"/> + <equivalence value="inexact"/> + </target> + </element> + <element> + <code value="suspended"/> + <display value="suspended"/> + <target> + <code value="registered"/> + <display value="Registered"/> + <equivalence value="inexact"/> + </target> + </element> + </group> +</ConceptMap> \ No newline at end of file diff --git a/input/pagecontent/CF-results.md b/input/pagecontent/CF-results.md index 9e5e03a..f02982a 100644 --- a/input/pagecontent/CF-results.md +++ b/input/pagecontent/CF-results.md @@ -16,7 +16,7 @@ Observation values are generic - they can be of any CDA type in CDA, and *almost |:----|:----|:----| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| |/code|.code<br/>&<br/>.category|Map to code using [CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept).<br/>Category (and target FHIR Profile) may be identified by looking up a LOINC code's CLASSTYPE (see process in next table).<br/>Alternatively, an extension for `<sdtc:category>` is being developed for CDA Organizer which, if present, will map directly to this field. -|/statusCode|.status|*TODO: ConceptMap* +|/statusCode|.status|[CDA Result Status → FHIR Result Status](./ConceptMap-CF-ResultStatus.html) |/effectiveTime|.effectiveDateTime<br/>or<br/>.effectivePeriod|If low and high are identical, use effectiveDateTime. If organizer/effectiveTime is missing, use the earliest and latest observation/effectiveTime as the source of the mapping.<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) |/specimen|.specimen|[See below](#c-cda-specimen-to-fhir-specimen) |/author|**[Provenance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-provenance.html)**|[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| @@ -30,7 +30,7 @@ Observation values are generic - they can be of any CDA type in CDA, and *almost |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| ||.category|If the code is LOINC, the category can be inferred from the LOINC code CLASSTYPE. Query a FHIR server via `{endpoint}CodeSystem/$lookup?system=http://loinc.org&code={code}&&property=CLASSTYPE` and set the category according to the CLASSTYPE property:<br/>1=Laboratory class (laboratory); 2=Clinical class (clinical-test); 3=Claims attachments (not mapped); 4=Surveys (survey) |/code |.code|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| -|/statusCode|.status|*TODO: ConceptMap* +|/statusCode|.status|/statusCode|.status|[CDA Result Status → FHIR Result Status](./ConceptMap-CF-ResultStatus.html) |/effectiveTime|.effectiveDateTime<br/>or<br/>.effectivePeriod|Prefer effectiveDateTime<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) |/value[xsi:type=PQ]|.valueQuantity|[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity) |/value[xsi:type=IVL_PQ]|.valueQuantity<br/>or<br/>.valueRange|[Ranges of Physical Quantities](mappingGuidance.html#ranges-of-physical-quantities) From 14371084542f24bb637bf6cfadd1390cfbe14867 Mon Sep 17 00:00:00 2001 From: jlyle1 <jay@lyle.net> Date: Mon, 21 Oct 2024 13:25:58 -0400 Subject: [PATCH 080/112] added FC result status concept map --- FHIR-us-ccda.xml | 1 + input/maps/ConceptMap-FC-ResultStatus.xml | 114 ++++++++++++++++++++++ 2 files changed, 115 insertions(+) create mode 100644 input/maps/ConceptMap-FC-ResultStatus.xml diff --git a/FHIR-us-ccda.xml b/FHIR-us-ccda.xml index 4538d2b..9f00510 100644 --- a/FHIR-us-ccda.xml +++ b/FHIR-us-ccda.xml @@ -93,6 +93,7 @@ <artifact id="ConceptMap/FC-DataAbsentReasonNullFlavor" key="ConceptMap-FC-DataAbsentReasonNullFlavor" name="FHIR Data Absent Reason to C-CDA NullFlavor"/> <artifact id="ConceptMap/FC-ImmunizationSite" key="ConceptMap-FC-ImmunizationSite" name="FHIR Immunization Site to C-CDA Immunization approachSiteCode"/> <artifact id="ConceptMap/FC-ImmunizationRefusal" key="ConceptMap-FC-ImmunizationRefusal" name="FHIR Immunization Status Reason to C-CDA Immunization Refusal"/> +<artifact id="ConceptMap/FC-ResultStatus" key="ConceptMap-FC-ResultStatus" name="FHIR ResultStatus to C-CDA ResultStatus"/> <artifact id="ConceptMap/FC-Severity" key="ConceptMap-FC-Severity" name="FHIR Severity to C-CDA Severity"/> <artifact id="ConceptMap/FC-AddressUse" key="ConceptMap-FC-AddressUse" name="FHIR to C-CDA Address Use"/> <artifact id="ConceptMap/FC-AdministrativeGender" key="ConceptMap-FC-AdministrativeGender" name="FHIR to C-CDA Adminmistrative Gender"/> diff --git a/input/maps/ConceptMap-FC-ResultStatus.xml b/input/maps/ConceptMap-FC-ResultStatus.xml new file mode 100644 index 0000000..b520837 --- /dev/null +++ b/input/maps/ConceptMap-FC-ResultStatus.xml @@ -0,0 +1,114 @@ +<ConceptMap xmlns="http://hl7.org/fhir" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"> + <id value="FC-ResultStatus"/> + <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"> + <valueCode value="cgp" /> + </extension> + <url value="http://hl7.org/fhir/us/ccda/ConceptMap/FC-ResultStatus"/> + <version value="4.0.1"/> + <name value="FHIRtoCCDAResultStatus"/> + <title value="FHIR ResultStatus to C-CDA ResultStatus"/> + <status value="active"/> + <experimental value="false"/> + <publisher value="HL7 International"/> + <description value="FHIR ResultStatus to C-CDA ResultStatus"/> + <contact> + <name value="HL7 International"/> + <telecom> + <system value="phone"/> + <value value="+1 734 677 7777"/> + </telecom> + <telecom> + <system value="fax"/> + <value value="+1 734 677 6622"/> + </telecom> + <telecom> + <system value="email"/> + <value value="info@hl7.org"/> + </telecom> + </contact> + <sourceUri value="http://hl7.org/fhir/ValueSet/observation-status"/> + <targetUri value="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.11.20.9.39"/> + <group> + <source value="http://hl7.org/fhir/observation-status"/> + <target value="http://terminology.hl7.org/CodeSystem/2.16.840.1.113883.5.14"/> + <element> + <code value="registered"/> + <display value="registered"/> + <target> + <code value="active"/> + <display value="Active"/> + <equivalence value="wider"/> + </target> + </element> + <element> + <code value="partial"/> + <display value="Partial"/> + <target> + <code value="active"/> + <display value="Active"/> + <equivalence value="wider"/> + </target> + </element> + <element> + <code value="preliminary"/> + <display value="Preliminary"/> + <target> + <code value="active"/> + <display value="Active"/> + <equivalence value="wider"/> + </target> + </element> + <element> + <code value="final"/> + <display value="Final"/> + <target> + <code value="completed"/> + <display value="completed"/> + <equivalence value="wider"/> + </target> + </element> + <element> + <code value="amended"/> + <display value="Amended"/> + <target> + <code value="completed"/> + <display value="completed"/> + <equivalence value="wider"/> + </target> + </element> + <element> + <code value="corrected"/> + <display value="Corrected"/> + <target> + <code value="completed"/> + <display value="completed"/> + <equivalence value="wider"/> + </target> + </element> + <element> + <code value="cancelled"/> + <display value="Cancelled"/> + <target> + <code value="cancelled"/> + <display value="cancelled"/> + <equivalence value="equal"/> + </target> + </element> + <element> + <code value="entered-in-error"/> + <display value="Entered-in-error"/> + <target> + <code value="aborted"/> + <display value="aborted"/> + <equivalence value="wider"/> + </target> + </element> + <element> + <code value="unknown"/> + <display value="unknown"/> + <target> + <equivalence value="unmatched"/> + </target> + </element> + </group> +</ConceptMap> \ No newline at end of file From 51202c7fe61a24448884b0d5211e3a9a4bc8370a Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Mon, 21 Oct 2024 12:47:02 -0500 Subject: [PATCH 081/112] Add note on coding display --- input/pagecontent/mappingGuidance.md | 2 ++ 1 file changed, 2 insertions(+) diff --git a/input/pagecontent/mappingGuidance.md b/input/pagecontent/mappingGuidance.md index 3f23ddc..781daaa 100644 --- a/input/pagecontent/mappingGuidance.md +++ b/input/pagecontent/mappingGuidance.md @@ -112,6 +112,8 @@ Some CDA temporal fields can be either a single point-in-time or an interval ran The structure for coding in CDA and FHIR are fundamentally different. CDA employs a mechanism (xsi:type [CD](https://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-CD.html) or [CE](https://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-CD.html)) where the code is included in the element and then originalText and translations elements may be provided as child elements. In FHIR, [CodeableConcept](http://hl7.org/fhir/datatypes.html#codeableconcept) places all codes in a coding list with a separate element for the text representation. +Both C-CDA and FHIR stipulate that `display`/`@displayName` represents one of the display strings defined for that code by the code system. If a source contains other text, the transforming party may choose to send the system value in display, put that original value in `text`/`<originalText>` and put the system value in display, or simply send the source value. + #### CDA Coding → FHIR CodeableConcept |CDA Property|FHIR Target|Notes| From 6b39b5ff93806e5c591ff5b53866b30ea0aecb7c Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Mon, 21 Oct 2024 13:35:06 -0500 Subject: [PATCH 082/112] Remove images in prep for HTML-based highlighting --- input/images/CF_VitalsHR_example.png | Bin 129590 -> 0 bytes input/images/CF_allergy_example.png | Bin 144269 -> 0 bytes input/images/CF_immunization_example.png | Bin 113863 -> 0 bytes input/images/CF_medication_example.png | Bin 81164 -> 0 bytes input/images/CF_patient_example.png | Bin 193610 -> 0 bytes input/images/CF_problem_example.png | Bin 98286 -> 0 bytes input/images/CF_procedure_example.png | Bin 82509 -> 0 bytes input/images/CF_smoking_example.png | Bin 142223 -> 0 bytes input/includes/CF_allergy_example.md | 5 - input/includes/CF_immunization_example.md | 5 - input/includes/CF_medication_example.md | 5 - input/includes/CF_patient_example.md | 5 - input/includes/CF_problem_example.md | 5 - input/includes/CF_procedure_example.md | 5 - input/includes/examplebutton.html | 17 --- input/pagecontent/CF-allergies.md | 158 ++++++++++++++++++++-- input/pagecontent/CF-immunizations.md | 8 +- input/pagecontent/CF-medications.md | 8 +- input/pagecontent/CF-patient.md | 7 +- input/pagecontent/CF-problems.md | 8 +- input/pagecontent/CF-procedures.md | 9 +- 21 files changed, 155 insertions(+), 90 deletions(-) delete mode 100644 input/images/CF_VitalsHR_example.png delete mode 100644 input/images/CF_allergy_example.png delete mode 100644 input/images/CF_immunization_example.png delete mode 100644 input/images/CF_medication_example.png delete mode 100644 input/images/CF_patient_example.png delete mode 100644 input/images/CF_problem_example.png 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Not all possible elements in CDA or FHIR may be represented. To access the content for the above example, click on the links below. diff --git a/input/includes/CF_immunization_example.md b/input/includes/CF_immunization_example.md deleted file mode 100644 index 2ddc3c5..0000000 --- a/input/includes/CF_immunization_example.md +++ /dev/null @@ -1,5 +0,0 @@ - - -<a href="CF_immunization_example.png" target="_blank"><img src="CF_immunization_example.png" /></a> - -An illustrative example with highlighting is shown above based on the consensus of mapping and guidance. Not all possible elements in CDA or FHIR may be represented. To access the content for the above example, click on the links below. diff --git a/input/includes/CF_medication_example.md b/input/includes/CF_medication_example.md deleted file mode 100644 index 8dfdafa..0000000 --- a/input/includes/CF_medication_example.md +++ /dev/null @@ -1,5 +0,0 @@ - - -<a href="CF_medication_example.png" target="_blank"><img src="CF_medication_example.png" /></a> - -An illustrative example with highlighting is shown above based on the consensus of mapping and guidance. Not all possible elements in CDA or FHIR may be represented. To access the content for the above example, click on the links below. diff --git a/input/includes/CF_patient_example.md b/input/includes/CF_patient_example.md deleted file mode 100644 index 8d3bd10..0000000 --- a/input/includes/CF_patient_example.md +++ /dev/null @@ -1,5 +0,0 @@ - - -<a href="CF_patient_example.png" target="_blank"><img src="CF_patient_example.png" /></a> - -An illustrative example with highlighting is shown above based on the consensus of mapping and guidance. Not all possible elements in CDA or FHIR may be represented. To access the content for the above example, click on the links below. diff --git a/input/includes/CF_problem_example.md b/input/includes/CF_problem_example.md deleted file mode 100644 index b3e7276..0000000 --- a/input/includes/CF_problem_example.md +++ /dev/null @@ -1,5 +0,0 @@ - - -<a href="CF_problem_example.png" target="_blank"><img src="CF_problem_example.png" /></a> - -An illustrative example with highlighting is shown above based on the consensus of mapping and guidance. Not all possible elements in CDA or FHIR may be represented. To access the content for the above example, click on the links below. diff --git a/input/includes/CF_procedure_example.md b/input/includes/CF_procedure_example.md deleted file mode 100644 index a073501..0000000 --- a/input/includes/CF_procedure_example.md +++ /dev/null @@ -1,5 +0,0 @@ - - -<a href="CF_procedure_example.png" target="_blank"><img src="CF_procedure_example.png" /></a> - -An illustrative example with highlighting is shown above based on the consensus of mapping and guidance. Not all possible elements in CDA or FHIR may be represented. To access the content for the above example, click on the links below. diff --git a/input/includes/examplebutton.html b/input/includes/examplebutton.html deleted file mode 100644 index 6abd4f0..0000000 --- a/input/includes/examplebutton.html +++ /dev/null @@ -1,17 +0,0 @@ -{% assign target = include.example | split: "." | first %} -{% assign file_type = include.example | split: "." | last %} -<p> - <button class="btn btn-info btn-lg btn-block" type="button" title="Click to Open or Close Example" data-toggle="collapse" data-target="#{{target}}" aria-expanded="false" aria-controls="collapseExample"> - {{include.b_title | default: "Example" }} - </button> -</p> -<div class="collapse" id="{{target}}" > - <div class="card card-body" markdown="1"> - {% if file_type =="xhtml" or file_type =="html" or file_type =="md"%} - {% include {{include.example}} %} - {% else %} - {% include {{target}}.md %} - {% endif %} - </div> -</div> -<br /> \ No newline at end of file diff --git a/input/pagecontent/CF-allergies.md b/input/pagecontent/CF-allergies.md index cba2026..ab0d732 100644 --- a/input/pagecontent/CF-allergies.md +++ b/input/pagecontent/CF-allergies.md @@ -1,9 +1,4 @@ -<style> -td, th { - border: 1px solid black!important; - max-width:500px; -} -</style> +<link rel="stylesheet" href="colors.css"> This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, please refer to [Allergies FHIR → CDA](./FC-allergies.html). For guidance on how to read the table below, see [Reading the C-CDA ↔ FHIR Mapping Pages](./mappingGuidance.html) @@ -41,14 +36,153 @@ When authors or other provenance are recorded in the parentƒ [Allergy Concern A ### Illustrative example -{% include examplebutton.html example="CF_allergy_example" b_title = "Click on Here To See Highlighted Example" %} +<table><tr><th>CDA Allergy Act</th><th>FHIR AllergyIntolerance Resource</th></tr> +<tr><td> +<div id="cda" class="border codeArea"><<span class="field">act</span> <span class="attrib">classCode=</span><span class="value">"ACT"</span> <span class="attrib">moodCode=</span><span class="value">"EVN"</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.30"</span> <span class="attrib">extension=</span><span class="value">"2015-08-01"</span> /> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.30"</span> /> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"1.3.6.1.4.1.22812.3.2009316.3.4.10"</span> <span class="attrib">extension=</span><span class="value">"<mark class="color10">545077400001</mark>"</span> /> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"1.3.6.1.4.1.22812.3.2009316.3.4.10"</span> <span class="attrib">extension=</span><span class="value">"<mark class="color11">545077400003</mark>"</span> /> + <<span class="field">code</span> <span class="attrib">code=</span><span class="value">"CONC"</span> <span class="attrib">codeSystem=</span><span class="value">"2.16.840.1.113883.5.6"</span> /> + <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"<mark class="color12">active</mark>"</span> /> + <<span class="field">effectiveTime</span> <span class="attrib">xsi:type=</span><span class="value">"IVL_TS"</span>> + <<span class="field">low</span> <span class="attrib">nullFlavor=</span><span class="value">"NI"</span> /> + </<span class="field">effectiveTime</span>> + <<span class="field">entryRelationship</span> <span class="attrib">typeCode=</span><span class="value">"SUBJ"</span>> + <<span class="field">observation</span> <span class="attrib">classCode=</span><span class="value">"OBS"</span> <span class="attrib">moodCode=</span><span class="value">"EVN"</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.7"</span> <span class="attrib">extension=</span><span class="value">"2014-06-09"</span> /> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.7"</span> /> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"<mark class="color13">1.3.6.1.4.1.22812.3.2009316.3.4.10.2</mark>"</span> <span class="attrib">extension=</span><span class="value">"<mark class="color10">545077400001</mark>"</span> /> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"<mark class="color13">1.3.6.1.4.1.22812.3.2009316.3.4.10.2</mark>"</span> <span class="attrib">extension=</span><span class="value">"<mark class="color11">545077400003</mark>"</span> /> + <<span class="field">code</span> <span class="attrib">code=</span><span class="value">"ASSERTION"</span> <span class="attrib">codeSystem=</span><span class="value">"2.16.840.1.113883.5.4"</span> /> + <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"completed"</span> /> + <<span class="field">effectiveTime</span> <span class="attrib">xsi:type=</span><span class="value">"IVL_TS"</span>> + <<span class="field">low</span> <span class="attrib">value=</span><span class="value">"<mark class="color14">20080501</mark>"</span> /> + </<span class="field">effectiveTime</span>> + <<span class="field">value</span> <span class="attrib">xsi:type=</span><span class="value">"CD"</span> + <span class="attrib">code=</span><span class="value">"<mark class="color15">419511003</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color16">2.16.840.1.113883.6.96</mark>"</span>> + <<span class="field">originalText</span>> + <<span class="field">reference</span> <span class="attrib">value=</span><span class="value">"#_6db75b62-deb2-4bab-b597-00c8ae86f6b4"</span> /> + </<span class="field">originalText</span>> + </<span class="field">value</span>> + <<span class="field">participant</span> <span class="attrib">typeCode=</span><span class="value">"CSM"</span>> + <<span class="field">participantRole</span> <span class="attrib">classCode=</span><span class="value">"MANU"</span>> + <<span class="field">playingEntity</span> <span class="attrib">classCode=</span><span class="value">"MMAT"</span>> + <<span class="field">code</span> + <span class="attrib">code=</span><span class="value">"<mark class="color17">1191</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color18">2.16.840.1.113883.6.88</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color19">Aspirin</mark>"</span>> + <<span class="field">translation</span> + <span class="attrib">code=</span><span class="value">"<mark class="color20">293586001</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color16">2.16.840.1.113883.6.96</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color24">Allergy to Aspirin</mark>"</span>/> + </<span class="field">code</span>> + </<span class="field">playingEntity</span>> + </<span class="field">participantRole</span>> + </<span class="field">participant</span>> + <<span class="field">entryRelationship</span> <span class="attrib">typeCode=</span><span class="value">"MFST"</span> <span class="attrib">inversionInd=</span><span class="value">"true"</span>> + <<span class="field">observation</span> <span class="attrib">classCode=</span><span class="value">"OBS"</span> <span class="attrib">moodCode=</span><span class="value">"EVN"</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.9"</span> <span class="attrib">extension=</span><span class="value">"2014-06-09"</span> /> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.9"</span> /> + <<span class="field">id</span> <span class="attrib">nullFlavor=</span><span class="value">"NI"</span> /> + <<span class="field">code</span> <span class="attrib">code=</span><span class="value">"ASSERTION"</span> <span class="attrib">codeSystem=</span><span class="value">"2.16.840.1.113883.5.4"</span> /> + <<span class="field">text</span>> + <<span class="field">reference</span> <span class="attrib">value=</span><span class="value">"#_8a7ed342-967a-400e-88d5-2f8c2b7cdda0"</span> /> + </<span class="field">text</span>> + <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"completed"</span> /> + <<span class="field">value</span> <span class="attrib">xsi:type=</span><span class="value">"CD"</span> + <span class="attrib">code=</span><span class="value">"<mark class="color22">247472004</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color16">2.16.840.1.113883.6.96</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color23">Wheal</mark>"</span>> + <<span class="field">originalText</span>> + <<span class="field">reference</span> <span class="attrib">value=</span><span class="value">"#_8a7ed342-967a-400e-88d5-2f8c2b7cdda0"</span> /> + </<span class="field">originalText</span>> + </<span class="field">value</span>> + <<span class="field">entryRelationship</span> <span class="attrib">typeCode=</span><span class="value">"SUBJ"</span> <span class="attrib">inversionInd=</span><span class="value">"true"</span>> + <<span class="field">observation</span> <span class="attrib">classCode=</span><span class="value">"OBS"</span> <span class="attrib">moodCode=</span><span class="value">"EVN"</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.8"</span> <span class="attrib">extension=</span><span class="value">"2014-06-09"</span> /> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.8"</span> /> + <<span class="field">code</span> <span class="attrib">code=</span><span class="value">"SEV"</span> <span class="attrib">codeSystem=</span><span class="value">"2.16.840.1.113883.5.4"</span> /> + <<span class="field">text</span>>Severe</<span class="field">text</span>> + <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"completed"</span> /> + <<span class="field">value</span> <span class="attrib">xsi:type=</span><span class="value">"CD"</span> + <span class="attrib">code=</span><span class="value">"24484000"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color16">2.16.840.1.113883.6.96</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color27">Severe</mark>"</span> /> + </<span class="field">observation</span>> + </<span class="field">entryRelationship</span>> + </<span class="field">observation</span>> + </<span class="field">entryRelationship</span>> + </<span class="field">observation</span>> + </<span class="field">entryRelationship</span>> +</<span class="field">act</span>></div> +</td><td> + +<div id="fhir" class="border codeArea">{ + "<span class="field">resourceType</span>": "<span class="value">AllergyIntolerance</span>", + "<span class="field">identifier</span>": [ + { + "<span class="field">system</span>": "<span class="value">urn:oid:<mark class="color13">1.3.6.1.4.1.22812.3.2009316.3.4.10.2</mark></span>", + "<span class="field">value</span>": "<span class="value"><mark class="color10">545077400001</mark></span>" + }, + { + "<span class="field">system</span>": "<span class="value">urn:oid:<mark class="color13">1.3.6.1.4.1.22812.3.2009316.3.4.10.2</mark></span>", + "<span class="field">value</span>": "<span class="value"><mark class="color11">545077400003</mark></span>" + } + ], + "<span class="field">clinicalStatus</span>": { + "<span class="field">coding</span>": [ + { + "<span class="field">system</span>": "<span class="value">http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical</span>", + "<span class="field">code</span>": "<span class="value"><mark class="color12">active</mark></span>" + } + ] + }, + "<span class="field">category</span>": [ + "<mark class="color15">medication</mark>" + ], + "<span class="field">code</span>": { + "<span class="field">coding</span>": [ + { + "<span class="field">system</span>": "<span class="value"><mark class="color18">http://www.nlm.nih.gov/research/umls/rxnorm</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color17">1191</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color19">Aspirin</mark></span>" + }, + { + "<span class="field">system</span>": "<span class="value"><mark class="color16">http://snomed.info/sct</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color20">293586001</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color24">Allergy to Aspirin</mark></span>" + } + ], + "<span class="field">text</span>": "<span class="value"><mark class="color19">Aspirin</mark></span>" + }, + "<span class="field">patient</span>": { + "<span class="field">reference</span>": "<span class="value">Patient/CF-patient</span>" + }, + "<span class="field">onsetDateTime</span>": "<span class="value"><mark class="color14">2008-05-01</mark></span>", + "<span class="field">reaction</span>": [ + { + "<span class="field">manifestation</span>": [ + { + "<span class="field">coding</span>": [ + { + "<span class="field">system</span>": "<span class="value"><mark class="color16">http://snomed.info/sct</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color22">247472004</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color23">Wheal</mark></span>" + } + ], + "<span class="field">text</span>": "<span class="value"><mark class="color23">Wheal</mark></span>" + } + ], + "<span class="field">severity</span>": "<span class="value"><mark class="color27">severe</mark></span>" + } + ] +}</div> +</td></tr></table> #### Links to example content The consensus mapping example developed through multiple vendors are available below: * [Allergy CDA example](./Binary-CF-allergy.html) -* [Allergy FHIR example](./AllergyIntolerance-CF-allergy.html) - -### Prior work and Expanded Spreadsheets - -As reviewed in the methodology, a more comprehensive review was performed via spreadsheets. These spreadsheets have been consolidated and further revised in the tables above but are provided for [reference here](https://github.com/HL7/ccda-on-fhir/blob/master/mappings/CF/CCDA-FHIR%20Allergy.csv) \ No newline at end of file +* [Allergy FHIR example](./AllergyIntolerance-CF-allergy.html) \ No newline at end of file diff --git a/input/pagecontent/CF-immunizations.md b/input/pagecontent/CF-immunizations.md index 6472c6a..403850b 100644 --- a/input/pagecontent/CF-immunizations.md +++ b/input/pagecontent/CF-immunizations.md @@ -40,14 +40,10 @@ Mapping is from `@moodCode="EVN"` (i.e. historical) immunizations, not `INT` (fu ### Illustrative example -{% include examplebutton.html example="CF_immunization_example" b_title = "Click Here To See Highlighted Example" %} + #### Links to example content The consensus mapping example developed through multiple vendors are available below: * [Immuniztion CDA example](./Binary-CF-immunization.html) -* [Immuniztion FHIR example](./Immunization-CF-immunization.html) - -### Prior work and Expanded Spreadsheets - -As reviewed in the methodology, a more comprehensive review was performed via spreadsheets. These spreadsheets have been consolidated and further revised in the tables above but are provided for [reference here](https://github.com/HL7/ccda-on-fhir/blob/master/mappings/CF/CCDA-FHIR%20Immunization.csv) \ No newline at end of file +* [Immuniztion FHIR example](./Immunization-CF-immunization.html) \ No newline at end of file diff --git a/input/pagecontent/CF-medications.md b/input/pagecontent/CF-medications.md index 5542f40..59fd972 100644 --- a/input/pagecontent/CF-medications.md +++ b/input/pagecontent/CF-medications.md @@ -72,14 +72,10 @@ MedicationRequest (and other resources) may represent the medication as a simple ### Illustrative example -{% include examplebutton.html example="CF_medication_example" b_title = "Click Here To See Highlighted Example" %} + #### Links to example content The consensus mapping example developed through multiple vendors are available below: * [Medication CDA example](./Binary-CF-medication.html) -* [MedicationRequest FHIR example](./MedicationRequest-CF-medication.html) - -### Prior work and Expanded Spreadsheets - -As reviewed in the methodology, a more comprehensive review was performed via spreadsheets. These spreadsheets have been consolidated and further revised in the tables above but are provided for [reference here](https://github.com/HL7/ccda-on-fhir/blob/master/mappings/CF/CCDA-FHIR%20MedicationRequest.csv) \ No newline at end of file +* [MedicationRequest FHIR example](./MedicationRequest-CF-medication.html) \ No newline at end of file diff --git a/input/pagecontent/CF-patient.md b/input/pagecontent/CF-patient.md index 16bfb22..857c98a 100644 --- a/input/pagecontent/CF-patient.md +++ b/input/pagecontent/CF-patient.md @@ -42,14 +42,9 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea ### Illustrative example -{% include examplebutton.html example="CF_patient_example" b_title = "Click Here To See Highlighted Example" %} #### Links to example content The consensus mapping example developed through multiple vendors are available below: * [Patient CDA example](./Binary-CF-patient.html) -* [Patient FHIR example](./Patient-CF-patient.html) - -### Prior work and Expanded Spreadsheets - -As reviewed in the methodology, a more comprehensive review was performed via spreadsheets. These spreadsheets have been consolidated and further revised in the tables above but are provided for [reference here](https://github.com/HL7/ccda-on-fhir/blob/master/mappings/CF/CCDA-FHIR%20Patient.csv) \ No newline at end of file +* [Patient FHIR example](./Patient-CF-patient.html) \ No newline at end of file diff --git a/input/pagecontent/CF-problems.md b/input/pagecontent/CF-problems.md index 280bbbe..4e12de0 100644 --- a/input/pagecontent/CF-problems.md +++ b/input/pagecontent/CF-problems.md @@ -40,14 +40,10 @@ When authors or other provenance are recorded in the parent [Problem Concern Act ### Illustrative example -{% include examplebutton.html example="CF_problem_example" b_title = "Click Here To See Highlighted Example" %} + #### Links to example content The consensus mapping example developed through multiple vendors are available below: * [Problem CDA example](./Binary-CF-problem.html) -* [Condition FHIR example](./Condition-CF-problem.html) - -### Prior work and Expanded Spreadsheets - -As reviewed in the methodology, a more comprehensive review was performed via spreadsheets. These spreadsheets have been consolidated and further revised in the tables above but are provided for [reference here](https://github.com/HL7/ccda-on-fhir/blob/master/mappings/CF/CCDA-FHIR%20Problem-Condition.csv) \ No newline at end of file +* [Condition FHIR example](./Condition-CF-problem.html) \ No newline at end of file diff --git a/input/pagecontent/CF-procedures.md b/input/pagecontent/CF-procedures.md index 3200ff9..30e76bb 100644 --- a/input/pagecontent/CF-procedures.md +++ b/input/pagecontent/CF-procedures.md @@ -33,15 +33,10 @@ C-CDA 2.1 describes three templates for Procedures: Procedure Activity Act, Proc ### Illustrative example -{% include examplebutton.html example="CF_procedure_example" b_title = "Click Here To See Highlighted Example" %} + #### Links to example content The consensus mapping example developed through multiple vendors are available below: * [Procedure CDA example](./Binary-CF-procedure.html) -* [Procedure FHIR example](./Procedure-CF-procedure.html) - - -### Prior work and Expanded Spreadsheets - -As reviewed in the methodology, a more comprehensive review was performed via spreadsheets. These spreadsheets have been consolidated and further revised in the tables above but are provided for [reference here](https://github.com/HL7/ccda-on-fhir/blob/master/mappings/CF/CCDA-FHIR%20Procedure.csv) \ No newline at end of file +* [Procedure FHIR example](./Procedure-CF-procedure.html) \ No newline at end of file From a66aefd2ea1753162af0a33bb778afc453e2e7c0 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Mon, 21 Oct 2024 14:51:30 -0500 Subject: [PATCH 083/112] Prep remaining CF pages for inline examples --- input/pagecontent/CF-encounters.md | 25 ++- input/pagecontent/CF-immunizations.md | 11 +- input/pagecontent/CF-medications.md | 13 +- input/pagecontent/CF-notes.md | 14 +- input/pagecontent/CF-participations.md | 6 +- input/pagecontent/CF-patient.md | 12 +- input/pagecontent/CF-problems.md | 13 +- input/pagecontent/CF-procedures.md | 13 +- input/pagecontent/CF-results.md | 15 +- input/pagecontent/CF-social.md | 33 +++- input/pagecontent/CF-vitals.md | 264 +------------------------ 11 files changed, 99 insertions(+), 320 deletions(-) diff --git a/input/pagecontent/CF-encounters.md b/input/pagecontent/CF-encounters.md index 3ad87f8..2390668 100644 --- a/input/pagecontent/CF-encounters.md +++ b/input/pagecontent/CF-encounters.md @@ -1,8 +1,4 @@ -<style> -td, th { - border: 1px solid black!important; -} -</style> +<link rel="stylesheet" href="colors.css"> This page provides a mapping from CDA to FHIR. <!-- For the FHIR to CDA mapping, please refer to [Encounters FHIR → CDA](./FC-encounters.html). --> For guidance on how to read the table below, see [Reading the C-CDA ↔ FHIR Mapping Pages](./mappingGuidance.html). @@ -28,9 +24,20 @@ Encounter Activities in the Encounters Section (or elsewhere in the document, su |**[Encounter Diagnosis](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-EncounterDiagnosis.html)** <sup>(b)</sup><br/>/entryRelationship/act[code/@code="29308-4"]/observation|**[Encounter Diagnosis](https://hl7.org/fhir/us/core/StructureDefinition-us-core-condition-encounter-diagnosis.html)**<br/>&<br/>.diagnosis.condition|The observation maps identically to [CDA → FHIR Problems](./CF-problems.html).<br/>Since this is an encounter diagnosis, the `Observation.category` should be set to `encounter-diagnosis`. -### Illustrative example +### Example: EncompassingEncounter + +<table><tr><th>CDA Example</th><th>FHIR Resource</th></tr> +<tr><td> +... +</td><td> +... +</td></tr></table> + +### Example: Encounter Activity + +<table><tr><th>CDA Example</th><th>FHIR Resource</th></tr> +<tr><td> ... -### Links to example content +</td><td> ... -### Prior work and Expanded Spreadsheets -... \ No newline at end of file +</td></tr></table> \ No newline at end of file diff --git a/input/pagecontent/CF-immunizations.md b/input/pagecontent/CF-immunizations.md index 403850b..2a07e1e 100644 --- a/input/pagecontent/CF-immunizations.md +++ b/input/pagecontent/CF-immunizations.md @@ -1,8 +1,4 @@ -<style> -td, th { - border: 1px solid black!important; -} -</style> +<link rel="stylesheet" href="colors.css"> This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, please refer to [Immunizations FHIR → CDA](./FC-immunizations.html). For guidance on how to read the table below, see [Reading the C-CDA ↔ FHIR Mapping Pages](./mappingGuidance.html) @@ -40,7 +36,12 @@ Mapping is from `@moodCode="EVN"` (i.e. historical) immunizations, not `INT` (fu ### Illustrative example +<table><tr><th>CDA Example</th><th>FHIR Resource</th></tr> +<tr><td> +</td><td> + +</td></tr></table> #### Links to example content diff --git a/input/pagecontent/CF-medications.md b/input/pagecontent/CF-medications.md index 59fd972..421bb8d 100644 --- a/input/pagecontent/CF-medications.md +++ b/input/pagecontent/CF-medications.md @@ -1,8 +1,4 @@ -<style> -td, th { - border: 1px solid black!important; -} -</style> +<link rel="stylesheet" href="colors.css"> This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, please refer to [Medications FHIR → CDA](./FC-medications.html). For guidance on how to read the table below, see [Reading the C-CDA ↔ FHIR Mapping Pages](./mappingGuidance.html) @@ -72,7 +68,12 @@ MedicationRequest (and other resources) may represent the medication as a simple ### Illustrative example - +<table><tr><th>CDA Example</th><th>FHIR Resource</th></tr> +<tr><td> +... +</td><td> +... +</td></tr></table> #### Links to example content diff --git a/input/pagecontent/CF-notes.md b/input/pagecontent/CF-notes.md index c17c80c..d73d527 100644 --- a/input/pagecontent/CF-notes.md +++ b/input/pagecontent/CF-notes.md @@ -1,8 +1,4 @@ -<style> -td, th { - border: 1px solid black!important; -} -</style> +<link rel="stylesheet" href="colors.css"> This page provides a mapping from CDA to FHIR. <!-- For the FHIR to CDA mapping, please refer to [Notes FHIR → CDA](./FC-notes.html). --> For guidance on how to read the table below, see [Reading the C-CDA ↔ FHIR Mapping Pages](./mappingGuidance.html). @@ -26,8 +22,10 @@ Clinical Notes may appear in their own section or as an entry in any open sectio ### Illustrative example + +<table><tr><th>CDA Example</th><th>FHIR Resource</th></tr> +<tr><td> ... -### Links to example content +</td><td> ... -### Prior work and Expanded Spreadsheets -... \ No newline at end of file +</td></tr></table> \ No newline at end of file diff --git a/input/pagecontent/CF-participations.md b/input/pagecontent/CF-participations.md index ce12114..eb8392f 100644 --- a/input/pagecontent/CF-participations.md +++ b/input/pagecontent/CF-participations.md @@ -1,8 +1,4 @@ -<style> -td, th { - border: 1px solid black!important; -} -</style> +<link rel="stylesheet" href="colors.css"> CDA defines participants in a number of elements, but the structure is often similar. These represent people (usually providers), organizations, and in some cases devices, locations, or some combination of all of the above. diff --git a/input/pagecontent/CF-patient.md b/input/pagecontent/CF-patient.md index 857c98a..0dff1b3 100644 --- a/input/pagecontent/CF-patient.md +++ b/input/pagecontent/CF-patient.md @@ -1,8 +1,4 @@ -<style> -td, th { - border: 1px solid black!important; -} -</style> +<link rel="stylesheet" href="colors.css"> This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, please refer to [Patient FHIR → CDA](./FC-patient.html). For guidance on how to read the table below, see [Reading the C-CDA ↔ FHIR Mapping Pages](./mappingGuidance.html) @@ -42,6 +38,12 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea ### Illustrative example +<table><tr><th>CDA Example</th><th>FHIR Resource</th></tr> +<tr><td> +... +</td><td> +... +</td></tr></table> #### Links to example content diff --git a/input/pagecontent/CF-problems.md b/input/pagecontent/CF-problems.md index 4e12de0..e72b1ad 100644 --- a/input/pagecontent/CF-problems.md +++ b/input/pagecontent/CF-problems.md @@ -1,8 +1,4 @@ -<style> -td, th { - border: 1px solid black!important; -} -</style> +<link rel="stylesheet" href="colors.css"> This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, please refer to [Problems FHIR → CDA](./FC-problems.html). For guidance on how to read the table below, see [Reading the C-CDA ↔ FHIR Mapping Pages](./mappingGuidance.html). @@ -40,7 +36,12 @@ When authors or other provenance are recorded in the parent [Problem Concern Act ### Illustrative example - +<table><tr><th>CDA Example</th><th>FHIR Resource</th></tr> +<tr><td> +... +</td><td> +... +</td></tr></table> #### Links to example content diff --git a/input/pagecontent/CF-procedures.md b/input/pagecontent/CF-procedures.md index 30e76bb..42723de 100644 --- a/input/pagecontent/CF-procedures.md +++ b/input/pagecontent/CF-procedures.md @@ -1,8 +1,4 @@ -<style> -td, th { - border: 1px solid black!important; -} -</style> +<link rel="stylesheet" href="colors.css"> This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, please refer to [Procedures FHIR → CDA](./FC-procedures.html). For guidance on how to read the table below, see [Reading the C-CDA ↔ FHIR Mapping Pages](./mappingGuidance.html) <br/><br/> @@ -33,7 +29,12 @@ C-CDA 2.1 describes three templates for Procedures: Procedure Activity Act, Proc ### Illustrative example - +<table><tr><th>CDA Example</th><th>FHIR Resource</th></tr> +<tr><td> +... +</td><td> +... +</td></tr></table> #### Links to example content diff --git a/input/pagecontent/CF-results.md b/input/pagecontent/CF-results.md index f02982a..ccbb37b 100644 --- a/input/pagecontent/CF-results.md +++ b/input/pagecontent/CF-results.md @@ -1,8 +1,4 @@ -<style> -td, th { - border: 1px solid black!important; -} -</style> +<link rel="stylesheet" href="colors.css"> This page provides a mapping from CDA to FHIR. <!-- For the FHIR to CDA mapping, please refer to [Results FHIR → CDA](./FC-results.html). --> For guidance on how to read the table below, see [Reading the C-CDA ↔ FHIR Mapping Pages](./mappingGuidance.html). @@ -64,8 +60,11 @@ C-CDA also defines a [Specimen Collection Procedure](https://hl7.org/cda/us/ccda |**C-CDA [Specimen Condtion Observation](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-SpecimenConditionObservation.html)**<br/>/value|.condition|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| ### Illustrative example + +<table><tr><th>CDA Example</th><th>FHIR Resource</th></tr> +<tr><td> ... -### Links to example content +</td><td> ... -### Prior work and Expanded Spreadsheets -... \ No newline at end of file +</td></tr></table> + diff --git a/input/pagecontent/CF-social.md b/input/pagecontent/CF-social.md index 6789ff1..003aeae 100644 --- a/input/pagecontent/CF-social.md +++ b/input/pagecontent/CF-social.md @@ -1,8 +1,4 @@ -<style> -td, th { - border: 1px solid black!important; -} -</style> +<link rel="stylesheet" href="colors.css"> This page provides a mapping from CDA to FHIR. <!-- For the FHIR to CDA mapping, please refer to [Results FHIR → CDA](./FC-results.html). --> For guidance on how to read the table below, see [Reading the C-CDA ↔ FHIR Mapping Pages](./mappingGuidance.html). @@ -65,4 +61,31 @@ In US Core, Pregnancy Intent was first defined in version 6. |/value|.valueCodeableConcept|Value sets are the same<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/value/@nullFlavor=UNK|.valueCodeableConcept|Unknown becomes an actual value with system = `http://terminology.hl7.org/CodeSystem/v3-NullFlavor`. Any other nullFlavors should use a data-absent-reason extension. +### Illustrative examples +The following is a general social history comparison between C-CDA and FHIR + +<table><tr><th>CDA Example</th><th>FHIR Resource</th></tr> +<tr><td> +... +</td><td> +... +</td></tr></table> + +### Example: Smoking Status + +<table><tr><th>CDA Example</th><th>FHIR Resource</th></tr> +<tr><td> +... +</td><td> +... +</td></tr></table> + +### Example: Pregnancy Observation + +<table><tr><th>CDA Example</th><th>FHIR Resource</th></tr> +<tr><td> +... +</td><td> +... +</td></tr></table> \ No newline at end of file diff --git a/input/pagecontent/CF-vitals.md b/input/pagecontent/CF-vitals.md index 91a2ca4..4eb2c31 100644 --- a/input/pagecontent/CF-vitals.md +++ b/input/pagecontent/CF-vitals.md @@ -46,260 +46,16 @@ C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or - Observation.valueQuantity represents the Oxygen saturation (e.g. `98%`) - Create individual components for `3150-0` - Inhaled Oxygen Concentration & `3151-8` - Inhaled Oxygen Flow Rate (only if values exist) -<table> -<tr><th>C-CDA Blood Pressure Example</th><th>FHIR Blood Pressure Example</th></tr> -<tr><td> -<div markdown="1"> -{% highlight xml %} -<organizer> - <!-- C-CDA Vital Signs Organizer --> - <templateId - root="2.16.840.1.113883.10.20.22.4.26" - extension="2015-08-01" /> - <id root="..." /> - <code - code="46680005" - codeSystem="2.16.840.1.113883.6.96" - codeSystemName="SNOMED CT" - displayName="Vital Signs" /> - <statusCode code="completed" /> - <!-- effectiveTime, author, etc stripped --> - <component> - <observation> - <!-- C-CDA Vital Signs Observation --> - <templateId - root="2.16.840.1.113883.10.20.22.4.27" - extension="2014-06-09" /> - <id root="..." /> - <code - code="8480-6" - codeSystem="2.16.840.1.113883.6.1" - codeSystemName="LOINC" - displayName="Systolic blood pressure" /> - <statusCode code="completed" /> - <value xsi:type="PQ" - value="115" - unit="mm[Hg]" /> - </observation> - </component> - <component> - <observation> - <!-- C-CDA Vital Signs Observation --> - <templateId - root="2.16.840.1.113883.10.20.22.4.27" - extension="2014-06-09" /> - <id root="..." /> - <code - code="8462-4" - codeSystem="2.16.840.1.113883.6.1" - codeSystemName="LOINC" - displayName="Diastolic blood pressure" /> - <value xsi:type="PQ" value="75" unit="mm[Hg]" /> - </observation> - </component> -</organizer> -{% endhighlight %} -</div> +### Illustrative example -</td><td> -<div markdown="1"> -{% highlight json %} -{ - "resourceType" : "Observation", - "status" : "final", - "category" : [{ - "coding" : [{ - "system" : "http://terminology.hl7.org/CodeSystem/observation-category", - "code" : "vital-signs" - }] - }], - "code" : { - "coding" : [{ - "system" : "http://loinc.org", - "code" : "85354-9", - "display" : "Blood pressure panel with all children optional" - }] - }, - // no valueQuantity - "component" : [{ - "code" : { - "coding" : [{ - "system" : "http://loinc.org", - "code" : "8480-6", - "display" : "Systolic blood pressure" - }], - "text" : "Systolic blood pressure" - }, - "valueQuantity" : { - "value" : 115, - "unit" : "mmHg", - "system" : "http://unitsofmeasure.org", - "code" : "mm[Hg]" - } - }, - { - "code" : { - "coding" : [{ - "system" : "http://loinc.org", - "code" : "8462-4", - "display" : "Diastolic blood pressure" - }], - "text" : "Diastolic blood pressure" - }, - "valueQuantity" : { - "value" : 75, - "unit" : "mmHg", - "system" : "http://unitsofmeasure.org", - "code" : "mm[Hg]" - } - }] -} -{% endhighlight %} -</div> -</td></tr> -<tr><th>C-CDA Pulse Oximetry Observations</th><th>FHIR Pulse Oximetry Observation</th></tr> +<table><tr><th>CDA Example</th><th>FHIR Resource</th></tr> <tr><td> -<div markdown="1"> - -{% highlight xml %} -<organizer> - <!-- C-CDA Vital Signs Organizer --> - <templateId - root="2.16.840.1.113883.10.20.22.4.26" - extension="2015-08-01" /> - <id root="..." /> - <code - code="46680005" - codeSystem="2.16.840.1.113883.6.96" - codeSystemName="SNOMED CT" - displayName="Vital Signs" /> - <statusCode code="completed" /> - <!-- effectiveTime, author, etc stripped --> - <component> - <observation> - <!-- C-CDA Vital Signs Observation --> - <templateId - root="2.16.840.1.113883.10.20.22.4.27" - extension="2014-06-09" /> - <id root="..." /> - <code - code="2708-6" - codeSystem="2.16.840.1.113883.6.1" - codeSystemName="LOINC" - displayName="Oxygen saturation" /> - <value xsi:type="PQ" - value="98" - unit="%" /> - </observation> - </component> - <component> - <observation> - <!-- C-CDA Vital Signs Observation --> - <templateId - root="2.16.840.1.113883.10.20.22.4.27" - extension="2014-06-09" /> - <id root="..." /> - <code - code="3151-8" - codeSystem="2.16.840.1.113883.6.1" - codeSystemName="LOINC" - displayName="Inhaled Oxygen Flow Rate" /> - <value xsi:type="PQ" - value="6" - unit="L/min" /> - </observation> - </component> - <component> - <observation> - <!-- C-CDA Vital Signs Observation --> - <templateId - root="2.16.840.1.113883.10.20.22.4.27" - extension="2014-06-09" /> - <id root="..." /> - <code - code="3150-0" - codeSystem="2.16.840.1.113883.6.1" - codeSystemName="LOINC" - displayName="Inhaled Oxygen Concentration" /> - <value xsi:type="PQ" - value="35" - unit="%" /> - </observation> - </component> -</organizer> -{% endhighlight %} -</div> - +... </td><td> -<div markdown="1"> -{% highlight json %} -{ - "resourceType" : "Observation", - "status" : "final", - "category" : [{ - "coding" : [{ - "system" : "http://terminology.hl7.org/CodeSystem/observation-category", - "code" : "vital-signs", - }], - }], - "code" : { - "coding" : [{ - "system" : "http://loinc.org", - "code" : "2708-6", - "display" : "Oxygen saturation in Arterial blood" - }, - { - "system" : "http://loinc.org", - "code" : "59408-5", - "display" : "Oxygen saturation in Arterial blood by Pulse oximetry" - }] - }, - "valueQuantity" : { - "value" : 98, - "unit" : "%", - "system" : "http://unitsofmeasure.org", - "code" : "%" - }, - "component" : [{ - "code" : { - "coding" : [{ - "system" : "http://loinc.org", - "code" : "3151-8", - "display" : "Inhaled oxygen flow rate" - }] - }, - "valueQuantity" : { - "value" : 6, - "unit" : "liters/min", - "system" : "http://unitsofmeasure.org", - "code" : "L/min" - } - }, - { - "code" : { - "coding" : [{ - "system" : "http://loinc.org", - "code" : "3150-0", - "display" : "Inhaled Oxygen Concentration" - }] - }, - "valueQuantity" : { - "value" : 35, - "unit" : "%", - "system" : "http://unitsofmeasure.org", - "code" : "%" - } - }] -} -{% endhighlight %} -</div> -</td></tr> -</table> - - -### Illustrative example +... +</td></tr></table> -(Main example still coming - just experimenting with new fancy-highlighter here; compare with auto-formatted XML/JSON above) +### Example: Blood Pressure <table> <tr><th>C-CDA Blood Pressure (Codes & Values Only)</th><th>FHIR Blood Pressure</th></tr> @@ -403,6 +159,7 @@ C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or }</div> </td></tr> +### Example: Pulse Oximetry <tr><th>C-CDA Pulse Oximetry (Codes & Values Only)</th><th>FHIR Pulse Oximetry</th></tr> <tr><td> @@ -529,10 +286,3 @@ C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or }</div> </td></tr> </table> - - - -### Links to example content -... -### Prior work and Expanded Spreadsheets -... \ No newline at end of file From 716a4e41d7ec5993843a16742690811eb9e262fd Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Mon, 21 Oct 2024 14:57:26 -0500 Subject: [PATCH 084/112] Add inline example for imms & procs --- input/pagecontent/CF-immunizations.md | 108 +++++++++++++++++++++++++- input/pagecontent/CF-procedures.md | 53 ++++++++++++- 2 files changed, 155 insertions(+), 6 deletions(-) diff --git a/input/pagecontent/CF-immunizations.md b/input/pagecontent/CF-immunizations.md index 2a07e1e..b569d62 100644 --- a/input/pagecontent/CF-immunizations.md +++ b/input/pagecontent/CF-immunizations.md @@ -36,11 +36,113 @@ Mapping is from `@moodCode="EVN"` (i.e. historical) immunizations, not `INT` (fu ### Illustrative example -<table><tr><th>CDA Example</th><th>FHIR Resource</th></tr> +<table><tr><th>CDA Immunization Example</th><th>FHIR Immunization Resource</th></tr> <tr><td> - +<div id="cda" class="border codeArea"><<span class="field">substanceAdministration</span> <span class="attrib">classCode=</span><span class="value">"SBADM"</span> <span class="attrib">moodCode=</span><span class="value">"EVN"</span> <span class="attrib">negationInd=</span><span class="value">"false"</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.52"</span>/> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.52"</span> <span class="attrib">extension=</span><span class="value">"2015-08-01"</span>/> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"<mark class="color10">e6f1ba43-c0ed-4b9b-9f12-f435d8ad8f92</mark>"</span>/> + <<span class="field">text</span>> + <<span class="field">reference</span> <span class="attrib">value=</span><span class="value">"#immun1"</span>/> + </<span class="field">text</span>> + <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"<mark class="color11">completed</mark>"</span>/> + <<span class="field">effectiveTime</span> <span class="attrib">value=</span><span class="value">"<mark class="color12">20100815</mark>"</span>/> + <<span class="field">consumable</span>> + <<span class="field">manufacturedProduct</span> <span class="attrib">classCode=</span><span class="value">"MANU"</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.54"</span>/> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.54"</span> <span class="attrib">extension=</span><span class="value">"2014-06-09"</span>/> + <<span class="field">manufacturedMaterial</span>> + <<span class="field">code</span> <span class="attrib">code=</span><mark class="color13"><span class="value">"88"</span></mark> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color14">2.16.840.1.113883.12.292</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color15">Influenza virus vaccine</mark>"</span> + <span class="attrib">codeSystemName=</span><mark class="color16"><span class="value">"CVX"</span></mark>> + <<span class="field">originalText</span>> + <<span class="field">reference</span> <span class="attrib">value=</span><span class="value">"#ImmunizationProduct_100"</span>/> + </<span class="field">originalText</span>> + </<span class="field">code</span>> + <lotNumberText<mark class="color17">>1<</mark>/lotNumberText> + </<span class="field">manufacturedMaterial</span>> + </<span class="field">manufacturedProduct</span>> + </<span class="field">consumable</span>> + <<span class="field">performer</span>> + <<span class="field">assignedEntity</span>> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.19.5.9999.456"</span> <span class="attrib">extension=</span><span class="value">"<mark class="color18">2981824</mark>"</span>/> + <<span class="field">addr</span>> + <<span class="field">streetAddressLine</span>>1021 Health Drive</<span class="field">streetAddressLine</span>> + <<span class="field">city</span>>Ann Arbor</<span class="field">city</span>> + <<span class="field">state</span>>MI</<span class="field">state</span>> + <<span class="field">postalCode</span>>99099</<span class="field">postalCode</span>> + <<span class="field">country</span>>US</<span class="field">country</span>> + </<span class="field">addr</span>> + <<span class="field">telecom</span> <span class="attrib">nullFlavor=</span><span class="value">"UNK"</span>/> + <<span class="field">assignedPerson</span>> + <<span class="field">name</span>> + <<span class="field">given</span>>Amanda</<span class="field">given</span>> + <<span class="field">family</span>>Assigned</<span class="field">family</span>> + </<span class="field">name</span>> + </<span class="field">assignedPerson</span>> + <<span class="field">representedOrganization</span>> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.19.5.9999.1394"</span>/> + <<span class="field">name</span>>Good Health Clinic</<span class="field">name</span>> + <<span class="field">telecom</span> <span class="attrib">nullFlavor=</span><span class="value">"UNK"</span>/> + <<span class="field">addr</span> <span class="attrib">nullFlavor=</span><span class="value">"UNK"</span>/> + </<span class="field">representedOrganization</span>> + </<span class="field">assignedEntity</span>> + </<span class="field">performer</span>> + <<span class="field">author</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.119"</span>/> + <<span class="field">time</span> <span class="attrib">value=</span><span class="value">"<mark class="color34">20100816</mark>"</span>/> + <<span class="field">assignedAuthor</span>> + <<span class="field">id</span> <span class="attrib">extension=</span><span class="value">"99999999"</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.4.6"</span>/> + <<span class="field">code</span> <span class="attrib">code=</span><span class="value">"207Q00000X"</span> + <span class="attrib">codeSystem=</span><span class="value">"2.16.840.1.113883.6.101"</span> + <span class="attrib">codeSystemName=</span><span class="value">"Health Care Provider Taxonomy"</span> + <span class="attrib">displayName=</span><span class="value">"Family Medicine"</span> /> + <<span class="field">telecom</span> <span class="attrib">use=</span><span class="value">"WP"</span> <span class="attrib">value=</span><span class="value">"tel:555-555-1002"</span>/> + <<span class="field">assignedPerson</span>> + <<span class="field">name</span>> + <<span class="field">given</span>>Henry</<span class="field">given</span>> + <<span class="field">family</span>>Seven</<span class="field">family</span>> + </<span class="field">name</span>> + </<span class="field">assignedPerson</span>> + </<span class="field">assignedAuthor</span>> + </<span class="field">author</span>> +</<span class="field">substanceAdministration</span>></div> </td><td> - +<div id="fhir" class="border codeArea">{ + "<span class="field">resourceType</span>" : "<span class="value">Immunization</span>", + "<span class="field">id</span>" : "<span class="value">CF-immunization</span>", + "<span class="field">identifier</span>" : [{ + "<span class="field">system</span>" : "<span class="value">urn:ietf:rfc:3986</span>", + "<span class="field">value</span>" : "<span class="value">urn:uuid:<mark class="color10">e6f1ba43-c0ed-4b9b-9f12-f435d8ad8f92</mark></span>" + }], + "<span class="field">status</span>" : "<span class="value"><mark class="color11">completed</mark></span>", + "<span class="field">vaccineCode</span>" : { + "<span class="field">coding</span>" : [{ + "<span class="field">system</span>" : "<span class="value"><mark class="color14">http://hl7.org/fhir/sid/cvx</mark></span>", + "<span class="field">code</span>" : <mark class="color13">"88"</mark>, + "<span class="field">display</span>" : "<span class="value"><mark class="color15">Influenza Virus Vaccine</mark>, unspecified formulation</span>" + }], + "<span class="field">text</span>" : "<span class="value"><mark class="color15">Influenza Virus Vaccine</mark></span>" + }, + "<span class="field">patient</span>" : { + "<span class="field">reference</span>" : "<span class="value">Patient/CF-patient</span>" + }, + "<span class="field">occurrenceDateTime</span>" : "<span class="value"><mark class="color12">2010-08-15</mark></span>", + "<span class="field">recorded</span>" : "<span class="value"><mark class="color34">2010-08-16</mark></span>", + "<span class="field">_primarySource</span>" : { + "<span class="field">extension</span>" : [{ + "<span class="field">url</span>" : "<span class="value">http://hl7.org/fhir/StructureDefinition/data-absent-reason</span>", + "<span class="field">valueCode</span>" : "<span class="value">unknown</span>" + }] + }, + "<span class="field">lotNumber</span>" : <mark class="color17">"1"</mark>, + "<span class="field">performer</span>" : [{ + "<span class="field">actor</span>" : { + "<span class="field">reference</span>" : "<span class="value">PractitionerRole/ccda-practitionerrole-<mark class="color18">2981824</mark></span>" + } + }] +}</div> </td></tr></table> #### Links to example content diff --git a/input/pagecontent/CF-procedures.md b/input/pagecontent/CF-procedures.md index 42723de..dbb733d 100644 --- a/input/pagecontent/CF-procedures.md +++ b/input/pagecontent/CF-procedures.md @@ -29,11 +29,58 @@ C-CDA 2.1 describes three templates for Procedures: Procedure Activity Act, Proc ### Illustrative example -<table><tr><th>CDA Example</th><th>FHIR Resource</th></tr> +<table><tr><th>CDA Procedure Example</th><th>FHIR Procedure Resource</th></tr> <tr><td> -... +<div id="cda" class="border codeArea"><<span class="field">procedure</span> <span class="attrib">classCode=</span><span class="value">"PROC"</span> <span class="attrib">moodCode=</span><span class="value">"EVN"</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.14"</span> <span class="attrib">extension=</span><span class="value">"2014-06-09"</span> /> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.14"</span> /> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"<mark class="color10">1.3.6.1.4.1.22812.3.2009316.3.4.7</mark>"</span> <span class="attrib">extension=</span><span class="value">"<mark class="color11">545069400001</mark>"</span> /> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"<mark class="color10">1.3.6.1.4.1.22812.3.2009316.3.4.7</mark>"</span> <span class="attrib">extension=</span><span class="value">"<mark class="color12">545069400003</mark>"</span> /> + <<span class="field">code</span> + <span class="attrib">code=</span><span class="value">"<mark class="color13">80146002</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color14">2.16.840.1.113883.6.96</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color15">Excision of appendix</mark>"</span>> + <<span class="field">originalText</span>> + <<span class="field">reference</span> <span class="attrib">value=</span><span class="value">"#_dfcf353c-538f-498a-9a53-80dda209e456"</span> /> + </<span class="field">originalText</span>> + <<span class="field">translation</span> + <span class="attrib">code=</span><span class="value">"<mark class="color16">0DBJ4ZZ</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"2.16.840.1.113883.6.90"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color17">Excision of appendix, Percutaneous Endoscopic Approach</mark>"</span>/> + </<span class="field">code</span>> + <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"<mark class="color18">completed</mark>"</span> /> + <<span class="field">effectiveTime</span> <span class="attrib">value=</span><span class="value">"<mark class="color19">20120806</mark>"</span>/> +</<span class="field">procedure</span>></div> </td><td> -... +<div id="fhir" class="border codeArea">{ + "<span class="field">resourceType</span>" : "<span class="value">Procedure</span>", + "<span class="field">identifier</span>" : [{ + "<span class="field">system</span>" : "<span class="value">urn:oid:<mark class="color10">1.3.6.1.4.1.22812.3.2009316.3.4.7</mark></span>", + "<span class="field">value</span>" : "<span class="value"><mark class="color11">545069400001</mark></span>" + }, + { + "<span class="field">system</span>" : "<span class="value">urn:oid:<mark class="color10">1.3.6.1.4.1.22812.3.2009316.3.4.7</mark></span>", + "<span class="field">value</span>" : "<span class="value"><mark class="color12">545069400003</mark></span>" + }], + "<span class="field">status</span>" : "<span class="value"><mark class="color18">completed</mark></span>", + "<span class="field">code</span>" : { + "<span class="field">coding</span>" : [{ + "<span class="field">system</span>" : "<span class="value"><mark class="color14">http://snomed.info/sct</mark></span>", + "<span class="field">code</span>" : "<span class="value"><mark class="color13">80146002</mark></span>", + "<span class="field">display</span>" : "<span class="value"><mark class="color15">Excision of appendix</mark></span>" + }, + { + "<span class="field">system</span>" : "<span class="value">http://www.cms.gov/Medicare/Coding/ICD10</span>", + "<span class="field">code</span>" : "<span class="value"><mark class="color16">0DBJ4ZZ</mark></span>", + "<span class="field">display</span>" : "<span class="value"><mark class="color17">Excision of appendix, Percutaneous Endoscopic Approach</mark></span>" + }], + "<span class="field">text</span>" : "<span class="value"><mark class="color15">Excision of appendix</mark></span>" + }, + "<span class="field">subject</span>" : { + "<span class="field">reference</span>" : "<span class="value">Patient/CF-patient</span>" + }, + "<span class="field">performedDateTime</span>" : "<span class="value"><mark class="color19">2012-08-06</mark></span>" +}</div> </td></tr></table> #### Links to example content From 17762319b33ef2f736456722060ee7ef3fb16c00 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Tue, 22 Oct 2024 09:11:11 -0500 Subject: [PATCH 085/112] Add highlighted medication example --- input/pagecontent/CF-medications.md | 316 +++++++++++++++++++++++++++- 1 file changed, 311 insertions(+), 5 deletions(-) diff --git a/input/pagecontent/CF-medications.md b/input/pagecontent/CF-medications.md index 421bb8d..10ead60 100644 --- a/input/pagecontent/CF-medications.md +++ b/input/pagecontent/CF-medications.md @@ -43,12 +43,12 @@ The C-CDA Example Search site maintains a document of [Common Medication Frequen |/consumable/manufacturedProduct/manufacturerOrganization|Medication.manufacturer|[See below](#c-cda-to-fhir-medication) |/author|.requester<br/>&<br/>**[Provenance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-procedure.html)**|[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| |/author/time|.authoredOn|Earliest, if more than one.<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)| -|**[Drug Vehicle](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-DrugVehicle.html)**<br/>/participant[@typeCode="COV"]/playingEntity/code|Medication.ingredient|[See below](#c-cda-to-fhir-medication) +|**[Drug Vehicle](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-DrugVehicle.html)**<br/>/participant[@typeCode="CSM"]/playingEntity/code|Medication.ingredient|[See below](#c-cda-to-fhir-medication) |**[Indication](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-Indication.html)**<br/>/entryRelationship[@typeCode="RSON"]/observation/value|.reasonCode|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |**[Free text sig](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-MedicationFreeTextSig.html)**<br/>/entryRelationship/substanceAdministration[code/@code="76662-6"]/text|.dosageInstruction.text|| |**[Instruction Activity](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-Instruction.html)**<br/>/entryRelationship[@typeCode="SUBJ" and @inversionInd="true"]/act|.dosageInstruction.patientInstruction<br/>.dosageInstruction.additionalInstruction|act/text or act/code/originalText can map to patientInstructions. If coded, can map to additionalInstruction. |**[Supply Order](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-MedicationSupplyOrder.html)**<br/>/entryRelationship[@typeCode="REFR"]/substanceAdministration[@moodCode="INT"]||Note: moodCode=INT means supply, moodCode=EVN means dispense, which is not documented here. -|../effectiveTime/high|.dispenseRequest.period.end|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)<br/>`low` would similarly map to `start`, but only high is called out in C-CDA.| +|../effectiveTime/high|.dispenseRequest.validityPeriod.end|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)<br/>`low` would similarly map to `start`, but only high is called out in C-CDA.| |../repeatNumber|.dispenseRequest.numberOfRepeatsAllowed|**Caution:** in CDA, repeatNumber indicates total number of dispenses allowed. In FHIR, this field is exclusive of the original dispense. So the `numberOfRepeatsAllowed` will be one less than `repeatNumber`. |../quantity|.dispenseRequest.quantity|[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity) |**[Comment Activity](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|| @@ -64,15 +64,321 @@ MedicationRequest (and other resources) may represent the medication as a simple |/administrationUnitCode|.form|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) |/consumable/manufacturedProduct/manufacturedMaterial/code|.code|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/consumable/manufacturedProduct/manufacturerOrganization|**[Organization](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-organization.html)**<br/>.manufacturer| -|**[Drug Vehicle](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-DrugVehicle.html)**<br/>/participant[@typeCode="COV"]/playingEntity/code|.ingredient.itemCodeableConcept|Set `.isActive = false`<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) +|**[Drug Vehicle](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-DrugVehicle.html)**<br/>/participant[@typeCode="CSM"]/playingEntity/code|.ingredient.itemCodeableConcept|Set `.isActive = false`<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) ### Illustrative example <table><tr><th>CDA Example</th><th>FHIR Resource</th></tr> <tr><td> -... +<div id="cda" class="border codeArea"><<span class="field">substanceAdministration</span> <span class="attrib">classCode=</span><span class="value">"SBADM"</span> <span class="attrib">moodCode=</span><span class="value">"INT"</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.16"</span> <span class="attrib">extension=</span><span class="value">"2014-06-09"</span>/> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.16"</span>/> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"<mark class="color10">cdbd33f0-6cde-11db-9fe1-0800200c9a66</mark>"</span>/> + <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"<mark class="color11">active</mark>"</span>/> + <<span class="field">effectiveTime</span> <span class="attrib">xsi:type=</span><span class="value">"IVL_TS"</span>> + <<span class="field">low</span> <span class="attrib">value=</span><span class="value">"20120806"</span>/> + <<span class="field">high</span> <span class="attrib">nullFlavor=</span><span class="value">"UNK"</span>/> + </<span class="field">effectiveTime</span>> + <<span class="field">effectiveTime</span> <span class="attrib">xsi:type=</span><span class="value">"PIVL_TS"</span> <span class="attrib">operator=</span>"A"> + <<span class="field">period</span> <span class="attrib">xsi:type=</span><span class="value">"IVL_PQ"</span>> + <<span class="field">low</span> <span class="attrib">value=</span><mark class="color13"><span class="value">"4"</span></mark> unit=<mark class="color14"><span class="value">"h"</span></mark>/> + <<span class="field">high</span> <span class="attrib">value=</span><mark class="color15"><span class="value">"6"</span></mark> unit=<mark class="color14"><span class="value">"h"</span></mark>/> + </<span class="field">period</span>> + </<span class="field">effectiveTime</span>> + <<span class="field">repeatNumber</span> <span class="attrib">value=</span><mark class="color16"><mark class="color40"><span class="value">"1"</span></mark></mark>/> + <<span class="field">routeCode</span> + <span class="attrib">code=</span><span class="value">"<mark class="color17">C38288</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color18">2.16.840.1.113883.3.26.1.1</mark>"</span> + <span class="attrib">codeSystemName=</span><span class="value">"NCI Thesaurus"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color19">Oral Route of Administration</mark>"</span>/> + <<span class="field">doseQuantity</span> <span class="attrib">value=</span><mark class="color16"><mark class="color40"><span class="value">"1"</span></mark></mark>/> + <<span class="field">maxDoseQuantity</span> > + <<span class="field">numerator</span> <span class="attrib">value=</span><mark class="color15"><span class="value">"6"</span></mark> <span class="attrib">unit=</span><span class="value">"<mark class="color20">{spray}</mark>"</span> /> + <<span class="field">denominator</span> <span class="attrib">value=</span><mark class="color16"><mark class="color40"><span class="value">"1"</span></mark></mark> <span class="attrib">unit=</span><span class="value">"<mark class="color21">{day}</mark>"</span> /> + </<span class="field">maxDoseQuantity</span>> + <<span class="field">administrationUnitCode</span> + <span class="attrib">code=</span><span class="value">"<mark class="color22">C48501</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color18">2.16.840.1.113883.3.26.1.1</mark>"</span> + <span class="attrib">codeSystemName=</span><span class="value">"National Cancer Institute (NCI) Thesaurus"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color23">Inhalation dosing unit</mark>"</span>/> + <<span class="field">consumable</span>> + <<span class="field">manufacturedProduct</span> <span class="attrib">classCode=</span><span class="value">"MANU"</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.23"</span> <span class="attrib">extension=</span><span class="value">"2014-06-09"</span>/> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.23"</span>/> + <<span class="field">manufacturedMaterial</span>> + <<span class="field">code</span> + <span class="attrib">code=</span><span class="value">"<mark class="color24">1190220</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color25">2.16.840.1.113883.6.88</mark>"</span> + <span class="attrib">codeSystemName=</span><span class="value">"<mark class="color25">RxNorm</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color26">ACTUAT albuterol 0.1 MG/ACTUAT ... Spray</mark>"</span>/> + </<span class="field">manufacturedMaterial</span>> + <<span class="field">manufacturerOrganization</span>> + <<span class="field">name</span>><mark class="color27">Good Vaccines Inc</mark></<span class="field">name</span>> + </<span class="field">manufacturerOrganization</span>> + </<span class="field">manufacturedProduct</span>> + </<span class="field">consumable</span>> + <<span class="field">author</span>> + <span class="comment"><!-- Time the author noted that patient is on medication --></span> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.119"</span>/> + <<span class="field">time</span> <span class="attrib">value=</span><span class="value">"<mark class="color28">201309111603-0700</mark>"</span>/> + <<span class="field">assignedAuthor</span>> + <span class="comment"><!-- Author maps to Provenance + not included in this example --></span> + </<span class="field">assignedAuthor</span>> + </<span class="field">author</span>> + <<span class="field">participant</span> <span class="attrib">typeCode=</span><span class="value">"CSM"</span>> + <<span class="field">participantRole</span> <span class="attrib">classCode=</span><span class="value">"MANU"</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.24"</span>/> + <<span class="field">code</span> <span class="attrib">code=</span><span class="value">"412307009"</span> + <span class="attrib">displayName=</span><span class="value">"Drug vehicle"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color29">2.16.840.1.113883.6.96</mark>"</span>/> + <<span class="field">playingEntity</span> <span class="attrib">classCode=</span><span class="value">"MMAT"</span>> + <<span class="field">code</span> <span class="attrib">code=</span><span class="value">"<mark class="color30">387390002</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color31">sodium chloride</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color29">2.16.840.1.113883.6.96</mark>"</span> + <span class="attrib">codeSystemName=</span><span class="value">"<mark class="color29">SNOMED</mark>"</span>/> + <<span class="field">name</span>><mark class="color31">sodium chloride</mark></<span class="field">name</span>> + </<span class="field">playingEntity</span>> + </<span class="field">participantRole</span>> + </<span class="field">participant</span>> + <<span class="field">entryRelationship</span> <span class="attrib">typeCode=</span><span class="value">"COMP"</span>> + <span class="comment"><!-- Medication Free Text SIG --></span> + <<span class="field">substanceAdministration</span> <span class="attrib">classCode=</span><span class="value">"SBADM"</span> <span class="attrib">moodCode=</span><span class="value">"EVN"</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.147"</span>/> + <<span class="field">code</span> <span class="attrib">code=</span><span class="value">"76662-6"</span> <span class="attrib">codeSystem=</span><span class="value">"2.16.840.1.113883.6.1"</span>/> + <<span class="field">text</span>> + <span class="comment"><!-- Resolves to: <mark class="color39">2 puffs every 4-6 hours as needed</mark> --></span> + <<span class="field">reference</span> <span class="attrib">value=</span><span class="value">"#MedicationSig_PRN_222222"</span>/> + </<span class="field">text</span>> + <<span class="field">consumable</span>> + <<span class="field">manufacturedProduct</span>> + <<span class="field">manufacturedLabeledDrug</span> <span class="attrib">nullFlavor=</span><span class="value">"NA"</span>/> + </<span class="field">manufacturedProduct</span>> + </<span class="field">consumable</span>> + </<span class="field">substanceAdministration</span>> + </<span class="field">entryRelationship</span>> + <<span class="field">entryRelationship</span> <span class="attrib">typeCode=</span><span class="value">"RSON"</span>> + <<span class="field">observation</span> <span class="attrib">classCode=</span><span class="value">"OBS"</span> <span class="attrib">moodCode=</span><span class="value">"EVN"</span>> + <span class="comment"><!-- Indication (V2) --></span> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.19"</span> <span class="attrib">extension=</span><span class="value">"2014-06-09"</span>/> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.19"</span>/> + <<span class="field">id</span> <span class="attrib">extension=</span><span class="value">"44"</span> <span class="attrib">root=</span><span class="value">"1.3.6.1.4.1.22812.3.99930.3.4.1.3"</span>/> + <<span class="field">code</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color29">2.16.840.1.113883.6.96</mark>"</span> + <span class="attrib">codeSystemName=</span><span class="value">"SNOMED CT"</span> + <span class="attrib">code=</span><span class="value">"404684003"</span> + <span class="attrib">displayName=</span><span class="value">"Clinical finding"</span>/> + <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"completed"</span>/> + <<span class="field">effectiveTime</span>> + <<span class="field">low</span> <span class="attrib">nullFlavor=</span><span class="value">"NI"</span>/> + </<span class="field">effectiveTime</span>> + <<span class="field">value</span> <span class="attrib">xsi:type=</span><span class="value">"CD"</span> + <span class="attrib">code=</span><span class="value">"<mark class="color32">56018004</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color29">2.16.840.1.113883.6.96</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color33">wheezing</mark>"</span> /> + </<span class="field">observation</span>> + </<span class="field">entryRelationship</span>> + <<span class="field">entryRelationship</span> <span class="attrib">typeCode=</span><span class="value">"SUBJ"</span> <span class="attrib">inversionInd=</span><span class="value">"true"</span>> + <<span class="field">act</span> <span class="attrib">classCode=</span><span class="value">"ACT"</span> <span class="attrib">moodCode=</span><span class="value">"INT"</span>> + <span class="comment"><!-- Instruction (V2) --></span> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.20"</span> <span class="attrib">extension=</span><span class="value">"2014-06-09"</span>/> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.20"</span>/> + <<span class="field">code</span> <span class="attrib">code=</span><span class="value">"<mark class="color34">1153465004</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color35">Education about overdosing</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color29">2.16.840.1.113883.6.96</mark>"</span> + <span class="attrib">codeSystemName=</span><span class="value">"<mark class="color29"><mark class="color29">SNOMED</mark> CT</mark>"</span>/> + <<span class="field">text</span>><mark class="color36">Do not overtake</mark></<span class="field">text</span>> + <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"completed"</span>/> + </<span class="field">act</span>> + </<span class="field">entryRelationship</span>> + <<span class="field">entryRelationship</span> <span class="attrib">typeCode=</span><span class="value">"REFR"</span>> + <<span class="field">supply</span> <span class="attrib">classCode=</span><span class="value">"SPLY"</span> <span class="attrib">moodCode=</span><span class="value">"EVN"</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.18"</span> <span class="attrib">extension=</span><span class="value">"2014-06-09"</span> /> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.18"</span>/> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"1.2.3.4.56789.1"</span> <span class="attrib">extension=</span><span class="value">"cb734647-fc99-424c-a864-7e3cda82e704"</span> /> + <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"completed"</span> /> + <<span class="field">effectiveTime</span>> + <<span class="field">high</span> <span class="attrib">value=</span><span class="value">"<mark class="color37">20121106</mark>"</span> /> + </<span class="field">effectiveTime</span>> + <span class="comment"><!-- Note in FHIR this is one less, so: 1 --></span> + <<span class="field">repeatNumber</span> <span class="attrib">value=</span><span class="value">"2"</span> /> + <<span class="field">quantity</span> <span class="attrib">value=</span><mark class="color38"><span class="value">"3"</span></mark> /> + <<span class="field">product</span>> + <<span class="field">manufacturedProduct</span> <span class="attrib">classCode=</span><span class="value">"MANU"</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.23"</span> <span class="attrib">extension=</span><span class="value">"2014-06-09"</span>/> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.23"</span>/> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"2a620155-9d11-439e-92b3-5d9815ff4ee8"</span>/> + <<span class="field">manufacturedMaterial</span>> + <<span class="field">code</span> + <span class="attrib">code=</span><span class="value">"<mark class="color24">1190220</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color25">2.16.840.1.113883.6.88</mark>"</span> + <span class="attrib">codeSystemName=</span><span class="value">"<mark class="color25">RxNorm</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color26">ACTUAT albuterol 0.1 MG/ACTUAT ... Spray</mark>"</span>/> + </<span class="field">manufacturedMaterial</span>> + </<span class="field">manufacturedProduct</span>> + </<span class="field">product</span>> + </<span class="field">supply</span>> + </<span class="field">entryRelationship</span>> + <<span class="field">precondition</span> <span class="attrib">typeCode=</span><span class="value">"PRCN"</span>> + <<span class="field">criterion</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.25"</span> <span class="attrib">extension=</span><span class="value">"2014-06-09"</span> /> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.25"</span>/> + <<span class="field">code</span> <span class="attrib">code=</span><span class="value">"ASSERTION"</span> <span class="attrib">codeSystem=</span><span class="value">"2.16.840.1.113883.5.4"</span> /> + <<span class="field">value</span> <span class="attrib">xsi:type=</span><span class="value">"CD"</span> + <span class="attrib">code=</span><span class="value">"<mark class="color32">56018004</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color29">2.16.840.1.113883.6.96</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color33">Wheezing</mark>"</span> /> + </<span class="field">criterion</span>> + </<span class="field">precondition</span>> +</<span class="field">substanceAdministration</span>></div> </td><td> -... +<div id="fhir" class="border codeArea">{ + "<span class="field">resourceType</span>": "<span class="value">MedicationRequest</span>", + "<span class="field">id</span>": "<span class="value">7fc60296-0667-4a44-86e5-4c432403532e</span>", + "<span class="field">identifier</span>": [ + { + "<span class="field">system</span>": "<span class="value">urn:ietf:rfc:3986</span>", + "<span class="field">value</span>": "<span class="value">urn:uuid:<mark class="color10">cdbd33f0-6cde-11db-9fe1-0800200c9a66</mark></span>" + } + ], + "<span class="field">status</span>": "<span class="value"><mark class="color11">active</mark></span>", + "<span class="field">intent</span>": "<span class="value">plan</span>", + "<span class="field">medicationReference</span>": { + "<span class="field">reference</span>": "<span class="value">#containedMed</span>" + }, + <span class="comment">/* Only one of these can be sent. + If not including a Medication resource + the code can just be sent in codeableConcept + "<span class="field">medicationCodeableConcept</span>": { + "<span class="field">coding</span>": [ + { + "<span class="field">system</span>": "<span class="value"><mark class="color25">http://www.nlm.nih.gov/research/umls/rxnorm</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color24">1190220</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color26">ACTUAT albuterol 0.1 MG/ACTUAT ... Spray</mark></span>" + } + ] + }, */ + </span>"<span class="field">subject</span>": { + "<span class="field">reference</span>": "<span class="value">Patient/18025725</span>" + }, + "<span class="field">authoredOn</span>": "<span class="value"><mark class="color28">2013-09-11T16:03:00-07:00</mark></span>", + "<span class="field">reasonCode</span>": [ + { + "<span class="field">coding</span>": [ + { + "<span class="field">system</span>": "<span class="value"><mark class="color29">http://snomed.info/sct</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color32">56018004</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color33">wheezing</mark></span>" + } + ] + } + ], + "<span class="field">dosageInstruction</span>": [ + { + "<span class="field">text</span>": "<span class="value"><mark class="color39">2 puffs every 4-6 hours as needed</mark></span>", + "<span class="field">patientInstruction</span>": "<span class="value"><mark class="color36">Do not overtake</mark></span>", + "<span class="field">additionalInstruction</span>": [ + { + "<span class="field">coding</span>": [ + { + "<span class="field">system</span>": "<span class="value"><mark class="color29">http://snomed.info/sct</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color34">1153465004</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color35">Education about overdosing</mark></span>" + } + ] + } + ], + "<span class="field">timing</span>": { + "<span class="field">period</span>": <mark class="color13">4,</mark> + "<span class="field">periodMax</span>": <mark class="color15">6,</mark> + "<span class="field">periodUnit</span>": <mark class="color14">"h"</mark> + }, + "<span class="field">asNeededCodeableConcept</span>": { + "<span class="field">coding</span>": [ + { + "<span class="field">system</span>": "<span class="value"><mark class="color29">http://snomed.info/sct</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color32">56018004</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color33">wheezing</mark></span>" + } + ] + }, + "<span class="field">route</span>": { + "<span class="field">coding</span>": [ + { + "<span class="field">system</span>": "<span class="value">http://ncithesaurus-stage.nci.nih.gov</span>", + "<span class="field">code</span>": "<span class="value"><mark class="color17">C38288</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color19">Oral Route of Administration</mark></span>" + } + ] + }, + "<span class="field">doseAndRate</span>": [ + { + "<span class="field">doseQuantity</span>": { + "<span class="field">value</span>": <mark class="color16"><mark class="color40">1 +</mark></mark> } + } + ], + "<span class="field">maxDosePerPeriod</span>": { + "<span class="field">numerator</span>": { + "<span class="field">value</span>": <span class="value">6,</span> + "<span class="field">unit</span>": "<span class="value"><mark class="color20">{spray}</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color20">{spray}</mark></span>", + "<span class="field">system</span>": "<span class="value">http://unitsofmeasure.org</span>" + }, + "<span class="field">denominator</span>": { + "<span class="field">value</span>": <span class="value">1,</span> + "<span class="field">unit</span>": "<span class="value"><mark class="color21">{day}</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color21">{day}</mark></span>", + "<span class="field">system</span>": "<span class="value">http://unitsofmeasure.org</span>" + } + } + } + ], + "<span class="field">dispenseRequest</span>": { + "<span class="field">numberOfRepeatsAllowed</span>": <span class="value">1,</span> + "<span class="field">validityPeriod</span>": { + "<span class="field">end</span>": "<span class="value"><mark class="color37">2012-11-06</mark></span>" + }, + "<span class="field">quantity</span>": { + "<span class="field">value</span>": <mark class="color38">3 +</mark> } + }, + "<span class="field">contained</span>": [{ + "<span class="field">resourceType</span>": "<span class="value">Medication</span>", + "<span class="field">id</span>": "<span class="value">containedMed</span>", + "<span class="field">code</span>": { + "<span class="field">coding</span>": [{ + "<span class="field">system</span>": "<span class="value"><mark class="color25">http://www.nlm.nih.gov/research/umls/rxnorm</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color24">1190220</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color26">ACTUAT albuterol 0.1 MG/ACTUAT ... Spray</mark></span>" + }] + }, + "<span class="field">form</span>": { + "<span class="field">coding</span>": [ + { + "<span class="field">system</span>": "<span class="value"><mark class="color18">http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color22">C48501</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color23">Inhalation dosing unit</mark></span>" + } + ] + }, + "<span class="field">manufacturer</span>": { + <span class="comment">// If more details exist, would map to Organization resource</span> + "<span class="field">display</span>": "<span class="value"><mark class="color27">Good Vaccines Inc</mark></span>" + }, + "<span class="field">ingredient</span>": [{ + "<span class="field">itemCodeableConcept</span>": { + "<span class="field">coding</span>": [ + { + "<span class="field">system</span>": "<span class="value"><mark class="color29">http://snomed.info/sct</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color30">387390002</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color31">sodium chloride</mark></span>" + } + ] + } + }] + }] +}</div> </td></tr></table> #### Links to example content From abea8c28668779e94d77bd6dca3ec11a0f4e67ea Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Tue, 22 Oct 2024 10:51:31 -0500 Subject: [PATCH 086/112] Add immunization mapping --- input/pagecontent/CF-immunizations.md | 310 ++++++++++++++++++++++---- 1 file changed, 267 insertions(+), 43 deletions(-) diff --git a/input/pagecontent/CF-immunizations.md b/input/pagecontent/CF-immunizations.md index b569d62..71fe503 100644 --- a/input/pagecontent/CF-immunizations.md +++ b/input/pagecontent/CF-immunizations.md @@ -39,40 +39,72 @@ Mapping is from `@moodCode="EVN"` (i.e. historical) immunizations, not `INT` (fu <table><tr><th>CDA Immunization Example</th><th>FHIR Immunization Resource</th></tr> <tr><td> <div id="cda" class="border codeArea"><<span class="field">substanceAdministration</span> <span class="attrib">classCode=</span><span class="value">"SBADM"</span> <span class="attrib">moodCode=</span><span class="value">"EVN"</span> <span class="attrib">negationInd=</span><span class="value">"false"</span>> + <span class="comment"><!-- ** Immunization activity ** --></span> <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.52"</span>/> <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.52"</span> <span class="attrib">extension=</span><span class="value">"2015-08-01"</span>/> <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"<mark class="color10">e6f1ba43-c0ed-4b9b-9f12-f435d8ad8f92</mark>"</span>/> <<span class="field">text</span>> <<span class="field">reference</span> <span class="attrib">value=</span><span class="value">"#immun1"</span>/> </<span class="field">text</span>> + <span class="comment"><!-- Indicates the status of the substanceAdministartion --></span> <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"<mark class="color11">completed</mark>"</span>/> <<span class="field">effectiveTime</span> <span class="attrib">value=</span><span class="value">"<mark class="color12">20100815</mark>"</span>/> + <<span class="field">repeatNumber</span> <span class="attrib">value=</span><mark class="color13"><span class="value">"1"</span></mark>/> + <<span class="field">routeCode</span> + <span class="attrib">code=</span><span class="value">"<mark class="color14">C28161</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"2.16.840.1.113883.3.26.1.1"</span> + <span class="attrib">codeSystemName=</span><span class="value">"National Cancer Institute (NCI) Thesaurus"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color15">Intramuscular Route of Administration</mark>"</span> /> + <<span class="field">approachSiteCode</span> + <span class="attrib">code=</span><span class="value">"<mark class="color16">700022004</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color17">2.16.840.1.113883.6.96</mark>"</span> + <span class="attrib">codeSystemName=</span><span class="value">"<mark class="color17"><mark class="color17">SNOMED</mark> CT</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color18">Muscle and/or tendon structure of upper limb</mark>"</span> /> + <<span class="field">doseQuantity</span> <span class="attrib">value=</span><mark class="color19"><span class="value">"60"</span></mark> unit=<mark class="color20"><span class="value">"ug"</span></mark> /> + <<span class="field">administrationUnitCode</span> + <span class="attrib">code=</span><span class="value">"C44278"</span> + <span class="attrib">codeSystem=</span><span class="value">"2.16.840.1.113883.3.26.1.1"</span> + <span class="attrib">codeSystemName=</span><span class="value">"National Cancer Institute (NCI) Thesaurus"</span> + <span class="attrib">displayName=</span><span class="value">"Unit"</span>/> <<span class="field">consumable</span>> <<span class="field">manufacturedProduct</span> <span class="attrib">classCode=</span><span class="value">"MANU"</span>> + <span class="comment"><!-- ** Immunization medication information ** --></span> <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.54"</span>/> <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.54"</span> <span class="attrib">extension=</span><span class="value">"2014-06-09"</span>/> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"5823d446-9066-11ee-b9d1-0242ac120002"</span>/> <<span class="field">manufacturedMaterial</span>> - <<span class="field">code</span> <span class="attrib">code=</span><mark class="color13"><span class="value">"88"</span></mark> - <span class="attrib">codeSystem=</span><span class="value">"<mark class="color14">2.16.840.1.113883.12.292</mark>"</span> - <span class="attrib">displayName=</span><span class="value">"<mark class="color15">Influenza virus vaccine</mark>"</span> - <span class="attrib">codeSystemName=</span><mark class="color16"><span class="value">"CVX"</span></mark>> + <<span class="field">code</span> + <span class="attrib">code=</span><mark class="color21"><span class="value">"88"</span></mark> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color22">2.16.840.1.113883.12.292</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color23">Influenza virus vaccine</mark>"</span> + <span class="attrib">codeSystemName=</span><span class="value">"CVX"</span>> <<span class="field">originalText</span>> <<span class="field">reference</span> <span class="attrib">value=</span><span class="value">"#ImmunizationProduct_100"</span>/> </<span class="field">originalText</span>> + <<span class="field">translation</span> + <span class="attrib">code=</span><span class="value">"<mark class="color24">49281-0422-50</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color25">2.16.840.1.113883.6.69</mark>"</span> + <span class="attrib">codeSystemName=</span><span class="value">"NDC"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color26">Influenza vaccine</mark>"</span>/> </<span class="field">code</span>> - <lotNumberText<mark class="color17">>1<</mark>/lotNumberText> + <<span class="field">lotNumberText</span>>1</<span class="field">lotNumberText</span>> </<span class="field">manufacturedMaterial</span>> + <<span class="field">manufacturerOrganization</span>> + <<span class="field">name</span>><mark class="color27">Health LS - Immuno Inc.</mark></<span class="field">name</span>> + </<span class="field">manufacturerOrganization</span>> </<span class="field">manufacturedProduct</span>> </<span class="field">consumable</span>> + <span class="comment"><!-- Optional Performer --></span> + <span class="comment"><!-- Creates resource: <mark class="color30">PractitionerRole/AmandaAtGoodHealthClinics</mark> --></span> + <span class="comment"><!-- With functionCode:<mark class="color31"> AP </mark>--></span> <<span class="field">performer</span>> <<span class="field">assignedEntity</span>> - <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.19.5.9999.456"</span> <span class="attrib">extension=</span><span class="value">"<mark class="color18">2981824</mark>"</span>/> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.19.5.9999.456"</span> <span class="attrib">extension=</span><span class="value">"2981824"</span>/> <<span class="field">addr</span>> <<span class="field">streetAddressLine</span>>1021 Health Drive</<span class="field">streetAddressLine</span>> <<span class="field">city</span>>Ann Arbor</<span class="field">city</span>> <<span class="field">state</span>>MI</<span class="field">state</span>> <<span class="field">postalCode</span>>99099</<span class="field">postalCode</span>> - <<span class="field">country</span>>US</<span class="field">country</span>> </<span class="field">addr</span>> <<span class="field">telecom</span> <span class="attrib">nullFlavor=</span><span class="value">"UNK"</span>/> <<span class="field">assignedPerson</span>> @@ -82,22 +114,16 @@ Mapping is from `@moodCode="EVN"` (i.e. historical) immunizations, not `INT` (fu </<span class="field">name</span>> </<span class="field">assignedPerson</span>> <<span class="field">representedOrganization</span>> - <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.19.5.9999.1394"</span>/> <<span class="field">name</span>>Good Health Clinic</<span class="field">name</span>> - <<span class="field">telecom</span> <span class="attrib">nullFlavor=</span><span class="value">"UNK"</span>/> - <<span class="field">addr</span> <span class="attrib">nullFlavor=</span><span class="value">"UNK"</span>/> </<span class="field">representedOrganization</span>> </<span class="field">assignedEntity</span>> </<span class="field">performer</span>> + <span class="comment"><!-- Optional Author --></span> <<span class="field">author</span>> <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.119"</span>/> - <<span class="field">time</span> <span class="attrib">value=</span><span class="value">"<mark class="color34">20100816</mark>"</span>/> + <<span class="field">time</span> <span class="attrib">value=</span><span class="value">"<mark class="color12">20100815</mark>"</span>/> <<span class="field">assignedAuthor</span>> <<span class="field">id</span> <span class="attrib">extension=</span><span class="value">"99999999"</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.4.6"</span>/> - <<span class="field">code</span> <span class="attrib">code=</span><span class="value">"207Q00000X"</span> - <span class="attrib">codeSystem=</span><span class="value">"2.16.840.1.113883.6.101"</span> - <span class="attrib">codeSystemName=</span><span class="value">"Health Care Provider Taxonomy"</span> - <span class="attrib">displayName=</span><span class="value">"Family Medicine"</span> /> <<span class="field">telecom</span> <span class="attrib">use=</span><span class="value">"WP"</span> <span class="attrib">value=</span><span class="value">"tel:555-555-1002"</span>/> <<span class="field">assignedPerson</span>> <<span class="field">name</span>> @@ -107,41 +133,239 @@ Mapping is from `@moodCode="EVN"` (i.e. historical) immunizations, not `INT` (fu </<span class="field">assignedPerson</span>> </<span class="field">assignedAuthor</span>> </<span class="field">author</span>> + <<span class="field">entryRelationship</span> <span class="attrib">typeCode=</span><span class="value">"RSON"</span>> + <<span class="field">observation</span> <span class="attrib">classCode=</span><span class="value">"OBS"</span> <span class="attrib">moodCode=</span><span class="value">"EVN"</span>> + <span class="comment"><!-- Indication (V2) --></span> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.19"</span> <span class="attrib">extension=</span><span class="value">"2014-06-09"</span>/> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.19"</span>/> + <<span class="field">code</span> + <span class="attrib">codeSystem=</span><span class="value">"2.16.840.1.113883.6.96"</span> + <span class="attrib">codeSystemName=</span><span class="value">"SNOMED CT"</span> + <span class="attrib">code=</span><span class="value">"404684003"</span> + <span class="attrib">displayName=</span><span class="value">"Clinical finding"</span>/> + <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"completed"</span>/> + <<span class="field">value</span> <span class="attrib">xsi:type=</span><span class="value">"CD"</span> + <span class="attrib">code=</span><span class="value">"<mark class="color28">195967001</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color17">2.16.840.1.113883.6.96</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color29">asthma</mark>"</span> /> + </<span class="field">observation</span>> + </<span class="field">entryRelationship</span>> + <span class="comment"><!-- Reaction becomes Observation with id: <mark class="color32">Observation/WithCode247472004Wheal</mark> --></span> + <<span class="field">entryRelationship</span> <span class="attrib">typeCode=</span><span class="value">"MFST"</span> <span class="attrib">inversionInd=</span><span class="value">"true"</span>> + <<span class="field">observation</span> <span class="attrib">classCode=</span><span class="value">"OBS"</span> <span class="attrib">moodCode=</span><span class="value">"EVN"</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.9"</span> <span class="attrib">extension=</span><span class="value">"2014-06-09"</span> /> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.9"</span> /> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"37006474-947a-11ee-b9d1-0242ac120002"</span>/> + <<span class="field">code</span> <span class="attrib">code=</span><span class="value">"ASSERTION"</span> <span class="attrib">codeSystem=</span><span class="value">"2.16.840.1.113883.5.4"</span> /> + <<span class="field">text</span>> + <<span class="field">reference</span> <span class="attrib">value=</span><span class="value">"#_8a7ed342-967a-400e-88d5-2f8c2b7cdda0"</span> /> + </<span class="field">text</span>> + <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"completed"</span> /> + <<span class="field">effectiveTime</span>> + <<span class="field">low</span> <span class="attrib">value=</span><span class="value">"20080501"</span>/> + <<span class="field">high</span> <span class="attrib">value=</span><span class="value">"20080501"</span>/> + </<span class="field">effectiveTime</span>> + <<span class="field">value</span> <span class="attrib">xsi:type=</span><span class="value">"CD"</span> + <span class="attrib">code=</span><span class="value">"247472004"</span> + <span class="attrib">codeSystem=</span><span class="value">"2.16.840.1.113883.6.96"</span> + <span class="attrib">displayName=</span><span class="value">"Wheal"</span> /> + </<span class="field">observation</span>> + </<span class="field">entryRelationship</span>> </<span class="field">substanceAdministration</span>></div> </td><td> <div id="fhir" class="border codeArea">{ - "<span class="field">resourceType</span>" : "<span class="value">Immunization</span>", - "<span class="field">id</span>" : "<span class="value">CF-immunization</span>", - "<span class="field">identifier</span>" : [{ - "<span class="field">system</span>" : "<span class="value">urn:ietf:rfc:3986</span>", - "<span class="field">value</span>" : "<span class="value">urn:uuid:<mark class="color10">e6f1ba43-c0ed-4b9b-9f12-f435d8ad8f92</mark></span>" - }], - "<span class="field">status</span>" : "<span class="value"><mark class="color11">completed</mark></span>", - "<span class="field">vaccineCode</span>" : { - "<span class="field">coding</span>" : [{ - "<span class="field">system</span>" : "<span class="value"><mark class="color14">http://hl7.org/fhir/sid/cvx</mark></span>", - "<span class="field">code</span>" : <mark class="color13">"88"</mark>, - "<span class="field">display</span>" : "<span class="value"><mark class="color15">Influenza Virus Vaccine</mark>, unspecified formulation</span>" - }], - "<span class="field">text</span>" : "<span class="value"><mark class="color15">Influenza Virus Vaccine</mark></span>" + "<span class="field">resourceType</span>": "<span class="value">Immunization</span>", + "<span class="field">id</span>": "<span class="value">2b622767-4560-46ba-a1ac-58092fcdcdda</span>", + "<span class="field">status</span>": "<span class="value"><mark class="color11">completed</mark></span>", + "<span class="field">identifier</span>": [ + { + "<span class="field">system</span>": "<span class="value">urn:ietf:rfc:3986</span>", + "<span class="field">value</span>": "<span class="value">urn:uuid:<mark class="color10">e6f1ba43-c0ed-4b9b-9f12-f435d8ad8f92</mark></span>" + } + ], + "<span class="field">vaccineCode</span>": { + "<span class="field">coding</span>": [ + { + "<span class="field">system</span>": "<span class="value"><mark class="color22">http://hl7.org/fhir/sid/cvx</mark></span>", + "<span class="field">code</span>": <mark class="color21">"88"</mark>, + "<span class="field">display</span>": "<span class="value"><mark class="color23">Influenza virus vaccine</mark></span>" + }, + { + "<span class="field">system</span>": "<span class="value"><mark class="color25">http://hl7.org/fhir/sid/ndc</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color24">49281-0422-50</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color26">Influenza vaccine</mark></span>" + } + ], + "<span class="field">text</span>": "<span class="value"><mark class="color23">Influenza virus vaccine</mark></span>" }, - "<span class="field">patient</span>" : { - "<span class="field">reference</span>" : "<span class="value">Patient/CF-patient</span>" + "<span class="field">doseQuantity</span>": { + "<span class="field">unit</span>": <mark class="color20">"ug"</mark>, + "<span class="field">value</span>": <mark class="color19">60,</mark> + "<span class="field">system</span>": "<span class="value">http://unitofmeasure.org</span>", + "<span class="field">code</span>": <mark class="color20">"ug"</mark> }, - "<span class="field">occurrenceDateTime</span>" : "<span class="value"><mark class="color12">2010-08-15</mark></span>", - "<span class="field">recorded</span>" : "<span class="value"><mark class="color34">2010-08-16</mark></span>", - "<span class="field">_primarySource</span>" : { - "<span class="field">extension</span>" : [{ - "<span class="field">url</span>" : "<span class="value">http://hl7.org/fhir/StructureDefinition/data-absent-reason</span>", - "<span class="field">valueCode</span>" : "<span class="value">unknown</span>" - }] + "<span class="field">lotNumber</span>": <mark class="color13">"1"</mark>, + "<span class="field">recorded</span>": "<span class="value"><mark class="color12">2010-08-15</mark></span>", + "<span class="field">performer</span>": [ + { + "<span class="field">actor</span>": { + "<span class="field">reference</span>": "<span class="value"><mark class="color30">PractitionerRole/AmandaAtGoodHealthClinics</mark></span>" + }, + "<span class="field">function</span>": { + "<span class="field">coding</span>": [ + { + "<span class="field">system</span>": "<span class="value">http://terminology.hl7.org/CodeSystem/v2-0443</span>", + "<span class="field">code</span>": <mark class="color31">"AP"</mark>, + "<span class="field">display</span>": "<span class="value">Administering Provider</span>" + } + ] + } + } + ], + "<span class="field">reasonCode</span>": [ + { + "<span class="field">coding</span>": [ + { + "<span class="field">system</span>": "<span class="value"><mark class="color17">http://snomed.info/sct</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color28">195967001</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color29">asthma</mark></span>" + } + ] + } + ], + "<span class="field">_primarySource</span>": { + "<span class="field">extension</span>": [ + { + "<span class="field">url</span>": "<span class="value">http://hl7.org/fhir/StructureDefinition/data-absent-reason</span>", + "<span class="field">valueCode</span>": "<span class="value">unknown</span>" + } + ] + }, + "<span class="field">manufacturer</span>": { + "<span class="field">display</span>": "<span class="value"><mark class="color27">Health LS - Immuno Inc.</mark></span>" }, - "<span class="field">lotNumber</span>" : <mark class="color17">"1"</mark>, - "<span class="field">performer</span>" : [{ - "<span class="field">actor</span>" : { - "<span class="field">reference</span>" : "<span class="value">PractitionerRole/ccda-practitionerrole-<mark class="color18">2981824</mark></span>" + "<span class="field">site</span>": { + "<span class="field">coding</span>": [ + { + "<span class="field">system</span>": "<span class="value"><mark class="color17">http://snomed.info/sct</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color16">700022004</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color18">Muscle and/or tendon structure of upper limb</mark></span>" + } + ] + }, + "<span class="field">route</span>": { + "<span class="field">coding</span>": [ + { + "<span class="field">system</span>": "<span class="value">http://ncithesaurus-stage.nci.nih.gov</span>", + "<span class="field">code</span>": "<span class="value"><mark class="color14">C28161</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color15">Intramuscular Route of Administration</mark></span>" + } + ] + }, + "<span class="field">patient</span>": { + "<span class="field">reference</span>": "<span class="value">Patient/6581e92eb6ff5dadc088eae5</span>" + }, + "<span class="field">protocolApplied</span>": [ + { + "<span class="field">doseNumberPositiveInt</span>": <mark class="color13">1 +</mark> } + ], + "<span class="field">occurrenceDateTime</span>": "<span class="value"><mark class="color12">2010-08-15</mark></span>", + "<span class="field">reaction</span>": [ + { + "<span class="field">detail</span>": { + "<span class="field">reference</span>": "<span class="value"><mark class="color32">Observation/WithCode247472004Wheal</mark></span>" + } } - }] + ] +}</div> +</td></tr></table> + +### Example: Refused Immunization + +<table><tr><th>CDA Refused Immunization Example</th><th>FHIR Immunization Resource</th></tr> +<tr><td> +<div id="cda" class="border codeArea"><<span class="field">entry</span> <span class="attrib">typeCode=</span><span class="value">"COMP"</span>> + <span class="comment"><!-- negationInd=true indicates substance was NOT given at this date--></span> + <<span class="field">substanceAdministration</span> <span class="attrib">classCode=</span><span class="value">"SBADM"</span> <span class="attrib">moodCode=</span><span class="value">"EVN"</span> <mark class="color10">negationInd=<span class="value">"true"</span></mark>> + <span class="comment"><!-- ** Immunization activity ** --></span> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.52"</span>/> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.52"</span> <span class="attrib">extension=</span><span class="value">"2015-08-01"</span>/> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"<mark class="color11">8d5942f9-5413-4486-af89-dcc5603dbec7</mark>"</span>/> + <<span class="field">text</span>> + <<span class="field">reference</span> <span class="attrib">value=</span><span class="value">"#immun2"</span>/> + </<span class="field">text</span>> + <span class="comment"><!-- Indicates the status of the substanceAdministartion --></span> + <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"completed"</span>/> + <<span class="field">effectiveTime</span> <span class="attrib">value=</span><span class="value">"<mark class="color12">20151115</mark>"</span>/> + <<span class="field">consumable</span>> + <<span class="field">manufacturedProduct</span> <span class="attrib">classCode=</span><span class="value">"MANU"</span>> + <span class="comment"><!-- ** Immunization medication information ** --></span> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.54"</span>/> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.54"</span> <span class="attrib">extension=</span><span class="value">"2014-06-09"</span>/> + <<span class="field">manufacturedMaterial</span>> + <<span class="field">code</span> + <span class="attrib">code=</span><mark class="color13"><span class="value">"43"</span></mark> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color14">2.16.840.1.113883.12.292</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color15">hepatitis B vaccine, adult dosage</mark>"</span> + <span class="attrib">codeSystemName=</span><span class="value">"CVX"</span>> + <<span class="field">originalText</span>>hepatitis B vaccine</<span class="field">originalText</span>> + </<span class="field">code</span>> + <lotNumberText<mark class="color16">>2<</mark>/lotNumberText> + </<span class="field">manufacturedMaterial</span>> + </<span class="field">manufacturedProduct</span>> + </<span class="field">consumable</span>> + <<span class="field">entryRelationship</span> <span class="attrib">typeCode=</span><span class="value">"RSON"</span>> + <<span class="field">observation</span> <span class="attrib">classCode=</span><span class="value">"OBS"</span> <span class="attrib">moodCode=</span><span class="value">"EVN"</span>> + <span class="comment"><!-- Immunization Refusal Reason --></span> + <span class="comment"><!-- Included the reason since it may be relevant + to a future clinician or quality measurement --></span> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.53"</span>/> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"c1296315-9a6d-45a2-aac0-ee225d375409"</span>/> + <<span class="field">code</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color17">patient objection</mark>"</span> + <span class="attrib">code=</span><span class="value">"<mark class="color18">PATOBJ</mark>"</span> + <span class="attrib">codeSystemName=</span><span class="value">"HL7 ActNoImmunizationReason"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color19">2.16.840.1.113883.5.8</mark>"</span>/> + <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"completed"</span>/> + </<span class="field">observation</span>> + </<span class="field">entryRelationship</span>> + </<span class="field">substanceAdministration</span>> +</<span class="field">entry</span>></div> +</td><td> +<div id="fhir" class="border codeArea">{ + "<span class="field">id</span>": "<span class="value">f122ceadccaa4a9accdc117634a89dda</span>", + "<span class="field">resourceType</span>": "<span class="value">Immunization</span>", + "<span class="field">vaccineCode</span>": { + "<span class="field">coding</span>": [{ + "<span class="field">code</span>": <mark class="color13">"43"</mark>, + "<span class="field">display</span>": "<span class="value"><mark class="color15">hepatitis B vaccine, adult dosage</mark></span>", + "<span class="field">system</span>": "<span class="value"><mark class="color14">http://hl7.org/fhir/sid/cvx</mark></span>" + }] + }, + "<span class="field">identifier</span>": [{ + "<span class="field">system</span>": "<span class="value">urn:ietf:rfc:3986</span>", + "<span class="field">value</span>": "<span class="value">urn:uuid:<mark class="color11">8d5942f9-5413-4486-af89-dcc5603dbec7</mark></span>" + }], + "<span class="field">lotNumber</span>": <mark class="color16">"2"</mark>, + "<span class="field">occurrenceDateTime</span>": "<span class="value"><mark class="color12">2015-11-15</mark></span>", + "<span class="field">patient</span>": { + "<span class="field">reference</span>": "<span class="value">Patient/fff</span>" + }, + "<span class="field">_primarySource</span>": { + "<span class="field">extension</span>": [{ + "<span class="field">url</span>": "<span class="value">http://hl7.org/fhir/StructureDefinition/data-absent-reason</span>", + "<span class="field">valueCode</span>": "<span class="value">unknown</span>" + }] + }, + "<span class="field">status</span>": "<span class="value"><mark class="color10">not-done</mark></span>", + "<span class="field">statusReason</span>": { + "<span class="field">coding</span>": [{ + "<span class="field">code</span>": "<span class="value"><mark class="color18">PATOBJ</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color17">patient objection</mark></span>", + "<span class="field">system</span>": "<span class="value"><mark class="color19">http://terminology.hl7.org/CodeSystem/v3-ActReason</mark></span>" + }] + } }</div> </td></tr></table> From 6c75c4a298c8bd3eed7f59a05121c5d1dfa06552 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Tue, 22 Oct 2024 12:54:23 -0500 Subject: [PATCH 087/112] Add note example --- input/pagecontent/CF-notes.md | 115 ++++++++++++++++++++++++++++++++-- 1 file changed, 109 insertions(+), 6 deletions(-) diff --git a/input/pagecontent/CF-notes.md b/input/pagecontent/CF-notes.md index d73d527..b15097f 100644 --- a/input/pagecontent/CF-notes.md +++ b/input/pagecontent/CF-notes.md @@ -11,21 +11,124 @@ Clinical Notes may appear in their own section or as an entry in any open sectio |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| |/code/translation|.type|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>**NOTE:** The root code in C-CDA is always `34109-9: Note`. A more specific code may be sent in translation which should be sent as the DocumentReference.type. If there is no translation, however, `34109-9` may be sent as the type. ||.category|Set to `clinical-note`. -|/text/@mediaType<br/>&<br/>/text/text()|.attachment.contentType<br/>&<br/>.attachment.data|If @mediaType is present, then representation should = B64, and the inner-text contents are embedded base64-encoded data. In this case, the mediaType and base64-encoded data map 1:1 to attachment.contentType and .data. -|/text/reference/@value|.attachment.contentType<br/>&<br/>.attachment.data|Convert the narrative element referenced by @value following [Narrative Text](mappingGuidance.html#narrative-text) guidance and use `application/xhtml+xml` as the contentType.<br/>If the narrative has minimal markup (i.e. only `<content>` and `<paragraph>` elements which can be converted to line breaks), it can be converted to `text/plain`.<br/>To send the raw CDA narrative without converting, use `application/cda+xml`, but this is less useful to receivers. +|/text/@mediaType<br/>&<br/>/text/text()|.content.attachment.contentType<br/>&<br/>.content.attachment.data|If @mediaType is present, then representation should = B64, and the inner-text contents are embedded base64-encoded data. In this case, the mediaType and base64-encoded data map 1:1 to attachment.contentType and .data. +|/text/reference/@value|.content.attachment.contentType<br/>&<br/>.content.attachment.data|Convert the narrative element referenced by @value following [Narrative Text](mappingGuidance.html#narrative-text) guidance and use `application/xhtml+xml` as the contentType.<br/>If the narrative has minimal markup (i.e. only `<content>` and `<paragraph>` elements which can be converted to line breaks), it can be converted to `text/plain`.<br/>To send the raw CDA narrative without converting, use `application/cda+xml`, but this is less useful to receivers. |/effectiveTime|.context.period|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) |/author|.author|[C-CDA → FHIR Participation](CF-participations.html) |/author/time|.date|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) |/entryRelationship[@typeCode=COMP]/encounter<br/>or<br/>Parent `<encounter>` element<br/>or<br/>`<encompassingEncounter>`|.context.encounter|C-CDA requires an encounter for notes, but allows for context conduction. If the Note Activity is in an entryRelationship chain that includes an Encounter Activity, use that. Otherwise, if the document contains an `<encompassingEncounter>`, that is the encounter for the note.<br/>[CDA → FHIR Encounters](CF-encounters.html) |/reference/externalDocument/id|.relatesTo.target.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| - +4dc41c26-43a4-48d9-b17e-067890006b29 ### Illustrative example -<table><tr><th>CDA Example</th><th>FHIR Resource</th></tr> +<table><tr><th>CDA Note Activity Example</th><th>FHIR DocumentReference Resource</th></tr> <tr><td> -... +<div id="cda" class="border codeArea"><<span class="field">act</span> <span class="attrib">classCode=</span><span class="value">"ACT"</span> <span class="attrib">moodCode=</span><span class="value">"EVN"</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.202"</span> <span class="attrib">extension=</span><span class="value">"2016-11-01"</span>/> + <<span class="field">code</span> + <span class="attrib">code=</span><span class="value">"<mark class="color10">34109-9</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color11">2.16.840.1.113883.6.1</mark>"</span> + <span class="attrib">codeSystemName=</span><span class="value">"<mark class="color11">LOINC</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color12">Note</mark>"</span>> + <span class="comment"><!-- Code must match or be equivalent to section code --></span> + <<span class="field">translation</span> + <span class="attrib">code=</span><span class="value">"<mark class="color13">11488-4</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color11">2.16.840.1.113883.6.1</mark>"</span> + <span class="attrib">codeSystemName=</span><span class="value">"<mark class="color11">LOINC</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color14">Consultation note</mark>"</span>/> + </<span class="field">code</span>> + <<span class="field">text</span> <span class="attrib">mediaType=</span><span class="value">"<mark class="color16">application/rtf</mark>"</span> <span class="attrib">representation=</span><span class="value">"B64"</span>> + <mark class="color15">e1xydGYxXGFuc2kgSGVsbG8gd29ybGQhfQ==</mark> + <<span class="field">reference</span> <span class="attrib">value=</span><span class="value">"#ConsultNote1"</span>/> + </<span class="field">text</span>> + <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"completed"</span>/> + <span class="comment"><!-- Clinically-relevant time of the note --></span> + <<span class="field">effectiveTime</span> <span class="attrib">value=</span><span class="value">"<mark class="color17">20160908</mark>"</span>/> + <span class="comment"><!-- Author Participation --></span> + <<span class="field">author</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.119"</span>/> + <span class="comment"><!-- Time note was actually written --></span> + <<span class="field">time</span> <span class="attrib">value=</span><span class="value">"<mark class="color18">20160908083215-0500</mark>"</span>/> + <<span class="field">assignedAuthor</span>> + <span class="comment"><!-- Full author information is elsewhere in the document . --></span> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"20cf14fb-b65c-4c8c-a54d-b0cca834c18c"</span>/> + <span class="comment"><!-- Becomes reference: <mark class="color20">Practitioner/DrSpecialist</mark> --></span> + <<span class="field">assignedPerson</span>> + <<span class="field">name</span>> + <<span class="field">prefix</span>>Dr.</<span class="field">prefix</span>> + <<span class="field">family</span>>Specialist</<span class="field">family</span>> + </<span class="field">name</span>> + </<span class="field">assignedPerson</span>> + </<span class="field">assignedAuthor</span>> + </<span class="field">author</span>> + <<span class="field">entryRelationship</span> <span class="attrib">typeCode=</span><span class="value">"COMP"</span>> + <span class="comment"><!-- Creates an encounter with reference: <mark class="color21">Encounter/123</mark> --></span> + <<span class="field">encounter</span>> + ... + </<span class="field">encounter</span>> + </<span class="field">entryRelationship</span>> + <<span class="field">reference</span> <span class="attrib">typeCode=</span><span class="value">"REFR"</span>> + <<span class="field">externalDocument</span>> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"<mark class="color19">4dc41c26-43a4-48d9-b17e-067890006b29</mark>"</span> /> + </<span class="field">externalDocument</span>> + </<span class="field">reference</span>> +</<span class="field">act</span>></div> </td><td> -... +<div id="fhir" class="border codeArea">{ + "<span class="field">resourceType</span>": "<span class="value">DocumentReference</span>", + "<span class="field">id</span>": "<span class="value">642ed1f93eec840007aaec72</span>", + "<span class="field">language</span>": "<span class="value">en-US</span>", + "<span class="field">status</span>": "<span class="value">current</span>", + "<span class="field">type</span>": { + "<span class="field">text</span>": "<span class="value"><mark class="color12">Note</mark></span>", + "<span class="field">coding</span>": [{ + "<span class="field">code</span>": "<span class="value"><mark class="color10">34109-9</mark></span>", + "<span class="field">system</span>": "<span class="value"><mark class="color11">http://loinc.org</mark></span>" + }, + { + "<span class="field">code</span>": "<span class="value"><mark class="color13">11488-4</mark></span>", + "<span class="field">system</span>": "<span class="value"><mark class="color11">http://loinc.org</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color14">Consultation Note</mark></span>" + }] + }, + "<span class="field">category</span>": [{ + "<span class="field">text</span>": "<span class="value">Clinical Note</span>", + "<span class="field">coding</span>": [{ + "<span class="field">code</span>": "<span class="value">clinical-Note</span>", + "<span class="field">system</span>": "<span class="value">http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category</span>", + "<span class="field">display</span>": "<span class="value">Clinical Note</span>" + }] + }], + "<span class="field">subject</span>": { + "<span class="field">reference</span>": "<span class="value">urn:uuid:a4986486-6599-4bb2-a7fb-e2deb8d50b5e</span>" + }, + "<span class="field">date</span>": "<span class="value"><mark class="color18">2016-09-08T08:32:15-05:00</mark></span>", + "<span class="field">author</span>": [{ + "<span class="field">reference</span>": "<span class="value"><mark class="color20">Practitioner/DrSpecialist</mark></span>" + }], + "<span class="field">content</span>": [{ + "<span class="field">attachment</span>": { + "<span class="field">data</span>": "<span class="value"><mark class="color15">e1xydGYxXGFuc2kgSGVsbG8gd29ybGQhfQ==</mark></span>", + "<span class="field">contentType</span>": "<span class="value"><mark class="color16">application/rtf</mark></span>" + } + }], + "<span class="field">context</span>": { + "<span class="field">period</span>": { + "<span class="field">start</span>": "<span class="value"><mark class="color17">2016-09-08</mark></span>" + }, + "<span class="field">encounter</span>": [{ + "<span class="field">reference</span>": "<span class="value"><mark class="color21">Encounter/123</mark></span>" + }] + }, + "<span class="field">relatesTo</span>": { + "<span class="field">target</span>": { + "<span class="field">identifier</span>": { + "<span class="field">system</span>": "<span class="value">urn:ietf:rfc:3986</span>", + "<span class="field">value</span>": "<span class="value">urn:uuid:<mark class="color19">4dc41c26-43a4-48d9-b17e-067890006b29</mark></span>" + } + } + } +}</div> </td></tr></table> \ No newline at end of file From 45078ac6bb7098dd36b49046df5151fbfba718f5 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Tue, 22 Oct 2024 16:10:12 -0500 Subject: [PATCH 088/112] Add patient example --- input/pagecontent/CF-patient.md | 264 +++++++++++++++++++++++++++++++- 1 file changed, 262 insertions(+), 2 deletions(-) diff --git a/input/pagecontent/CF-patient.md b/input/pagecontent/CF-patient.md index 0dff1b3..dcf7843 100644 --- a/input/pagecontent/CF-patient.md +++ b/input/pagecontent/CF-patient.md @@ -40,9 +40,269 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea <table><tr><th>CDA Example</th><th>FHIR Resource</th></tr> <tr><td> -... +<div id="cda" class="border codeArea"><<span class="field">recordTarget</span>> + <<span class="field">patientRole</span>> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"<mark class="color10">068F3166-5721-4D69-94ED-8278FF035B8A</mark>"</span> /> + <<span class="field">addr</span> <span class="attrib">use=</span><mark class="color11"><span class="value">"H"</span></mark>> + <<span class="field">streetAddressLine</span>><mark class="color12">1357 Amber Drive</mark></<span class="field">streetAddressLine</span>> + <<span class="field">city</span>><mark class="color13">Beaverton</mark></<span class="field">city</span>> + <<span class="field">state</span>>OR</<span class="field">state</span>> + <<span class="field">postalCode</span>><mark class="color14">97006</mark></<span class="field">postalCode</span>> + </<span class="field">addr</span>> + <<span class="field">telecom</span> <span class="attrib">value=</span><span class="value">"tel:<mark class="color15">+1(565)867-5309</mark>"</span> <span class="attrib">use=</span><span class="value">"MC"</span>/> + <<span class="field">patient</span>> + <<span class="field">name</span> <span class="attrib">use=</span><span class="value">"L"</span>> + <<span class="field">given</span>><mark class="color16">Myra</mark></<span class="field">given</span>> + <<span class="field">family</span>><mark class="color17">Jones</mark></<span class="field">family</span>> + </<span class="field">name</span>> + <<span class="field">administrativeGenderCode</span> + <span class="attrib">code=</span><mark class="color18"><span class="value">"F"</span></mark> + <span class="attrib">codeSystem=</span><span class="value">"2.16.840.1.113883.5.1"</span> /> + <<span class="field">birthTime</span> <span class="attrib">value=</span><span class="value">"<mark class="color19">19470501</mark>"</span> /> + <<span class="field">sdtc:deceasedInd</span> <span class="attrib">value=</span><span class="value">"<mark class="color20">false</mark>"</span> /> + <<span class="field">maritalStatusCode</span> + <span class="attrib">code=</span><mark class="color21"><span class="value">"M"</span></mark> + <span class="attrib">displayName=</span><span class="value">"<mark class="color22">Married</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"2.16.840.1.113883.5.2"</span> + <span class="attrib">codeSystemName=</span><span class="value">"MaritalStatus"</span>/> + <<span class="field">religiousAffiliationCode</span> + <span class="attrib">code=</span><span class="value">"<mark class="color23">1013</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color24">Christian (non-Catholic, non-specific)</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"2.16.840.1.113883.5.1076"</span> + <span class="attrib">codeSystemName=</span><span class="value">"HL7 Religious Affiliation"</span>/> + <<span class="field">raceCode</span> + <span class="attrib">code=</span><span class="value">"<mark class="color25">2106-3</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color26">2.16.840.1.113883.6.238</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color27">White</mark>"</span> /> + <<span class="field">sdtc:raceCode</span> + <span class="attrib">code=</span><span class="value">"<mark class="color28">2108-9</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color29">European</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color26">2.16.840.1.113883.6.238</mark>"</span> /> + <<span class="field">ethnicGroupCode</span> + <span class="attrib">code=</span><span class="value">"<mark class="color30">2135-2</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color26">2.16.840.1.113883.6.238</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color31">Hispanic or Latino</mark>"</span> /> + <<span class="field">sdtc:ethnicGroupCode</span> + <span class="attrib">code=</span><span class="value">"<mark class="color32"><mark class="color32">20146-9</mark></mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color33">Spanish Basque</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color26">2.16.840.1.113883.6.238</mark>"</span> /> + <<span class="field">guardian</span>> + <<span class="field">code</span> + <span class="attrib">code=</span><mark class="color34"><span class="value">"FTH"</span></mark> + <span class="attrib">displayName=</span><span class="value">"<mark class="color35">father</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"2.16.840.1.113883.5.111"</span> + <span class="attrib">codeSystemName=</span><span class="value">"RoleCode"</span> /> + <<span class="field">addr</span> <span class="attrib">use=</span><mark class="color11"><span class="value">"H"</span></mark>> + <<span class="field">streetAddressLine</span>><mark class="color36">123 main street</mark></<span class="field">streetAddressLine</span>> + <<span class="field">city</span>><mark class="color13">Beaverton</mark></<span class="field">city</span>> + <<span class="field">state</span>>OR</<span class="field">state</span>> + <<span class="field">postalCode</span>><mark class="color37">97867</mark></<span class="field">postalCode</span>> + </<span class="field">addr</span>> + <<span class="field">telecom</span> <span class="attrib">value=</span><span class="value">"tel:<mark class="color38">+1(555)555-2008</mark>"</span> <span class="attrib">use=</span><span class="value">"MC"</span> /> + <<span class="field">guardianPerson</span>> + <<span class="field">name</span>> + <<span class="field">given</span>><mark class="color39">Boris</mark></<span class="field">given</span>> + <<span class="field">given</span> <span class="attrib">qualifier=</span><span class="value">"CL"</span><mark class="color40">>Bo<</mark>/given> + <<span class="field">family</span>><mark class="color41">Betterhalf</mark></<span class="field">family</span>> + </<span class="field">name</span>> + </<span class="field">guardianPerson</span>> + </<span class="field">guardian</span>> + <<span class="field">birthplace</span>> + <<span class="field">place</span>> + <<span class="field">addr</span>> + <<span class="field">streetAddressLine</span>><mark class="color42">4444 Birth Street</mark></<span class="field">streetAddressLine</span>> + <<span class="field">city</span>><mark class="color13">Beaverton</mark></<span class="field">city</span>> + <<span class="field">state</span>>OR</<span class="field">state</span>> + <<span class="field">postalCode</span>><mark class="color37">97867</mark></<span class="field">postalCode</span>> + </<span class="field">addr</span>> + </<span class="field">place</span>> + </<span class="field">birthplace</span>> + <<span class="field">languageCommunication</span>> + <<span class="field">languageCode</span> <span class="attrib">code=</span><mark class="color10"><span class="value">"en"</span></mark> /> + <<span class="field">modeCode</span> + <span class="attrib">code=</span><mark class="color11"><span class="value">"ESP"</span></mark> + <span class="attrib">displayName=</span><span class="value">"<mark class="color12">Expressed spoken</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"2.16.840.1.113883.5.60"</span> + <span class="attrib">codeSystemName=</span><span class="value">"LanguageAbilityMode"</span>/> + <<span class="field">proficiencyLevelCode</span> + <span class="attrib">code=</span><mark class="color13"><span class="value">"G"</span></mark> + <span class="attrib">displayName=</span><span class="value">"<mark class="color14">Good</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"2.16.840.1.113883.5.61"</span> + <span class="attrib">codeSystemName=</span><span class="value">"LanguageAbilityProficiency"</span>/> + <<span class="field">preferenceInd</span> <span class="attrib">value=</span><span class="value">"<mark class="color15">true</mark>"</span> /> + </<span class="field">languageCommunication</span>> + </<span class="field">patient</span>> + <span class="comment"><!-- Creates reference: <mark class="color16">Organization/PCPartnersTest</mark> --></span> + <<span class="field">providerOrganization</span>> + <<span class="field">id</span> <span class="attrib">extension=</span><span class="value">"3"</span> <span class="attrib">root=</span><span class="value">"1.3.6.1.4.1.22812.3.2009316.3"</span> /> + <<span class="field">name</span>>Primary Care's Partners Test</<span class="field">name</span>> + <<span class="field">telecom</span> <span class="attrib">use=</span><span class="value">"WP"</span> <span class="attrib">value=</span><span class="value">"tel:+1-(676)857-6769"</span> /> + </<span class="field">providerOrganization</span>> + </<span class="field">patientRole</span>> +</<span class="field">recordTarget</span>></div> </td><td> -... +<div id="fhir" class="border codeArea">{ + "<span class="field">resourceType</span>": "<span class="value">Patient</span>", + "<span class="field">id</span>": "<span class="value">6581e92eb6ff5dadc088eae5</span>", + "<span class="field">identifier</span>": [{ + "<span class="field">system</span>": "<span class="value">urn:uuid:<mark class="color10">068f3166-5721-4d69-94ed-8278ff035b8a</mark></span>", + "<span class="field">value</span>": "<span class="value">urn:ietf:rfc:3986</span>" + }], + "<span class="field">language</span>": "<span class="value">en-US</span>", + "<span class="field">extension</span>": [{ + "<span class="field">url</span>": "<span class="value">http://hl7.org/fhir/StructureDefinition/patient-religion</span>", + "<span class="field">valueCodeableConcept</span>": { + "<span class="field">coding</span>": [{ + "<span class="field">system</span>": "<span class="value">http://terminology.hl7.org/CodeSystem/v3-ReligiousAffiliation</span>", + "<span class="field">code</span>": "<span class="value"><mark class="color23">1013</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color24">Christian (non-Catholic, non-specific)</mark></span>" + }] + } + }, { + "<span class="field">url</span>": "<span class="value">http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity</span>", + "<span class="field">extension</span>": [{ + "<span class="field">url</span>": "<span class="value">ombCategory</span>", + "<span class="field">valueCoding</span>": { + "<span class="field">system</span>": "<span class="value">urn:oid:<mark class="color26">2.16.840.1.113883.6.238</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color30">2135-2</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color31">Hispanic or Latino</mark></span>" + } + }, { + "<span class="field">url</span>": "<span class="value">text</span>", + "<span class="field">valueString</span>": "<span class="value"><mark class="color31">Hispanic or Latino</mark>, <mark class="color33">Spanish Basque</mark></span>" + }, { + "<span class="field">url</span>": "<span class="value">detailed</span>", + "<span class="field">valueCoding</span>": { + "<span class="field">system</span>": "<span class="value">urn:oid:<mark class="color26">2.16.840.1.113883.6.238</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color32"><mark class="color32">20146-9</mark></mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color33">Spanish Basque</mark></span>" + } + }] + }, { + "<span class="field">url</span>": "<span class="value">http://hl7.org/fhir/us/core/StructureDefinition/us-core-race</span>", + "<span class="field">extension</span>": [{ + "<span class="field">url</span>": "<span class="value">ombCategory</span>", + "<span class="field">valueCoding</span>": { + "<span class="field">system</span>": "<span class="value">urn:oid:<mark class="color26">2.16.840.1.113883.6.238</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color25">2106-3</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color27">White</mark></span>" + } + }, { + "<span class="field">url</span>": "<span class="value">text</span>", + "<span class="field">valueString</span>": "<span class="value"><mark class="color27">White</mark>, <mark class="color29">European</mark></span>" + }, { + "<span class="field">url</span>": "<span class="value">detailed</span>", + "<span class="field">valueCoding</span>": { + "<span class="field">system</span>": "<span class="value">urn:oid:<mark class="color26">2.16.840.1.113883.6.238</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color28">2108-9</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color29">European</mark></span>" + } + }] + }, + { + "<span class="field">url</span>": "<span class="value">http://hl7.org/fhir/StructureDefinition/patient-birthPlace</span>", + "<span class="field">valueAddress</span>": { + "<span class="field">line</span>": ["<mark class="color42">4444 Birth Street</mark>"], + "<span class="field">city</span>": "<span class="value"><mark class="color13">Beaverton</mark></span>", + "<span class="field">state</span>": "<span class="value">OR</span>", + "<span class="field">postalCode</span>": "<span class="value"><mark class="color37">97867</mark></span>" + } + }], + "<span class="field">name</span>": [{ + "<span class="field">text</span>": "<span class="value"><mark class="color16">Myra</mark> <mark class="color17">Jones</mark></span>", + "<span class="field">use</span>": "<span class="value">usual</span>", + "<span class="field">family</span>": "<span class="value"><mark class="color17">Jones</mark></span>", + "<span class="field">given</span>": ["<mark class="color16">Myra</mark>"] + }], + "<span class="field">telecom</span>": [{ + "<span class="field">system</span>": "<span class="value">phone</span>", + "<span class="field">value</span>": "<span class="value"><mark class="color15">+1(565)867-5309</mark></span>", + "<span class="field">use</span>": "<span class="value">mobile</span>" + }], + "<span class="field">gender</span>": "<span class="value"><mark class="color18">female</mark></span>", + "<span class="field">birthDate</span>": "<span class="value"><mark class="color19">1947-05-01</mark></span>", + "<span class="field">deceasedBoolean</span>": <mark class="color20">false</mark>, + "<span class="field">address</span>": [{ + "<span class="field">use</span>": "<span class="value"><mark class="color11">home</mark></span>", + "<span class="field">text</span>": "<span class="value"><mark class="color12">1357 Amber Drive</mark> <mark class="color13">Beaverton</mark> OR <mark class="color14">97006</mark></span>", + "<span class="field">line</span>": ["<mark class="color12">1357 Amber Drive</mark>"], + "<span class="field">city</span>": "<span class="value"><mark class="color13">Beaverton</mark></span>", + "<span class="field">state</span>": "<span class="value">OR</span>", + "<span class="field">postalCode</span>": "<span class="value"><mark class="color14">97006</mark></span>" + }], + "<span class="field">maritalStatus</span>": { + "<span class="field">coding</span>": [{ + "<span class="field">system</span>": "<span class="value">http://terminology.hl7.org/CodeSystem/v3-MaritalStatus</span>", + "<span class="field">code</span>": <mark class="color21">"M"</mark>, + "<span class="field">display</span>": "<span class="value"><mark class="color22">Married</mark></span>" + }] + }, + "<span class="field">contact</span>": [{ + "<span class="field">relationship</span>": [{ + "<span class="field">coding</span>": [{ + "<span class="field">system</span>": "<span class="value">http://terminology.hl7.org/CodeSystem/v3-RoleCode</span>", + "<span class="field">code</span>": "<span class="value">GUARD</span>", + "<span class="field">display</span>": "<span class="value">Guardian</span>" + }] + }, { + "<span class="field">coding</span>": [{ + "<span class="field">system</span>": "<span class="value">http://terminology.hl7.org/CodeSystem/v3-RoleCode</span>", + "<span class="field">code</span>": <mark class="color34">"FTH"</mark>, + "<span class="field">display</span>": "<span class="value"><mark class="color35">father</mark></span>" + }] + }], + "<span class="field">name</span>": { + "<span class="field">family</span>": "<span class="value"><mark class="color41">Betterhalf</mark></span>", + "<span class="field">given</span>": [ + "<mark class="color39">Boris</mark>", + <mark class="color40">"Bo"</mark> + ] + }, + "<span class="field">telecom</span>": [{ + "<span class="field">system</span>": "<span class="value">phone</span>", + "<span class="field">value</span>": "<span class="value"><mark class="color38">+1(555)555-2008</mark></span>", + "<span class="field">use</span>": "<span class="value">mobile</span>" + }], + "<span class="field">address</span>": { + "<span class="field">use</span>": "<span class="value"><mark class="color11">home</mark></span>", + "<span class="field">line</span>": ["<mark class="color36">123 main street</mark>"], + "<span class="field">city</span>": "<span class="value"><mark class="color13">Beaverton</mark></span>", + "<span class="field">state</span>": "<span class="value">OR</span>", + "<span class="field">postalCode</span>": "<span class="value"><mark class="color37">97867</mark></span>" + } + }], + "<span class="field">communication</span>": [{ + "<span class="field">language</span>": { + "<span class="field">coding</span>": [{ + "<span class="field">system</span>": "<span class="value">urn:ietf:bcp:47</span>", + "<span class="field">code</span>": <mark class="color10">"en"</mark>, + "<span class="field">display</span>": "<span class="value">English</span>" + }] + }, + "<span class="field">preferred</span>": <mark class="color15">true</mark>, + "<span class="field">extension</span>": [{ + "<span class="field">url</span>": "<span class="value">http://hl7.org/fhir/StructureDefinition/patient-proficiency</span>", + "<span class="field">extension</span>": [{ + "<span class="field">url</span>": "<span class="value">level</span>", + "<span class="field">valueCoding</span>": { + "<span class="field">system</span>": "<span class="value">http://terminology.hl7.org/CodeSystem/v3-LanguageAbilityProficiency</span>", + "<span class="field">code</span>": <mark class="color13">"G"</mark>, + "<span class="field">display</span>": "<span class="value"><mark class="color14">Good</mark></span>" + } + }, { + "<span class="field">url</span>": "<span class="value">type</span>", + "<span class="field">valueCoding</span>": { + "<span class="field">system</span>": "<span class="value">http://terminology.hl7.org/CodeSystem/v3-LanguageAbilityMode</span>", + "<span class="field">code</span>": <mark class="color11">"ESP"</mark>, + "<span class="field">display</span>": "<span class="value"><mark class="color12">Expressed spoken</mark></span>" + } + }] + }] + }], + "<span class="field">managingOrganization</span>": { + "<span class="field">reference</span>": "<span class="value"><mark class="color16">Organization/PCPartnersTest</mark></span>" + } +}</div> </td></tr></table> #### Links to example content From 07382f181364bc77ed222212c7048e11ae4df5c7 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Thu, 24 Oct 2024 08:18:31 -0500 Subject: [PATCH 089/112] Fix CF Results map; couple other links --- FHIR-us-ccda.xml | 2 +- ...l => ConceptMap-CF-ResultReportStatus.xml} | 13 +- input/pagecontent/CF-encounters.md | 6 +- input/pagecontent/CF-patient.md | 2 +- input/pagecontent/CF-problems.md | 353 +++++++++++++++++- input/pagecontent/CF-results.md | 4 +- 6 files changed, 364 insertions(+), 16 deletions(-) rename input/maps/{ConceptMap-CF-ResultStatus.xml => ConceptMap-CF-ResultReportStatus.xml} (82%) diff --git a/FHIR-us-ccda.xml b/FHIR-us-ccda.xml index 9f00510..d75ce35 100644 --- a/FHIR-us-ccda.xml +++ b/FHIR-us-ccda.xml @@ -37,7 +37,7 @@ <artifact id="ConceptMap/CF-Criticality" key="ConceptMap-CF-Criticality" name="CCDA Criticality to FHIR Criticality"/> <artifact id="ConceptMap/CF-MedActivityMood" key="ConceptMap-CF-MedActivityMood" name="CCDA Medication Activity Mood to FHIR MedicationRequest.intent"/> <artifact id="ConceptMap/CF-ConditionClinicalStatus" key="ConceptMap-CF-ConditionClinicalStatus" name="CCDA Problem Concern Status to FHIR Condition Clinical Status"/> -<artifact id="ConceptMap/CF-ResultStatus" key="ConceptMap-CF-ResultStatus" name="CCDA ResultStatus to FHIR ResultStatus"/> +<artifact id="ConceptMap/CF-ResultReportStatus" key="ConceptMap-CF-ResultReportStatus" name="CCDA ResultStatus to FHIR DiagnosticReport status"/> <artifact id="CapabilityStatement/CcdaOnFhirClient" key="CapabilityStatement-CcdaOnFhirClient" name="CCDA on FHIR Client"/> <artifact id="CapabilityStatement/CcdaOnFhirServer" key="CapabilityStatement-CcdaOnFhirServer" name="CCDA on FHIR Server"/> <artifact id="ConceptMap/CF-AllergyIntoleranceCategory" key="ConceptMap-CF-AllergyIntoleranceCategory" name="CCDA to FHIR Allergy Intolerance Category"/> diff --git a/input/maps/ConceptMap-CF-ResultStatus.xml b/input/maps/ConceptMap-CF-ResultReportStatus.xml similarity index 82% rename from input/maps/ConceptMap-CF-ResultStatus.xml rename to input/maps/ConceptMap-CF-ResultReportStatus.xml index 53b0628..e0928a2 100644 --- a/input/maps/ConceptMap-CF-ResultStatus.xml +++ b/input/maps/ConceptMap-CF-ResultReportStatus.xml @@ -1,16 +1,16 @@ <ConceptMap xmlns="http://hl7.org/fhir" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"> - <id value="CF-ResultStatus"/> + <id value="CF-ResultReportStatus"/> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"> <valueCode value="cgp" /> </extension> - <url value="http://hl7.org/fhir/us/ccda/ConceptMap/CF-ResultStatus"/> + <url value="http://hl7.org/fhir/us/ccda/ConceptMap/CF-ResultReportStatus"/> <version value="4.0.1"/> - <name value="CCDAtoFHIRResultStatus"/> - <title value="CCDA ResultStatus to FHIR ResultStatus"/> + <name value="CCDAtoFHIRResultReportStatus"/> + <title value="CCDA ResultStatus to FHIR DiagnosticReport status"/> <status value="active"/> <experimental value="false"/> <publisher value="HL7 International"/> - <description value="C-CDA ResultStatus to FHIR ResultStatus"/> + <description value="C-CDA Result Status to FHIR DiagnosticReport status"/> <contact> <name value="HL7 International"/> <telecom> @@ -47,6 +47,7 @@ <code value="registered"/> <display value="Registered"/> <equivalence value="inexact"/> + <comment value="Caution: Multiple values map to FHIR inexact."/> </target> </element> <element> @@ -74,6 +75,7 @@ <code value="registered"/> <display value="Registered"/> <equivalence value="inexact"/> + <comment value="Caution: Multiple values map to FHIR inexact."/> </target> </element> <element> @@ -83,6 +85,7 @@ <code value="registered"/> <display value="Registered"/> <equivalence value="inexact"/> + <comment value="Caution: Multiple values map to FHIR inexact."/> </target> </element> </group> diff --git a/input/pagecontent/CF-encounters.md b/input/pagecontent/CF-encounters.md index 2390668..ad7b1d1 100644 --- a/input/pagecontent/CF-encounters.md +++ b/input/pagecontent/CF-encounters.md @@ -15,11 +15,11 @@ Encounter Activities in the Encounters Section (or elsewhere in the document, su |/statusCode <sup>(b)</sup>|.status|[CDA → FHIR encounter status](ConceptMap-CF-EncounterStatus.html)<br/>**Note:** statusCode is optional in C-CDA. If missing, fallback to effectiveTime mapping. |/effectiveTime|.status|If effectiveTime is a single timestamp or contains a high, status = `"finished"`.<br/>If low is present and high is missing, the status may be `"in-progress"` but implementers may choose to evaluate historical values as `"finished"` or `"unknown"` if appropriate. |/effectiveTime/@value<br/>/effectiveTime/low/@value|.period.start|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) -|/effectiveTime/high/@value|.period.end +|/effectiveTime/high/@value|.period.end|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) |/sdtc:dischargeDispositionCode <sup>(b)</sup><br/>/dischargeDispositionCode <sup>(h)</sup>|.hospialization.dischargeDisposition|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) -|/performer <sup>(b)</sup><br/>/encounterParticipant <sup>(h)</sup>|.participant|*TODO: Mapping Guidance for general performers (Participant vs ParticipantRole vs Organization)* +|/performer <sup>(b)</sup><br/>/encounterParticipant <sup>(h)</sup>|.participant|[C-CDA → FHIR Participation](CF-participations.html) |/performer/sdtc:functionCode <sup>(b)</sup>|.participant.type|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) -|/participant[@typeCode="LOC"] <sup>(b)</sup><br/>/location <sup>(h)</sup>|.location +|/participant[@typeCode="LOC"] <sup>(b)</sup><br/>/location <sup>(h)</sup>|.location|[C-CDA → FHIR Participation](CF-participations.html) |**[Indication](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-Indication.html)** <sup>(b)</sup><br/>/entryRelationship[@typeCode="RSON"]/observation|.reasonCode<br/>or<br/>.reasonReference|If the id of the indication references a problem in the document that has been converted to a FHIR resource, populate .reasonReference with a reference to that resource. Otherwise, map observation/value to .reasonCode.<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) |**[Encounter Diagnosis](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-EncounterDiagnosis.html)** <sup>(b)</sup><br/>/entryRelationship/act[code/@code="29308-4"]/observation|**[Encounter Diagnosis](https://hl7.org/fhir/us/core/StructureDefinition-us-core-condition-encounter-diagnosis.html)**<br/>&<br/>.diagnosis.condition|The observation maps identically to [CDA → FHIR Problems](./CF-problems.html).<br/>Since this is an encounter diagnosis, the `Observation.category` should be set to `encounter-diagnosis`. diff --git a/input/pagecontent/CF-patient.md b/input/pagecontent/CF-patient.md index dcf7843..2e58eae 100644 --- a/input/pagecontent/CF-patient.md +++ b/input/pagecontent/CF-patient.md @@ -38,7 +38,7 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea ### Illustrative example -<table><tr><th>CDA Example</th><th>FHIR Resource</th></tr> +<table><tr><th>CDA RecordTarget Example</th><th>FHIR Patient Resource</th></tr> <tr><td> <div id="cda" class="border codeArea"><<span class="field">recordTarget</span>> <<span class="field">patientRole</span>> diff --git a/input/pagecontent/CF-problems.md b/input/pagecontent/CF-problems.md index e72b1ad..c3068d5 100644 --- a/input/pagecontent/CF-problems.md +++ b/input/pagecontent/CF-problems.md @@ -34,13 +34,358 @@ Note that C-CDA includes a Concern wrapper act from which status may be read; mo When authors or other provenance are recorded in the parent [Problem Concern Act](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ProblemConcernAct.html), it is recommended that those data be mapped to the FHIR Condition. -### Illustrative example +### Illustrative examples -<table><tr><th>CDA Example</th><th>FHIR Resource</th></tr> +<table><tr><th>CDA Problem Example</th><th>FHIR Condition Resource</th></tr> <tr><td> -... +<div id="cda" class="border codeArea"><<span class="field">act</span> <span class="attrib">classCode=</span><span class="value">"ACT"</span> <span class="attrib">moodCode=</span><span class="value">"EVN"</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.3"</span> + <span class="attrib">extension=</span><span class="value">"2015-08-01"</span> /> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.3"</span> /> + <<span class="field">id</span> <span class="attrib">extension=</span><span class="value">"<mark class="color10">545069300001</mark>"</span> <span class="attrib">root=</span><span class="value">"1.3.6.1.4.1.22812.3.2009316.3.4.1"</span> /> + <<span class="field">code</span> <span class="attrib">code=</span><span class="value">"CONC"</span> <span class="attrib">codeSystem=</span><span class="value">"2.16.840.1.113883.5.6"</span> /> + <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"active"</span> /> + <<span class="field">effectiveTime</span> > + <<span class="field">low</span> <span class="attrib">value=</span><span class="value">"<mark class="color11">20120806</mark>"</span> /> + </<span class="field">effectiveTime</span>> + <<span class="field">entryRelationship</span> <span class="attrib">typeCode=</span><span class="value">"SUBJ"</span>> + <<span class="field">observation</span> <span class="attrib">classCode=</span><span class="value">"OBS"</span> <span class="attrib">moodCode=</span><span class="value">"EVN"</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.4"</span> + <span class="attrib">extension=</span><span class="value">"2015-08-01"</span> /> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.4"</span> /> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"<mark class="color12">1.3.6.1.4.1.22812.3.2009316.3.4.1.2.1</mark>"</span> + <span class="attrib">extension=</span><span class="value">"<mark class="color10">545069300001</mark>"</span>/> + <<span class="field">code</span> <span class="attrib">code=</span><span class="value">"55607006"</span> <span class="attrib">codeSystem=</span><span class="value">"2.16.840.1.113883.6.96"</span>> + <<span class="field">translation</span> <span class="attrib">nullFlavor=</span><span class="value">"NI"</span> /> + </<span class="field">code</span>> + <<span class="field">text</span>> + <<span class="field">reference</span> <span class="attrib">value=</span><span class="value">"#_5011447a-e27f-471d-9e1f-541148c5282f"</span> /> + </<span class="field">text</span>> + <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"completed"</span> /> + <<span class="field">effectiveTime</span> > + <<span class="field">low</span> <span class="attrib">value=</span><span class="value">"<mark class="color11">20120806</mark>"</span> /> + </<span class="field">effectiveTime</span>> + <<span class="field">value</span> <span class="attrib">xsi:type=</span><span class="value">"CD"</span> + <span class="attrib">code=</span><span class="value">"<mark class="color14">233604007</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color13">2.16.840.1.113883.6.96</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color15">Pneumonia</mark>"</span>> + <<span class="field">translation</span> <span class="attrib">code=</span><mark class="color16"><span class="value">"486"</span></mark> <span class="attrib">codeSystem=</span><span class="value">"<mark class="color17">2.16.840.1.113883.6.103</mark>"</span> /> + <<span class="field">translation</span> <span class="attrib">code=</span><span class="value">"<mark class="color18">J18.9</mark>"</span> <span class="attrib">codeSystem=</span><span class="value">"<mark class="color19">2.16.840.1.113883.6.90</mark>"</span> /> + <<span class="field">translation</span> <span class="attrib">code=</span><span class="value">"<mark class="color20">87580</mark>"</span> <span class="attrib">codeSystem=</span><span class="value">"<mark class="color21">2.16.840.1.113883.3.247.1.1</mark>"</span> /> + </<span class="field">value</span>> + <span class="comment"><!-- Becomes recorder with reference: <mark class="color26">Practitioner/ProblemAuthor</mark> --></span> + <<span class="field">author</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.119"</span>/> + <<span class="field">time</span> <span class="attrib">value=</span><span class="value">"<mark class="color22">20140104</mark>"</span>/> + <<span class="field">assignedAuthor</span>> + <<span class="field">id</span> <span class="attrib">extension=</span><span class="value">"99999999"</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.4.6"</span>/> + <<span class="field">telecom</span> <span class="attrib">use=</span><span class="value">"WP"</span> <span class="attrib">value=</span><span class="value">"tel:555-555-1002"</span>/> + <<span class="field">assignedPerson</span>> + <<span class="field">name</span>> + <<span class="field">given</span>>Henry</<span class="field">given</span>> + <<span class="field">family</span>>SevenObs</<span class="field">family</span>> + </<span class="field">name</span>> + </<span class="field">assignedPerson</span>> + </<span class="field">assignedAuthor</span>> + </<span class="field">author</span>> + <<span class="field">entryRelationship</span> <span class="attrib">typeCode=</span><span class="value">"REFR"</span>> + <<span class="field">observation</span> <span class="attrib">classCode=</span><span class="value">"OBS"</span> <span class="attrib">moodCode=</span><span class="value">"EVN"</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.6"</span> + <span class="attrib">extension=</span><span class="value">"2019-06-20"</span> /> + <<span class="field">code</span> <span class="attrib">code=</span><span class="value">"33999-4"</span> <span class="attrib">codeSystem=</span><span class="value">"2.16.840.1.113883.6.1"</span> /> + <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"completed"</span> /> + <<span class="field">value</span> <span class="attrib">xsi:type=</span><span class="value">"CD"</span> + <span class="attrib">code=</span><span class="value">"<mark class="color23">246455001</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color13">2.16.840.1.113883.6.96</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color23">Recurrence</mark>"</span> /> + </<span class="field">observation</span>> + </<span class="field">entryRelationship</span>> + <<span class="field">entryRelationship</span> <span class="attrib">typeCode=</span><span class="value">"SUBJ"</span> <span class="attrib">inversionInd=</span><span class="value">"true"</span>> + <<span class="field">observation</span> <span class="attrib">classCode=</span><span class="value">"OBS"</span> <span class="attrib">moodCode=</span><span class="value">"EVN"</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.31"</span> /> + <span class="comment"><!-- Age observation --></span> + <<span class="field">code</span> <span class="attrib">code=</span><span class="value">"445518008"</span> + <span class="attrib">codeSystem=</span><span class="value">"2.16.840.1.113883.6.96"</span> + <span class="attrib">displayName=</span><span class="value">"Age At Onset"</span> /> + <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"completed"</span> /> + <<span class="field">value</span> <span class="attrib">xsi:type=</span><span class="value">"PQ"</span> <span class="attrib">value=</span><mark class="color24"><span class="value">"65"</span></mark> unit=<mark class="color25"><span class="value">"a"</span></mark> /> + </<span class="field">observation</span>> + </<span class="field">entryRelationship</span>> + </<span class="field">observation</span>> + </<span class="field">entryRelationship</span>> +</<span class="field">act</span>></div> </td><td> -... +<div id="fhir" class="border codeArea">{ + "<span class="field">resourceType</span>": "<span class="value">Condition</span>", + "<span class="field">id</span>": "<span class="value">6581e92f2d59f701ecc0f914</span>", + "<span class="field">identifier</span>": [{ + "<span class="field">system</span>": "<span class="value">urn:oid:<mark class="color12">1.3.6.1.4.1.22812.3.2009316.3.4.1.2.1</mark></span>", + "<span class="field">value</span>": "<span class="value"><mark class="color10">545069300001</mark></span>" + }], + "<span class="field">clinicalStatus</span>": { + "<span class="field">coding</span>": [{ + "<span class="field">system</span>": "<span class="value">http://terminology.hl7.org/CodeSystem/condition-clinical</span>", + "<span class="field">code</span>": "<span class="value"><mark class="color23">recurrence</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color23">recurrence</mark></span>" + }] + }, + "<span class="field">category</span>": [{ + "<span class="field">coding</span>": [{ + "<span class="field">system</span>": "<span class="value">http://terminology.hl7.org/CodeSystem/condition-category</span>", + "<span class="field">code</span>": "<span class="value">problem-list-item</span>", + "<span class="field">display</span>": "<span class="value">Problem List Item</span>" + }] + }], + "<span class="field">code</span>": { + "<span class="field">coding</span>": [ + { + "<span class="field">system</span>": "<span class="value"><mark class="color13">http://snomed.info/sct</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color14">233604007</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color15">Pneumonia</mark></span>" + }, + { + "<span class="field">system</span>": "<span class="value"><mark class="color17">http://hl7.org/fhir/sid/icd-9-cm</mark></span>", + "<span class="field">code</span>": <mark class="color16">"486"</mark>, + "<span class="field">display</span>": "<span class="value"><mark class="color15">Pneumonia</mark>, organism unspecified</span>" + }, + { + "<span class="field">system</span>": "<span class="value"><mark class="color19">http://hl7.org/fhir/sid/icd-10-cm</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color18">J18.9</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color15">Pneumonia</mark>, unspecified organism</span>" + }, + { + "<span class="field">system</span>": "<span class="value">urn:oid:<mark class="color21">2.16.840.1.113883.3.247.1.1</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color20">87580</mark></span>" + } + ], + "<span class="field">text</span>": "<span class="value"><mark class="color15">Pneumonia</mark></span>" + }, + "<span class="field">subject</span>": { + "<span class="field">reference</span>": "<span class="value">Patient/6581e92eb6ff5dadc088eae5</span>", + "<span class="field">display</span>": "<span class="value">Myra Jones</span>" + }, + "<span class="field">onsetDate</span>": "<span class="value"><mark class="color11">2012-08-06</mark></span>", + <span class="comment">/* Note only one of onsetDate or onsetAge is allowed */ + </span>"<span class="field">onsetAge</span>": { + "<span class="field">value</span>": <mark class="color24">65,</mark> + "<span class="field">unit</span>": "<span class="value">year</span>", + "<span class="field">code</span>": <mark class="color25">"a"</mark>, + "<span class="field">system</span>": "<span class="value">http://unitsofmeasure.org</span>" + }, + "<span class="field">recordedDate</span>": "<span class="value"><mark class="color22">2014-01-04</mark></span>", + "<span class="field">recorder</span>": { + "<span class="field">reference</span>": "<span class="value"><mark class="color26">Practitioner/ProblemAuthor</mark></span>" + } +}</div> +</td></tr></table> + +### Example: SDOH Problem + +<table> +<tr><th>CDA SDOH Problem</th><th>FHIR Condition Resource</th></tr> +<tr><td> +<div id="cda" class="border codeArea"><<span class="field">act</span> <span class="attrib">classCode=</span><span class="value">"ACT"</span> <span class="attrib">moodCode=</span><span class="value">"EVN"</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.3"</span> <span class="attrib">extension=</span><span class="value">"2015-08-01"</span> /> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.3"</span> /> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"b46f0fc0-986f-11ee-b9d1-0242ac120002"</span>/> + <<span class="field">code</span> <span class="attrib">code=</span><span class="value">"CONC"</span> <span class="attrib">codeSystem=</span><span class="value">"2.16.840.1.113883.5.6"</span>/> + <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"<mark class="color10">active</mark>"</span>/> + <<span class="field">effectiveTime</span>> + <<span class="field">low</span> <span class="attrib">value=</span><span class="value">"20130101"</span>/> + </<span class="field">effectiveTime</span>> + <<span class="field">entryRelationship</span> <span class="attrib">typeCode=</span><span class="value">"SUBJ"</span>> + <span class="comment"><!-- SDOH Problem --></span> + <<span class="field">observation</span> <span class="attrib">classCode=</span><span class="value">"OBS"</span> <span class="attrib">moodCode=</span><span class="value">"EVN"</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.4"</span>/> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.4"</span> <span class="attrib">extension=</span><span class="value">"2015-08-01"</span>/> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.4"</span> <span class="attrib">extension=</span><span class="value">"2022-06-01"</span>/> + <<span class="field">id</span> <span class="attrib">extension=</span><span class="value">"<mark class="color11">68993</mark>"</span> <span class="attrib">root=</span><span class="value">"<mark class="color12">1.2.840.114350.1.13.6289.1.7.2.768076</mark>"</span>/> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"093A5380-00CE-11E6-B4C5-0050568B000B"</span> <span class="attrib">extension=</span><span class="value">"1.1"</span>/> + <<span class="field">code</span> <span class="attrib">code=</span><span class="value">"55607006"</span> <span class="attrib">codeSystem=</span><span class="value">"2.16.840.1.113883.6.96"</span> + <span class="attrib">codeSystemName=</span><span class="value">"SNOMED CT"</span> <span class="attrib">displayName=</span><span class="value">"Problem"</span>> + <<span class="field">originalText</span>>Problem</<span class="field">originalText</span>> + <<span class="field">translation</span> <span class="attrib">code=</span><span class="value">"75326-9"</span> <span class="attrib">codeSystem=</span><span class="value">"2.16.840.1.113883.6.1"</span> + <span class="attrib">codeSystemName=</span><span class="value">"LOINC"</span> <span class="attrib">displayName=</span><span class="value">"Problem"</span>/> + </<span class="field">code</span>> + <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"completed"</span>/> + <<span class="field">effectiveTime</span>> + <<span class="field">low</span> <span class="attrib">value=</span><span class="value">"<mark class="color15">20100909</mark>"</span>/> + </<span class="field">effectiveTime</span>> + <<span class="field">value</span> <span class="attrib">xsi:type=</span><span class="value">"CD"</span> + <span class="attrib">code=</span><span class="value">"<mark class="color16">445281000124101</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color17">Nutrition impaired due to limited access to healthful foods</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color13">2.16.840.1.113883.6.96</mark>"</span> + <span class="attrib">codeSystemName=</span><span class="value">"<mark class="color13"><mark class="color13">SNOMED</mark> CT</mark>"</span>> + <<span class="field">translation</span> <span class="attrib">code=</span><span class="value">"<mark class="color18">Z59.48</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color19">2.16.840.1.113883.6.90</mark>"</span> + <span class="attrib">codeSystemName=</span><span class="value">"<mark class="color19">ICD-10-CM</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color20">Other specified lack of adequate food</mark>"</span>/> + </<span class="field">value</span>> + <span class="comment"><!-- Assessment Scale Observation --></span> + <span class="comment"><!-- Creates observation referenced by evidence.detail --></span> + <span class="comment"><!-- This one: <mark class="color29">#sdoh1</mark> --></span> + <<span class="field">entryRelationship</span> <span class="attrib">typeCode=</span><span class="value">"SPRT"</span>> + <<span class="field">observation</span> <span class="attrib">classCode=</span><span class="value">"OBS"</span> <span class="attrib">moodCode=</span><span class="value">"EVN"</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.69"</span>/> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.69"</span> + <span class="attrib">extension=</span><span class="value">"2022-06-01"</span>/> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"f4dce790-8328-11db-9fe1-0800200c9a44"</span>/> + <<span class="field">code</span> <span class="attrib">code=</span><span class="value">"<mark class="color21">88122-7</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"(I/We) worried whether (my/our) food would run out..."</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color14">2.16.840.1.113883.6.1</mark>"</span> + <span class="attrib">codeSystemName=</span><span class="value">"<mark class="color14">LOINC</mark>"</span>/> + <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"completed"</span>/> + <<span class="field">effectiveTime</span> <span class="attrib">value=</span><span class="value">"<mark class="color15">20100909</mark>"</span>/> + <<span class="field">value</span> <span class="attrib">xsi:type=</span><span class="value">"CD"</span> + <span class="attrib">code=</span><span class="value">"<mark class="color22">LA28397-0</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color23">Often true</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color14">2.16.840.1.113883.6.1</mark>"</span>> + <span class="comment"><!-- For review .... this doesn't look right --></span> + <<span class="field">translation</span> <span class="attrib">code=</span><span class="value">"1"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color14">2.16.840.1.113883.6.1</mark>"</span> + <span class="attrib">codeSystemName=</span><span class="value">"<mark class="color14">LOINC</mark>"</span>/> + </<span class="field">value</span>> + </<span class="field">observation</span>> + </<span class="field">entryRelationship</span>> + <span class="comment"><!-- Creates observation referenced by evidence.detail --></span> + <span class="comment"><!-- This one: <mark class="color30">#sdoh2</mark> --></span> + <<span class="field">entryRelationship</span> <span class="attrib">typeCode=</span><span class="value">"SPRT"</span>> + <<span class="field">observation</span> <span class="attrib">classCode=</span><span class="value">"OBS"</span> <span class="attrib">moodCode=</span><span class="value">"EVN"</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.69"</span>/> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.69"</span> + <span class="attrib">extension=</span><span class="value">"2022-06-01"</span>/> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"0e9c5b7c-9def-11ee-8c90-0242ac120002"</span>/> + <<span class="field">code</span> <span class="attrib">code=</span><span class="value">"<mark class="color24">88124-3</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color25">Food insecurity risk [HVS]</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color14">2.16.840.1.113883.6.1</mark>"</span> + <span class="attrib">codeSystemName=</span><span class="value">"<mark class="color14">LOINC</mark>"</span>/> + <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"completed"</span>/> + <<span class="field">effectiveTime</span> <span class="attrib">value=</span><span class="value">"<mark class="color15">20100909</mark>"</span>/> + <<span class="field">value</span> <span class="attrib">xsi:type=</span><span class="value">"CD"</span> + <span class="attrib">code=</span><span class="value">"<mark class="color26">LA19952-3</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color27">At risk</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color14">2.16.840.1.113883.6.1</mark>"</span>/> + </<span class="field">observation</span>> + </<span class="field">entryRelationship</span>> + <span class="comment"><!-- Date of Diagnosis Act --></span> + <<span class="field">entryRelationship</span> <span class="attrib">typeCode=</span><span class="value">"COMP"</span>> + <<span class="field">act</span> <span class="attrib">classCode=</span><span class="value">"ACT"</span> <span class="attrib">moodCode=</span><span class="value">"EVN"</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.502"</span> + <span class="attrib">extension=</span><span class="value">"2022-06-01"</span>/> + <<span class="field">code</span> <span class="attrib">code=</span><span class="value">"77975-1"</span> + <span class="attrib">codeSystem=</span><span class="value">"2.16.840.1.113883.6.1"</span> + <span class="attrib">codeSystemName=</span><span class="value">"LOINC"</span> + <span class="attrib">displayName=</span><span class="value">"Earliest date of diagnosis"</span>/> + <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"completed"</span>/> + <span class="comment"><!-- SHALL to the year (MAY be more specific) --></span> + <<span class="field">effectiveTime</span> <span class="attrib">value=</span><span class="value">"<mark class="color28">20100101</mark>"</span>/> + </<span class="field">act</span>> + </<span class="field">entryRelationship</span>> + </<span class="field">observation</span>> + </<span class="field">entryRelationship</span>> +</<span class="field">act</span>></div> +</td><td> +<div id="fhir" class="border codeArea">{ + "<span class="field">resourceType</span>": "<span class="value">Condition</span>", + "<span class="field">language</span>": "<span class="value">en-US</span>", + "<span class="field">identifier</span>": [{ + "<span class="field">system</span>": "<span class="value">urn:oid:<mark class="color12">1.2.840.114350.1.13.6289.1.7.2.768076</mark></span>", + "<span class="field">value</span>": "<span class="value"><mark class="color11">68993</mark></span>" + }], + "<span class="field">clinicalStatus</span>": { + "<span class="field">coding</span>": [{ + "<span class="field">system</span>": "<span class="value">http://terminology.hl7.org/CodeSystem/condition-clinical</span>", + "<span class="field">code</span>": "<span class="value"><mark class="color10">active</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color10">active</mark></span>" + }] + }, + "<span class="field">category</span>": [{ + "<span class="field">coding</span>": [{ + "<span class="field">system</span>": "<span class="value">http://terminology.hl7.org/CodeSystem/condition-category</span>", + "<span class="field">code</span>": "<span class="value">problem-list-item</span>", + "<span class="field">display</span>": "<span class="value">Problem List Item</span>" + }] + }], + "<span class="field">code</span>": { + "<span class="field">coding</span>": [{ + "<span class="field">system</span>": "<span class="value"><mark class="color13">http://snomed.info/sct</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color16">445281000124101</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color17">Nutrition impaired due to limited access to healthful foods</mark></span>" + }, + { + "<span class="field">system</span>": "<span class="value"><mark class="color19">http://hl7.org/fhir/sid/icd-10-cm</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color18">Z59.48</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color20">Other specified lack of adequate food</mark></span>" + } + ]}, + "<span class="field">subject</span>": { + "<span class="field">reference</span>": "<span class="value">Patient/6581e92eb6ff5dadc088eae5</span>" + }, + "<span class="field">onsetDateTime</span>": "<span class="value"><mark class="color15">2010-09-09</mark></span>", + "<span class="field">extension</span>": [{ + "<span class="field">url</span>": "<span class="value">http://hl7.org/fhir/StructureDefinition/condition-assertedDate</span>", + "<span class="field">valueDateTime</span>": "<span class="value"><mark class="color28">2010-01-01</mark></span>" + }], + "<span class="field">evidence</span>": [{ + "<span class="field">detail</span>": [{ + "<span class="field">reference</span>": "<span class="value"><mark class="color29">#sdoh1</mark></span>" + }, { + "<span class="field">reference</span>": "<span class="value"><mark class="color30">#sdoh2</mark></span>" + }] + }], + "<span class="field">contained</span>": [{ + "<span class="field">resourceType</span>": "<span class="value">Observation</span>", + "<span class="field">id</span>": "<span class="value">sdoh1</span>", + "<span class="field">status</span>": "<span class="value">final</span>", + "<span class="field">category</span>": [{ + "<span class="field">coding</span>": [{ + "<span class="field">code</span>": "<span class="value">survey</span>", + "<span class="field">system</span>": "<span class="value">http://terminology.hl7.org/CodeSystem/observation-category</span>" + }] + }], + "<span class="field">code</span>": { + "<span class="field">coding</span>": [{ + "<span class="field">value</span>": "<span class="value"><mark class="color21">88122-7</mark></span>", + "<span class="field">system</span>": "<span class="value"><mark class="color14">http://loinc.org</mark></span>" + }] + }, + "<span class="field">subject</span>": { "reference": "<span class="value">Patient/6581e92eb6ff5dadc088eae5</span>" }, + "<span class="field">effectiveDateTime</span>": "<span class="value"><mark class="color15">2010-09-09</mark></span>", + "<span class="field">valueCodeableConcept</span>": { + "<span class="field">coding</span>": [{ + "<span class="field">code</span>": "<span class="value"><mark class="color22">LA28397-0</mark></span>", + "<span class="field">system</span>": "<span class="value"><mark class="color14">http://loinc.org</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color23">Often true</mark></span>" + }] + } + }, { + "<span class="field">resourceType</span>": "<span class="value">Observation</span>", + "<span class="field">id</span>": "<span class="value">sdoh2</span>", + "<span class="field">status</span>": "<span class="value">final</span>", + "<span class="field">category</span>": [{ + "<span class="field">coding</span>": [{ + "<span class="field">code</span>": "<span class="value">survey</span>", + "<span class="field">system</span>": "<span class="value">http://terminology.hl7.org/CodeSystem/observation-category</span>" + }] + }], + "<span class="field">code</span>": { + "<span class="field">coding</span>": [{ + "<span class="field">value</span>": "<span class="value"><mark class="color24">88124-3</mark></span>", + "<span class="field">system</span>": "<span class="value"><mark class="color14">http://loinc.org</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color25">Food insecurity risk [HVS]</mark></span>" + }] + }, + "<span class="field">subject</span>": { "reference": "<span class="value">Patient/6581e92eb6ff5dadc088eae5</span>" }, + "<span class="field">effectiveDateTime</span>": "<span class="value"><mark class="color15">2010-09-09</mark></span>", + "<span class="field">valueCodeableConcept</span>": { + "<span class="field">coding</span>": [{ + "<span class="field">code</span>": "<span class="value"><mark class="color26">LA19952-3</mark></span>", + "<span class="field">system</span>": "<span class="value"><mark class="color14">http://loinc.org</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color27">At risk</mark></span>" + }] + } + }] +}</div> </td></tr></table> #### Links to example content diff --git a/input/pagecontent/CF-results.md b/input/pagecontent/CF-results.md index ccbb37b..c0d2565 100644 --- a/input/pagecontent/CF-results.md +++ b/input/pagecontent/CF-results.md @@ -12,7 +12,7 @@ Observation values are generic - they can be of any CDA type in CDA, and *almost |:----|:----|:----| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| |/code|.code<br/>&<br/>.category|Map to code using [CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept).<br/>Category (and target FHIR Profile) may be identified by looking up a LOINC code's CLASSTYPE (see process in next table).<br/>Alternatively, an extension for `<sdtc:category>` is being developed for CDA Organizer which, if present, will map directly to this field. -|/statusCode|.status|[CDA Result Status → FHIR Result Status](./ConceptMap-CF-ResultStatus.html) +|/statusCode|.status|[CDA Result Status → FHIR Result Report Status](./ConceptMap-CF-ResultReportStatus.html) |/effectiveTime|.effectiveDateTime<br/>or<br/>.effectivePeriod|If low and high are identical, use effectiveDateTime. If organizer/effectiveTime is missing, use the earliest and latest observation/effectiveTime as the source of the mapping.<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) |/specimen|.specimen|[See below](#c-cda-specimen-to-fhir-specimen) |/author|**[Provenance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-provenance.html)**|[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| @@ -26,7 +26,7 @@ Observation values are generic - they can be of any CDA type in CDA, and *almost |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| ||.category|If the code is LOINC, the category can be inferred from the LOINC code CLASSTYPE. Query a FHIR server via `{endpoint}CodeSystem/$lookup?system=http://loinc.org&code={code}&&property=CLASSTYPE` and set the category according to the CLASSTYPE property:<br/>1=Laboratory class (laboratory); 2=Clinical class (clinical-test); 3=Claims attachments (not mapped); 4=Surveys (survey) |/code |.code|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| -|/statusCode|.status|/statusCode|.status|[CDA Result Status → FHIR Result Status](./ConceptMap-CF-ResultStatus.html) +|/statusCode|.status|*TODO: Observation Status Map* |/effectiveTime|.effectiveDateTime<br/>or<br/>.effectivePeriod|Prefer effectiveDateTime<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) |/value[xsi:type=PQ]|.valueQuantity|[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity) |/value[xsi:type=IVL_PQ]|.valueQuantity<br/>or<br/>.valueRange|[Ranges of Physical Quantities](mappingGuidance.html#ranges-of-physical-quantities) From 763fee8e5fb8feb754821d239532f7518b0924cd Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Thu, 24 Oct 2024 08:25:20 -0500 Subject: [PATCH 090/112] Split severity to make table readable --- input/pagecontent/CF-allergies.md | 2 +- 1 file changed, 1 insertion(+), 1 deletion(-) diff --git a/input/pagecontent/CF-allergies.md b/input/pagecontent/CF-allergies.md index ab0d732..e7e0f15 100644 --- a/input/pagecontent/CF-allergies.md +++ b/input/pagecontent/CF-allergies.md @@ -21,7 +21,7 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea |/participant/participantRole/playingEntity/code<br/>&<br/>/value|.code|**Constraint:** When CDA negation is true and nullFlavor is used in playingEntity/code<br/>[CDA No known allergy → FHIR code](ConceptMap-CF-NoKnownAllergies.html)<br/> When negation is true and playingEntity/code is populated, use equivalent negated concept (e.g. map latex substance to no known latex allergy [1003774007, SNOMED CT]) if available. If not, use the [substanceExposureRisk extension](https://hl7.org/fhir/extensions/StructureDefinition-allergyintolerance-substanceExposureRisk.html), placing the substance in the substance sub-extension and setting the exposureRisk sub-extension to `no-known-reaction-risk`. Note that when using this extension, the AllergyIntolerance resource will not be a conformant US Core AllergyIntolerance since the extension prohibits the required .code element.| |**[Status](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-AllergyStatusObservation.html)**<br/>/entryRelationship/observation[code/@code="33999-4"]/value³|.clinicalStatus|[CDA Allergy Status Observation value → FHIR clinicalStatus](./ConceptMap-CF-AllergyStatus.html) |**[Reaction](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ReactionObservation.html)**<br/>/entryRelationship[@typeCode="MFST"]/observation/value³|.reaction.manifestation|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>Both use SNOMED clinical findings with minor valueSet definition differences -|**[Severity](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-SeverityObservation.html)** (nested inside Reaction)<br/>/entryRelationship[@typeCode="MFST"]/observation/entryRelationship/observation[code/@code="SEV"]/value³|.reaction.severity|[CDA Severity value → FHIR Severity](./ConceptMap-CF-Severity.html)<br/>**Note:** CDA documents should not assign severity at the Allergy level.<br/><br/>In cases where CDA assigns severity only to the Allergy rather than the reaction, map the severity to FHIR reaction severity, even if there are more than one. This means assuming that the same severity applies to all child reactions.<br/><br/>If severity is assigned at both levels, the reaction level should be used. +|**[Severity](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-SeverityObservation.html)** (nested inside Reaction)<br/>/entryRelationship[@typeCode="MFST"]/observation/...<br/>   ...entryRelationship/observation[code/@code="SEV"]/value³|.reaction.severity|[CDA Severity value → FHIR Severity](./ConceptMap-CF-Severity.html)<br/>**Note:** CDA documents should not assign severity at the Allergy level.<br/><br/>In cases where CDA assigns severity only to the Allergy rather than the reaction, map the severity to FHIR reaction severity, even if there are more than one. This means assuming that the same severity applies to all child reactions.<br/><br/>If severity is assigned at both levels, the reaction level should be used. |**[Criticality](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-CriticalityObservation.html)**<br/>/entryRelationship/observation[code/@code="82606-5"]/value³|.criticality|[CDA Criticality value → FHIR Criticality](./ConceptMap-CF-Criticality.html) |**[Comment Activity](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text³|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|| From 1c9b2b7f9a7c6f84fed88b31b0b90cfdae2fd249 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Thu, 24 Oct 2024 08:59:27 -0500 Subject: [PATCH 091/112] Fix comment on result status map --- input/maps/ConceptMap-CF-ResultReportStatus.xml | 6 +++--- 1 file changed, 3 insertions(+), 3 deletions(-) diff --git a/input/maps/ConceptMap-CF-ResultReportStatus.xml b/input/maps/ConceptMap-CF-ResultReportStatus.xml index e0928a2..bc24780 100644 --- a/input/maps/ConceptMap-CF-ResultReportStatus.xml +++ b/input/maps/ConceptMap-CF-ResultReportStatus.xml @@ -47,7 +47,7 @@ <code value="registered"/> <display value="Registered"/> <equivalence value="inexact"/> - <comment value="Caution: Multiple values map to FHIR inexact."/> + <comment value="Caution: Multiple values map to the FHIR concept of regeistered."/> </target> </element> <element> @@ -75,7 +75,7 @@ <code value="registered"/> <display value="Registered"/> <equivalence value="inexact"/> - <comment value="Caution: Multiple values map to FHIR inexact."/> + <comment value="Caution: Multiple values map to the FHIR concept of regeistered."/> </target> </element> <element> @@ -85,7 +85,7 @@ <code value="registered"/> <display value="Registered"/> <equivalence value="inexact"/> - <comment value="Caution: Multiple values map to FHIR inexact."/> + <comment value="Caution: Multiple values map to the FHIR concept of regeistered."/> </target> </element> </group> From 81b047020ae45de314f9fe88c44bf882f43122a0 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Thu, 24 Oct 2024 11:04:58 -0500 Subject: [PATCH 092/112] Add note about contained --- input/pagecontent/CF-medications.md | 4 +++- 1 file changed, 3 insertions(+), 1 deletion(-) diff --git a/input/pagecontent/CF-medications.md b/input/pagecontent/CF-medications.md index 10ead60..2e1295a 100644 --- a/input/pagecontent/CF-medications.md +++ b/input/pagecontent/CF-medications.md @@ -68,7 +68,7 @@ MedicationRequest (and other resources) may represent the medication as a simple ### Illustrative example -<table><tr><th>CDA Example</th><th>FHIR Resource</th></tr> +<table><tr><th>CDA Medication Example</th><th>FHIR MedicationRequest and Medication Resources</th></tr> <tr><td> <div id="cda" class="border codeArea"><<span class="field">substanceAdministration</span> <span class="attrib">classCode=</span><span class="value">"SBADM"</span> <span class="attrib">moodCode=</span><span class="value">"INT"</span>> <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.16"</span> <span class="attrib">extension=</span><span class="value">"2014-06-09"</span>/> @@ -232,6 +232,8 @@ MedicationRequest (and other resources) may represent the medication as a simple </<span class="field">precondition</span>> </<span class="field">substanceAdministration</span>></div> </td><td> +<b>Note:</b> The following shows a MedicationRequest resource with a Medication resource embedded in its contained property. This was done for ease of creating a single, visual, highlighted example, but implementers may choose to create separate, external resources according to their own policy. + <div id="fhir" class="border codeArea">{ "<span class="field">resourceType</span>": "<span class="value">MedicationRequest</span>", "<span class="field">id</span>": "<span class="value">7fc60296-0667-4a44-86e5-4c432403532e</span>", From 80db5253f5128de4ce83abf6379d115c026b0ecf Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Thu, 24 Oct 2024 11:05:08 -0500 Subject: [PATCH 093/112] Remove "1" LOINC --- input/pagecontent/CF-problems.md | 4 ---- 1 file changed, 4 deletions(-) diff --git a/input/pagecontent/CF-problems.md b/input/pagecontent/CF-problems.md index c3068d5..37ac6b9 100644 --- a/input/pagecontent/CF-problems.md +++ b/input/pagecontent/CF-problems.md @@ -240,10 +240,6 @@ When authors or other provenance are recorded in the parent [Problem Concern Act <span class="attrib">code=</span><span class="value">"<mark class="color22">LA28397-0</mark>"</span> <span class="attrib">displayName=</span><span class="value">"<mark class="color23">Often true</mark>"</span> <span class="attrib">codeSystem=</span><span class="value">"<mark class="color14">2.16.840.1.113883.6.1</mark>"</span>> - <span class="comment"><!-- For review .... this doesn't look right --></span> - <<span class="field">translation</span> <span class="attrib">code=</span><span class="value">"1"</span> - <span class="attrib">codeSystem=</span><span class="value">"<mark class="color14">2.16.840.1.113883.6.1</mark>"</span> - <span class="attrib">codeSystemName=</span><span class="value">"<mark class="color14">LOINC</mark>"</span>/> </<span class="field">value</span>> </<span class="field">observation</span>> </<span class="field">entryRelationship</span>> From 223e8c3854f51e85fa4335cb8da1dc78a3dc6073 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Thu, 24 Oct 2024 11:17:55 -0500 Subject: [PATCH 094/112] Renamed "Illustrative example" --- input/pagecontent/CF-allergies.md | 2 +- input/pagecontent/CF-immunizations.md | 2 +- input/pagecontent/CF-medications.md | 2 +- input/pagecontent/CF-notes.md | 2 +- input/pagecontent/CF-patient.md | 2 +- input/pagecontent/CF-problems.md | 2 +- input/pagecontent/CF-procedures.md | 2 +- input/pagecontent/CF-results.md | 7 +++++-- input/pagecontent/CF-social.md | 2 +- input/pagecontent/CF-vitals.md | 7 +++++-- 10 files changed, 18 insertions(+), 12 deletions(-) diff --git a/input/pagecontent/CF-allergies.md b/input/pagecontent/CF-allergies.md index e7e0f15..562763f 100644 --- a/input/pagecontent/CF-allergies.md +++ b/input/pagecontent/CF-allergies.md @@ -34,7 +34,7 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea When authors or other provenance are recorded in the parentƒ [Allergy Concern Act](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-AllergyConcernAct.html), it is recommended that those data be mapped to the FHIR AllergyIntolerance. -### Illustrative example +### Example <table><tr><th>CDA Allergy Act</th><th>FHIR AllergyIntolerance Resource</th></tr> <tr><td> diff --git a/input/pagecontent/CF-immunizations.md b/input/pagecontent/CF-immunizations.md index 71fe503..b82d3b4 100644 --- a/input/pagecontent/CF-immunizations.md +++ b/input/pagecontent/CF-immunizations.md @@ -34,7 +34,7 @@ Mapping is from `@moodCode="EVN"` (i.e. historical) immunizations, not `INT` (fu 1\. XPath abbrievated for C-CDA Immunization Activity as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="11369-6"]/entry/substanceAdministration<br/> 2\. Both indication and refusal reason are observations related by @typeCode="RSON". Typically templateIds should not be used to identify content, but the Indication template does not require a specific code. If the observation/code comes from ValueSet [No Immunization Reason](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.1.11.19717/expansion/Latest), then it is clearly a refusal reason. If it comes from ValueSet [Problem Type](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.88.12.3221.7.2/expansion/Latest), then it is an indication. But if the code comes from neither value set, the observation is *possibly* an indication, but the only way to know is to check the templateId. -### Illustrative example +### Example: Standard Immunization <table><tr><th>CDA Immunization Example</th><th>FHIR Immunization Resource</th></tr> <tr><td> diff --git a/input/pagecontent/CF-medications.md b/input/pagecontent/CF-medications.md index 2e1295a..fba4dd2 100644 --- a/input/pagecontent/CF-medications.md +++ b/input/pagecontent/CF-medications.md @@ -66,7 +66,7 @@ MedicationRequest (and other resources) may represent the medication as a simple |/consumable/manufacturedProduct/manufacturerOrganization|**[Organization](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-organization.html)**<br/>.manufacturer| |**[Drug Vehicle](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-DrugVehicle.html)**<br/>/participant[@typeCode="CSM"]/playingEntity/code|.ingredient.itemCodeableConcept|Set `.isActive = false`<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) -### Illustrative example +### Example <table><tr><th>CDA Medication Example</th><th>FHIR MedicationRequest and Medication Resources</th></tr> <tr><td> diff --git a/input/pagecontent/CF-notes.md b/input/pagecontent/CF-notes.md index b15097f..617b512 100644 --- a/input/pagecontent/CF-notes.md +++ b/input/pagecontent/CF-notes.md @@ -21,7 +21,7 @@ Clinical Notes may appear in their own section or as an entry in any open sectio 4dc41c26-43a4-48d9-b17e-067890006b29 -### Illustrative example +### Example <table><tr><th>CDA Note Activity Example</th><th>FHIR DocumentReference Resource</th></tr> <tr><td> diff --git a/input/pagecontent/CF-patient.md b/input/pagecontent/CF-patient.md index 2e58eae..f205976 100644 --- a/input/pagecontent/CF-patient.md +++ b/input/pagecontent/CF-patient.md @@ -36,7 +36,7 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea 1\. XPath abbrievated for C-CDA US Realm recordTarget as: <br/> ClinicalDocument/recordTarget/patientRole -### Illustrative example +### Example <table><tr><th>CDA RecordTarget Example</th><th>FHIR Patient Resource</th></tr> <tr><td> diff --git a/input/pagecontent/CF-problems.md b/input/pagecontent/CF-problems.md index 37ac6b9..e545a06 100644 --- a/input/pagecontent/CF-problems.md +++ b/input/pagecontent/CF-problems.md @@ -34,7 +34,7 @@ Note that C-CDA includes a Concern wrapper act from which status may be read; mo When authors or other provenance are recorded in the parent [Problem Concern Act](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ProblemConcernAct.html), it is recommended that those data be mapped to the FHIR Condition. -### Illustrative examples +### Example: Standard Problem <table><tr><th>CDA Problem Example</th><th>FHIR Condition Resource</th></tr> <tr><td> diff --git a/input/pagecontent/CF-procedures.md b/input/pagecontent/CF-procedures.md index dbb733d..b80c016 100644 --- a/input/pagecontent/CF-procedures.md +++ b/input/pagecontent/CF-procedures.md @@ -27,7 +27,7 @@ C-CDA 2.1 describes three templates for Procedures: Procedure Activity Act, Proc 1\. XPath abbrievated for C-CDA Procedure as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="47519-4"]/entry/procedure -### Illustrative example +### Example <table><tr><th>CDA Procedure Example</th><th>FHIR Procedure Resource</th></tr> <tr><td> diff --git a/input/pagecontent/CF-results.md b/input/pagecontent/CF-results.md index c0d2565..650f732 100644 --- a/input/pagecontent/CF-results.md +++ b/input/pagecontent/CF-results.md @@ -59,12 +59,15 @@ C-CDA also defines a [Specimen Collection Procedure](https://hl7.org/cda/us/ccda |**C-CDA [Specimen Collection Procedure](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-SpecimenCollectionProcedure.html)**<br/>/targetSiteCode|.collection.bodySite|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |**C-CDA [Specimen Condtion Observation](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-SpecimenConditionObservation.html)**<br/>/value|.condition|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| -### Illustrative example +### Example -<table><tr><th>CDA Example</th><th>FHIR Resource</th></tr> +<table><tr><th>CDA Result Example</th><th>FHIR DiagnosticReport and Observation Resources</th></tr> <tr><td> ... </td><td> +<b>Note:</b> The following shows a DiagnosticReport resource Observation resources embedded in its contained property. This was done for ease of creating a single, visual, highlighted example, but implementers may choose to create separate, external resources according to their own policy. +<br/> + ... </td></tr></table> diff --git a/input/pagecontent/CF-social.md b/input/pagecontent/CF-social.md index 003aeae..b27dd4a 100644 --- a/input/pagecontent/CF-social.md +++ b/input/pagecontent/CF-social.md @@ -61,7 +61,7 @@ In US Core, Pregnancy Intent was first defined in version 6. |/value|.valueCodeableConcept|Value sets are the same<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/value/@nullFlavor=UNK|.valueCodeableConcept|Unknown becomes an actual value with system = `http://terminology.hl7.org/CodeSystem/v3-NullFlavor`. Any other nullFlavors should use a data-absent-reason extension. -### Illustrative examples +### Example: General Social History Observation The following is a general social history comparison between C-CDA and FHIR diff --git a/input/pagecontent/CF-vitals.md b/input/pagecontent/CF-vitals.md index 4eb2c31..1fc9c11 100644 --- a/input/pagecontent/CF-vitals.md +++ b/input/pagecontent/CF-vitals.md @@ -46,12 +46,15 @@ C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or - Observation.valueQuantity represents the Oxygen saturation (e.g. `98%`) - Create individual components for `3150-0` - Inhaled Oxygen Concentration & `3151-8` - Inhaled Oxygen Flow Rate (only if values exist) -### Illustrative example +### Example: Simple Vitals Panel -<table><tr><th>CDA Example</th><th>FHIR Resource</th></tr> +<table><tr><th>CDA Vitals Example</th><th>FHIR Observation Resources</th></tr> <tr><td> ... </td><td> +<b>Note:</b> The following shows an Observation resource for the panel with individual Observation resources embedded in its contained property. This was done for ease of creating a single, visual, highlighted example, but implementers may choose to create separate, external resources according to their own policy. +<br/> + ... </td></tr></table> From c576537ddcd4bfc263dac586d0f0991455b5f4b5 Mon Sep 17 00:00:00 2001 From: jlyle1 <jay@lyle.net> Date: Thu, 24 Oct 2024 18:33:06 -0400 Subject: [PATCH 095/112] Added appended to FC result status --- input/maps/ConceptMap-CF-ResultStatus.xml | 2 +- input/maps/ConceptMap-FC-ResultStatus.xml | 9 +++++++++ input/pagecontent/CF-encounters.md | 2 +- input/pagecontent/CF-results.md | 2 +- 4 files changed, 12 insertions(+), 3 deletions(-) diff --git a/input/maps/ConceptMap-CF-ResultStatus.xml b/input/maps/ConceptMap-CF-ResultStatus.xml index 53b0628..847bfa7 100644 --- a/input/maps/ConceptMap-CF-ResultStatus.xml +++ b/input/maps/ConceptMap-CF-ResultStatus.xml @@ -55,7 +55,7 @@ <target> <code value="cancelled"/> <display value="Cancelled"/> - <equivalence value="wider"/> + <equivalence value="equal"/> </target> </element> <element> diff --git a/input/maps/ConceptMap-FC-ResultStatus.xml b/input/maps/ConceptMap-FC-ResultStatus.xml index b520837..12f067a 100644 --- a/input/maps/ConceptMap-FC-ResultStatus.xml +++ b/input/maps/ConceptMap-FC-ResultStatus.xml @@ -85,6 +85,15 @@ <equivalence value="wider"/> </target> </element> + <element> + <code value="appended"/> + <display value="appended"/> + <target> + <code value="completed"/> + <display value="completed"/> + <equivalence value="wider"/> + </target> + </element> <element> <code value="cancelled"/> <display value="Cancelled"/> diff --git a/input/pagecontent/CF-encounters.md b/input/pagecontent/CF-encounters.md index 2390668..f3f0cbe 100644 --- a/input/pagecontent/CF-encounters.md +++ b/input/pagecontent/CF-encounters.md @@ -17,7 +17,7 @@ Encounter Activities in the Encounters Section (or elsewhere in the document, su |/effectiveTime/@value<br/>/effectiveTime/low/@value|.period.start|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) |/effectiveTime/high/@value|.period.end |/sdtc:dischargeDispositionCode <sup>(b)</sup><br/>/dischargeDispositionCode <sup>(h)</sup>|.hospialization.dischargeDisposition|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) -|/performer <sup>(b)</sup><br/>/encounterParticipant <sup>(h)</sup>|.participant|*TODO: Mapping Guidance for general performers (Participant vs ParticipantRole vs Organization)* +|/performer <sup>(b)</sup><br/>/encounterParticipant <sup>(h)</sup>|.participant| See [participation guidance](CF-participations.html#cda-to-fhir-practitioner) |/performer/sdtc:functionCode <sup>(b)</sup>|.participant.type|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) |/participant[@typeCode="LOC"] <sup>(b)</sup><br/>/location <sup>(h)</sup>|.location |**[Indication](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-Indication.html)** <sup>(b)</sup><br/>/entryRelationship[@typeCode="RSON"]/observation|.reasonCode<br/>or<br/>.reasonReference|If the id of the indication references a problem in the document that has been converted to a FHIR resource, populate .reasonReference with a reference to that resource. Otherwise, map observation/value to .reasonCode.<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) diff --git a/input/pagecontent/CF-results.md b/input/pagecontent/CF-results.md index ccbb37b..59f770c 100644 --- a/input/pagecontent/CF-results.md +++ b/input/pagecontent/CF-results.md @@ -26,7 +26,7 @@ Observation values are generic - they can be of any CDA type in CDA, and *almost |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| ||.category|If the code is LOINC, the category can be inferred from the LOINC code CLASSTYPE. Query a FHIR server via `{endpoint}CodeSystem/$lookup?system=http://loinc.org&code={code}&&property=CLASSTYPE` and set the category according to the CLASSTYPE property:<br/>1=Laboratory class (laboratory); 2=Clinical class (clinical-test); 3=Claims attachments (not mapped); 4=Surveys (survey) |/code |.code|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| -|/statusCode|.status|/statusCode|.status|[CDA Result Status → FHIR Result Status](./ConceptMap-CF-ResultStatus.html) +|/statusCode|.status|[CDA Result Status → FHIR Result Status](./ConceptMap-CF-ResultStatus.html) |/effectiveTime|.effectiveDateTime<br/>or<br/>.effectivePeriod|Prefer effectiveDateTime<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) |/value[xsi:type=PQ]|.valueQuantity|[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity) |/value[xsi:type=IVL_PQ]|.valueQuantity<br/>or<br/>.valueRange|[Ranges of Physical Quantities](mappingGuidance.html#ranges-of-physical-quantities) From 5f1c95ae708b0dd57031e7950c0ea50ffe4219b6 Mon Sep 17 00:00:00 2001 From: jlyle1 <jay@lyle.net> Date: Thu, 24 Oct 2024 18:39:11 -0400 Subject: [PATCH 096/112] assigned result status map to sdoh --- input/pagecontent/CF-social.md | 2 +- 1 file changed, 1 insertion(+), 1 deletion(-) diff --git a/input/pagecontent/CF-social.md b/input/pagecontent/CF-social.md index b27dd4a..e01e0b2 100644 --- a/input/pagecontent/CF-social.md +++ b/input/pagecontent/CF-social.md @@ -19,7 +19,7 @@ This maps to US Core version 6's Simple Observation. Previous versions of US Cor |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| ||.category|Set to `social-history` from [Observation Category Codes](https://build.fhir.org/ig/HL7/UTG/CodeSystem-observation-category.html)<br/>Additional SDOH categories may be set as well, depending on the code of the observation. |/code |.code|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| -|/statusCode|.status|*TODO: ConceptMap* +|/statusCode|.status|[CDA Result Status → FHIR Result Status](./ConceptMap-CF-ResultStatus.html) |/effectiveTime|.effectiveDateTime<br/>or<br/>.effectivePeriod|Prefer effectiveDateTime<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) |/value[xsi:type=PQ]|.valueQuantity|[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity) |/value[xsi:type=IVL_PQ]|.valueQuantity<br/>or<br/>.valueRange|[Ranges of Physical Quantities](mappingGuidance.html#ranges-of-physical-quantities) From d08a3fa31b5d5d2710b06e8f64bef122c660a377 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Mon, 28 Oct 2024 09:04:12 -0500 Subject: [PATCH 097/112] Update procedure note for act & observation --- input/pagecontent/CF-procedures.md | 2 +- 1 file changed, 1 insertion(+), 1 deletion(-) diff --git a/input/pagecontent/CF-procedures.md b/input/pagecontent/CF-procedures.md index b80c016..e81c1ce 100644 --- a/input/pagecontent/CF-procedures.md +++ b/input/pagecontent/CF-procedures.md @@ -3,7 +3,7 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, please refer to [Procedures FHIR → CDA](./FC-procedures.html). For guidance on how to read the table below, see [Reading the C-CDA ↔ FHIR Mapping Pages](./mappingGuidance.html) <br/><br/> #### Note on template selection -C-CDA 2.1 describes three templates for Procedures: Procedure Activity Act, Procedure Activity Observation, and Procedure Activity Procedure. Procedure Activity Procedure is the most complete, containing everything the other two contain except Observation.value, and several properties not contained by the others. The [C-CDA 2.1 Companion Guide](https://www.hl7.org/ccdasearch/pdfs/Companion_Guide.pdf) points out that "most vendors successfully and exclusively use the . . . Procedure Activity Procedure," and it then specifies this template for "all interventional, non-interventional, surgical, diagnostic, or therapeutic procedures or treatments pertinent to the patient historically at the time the document is generated." For this reason, we begin with this most common pattern in this publication. Additional guidance for the other two templates (which will be very similar) will be forthcoming. +C-CDA 2.1 describes three templates for Procedures: Procedure Activity Act, Procedure Activity Observation, and Procedure Activity Procedure. Procedure Activity Procedure is the most complete, containing everything the other two contain except Observation.value, and several properties not contained by the others. The [C-CDA 2.1 Companion Guide](https://www.hl7.org/ccdasearch/pdfs/Companion_Guide.pdf) points out that "most vendors successfully and exclusively use the . . . Procedure Activity Procedure," and it then specifies this template for "all interventional, non-interventional, surgical, diagnostic, or therapeutic procedures or treatments pertinent to the patient historically at the time the document is generated." For this reason, we have only provided a mapping from Procedure Activity Procedure. Procedure Activity Act can use the same mapping to a FHIR Procedure resource because it contains a subset of the fields available in Procedure Activity Procedure. Procedure Activity Observation can be mapped to either a Procedure resource or to an Observation resource using the [results](CF-results.html) mapping (or a combination of the two). <br /> <br /> From 63f59ccf8ae48950fc67be2c3c98a4b62d58dd2d Mon Sep 17 00:00:00 2001 From: jlyle1 <jay@lyle.net> Date: Mon, 28 Oct 2024 13:22:38 -0400 Subject: [PATCH 098/112] roadmap comment re uscdi, deprecation --- FHIR-us-ccda.xml | 1 + .../maps/ConceptMap-CF-ResultReportStatus.xml | 4 +- input/maps/ConceptMap-CF-ResultStatus.xml | 92 +++++++++++++++++++ input/pagecontent/CF-results.md | 4 +- input/pagecontent/CF-social.md | 2 +- input/pagecontent/mappingBackground.md | 2 + 6 files changed, 100 insertions(+), 5 deletions(-) create mode 100644 input/maps/ConceptMap-CF-ResultStatus.xml diff --git a/FHIR-us-ccda.xml b/FHIR-us-ccda.xml index d75ce35..e8045a6 100644 --- a/FHIR-us-ccda.xml +++ b/FHIR-us-ccda.xml @@ -38,6 +38,7 @@ <artifact id="ConceptMap/CF-MedActivityMood" key="ConceptMap-CF-MedActivityMood" name="CCDA Medication Activity Mood to FHIR MedicationRequest.intent"/> <artifact id="ConceptMap/CF-ConditionClinicalStatus" key="ConceptMap-CF-ConditionClinicalStatus" name="CCDA Problem Concern Status to FHIR Condition Clinical Status"/> <artifact id="ConceptMap/CF-ResultReportStatus" key="ConceptMap-CF-ResultReportStatus" name="CCDA ResultStatus to FHIR DiagnosticReport status"/> +<artifact id="ConceptMap/CF-ResultStatus" key="ConceptMap-CF-ResultStatus" name="CCDA ResultStatus to FHIR Observation Status"/> <artifact id="CapabilityStatement/CcdaOnFhirClient" key="CapabilityStatement-CcdaOnFhirClient" name="CCDA on FHIR Client"/> <artifact id="CapabilityStatement/CcdaOnFhirServer" key="CapabilityStatement-CcdaOnFhirServer" name="CCDA on FHIR Server"/> <artifact id="ConceptMap/CF-AllergyIntoleranceCategory" key="ConceptMap-CF-AllergyIntoleranceCategory" name="CCDA to FHIR Allergy Intolerance Category"/> diff --git a/input/maps/ConceptMap-CF-ResultReportStatus.xml b/input/maps/ConceptMap-CF-ResultReportStatus.xml index 615b921..d167dd3 100644 --- a/input/maps/ConceptMap-CF-ResultReportStatus.xml +++ b/input/maps/ConceptMap-CF-ResultReportStatus.xml @@ -27,10 +27,10 @@ </telecom> </contact> <sourceUri value="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.11.20.9.39"/> - <targetUri value="http://hl7.org/fhir/ValueSet/observation-status"/> + <targetUri value="http://hl7.org/fhir/ValueSet/diagnostic-report-status"/> <group> <source value="http://terminology.hl7.org/CodeSystem/2.16.840.1.113883.5.14"/> - <target value="http://hl7.org/fhir/observation-status"/> + <target value="http://hl7.org/fhir/diagnostic-report-status"/> <element> <code value="aborted"/> <display value="aborted"/> diff --git a/input/maps/ConceptMap-CF-ResultStatus.xml b/input/maps/ConceptMap-CF-ResultStatus.xml new file mode 100644 index 0000000..b6dc605 --- /dev/null +++ b/input/maps/ConceptMap-CF-ResultStatus.xml @@ -0,0 +1,92 @@ +<ConceptMap xmlns="http://hl7.org/fhir" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"> + <id value="CF-ResultStatus"/> + <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"> + <valueCode value="cgp" /> + </extension> + <url value="http://hl7.org/fhir/us/ccda/ConceptMap/CF-ResultStatus"/> + <version value="4.0.1"/> + <name value="CCDAtoFHIRResultStatus"/> + <title value="CCDA ResultStatus to FHIR Observation Status"/> + <status value="active"/> + <experimental value="false"/> + <publisher value="HL7 International"/> + <description value="C-CDA Result Status to FHIR Observation Status"/> + <contact> + <name value="HL7 International"/> + <telecom> + <system value="phone"/> + <value value="+1 734 677 7777"/> + </telecom> + <telecom> + <system value="fax"/> + <value value="+1 734 677 6622"/> + </telecom> + <telecom> + <system value="email"/> + <value value="info@hl7.org"/> + </telecom> + </contact> + <sourceUri value="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.11.20.9.39"/> + <targetUri value="http://hl7.org/fhir/ValueSet/observation-status"/> + <group> + <source value="http://terminology.hl7.org/CodeSystem/2.16.840.1.113883.5.14"/> + <target value="http://hl7.org/fhir/observation-status"/> + <element> + <code value="aborted"/> + <display value="aborted"/> + <target> + <code value="cancelled"/> + <display value="Cancelled"/> + <equivalence value="wider"/> + </target> + </element> + <element> + <code value="active"/> + <display value="active"/> + <target> + <code value="registered"/> + <display value="Registered"/> + <equivalence value="inexact"/> + <comment value="Caution: Multiple values map to the FHIR concept of regeistered."/> + </target> + </element> + <element> + <code value="cancelled"/> + <display value="cancelled"/> + <target> + <code value="cancelled"/> + <display value="Cancelled"/> + <equivalence value="equal"/> + </target> + </element> + <element> + <code value="completed"/> + <display value="completed"/> + <target> + <code value="final"/> + <display value="Final"/> + <equivalence value="equal"/> + </target> + </element> + <element> + <code value="held"/> + <display value="held"/> + <target> + <code value="registered"/> + <display value="Registered"/> + <equivalence value="inexact"/> + <comment value="Caution: Multiple values map to the FHIR concept of regeistered."/> + </target> + </element> + <element> + <code value="suspended"/> + <display value="suspended"/> + <target> + <code value="registered"/> + <display value="Registered"/> + <equivalence value="inexact"/> + <comment value="Caution: Multiple values map to the FHIR concept of regeistered."/> + </target> + </element> + </group> +</ConceptMap> \ No newline at end of file diff --git a/input/pagecontent/CF-results.md b/input/pagecontent/CF-results.md index 78cbe0b..9d28289 100644 --- a/input/pagecontent/CF-results.md +++ b/input/pagecontent/CF-results.md @@ -12,7 +12,7 @@ Observation values are generic - they can be of any CDA type in CDA, and *almost |:----|:----|:----| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| |/code|.code<br/>&<br/>.category|Map to code using [CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept).<br/>Category (and target FHIR Profile) may be identified by looking up a LOINC code's CLASSTYPE (see process in next table).<br/>Alternatively, an extension for `<sdtc:category>` is being developed for CDA Organizer which, if present, will map directly to this field. -|/statusCode|.status|[CDA Result Status → FHIR Result Report Status](./ConceptMap-CF-ResultReportStatus.html) +|/statusCode|.status|[CDA Result Status → FHIR Report Status](./ConceptMap-CF-ResultReportStatus.html) |/effectiveTime|.effectiveDateTime<br/>or<br/>.effectivePeriod|If low and high are identical, use effectiveDateTime. If organizer/effectiveTime is missing, use the earliest and latest observation/effectiveTime as the source of the mapping.<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) |/specimen|.specimen|[See below](#c-cda-specimen-to-fhir-specimen) |/author|**[Provenance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-provenance.html)**|[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| @@ -26,7 +26,7 @@ Observation values are generic - they can be of any CDA type in CDA, and *almost |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| ||.category|If the code is LOINC, the category can be inferred from the LOINC code CLASSTYPE. Query a FHIR server via `{endpoint}CodeSystem/$lookup?system=http://loinc.org&code={code}&&property=CLASSTYPE` and set the category according to the CLASSTYPE property:<br/>1=Laboratory class (laboratory); 2=Clinical class (clinical-test); 3=Claims attachments (not mapped); 4=Surveys (survey) |/code |.code|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| -|/statusCode|.status|[CDA Result Status → FHIR Result Status](./ConceptMap-CF-ResultStatus.html) +|/statusCode|.status|[CDA Result Status → FHIR Observation Status](./ConceptMap-CF-ResultStatus.html) |/effectiveTime|.effectiveDateTime<br/>or<br/>.effectivePeriod|Prefer effectiveDateTime<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) |/value[xsi:type=PQ]|.valueQuantity|[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity) |/value[xsi:type=IVL_PQ]|.valueQuantity<br/>or<br/>.valueRange|[Ranges of Physical Quantities](mappingGuidance.html#ranges-of-physical-quantities) diff --git a/input/pagecontent/CF-social.md b/input/pagecontent/CF-social.md index e01e0b2..a583390 100644 --- a/input/pagecontent/CF-social.md +++ b/input/pagecontent/CF-social.md @@ -19,7 +19,7 @@ This maps to US Core version 6's Simple Observation. Previous versions of US Cor |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| ||.category|Set to `social-history` from [Observation Category Codes](https://build.fhir.org/ig/HL7/UTG/CodeSystem-observation-category.html)<br/>Additional SDOH categories may be set as well, depending on the code of the observation. |/code |.code|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| -|/statusCode|.status|[CDA Result Status → FHIR Result Status](./ConceptMap-CF-ResultStatus.html) +|/statusCode|.status|[CDA Result Status → FHIR Observation Status](./ConceptMap-CF-ResultStatus.html) |/effectiveTime|.effectiveDateTime<br/>or<br/>.effectivePeriod|Prefer effectiveDateTime<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) |/value[xsi:type=PQ]|.valueQuantity|[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity) |/value[xsi:type=IVL_PQ]|.valueQuantity<br/>or<br/>.valueRange|[Ranges of Physical Quantities](mappingGuidance.html#ranges-of-physical-quantities) diff --git a/input/pagecontent/mappingBackground.md b/input/pagecontent/mappingBackground.md index 573bbb7..0f43e3c 100644 --- a/input/pagecontent/mappingBackground.md +++ b/input/pagecontent/mappingBackground.md @@ -26,6 +26,8 @@ In our first publication, we focused on the subset of domains that are recognize Bi-directional automated transform is possible in constrained use cases but is not lossless due to varying flexibility and expressiveness in the standards. Use of extensions may mitigate the loss of information in transformation but may not be included in this guide. The CDA content is scoped by C-CDA R2.1 and the C-CDA Companion Guide R2, FHIR content by US Core R4, and, by implication, US Core Data for Interoperability (USCDI). +Our roadmap prioritizes USCDI, so we strive to map items in the respective standards that support USCDI. As elements are added to new versions of USCDI, we may map them in advance, especially when we are already engaged in a related domain. We also may omit or defer maps for elements that are both difficult and of dubious use, i.e., items that are not in USCDI and are deprecated or omitted from later editions of either specification. + We employed several tactics to meet our goals. Standards developers drafted maps based on the respective specifications, and these were reviewed by stakeholders both offline and at public, regularly scheduled meetings. These meetings included implementors, terminologists, regulatory and public health representatives, and strategists, who engaged in realignment, consensus-seeking, and reformatting of the maps for a variety of audiences. Difficult questions were escalated to the work groups responsible for the specifications. Issues and their resolutions were logged in the publicly accessible project site. In addition, the project team employed the example-based approach through Connectathons with vendors and experts in the standards community. The approach involves sharing inbound examples among the vendors, comparing the outbound artifacts generated by these vendors, and discussing with the group to achieve alignment in best practice recommendations. Our team has been focused on the generated artifacts, regardless of the transformation technologies, so any vendor is empowered to achieve the same transformation results. Note that, to date, the Connectathons have addresses only the CDA-to-FHIR cases, though two implementers have provided feedback on the FHIR-to-CDA cases. From 03291d1e122767ec8f1ec9a005a28145227eaa6c Mon Sep 17 00:00:00 2001 From: jlyle1 <jay@lyle.net> Date: Thu, 31 Oct 2024 15:00:22 -0400 Subject: [PATCH 099/112] rename ConceptMap-FC-ResultStatus; remove partial --- ...tus.xml => ConceptMap-FC-ObservationStatus.xml} | 9 --------- input/pagecontent/FC-vitals.md | 14 +++++++------- 2 files changed, 7 insertions(+), 16 deletions(-) rename input/maps/{ConceptMap-FC-ResultStatus.xml => ConceptMap-FC-ObservationStatus.xml} (93%) diff --git a/input/maps/ConceptMap-FC-ResultStatus.xml b/input/maps/ConceptMap-FC-ObservationStatus.xml similarity index 93% rename from input/maps/ConceptMap-FC-ResultStatus.xml rename to input/maps/ConceptMap-FC-ObservationStatus.xml index 12f067a..8fd6e1d 100644 --- a/input/maps/ConceptMap-FC-ResultStatus.xml +++ b/input/maps/ConceptMap-FC-ObservationStatus.xml @@ -40,15 +40,6 @@ <equivalence value="wider"/> </target> </element> - <element> - <code value="partial"/> - <display value="Partial"/> - <target> - <code value="active"/> - <display value="Active"/> - <equivalence value="wider"/> - </target> - </element> <element> <code value="preliminary"/> <display value="Preliminary"/> diff --git a/input/pagecontent/FC-vitals.md b/input/pagecontent/FC-vitals.md index ce25f2e..d548847 100644 --- a/input/pagecontent/FC-vitals.md +++ b/input/pagecontent/FC-vitals.md @@ -13,12 +13,12 @@ FHIR Vitals that are grouped into a panel using the memberOf property are mapped |FHIR<br/>[Vital Signs Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-vital-signs.html)|C-CDA¹<br/>[Vital SignsOrganizer](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-VitalSignsOrganizer.html)|Transform Steps| |:----|:----|:----| |.identifier|/id|[FHIR identifier ↔ CDA id](mappingGuidance.html#cda-id--fhir-identifier)| -|.category = `vital-signs` from [Vital Signs value set](https://hl7.org/fhir/us/core/STU4/ValueSet-us-core-vital-signs.html)|| -|.code = `85353-1` [CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)||| -|.status|/statusCode|*TODO: ConceptMap* -|.effectiveDateTime|/effectiveTime|Use value -|.effectivePeriod|/effectiveTime|Use high and low <br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) -|.hasMember|component|Reference to each vital sign observation +|.category = `vital-signs` ||| +|.code = `85353-1` ||[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| +|.status|/statusCode|[FHIR Observation Status → CDA Result Status](./ConceptMap-FC-ObservationStatus.html)<br/> CDA requires 'completed', which will usually be the case| +|.effectiveDateTime|/effectiveTime|Use value| +|.effectivePeriod|/effectiveTime|Use high and low <br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)| +|.hasMember|component|Reference to each vital sign observation | ### FHIR Observation to C-CDA Vital Signs Observation @@ -34,7 +34,7 @@ FHIR Vitals that are grouped into a panel using the memberOf property are mapped |.interpretation|/interpretationCode|[FHIR CodeableConcept ↔ CDA coding](mappingGuidance.html#fhir-codeableconcept--cda-coding)| |.method|/methodCode|[FHIR CodeableConcept ↔ CDA coding](mappingGuidance.html#fhir-codeableconcept--cda-coding)| |.bodySite|/targetSiteCode|[FHIR CodeableConcept ↔ CDA coding](mappingGuidance.html#fhir-codeableconcept--cda-coding)| -|||author-provenance: *TODO* + ### Illustrative example \ No newline at end of file From 36ed7e85e574f82b1e260743eef6da7c1f9d36f3 Mon Sep 17 00:00:00 2001 From: jlyle1 <jay@lyle.net> Date: Thu, 31 Oct 2024 16:42:39 -0400 Subject: [PATCH 100/112] removed extraneous value from obs status --- input/maps/ConceptMap-FC-ObservationStatus.xml | 9 --------- 1 file changed, 9 deletions(-) diff --git a/input/maps/ConceptMap-FC-ObservationStatus.xml b/input/maps/ConceptMap-FC-ObservationStatus.xml index 8fd6e1d..ba747ed 100644 --- a/input/maps/ConceptMap-FC-ObservationStatus.xml +++ b/input/maps/ConceptMap-FC-ObservationStatus.xml @@ -76,15 +76,6 @@ <equivalence value="wider"/> </target> </element> - <element> - <code value="appended"/> - <display value="appended"/> - <target> - <code value="completed"/> - <display value="completed"/> - <equivalence value="wider"/> - </target> - </element> <element> <code value="cancelled"/> <display value="Cancelled"/> From 47bdc40532cb9b73ea503d94a4d4935cd4fb53a4 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Mon, 4 Nov 2024 09:46:10 -0600 Subject: [PATCH 101/112] Add vitals and results highlighted examples --- input/pagecontent/CF-results.md | 158 +++++++++++++++++++++++++++++++- input/pagecontent/CF-vitals.md | 111 +++++++++++++++++++++- 2 files changed, 261 insertions(+), 8 deletions(-) diff --git a/input/pagecontent/CF-results.md b/input/pagecontent/CF-results.md index 9d28289..11e7509 100644 --- a/input/pagecontent/CF-results.md +++ b/input/pagecontent/CF-results.md @@ -63,11 +63,163 @@ C-CDA also defines a [Specimen Collection Procedure](https://hl7.org/cda/us/ccda <table><tr><th>CDA Result Example</th><th>FHIR DiagnosticReport and Observation Resources</th></tr> <tr><td> -... +<div id="cda" class="border codeArea"><<span class="field">organizer</span> <span class="attrib">classCode=</span><span class="value">"BATTERY"</span> <span class="attrib">moodCode=</span><span class="value">"EVN"</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.1"</span> <span class="attrib">extension=</span><span class="value">"2015-08-01"</span>/> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.1"</span>/> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"<mark class="color10">1.3.6.1.4.1.22812.20.1.1.4.5</mark>"</span> <span class="attrib">extension=</span><span class="value">"<mark class="color11">R123</mark>"</span>/> + <<span class="field">code</span> + <span class="attrib">code=</span><span class="value">"<mark class="color12">24357-6</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color13">2.16.840.1.113883.6.1</mark>"</span>> + <<span class="field">originalText</span>> + <span class="comment"><!-- Resolves to: <mark class="color22">Urinanalysis macro (dipstick) panel</mark> --></span> + <<span class="field">reference</span> <span class="attrib">value=</span><span class="value">"#_panel1Name"</span>/> + </<span class="field">originalText</span>> + </<span class="field">code</span>> + <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"completed"</span>/> + <<span class="field">effectiveTime</span> <span class="attrib">xsi:type=</span><span class="value">"IVL_TS"</span>> + <<span class="field">low</span> <span class="attrib">value=</span><span class="value">"<mark class="color14">20150622</mark>"</span>/> + <<span class="field">high</span> <span class="attrib">value=</span><span class="value">"<mark class="color14">20150622</mark>"</span>/> + </<span class="field">effectiveTime</span>> + <span class="comment"><!-- Becomes a FHIR reference: <mark class="color23">Practitioner/62f17e2ae0231200076884d0</mark> --></span> + <<span class="field">performer</span> <span class="attrib">typeCode=</span><span class="value">"PRF"</span>> + <<span class="field">assignedEntity</span>> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.19.5"</span>/> + <<span class="field">representedOrganization</span>> + <<span class="field">name</span>>Value Labs</<span class="field">name</span>> + </<span class="field">representedOrganization</span>> + </<span class="field">assignedEntity</span>> + </<span class="field">performer</span>> + <span class="comment"><!-- components removed to simplify example --></span> + <<span class="field">component</span>> + <<span class="field">observation</span> <span class="attrib">classCode=</span><span class="value">"OBS"</span> <span class="attrib">moodCode=</span><span class="value">"EVN"</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.2"</span> + <span class="attrib">extension=</span><span class="value">"2015-08-01"</span>/> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.2"</span>/> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"<mark class="color10">1.3.6.1.4.1.22812.20.1.1.4.5</mark>"</span> <span class="attrib">extension=</span><span class="value">"<mark class="color15">OBS13</mark>"</span>/> + <<span class="field">code</span> + <span class="attrib">code=</span><span class="value">"<mark class="color16">5811-5</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color13">2.16.840.1.113883.6.1</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color17">Specific gravity of Urine by Test strip</mark>"</span>> + <<span class="field">originalText</span>> + <span class="comment"><!-- reference the text of the coded component --></span> + <<span class="field">reference</span> <span class="attrib">value=</span><span class="value">"#_ea838e08-d5eb-4ed4-a176-e5f9a831a780"</span>/> + </<span class="field">originalText</span>> + </<span class="field">code</span>> + <<span class="field">text</span>> + <span class="comment"><!-- reference the entire text of the component --></span> + <<span class="field">reference</span> <span class="attrib">value=</span><span class="value">"#_13a52df8-79ed-4689-a9da-14c5905de830"</span>/> + </<span class="field">text</span>> + <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"completed"</span>/> + <<span class="field">effectiveTime</span> <span class="attrib">value=</span><span class="value">"<mark class="color14">20150622</mark>"</span>/> + <<span class="field">value</span> <span class="attrib">xsi:type=</span><span class="value">"PQ"</span> <span class="attrib">value=</span><span class="value">"<mark class="color18">1.015</mark>"</span> <span class="attrib">unit=</span><mark class="color19"><span class="value">"1"</span></mark>/> + <<span class="field">referenceRange</span>> + <<span class="field">observationRange</span>> + <<span class="field">text</span>> + <span class="comment"><!-- reference the text of the reference range --></span> + <<span class="field">reference</span> <span class="attrib">value=</span><span class="value">"#_08b7d0ee-aff1-4144-a3a5-c89d56d855ad"</span>/> + </<span class="field">text</span>> + <<span class="field">value</span> <span class="attrib">xsi:type=</span><span class="value">"IVL_PQ"</span>> + <<span class="field">low</span> <span class="attrib">value=</span><span class="value">"<mark class="color20">1.005</mark>"</span> <span class="attrib">unit=</span><mark class="color19"><span class="value">"1"</span></mark>/> + <span class="comment"><!-- Note this will create a precision extension with + url: <mark class="color24">http://hl7.org/fhir/StructureDefinition/quantity-precision</mark> --></span> + <<span class="field">high</span> <span class="attrib">value=</span><span class="value">"<mark class="color21">1.030</mark>"</span> <span class="attrib">unit=</span><mark class="color19"><span class="value">"1"</span></mark>/> + </<span class="field">value</span>> + </<span class="field">observationRange</span>> + </<span class="field">referenceRange</span>> + </<span class="field">observation</span>> + </<span class="field">component</span>> + <span class="comment"><!-- components removed to simplify example --></span> +</<span class="field">organizer</span>></div> </td><td> -<b>Note:</b> The following shows a DiagnosticReport resource Observation resources embedded in its contained property. This was done for ease of creating a single, visual, highlighted example, but implementers may choose to create separate, external resources according to their own policy. +<b>Note:</b> The following shows a DiagnosticReport resource with an Observation resource embedded in its contained property. This was done for ease of creating a single, visual, highlighted example, but implementers may choose to create separate, external resources according to their own policy. <br/> -... +<div id="fhir" class="border codeArea">{ + "<span class="field">resourceType</span>": "<span class="value">DiagnosticReport</span>", + "<span class="field">id</span>": "<span class="value">62f17e2aa2392d0008fbb236</span>", + "<span class="field">identifier</span>": [{ + "<span class="field">value</span>": "<span class="value"><mark class="color11">R123</mark></span>", + "<span class="field">system</span>": "<span class="value">urn:oid:<mark class="color10">1.3.6.1.4.1.22812.20.1.1.4.5</mark></span>" + }], + "<span class="field">status</span>": "<span class="value">final</span>", + "<span class="field">category</span>": [{ + "<span class="field">coding</span>": [{ + "<span class="field">system</span>": "<span class="value">http://terminology.hl7.org/CodeSystem/v2-0074</span>", + "<span class="field">code</span>": "<span class="value">LAB</span>", + "<span class="field">display</span>": "<span class="value">Laboratory</span>" + }] + }], + "<span class="field">code</span>": { + "<span class="field">coding</span>": [{ + "<span class="field">system</span>": "<span class="value"><mark class="color13">http://loinc.org</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color12">24357-6</mark></span>" + }], + "<span class="field">text</span>": "<span class="value"><mark class="color22">Urinanalysis macro (dipstick) panel</mark></span>" + }, + "<span class="field">subject</span>": { + "<span class="field">reference</span>": "<span class="value">Patient/62f17e29b7532c0009e217b7</span>" + }, + "<span class="field">effectiveDateTime</span>": "<span class="value"><mark class="color14">2015-06-22</mark></span>", + "<span class="field">issued</span>": { + "<span class="field">extension</span>": [{ + "<span class="field">url</span>": "<span class="value">http://hl7.org/fhir/extension-data-absent-reason</span>", + "<span class="field">valueCode</span>": "<span class="value">unknown</span>" + }] + }, + "<span class="field">performer</span>": [{ + "<span class="field">reference</span>": "<span class="value"><mark class="color23">Practitioner/62f17e2ae0231200076884d0</mark></span>" + }], + "<span class="field">result</span>": [{ + "<span class="field">reference</span>": "<span class="value">#exampleObs</span>" + }], + "<span class="field">contained</span>": [{ + "<span class="field">resourceType</span>": "<span class="value">Observation</span>", + "<span class="field">id</span>": "<span class="value">exampleObs</span>", + "<span class="field">identifier</span>": [{ + "<span class="field">system</span>": "<span class="value">urn:oid:<mark class="color10">1.3.6.1.4.1.22812.20.1.1.4.5</mark></span>", + "<span class="field">value</span>": "<span class="value"><mark class="color15">OBS13</mark></span>" + }], + "<span class="field">status</span>": "<span class="value">final</span>", + "<span class="field">category</span>": [{ + "<span class="field">coding</span>": [{ + "<span class="field">system</span>": "<span class="value">http://terminology.hl7.org/CodeSystem/observation-category</span>", + "<span class="field">code</span>": "<span class="value">laboratory</span>", + "<span class="field">display</span>": "<span class="value">Laboratory</span>" + }] + }], + "<span class="field">code</span>": { + "<span class="field">coding</span>": [{ + "<span class="field">system</span>": "<span class="value"><mark class="color13">http://loinc.org</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color16">5811-5</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color17">Specific gravity of Urine by Test strip</mark></span>" + }], + "<span class="field">text</span>": "<span class="value"><mark class="color17">Specific gravity of Urine by Test strip</mark></span>" + }, + "<span class="field">subject</span>": { + "<span class="field">reference</span>": "<span class="value">Patient/62f17e29b7532c0009e217b7</span>" + }, + "<span class="field">effectiveDateTime</span>": "<span class="value"><mark class="color14">2015-06-22</mark></span>", + "<span class="field">valueQuantity</span>": { + "<span class="field">value</span>": <mark class="color18">1.015</mark>, + "<span class="field">unit</span>": <mark class="color19">"1"</mark> + }, + "<span class="field">referenceRange</span>": [{ + "<span class="field">low</span>": { + "<span class="field">value</span>": <mark class="color20">1.005</mark>, + "<span class="field">unit</span>": <mark class="color19">"1"</mark> + }, + "<span class="field">high</span>": { + "<span class="field">value</span>": <mark class="color21">1.03</mark>, + "<span class="field">unit</span>": <mark class="color19">"1"</mark>, + "<span class="field">_value</span>": { + "<span class="field">extension</span>": [{ + "<span class="field">url</span>": "<span class="value"><mark class="color24">http://hl7.org/fhir/StructureDefinition/quantity-precision</mark></span>", + "<span class="field">valueInteger</span>": 3 + }] + } + } + }] + }] +}</div> </td></tr></table> diff --git a/input/pagecontent/CF-vitals.md b/input/pagecontent/CF-vitals.md index 1fc9c11..327e9ce 100644 --- a/input/pagecontent/CF-vitals.md +++ b/input/pagecontent/CF-vitals.md @@ -50,12 +50,113 @@ C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or <table><tr><th>CDA Vitals Example</th><th>FHIR Observation Resources</th></tr> <tr><td> -... +<div id="cda" class="border codeArea"><<span class="field">organizer</span> <span class="attrib">classCode=</span><span class="value">"CLUSTER"</span> <span class="attrib">moodCode=</span><span class="value">"EVN"</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.26"</span>/> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.26"</span> + <span class="attrib">extension=</span><span class="value">"2015-08-01"</span>/> + <<span class="field">id</span> + <span class="attrib">extension=</span><span class="value">"<mark class="color10">21688133041015158234</mark>"</span> + <span class="attrib">root=</span><span class="value">"<mark class="color11">2.16.840.1.113883.3.42.126.100001.19</mark>"</span>/> + <<span class="field">code</span> + <span class="attrib">code=</span><span class="value">"<mark class="color12">46680005</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color13">Vital Signs</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"2.16.840.1.113883.6.96"</span> + <span class="attrib">codeSystemName=</span><span class="value">"SNOMED CT"</span>> + <<span class="field">translation</span> <span class="attrib">code=</span><span class="value">"<mark class="color14">74728-7</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color15">2.16.840.1.113883.6.1</mark>"</span> + <span class="attrib">codeSystemName=</span><span class="value">"<mark class="color15">LOINC</mark>"</span>/> + </<span class="field">code</span>> + <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"completed"</span>/> + <<span class="field">effectiveTime</span> <span class="attrib">value=</span><span class="value">"<mark class="color16">20140520193605-0600</mark>"</span>/> + <span class="comment"><!-- Each vital sign should be its own component. --></span> + <<span class="field">component</span>> + <<span class="field">observation</span> <span class="attrib">classCode=</span><span class="value">"OBS"</span> <span class="attrib">moodCode=</span><span class="value">"EVN"</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.27"</span>/> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.27"</span> + <span class="attrib">extension=</span><span class="value">"2014-06-09"</span>/> + <<span class="field">id</span> + <span class="attrib">extension=</span><span class="value">"<mark class="color17">216881330410151584</mark>"</span> + <span class="attrib">root=</span><span class="value">"<mark class="color11">2.16.840.1.113883.3.42.126.100001.19</mark>"</span>/> + <<span class="field">code</span> <span class="attrib">code=</span><span class="value">"<mark class="color18">8867-4</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color15">2.16.840.1.113883.6.1</mark>"</span> + <span class="attrib">codeSystemName=</span><span class="value">"<mark class="color15">LOINC</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color19">HEART RATE</mark>"</span>/> + <<span class="field">text</span>> + <<span class="field">reference</span> <span class="attrib">value=</span><span class="value">"#Pulse_1"</span>/> + </<span class="field">text</span>> + <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"completed"</span>/> + <<span class="field">effectiveTime</span> <span class="attrib">value=</span><span class="value">"<mark class="color16">20140520193605-0600</mark>"</span>/> + <<span class="field">value</span> <span class="attrib">xsi:type=</span><span class="value">"PQ"</span> + <span class="attrib">value=</span><mark class="color20"><span class="value">"80"</span></mark> + <span class="attrib">unit=</span><span class="value">"<mark class="color21">/min</mark>"</span>/> + </<span class="field">observation</span>> + </<span class="field">component</span>> +</<span class="field">organizer</span>></div> </td><td> -<b>Note:</b> The following shows an Observation resource for the panel with individual Observation resources embedded in its contained property. This was done for ease of creating a single, visual, highlighted example, but implementers may choose to create separate, external resources according to their own policy. +<b>Note:</b> The following shows an Observation resource for the panel with an individual Observation resource embedded in its contained property. This was done for ease of creating a single, visual, highlighted example, but implementers may choose to create separate, external resources according to their own policy. <br/> -... +<div id="fhir" class="border codeArea">{ + "<span class="field">resourceType</span>": "<span class="value">Observation</span>", + "<span class="field">identifier</span>": [{ + "<span class="field">value</span>": "<span class="value"><mark class="color10">21688133041015158234</mark></span>", + "<span class="field">system</span>": "<span class="value">urn:oid:<mark class="color11">2.16.840.1.113883.3.42.126.100001.19</mark></span>" + }], + "<span class="field">status</span>": "<span class="value">final</span>", + "<span class="field">category</span>": [{ + "<span class="field">text</span>": "<span class="value"><mark class="color12">vital-signs</mark></span>", + "<span class="field">coding</span>": [{ + "<span class="field">code</span>": "<span class="value"><mark class="color12">vital-signs</mark></span>", + "<span class="field">system</span>": "<span class="value">http://terminology.hl7.org/CodeSystem/observation-category</span>", + "<span class="field">display</span>": "<span class="value"><mark class="color13">Vital Signs</mark></span>" + }] + }], + "<span class="field">code</span>": { + "<span class="field">text</span>": "<span class="value">Vital Signs Panel</span>", + "<span class="field">coding</span>": [{ + "<span class="field">code</span>": "<span class="value"><mark class="color14">85353-1</mark></span>", + "<span class="field">system</span>": "<span class="value"><mark class="color15">http://loinc.org</mark></span>" + }] + }, + "<span class="field">subject</span>": { + "<span class="field">reference</span>": "<span class="value">urn:uuid:a4986486-6599-4bb2-a7fb-e2deb8d50b5e</span>" + }, + "<span class="field">effectiveDateTime</span>": "<span class="value"><mark class="color16">2014-05-20T19:36:05-06:00</mark></span>", + "<span class="field">hasMember</span>": [{ + "<span class="field">reference</span>": "<span class="value">#heartRate</span>" + }], + "<span class="field">contains</span>": [{ + "<span class="field">resourceType</span>": "<span class="value">Observation</span>", + "<span class="field">id</span>": "<span class="value">heartRate</span>", + "<span class="field">identifier</span>": [{ + "<span class="field">system</span>": "<span class="value">urn:oid:<mark class="color11">2.16.840.1.113883.3.42.126.100001.19</mark></span>", + "<span class="field">value</span>": "<span class="value"><mark class="color17">216881330410151584</mark></span>" + }], + "<span class="field">status</span>": "<span class="value">final</span>", + "<span class="field">category</span>": [{ + "<span class="field">coding</span>": [{ + "<span class="field">system</span>": "<span class="value">http://terminology.hl7.org/CodeSystem/observation-category</span>", + "<span class="field">code</span>": "<span class="value"><mark class="color12">vital-signs</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color13">Vital Signs</mark></span>" + }] + }], + "<span class="field">code</span>": { + "<span class="field">coding</span>": [{ + "<span class="field">system</span>": "<span class="value"><mark class="color15">http://loinc.org</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color18">8867-4</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color19">HEART RATE</mark></span>" + }] + }, + "<span class="field">subject</span>": { + "<span class="field">reference</span>": "<span class="value">Patient/62f17e29b7532c0009e217b7</span>" + }, + "<span class="field">effectiveDateTime</span>": "<span class="value"><mark class="color16">2014-05-20T19:36:05-06:00</mark></span>", + "<span class="field">valueQuantity</span>": { + "<span class="field">value</span>": <mark class="color20">80,</mark> + "<span class="field">unit</span>": "<span class="value"><mark class="color21">/min</mark></span>" + } + }] +}</div> </td></tr></table> ### Example: Blood Pressure @@ -160,11 +261,11 @@ C-CDA vitals are typically grouped into a Vital Signs Organizer to group one or } }] }</div> -</td></tr> +</td></tr></table> ### Example: Pulse Oximetry -<tr><th>C-CDA Pulse Oximetry (Codes & Values Only)</th><th>FHIR Pulse Oximetry</th></tr> +<table><tr><th>C-CDA Pulse Oximetry (Codes & Values Only)</th><th>FHIR Pulse Oximetry</th></tr> <tr><td> <div class="border codeArea"><<span class="field">organizer</span>> <span class="comment"><!-- C-CDA Vital Signs Organizer --></span> From a0bb76d003dca928e13f90cf094fd78a158af765 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Mon, 4 Nov 2024 09:46:43 -0600 Subject: [PATCH 102/112] Fix typo in concept map --- input/maps/ConceptMap-CF-ResultReportStatus.xml | 6 +++--- 1 file changed, 3 insertions(+), 3 deletions(-) diff --git a/input/maps/ConceptMap-CF-ResultReportStatus.xml b/input/maps/ConceptMap-CF-ResultReportStatus.xml index d167dd3..afc2c6e 100644 --- a/input/maps/ConceptMap-CF-ResultReportStatus.xml +++ b/input/maps/ConceptMap-CF-ResultReportStatus.xml @@ -47,7 +47,7 @@ <code value="registered"/> <display value="Registered"/> <equivalence value="inexact"/> - <comment value="Caution: Multiple values map to the FHIR concept of regeistered."/> + <comment value="Caution: Multiple values map to the FHIR concept of registered."/> </target> </element> <element> @@ -75,7 +75,7 @@ <code value="registered"/> <display value="Registered"/> <equivalence value="inexact"/> - <comment value="Caution: Multiple values map to the FHIR concept of regeistered."/> + <comment value="Caution: Multiple values map to the FHIR concept of registered."/> </target> </element> <element> @@ -85,7 +85,7 @@ <code value="registered"/> <display value="Registered"/> <equivalence value="inexact"/> - <comment value="Caution: Multiple values map to the FHIR concept of regeistered."/> + <comment value="Caution: Multiple values map to the FHIR concept of registered."/> </target> </element> </group> From d329b2edf27141fe41c599e26304ba61a6368ec0 Mon Sep 17 00:00:00 2001 From: jlyle1 <jay@lyle.net> Date: Thu, 7 Nov 2024 17:11:56 -0500 Subject: [PATCH 103/112] added social history examples for smoking --- input/pagecontent/CF-social.md | 79 ++++++++++++++++++++++++++++------ 1 file changed, 67 insertions(+), 12 deletions(-) diff --git a/input/pagecontent/CF-social.md b/input/pagecontent/CF-social.md index a583390..a1743f9 100644 --- a/input/pagecontent/CF-social.md +++ b/input/pagecontent/CF-social.md @@ -61,25 +61,80 @@ In US Core, Pregnancy Intent was first defined in version 6. |/value|.valueCodeableConcept|Value sets are the same<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/value/@nullFlavor=UNK|.valueCodeableConcept|Unknown becomes an actual value with system = `http://terminology.hl7.org/CodeSystem/v3-NullFlavor`. Any other nullFlavors should use a data-absent-reason extension. -### Example: General Social History Observation +### Example: Smoking Status -The following is a general social history comparison between C-CDA and FHIR +The following is a comparison between C-CDA and FHIR Smoking Status Observations <table><tr><th>CDA Example</th><th>FHIR Resource</th></tr> <tr><td> -... +<div id="cda" class="border codeArea"> +<<span class="field">entry</span>> + <<span class="field">observation</span> <span class="attrib">classCode=</span><span class="value">"OBS"</span> <span class="attrib">moodCode=</span><span class="value">"EVN"</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.78"</span>/> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.78"</span> + <span class="attrib">extension=</span><span class="value">"2014-06-09"</span>/> + <<span class="field">id</span> <span class="attrib">extension=</span><span class="value">"<mark class="color10">123456789</mark>"</span> <span class="attrib">root=</span><span class="value">"<mark class="color11">2.16.840.1.113883.19</mark>"</span> /> + <<span class="field">code</span> + <span class="attrib">code=</span><span class="value">"<mark class="color12">72166-2</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color13">2.16.840.1.113883.6.1</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color14">Tobacco smoking status NHIS</mark>"</span>/> + <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"completed"</span>/> + <<span class="field">effectiveTime</span> <span class="attrib">value=</span><span class="value">"201406061032-0500"</span>/> + <<span class="field">value</span> <span class="attrib">xsi:type=</span><span class="value">"CD"</span> + <span class="attrib">code=</span><span class="value">"<mark class="color15">449868002</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color16">2.16.840.1.113883.6.96</mark>"</span> + <span class="attrib">codeSystemName=</span><span class="value">"<mark class="color16"><mark class="color16">SNOMED</mark> CT</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color17">Current every day smoker</mark>"</span>/> + </<span class="field">observation</span>> +</<span class="field">entry</span>></div> </td><td> -... +<div id="fhir" class="border codeArea">{ + "<span class="field">fullUrl</span>": "<span class="value">http://fhir:3447/4_0_0/Observation/62f17e2aa2392d0008fbb23a</span>", + "<span class="field">resource</span>": { + "<span class="field">resourceType</span>": "<span class="value">Observation</span>", + "<span class="field">id</span>": "<span class="value">62f17e2aa2392d0008fbb23a</span>", + "<span class="field">language</span>": "<span class="value">en-US</span>", + "<span class="field">identifier</span>": [{ + "<span class="field">system</span>": "<span class="value">urn:oid:<mark class="color11">2.16.840.1.113883.19</mark></span>", + "<span class="field">value</span>": "<span class="value"><mark class="color10">123456789</mark></span>" + }], + "<span class="field">status</span>": "<span class="value">final</span>", + "<span class="field">category</span>": [{ + "<span class="field">coding</span>": [ + { + "<span class="field">system</span>": "<span class="value">http://terminology.hl7.org/CodeSystem/observation-category</span>", + "<span class="field">code</span>": "<span class="value">social-history</span>", + "<span class="field">display</span>": "<span class="value">Social History</span>" + }] + }], + "<span class="field">code</span>": { + "<span class="field">coding</span>": [ + { + "<span class="field">system</span>": "<span class="value"><mark class="color13">http://loinc.org</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color12">72166-2</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color14">Tobacco smoking status NHIS</mark></span>" + }] + }, + "<span class="field">subject</span>": { + "<span class="field">reference</span>": "<span class="value">Patient/62f17e29b7532c0009e217b7</span>" + }, + "<span class="field">effectiveDateTime</span>": "<span class="value">2014-06-06T15:32:00.000Z</span>", + "<span class="field">issued</span>": "<span class="value">2014-06-06T15:32:00.000Z</span>", + "<span class="field">performer</span>": [ + { + "<span class="field">reference</span>": "<span class="value">Practitioner/62f17e2ae0231200076884d5</span>" + }], + "<span class="field">valueCodeableConcept</span>": { + "<span class="field">coding</span>": [ + { + "<span class="field">system</span>": "<span class="value"><mark class="color16">http://www.snomed.org/</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color15">449868002</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color17">Current every day smoker</mark></span>" + }] + }} +}</div> </td></tr></table> -### Example: Smoking Status - -<table><tr><th>CDA Example</th><th>FHIR Resource</th></tr> -<tr><td> -... -</td><td> -... -</td></tr></table> ### Example: Pregnancy Observation From eb3c7cea5a36a2acb90735a951188a7613efd125 Mon Sep 17 00:00:00 2001 From: jlyle1 <jay@lyle.net> Date: Fri, 8 Nov 2024 16:15:09 -0500 Subject: [PATCH 104/112] added scope/priority note to background --- input/pagecontent/mappingBackground.md | 15 +++++++++++++++ 1 file changed, 15 insertions(+) diff --git a/input/pagecontent/mappingBackground.md b/input/pagecontent/mappingBackground.md index 0f43e3c..5404e50 100644 --- a/input/pagecontent/mappingBackground.md +++ b/input/pagecontent/mappingBackground.md @@ -28,6 +28,21 @@ Bi-directional automated transform is possible in constrained use cases but is n Our roadmap prioritizes USCDI, so we strive to map items in the respective standards that support USCDI. As elements are added to new versions of USCDI, we may map them in advance, especially when we are already engaged in a related domain. We also may omit or defer maps for elements that are both difficult and of dubious use, i.e., items that are not in USCDI and are deprecated or omitted from later editions of either specification. +For FHIR-to-C-CDA maps, our source scope is US Core 4. For targets, we use the following priority: +1. C-CDA 2.1 +2. C-CDA Companion Guide +3. CDA + +For C-CDA-to-FHIR maps, our source scope is C-CDA 2.1 support for USCDI 1. For targets, we use the following priority for targets, trying to map as high up on the list as possible +1. US Core 4 Profiles +2. FHIR Core +3. FHIR Core Extensions +4. Extensions from other US Core releases +5. Extensions that pre-adopt Core FHIR properties <br/> + and, in cases where none of these suffice but the element is critical we reserve the option of +6. Defining new assets (extensions, Observations) + + We employed several tactics to meet our goals. Standards developers drafted maps based on the respective specifications, and these were reviewed by stakeholders both offline and at public, regularly scheduled meetings. These meetings included implementors, terminologists, regulatory and public health representatives, and strategists, who engaged in realignment, consensus-seeking, and reformatting of the maps for a variety of audiences. Difficult questions were escalated to the work groups responsible for the specifications. Issues and their resolutions were logged in the publicly accessible project site. In addition, the project team employed the example-based approach through Connectathons with vendors and experts in the standards community. The approach involves sharing inbound examples among the vendors, comparing the outbound artifacts generated by these vendors, and discussing with the group to achieve alignment in best practice recommendations. Our team has been focused on the generated artifacts, regardless of the transformation technologies, so any vendor is empowered to achieve the same transformation results. Note that, to date, the Connectathons have addresses only the CDA-to-FHIR cases, though two implementers have provided feedback on the FHIR-to-CDA cases. From cefac1bdace105bec3ec643b0b74472b580e2976 Mon Sep 17 00:00:00 2001 From: jlyle1 <jay@lyle.net> Date: Thu, 14 Nov 2024 15:16:33 -0500 Subject: [PATCH 105/112] ballot edit tweaks to allergy, encounter, imm --- input/pagecontent/CF-allergies.md | 5 +++-- input/pagecontent/CF-encounters.md | 2 +- input/pagecontent/CF-immunizations.md | 4 ++-- input/pagecontent/mappingBackground.md | 17 +---------------- input/pagecontent/mappingGuidance.md | 9 +++++++++ 5 files changed, 16 insertions(+), 21 deletions(-) diff --git a/input/pagecontent/CF-allergies.md b/input/pagecontent/CF-allergies.md index 562763f..fe40d98 100644 --- a/input/pagecontent/CF-allergies.md +++ b/input/pagecontent/CF-allergies.md @@ -14,8 +14,9 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea |/@negationInd||See constraints under /participant |/id|.identifier| [CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| |/effectiveTime/low|.onsetDateTime|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)<br/>effectiveTime/high should not be mapped within onset (DateTime or Period)| +|/effectiveTime/high|.extension:[allergyintolerance-abatement](http://hl7.org/fhir/StructureDefinition/allergyintolerance-abatement)|| |/value|.type<br/>&<br/>.category|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>[CDA value → FHIR type](ConceptMap-CF-AllergyIntoleranceType.html) <br/> [CDA value → FHIR category](./ConceptMap-CF-AllergyIntoleranceCategory.html)| -|/author|.recorder<br/>&<br/>**[Provenance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-provenance.html)**|**Constraint:** Only map single CDA author to FHIR recorder<br/>[Guidance on CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| +|/author|.recorder<br/>&<br/>**[Provenance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-provenance.html)**|**Constraint:** Only map last CDA author to FHIR recorder<br/>[Guidance on CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| |/author/time|.recordedDate|**Constraint:** Only map earliest author/time <br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)| |/participant/participantRole/playingEntity/code|.code|**Constraint:** When CDA negation is absent or false<br/>[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |/participant/participantRole/playingEntity/code<br/>&<br/>/value|.code|**Constraint:** When CDA negation is true and nullFlavor is used in playingEntity/code<br/>[CDA No known allergy → FHIR code](ConceptMap-CF-NoKnownAllergies.html)<br/> When negation is true and playingEntity/code is populated, use equivalent negated concept (e.g. map latex substance to no known latex allergy [1003774007, SNOMED CT]) if available. If not, use the [substanceExposureRisk extension](https://hl7.org/fhir/extensions/StructureDefinition-allergyintolerance-substanceExposureRisk.html), placing the substance in the substance sub-extension and setting the exposureRisk sub-extension to `no-known-reaction-risk`. Note that when using this extension, the AllergyIntolerance resource will not be a conformant US Core AllergyIntolerance since the extension prohibits the required .code element.| @@ -32,7 +33,7 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea 3\. Note that these entryRelationships will also have inversionInd="true" in CDA -When authors or other provenance are recorded in the parentƒ [Allergy Concern Act](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-AllergyConcernAct.html), it is recommended that those data be mapped to the FHIR AllergyIntolerance. +When authors or other provenance are recorded only in the parent [Allergy Concern Act](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-AllergyConcernAct.html), it is recommended that those data be mapped to the FHIR AllergyIntolerance. ### Example diff --git a/input/pagecontent/CF-encounters.md b/input/pagecontent/CF-encounters.md index ad7b1d1..0575966 100644 --- a/input/pagecontent/CF-encounters.md +++ b/input/pagecontent/CF-encounters.md @@ -2,7 +2,7 @@ This page provides a mapping from CDA to FHIR. <!-- For the FHIR to CDA mapping, please refer to [Encounters FHIR → CDA](./FC-encounters.html). --> For guidance on how to read the table below, see [Reading the C-CDA ↔ FHIR Mapping Pages](./mappingGuidance.html). -Encounter Activities in the Encounters Section (or elsewhere in the document, such as `<entryReference>` on Clinical Notes) correspond FHIR Encounter resources. If the document itself contains a `componentOf/encompassingEncounter`, this should also be converted to a FHIR Encounter resource. In all cases, when the same encounter is referenced multiple times (such as the `encompassingEncounter` and an Encounter Activity in the Encounters Section containing the same `<id>`), it should be converted to the same FHIR resource. +Encounter Activities in the Encounters Section (or elsewhere in the document, such as `<entryReference>` on Clinical Notes) correspond FHIR Encounter resources. If the document itself contains a `componentOf/encompassingEncounter`, this should also be converted to a FHIR Encounter resource. In all cases, when the same encounter is referenced multiple times (such as the `encompassingEncounter` and an Encounter Activity in the Encounters Section containing the same `<id>`), it should be converted to a single FHIR resource. ### C-CDA Encounter to FHIR <sup>(b)</sup> - indicates element is only present in Encounter Activity in the body of the document<br/><sup>(h)</sup> - indicates element is only present in EncompassingEncounter in the header of the document diff --git a/input/pagecontent/CF-immunizations.md b/input/pagecontent/CF-immunizations.md index b82d3b4..f3c3055 100644 --- a/input/pagecontent/CF-immunizations.md +++ b/input/pagecontent/CF-immunizations.md @@ -2,7 +2,7 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, please refer to [Immunizations FHIR → CDA](./FC-immunizations.html). For guidance on how to read the table below, see [Reading the C-CDA ↔ FHIR Mapping Pages](./mappingGuidance.html) -Mapping is from `@moodCode="EVN"` (i.e. historical) immunizations, not `INT` (future / planned) immunizations. +Mapping is from `@moodCode="EVN"` (i.e. historical) immunizations, not `INT` (future / planned) immunizations. For INT, use the MedicationRequest resource. <br /> <br /> @@ -21,7 +21,7 @@ Mapping is from `@moodCode="EVN"` (i.e. historical) immunizations, not `INT` (fu |/consumable/manufacturedProduct/manufacturedMaterial/code|.vaccineCode|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) |/consumable/manufacturedMaterial/lotNumberText|.lotNumber|| |/consumable/manufacturedMaterial/manufacturerOrganization|.manufacturer| -|N/A|.primarySource|Since this is unavailable in CDA, when mapping to a FHIR profile that requires the element (such as USCore prior to Release 6), include a [data-absent-reason extension](http://hl7.org/fhir/StructureDefinition/data-absent-reason). +|N/A|.primarySource|Since this is unavailable in CDA, when mapping to a FHIR profile that requires the element (such as USCore prior to Release 6), include a [data-absent-reason extension](http://hl7.org/fhir/StructureDefinition/data-absent-reason) such as 'unsupported'. |/author|**[Provenance](http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-provenance.html)**|[CDA ↔ FHIR Provenance](mappingGuidance.html#cda--fhir-provenance)| |/author/time|.recorded|Earliest, if more than one.<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) |/performer|.performer|Set ```performer.function="AP"``` diff --git a/input/pagecontent/mappingBackground.md b/input/pagecontent/mappingBackground.md index 5404e50..70b501c 100644 --- a/input/pagecontent/mappingBackground.md +++ b/input/pagecontent/mappingBackground.md @@ -5,7 +5,7 @@ In our first publication, we focused on the subset of domains that are recognize <div xmlns="http://www.w3.org/1999/xhtml" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"> <blockquote class="stu-note"> <b>Mapping Consensus</b> - <p>Note that C-CDA → FHIR mappings had a significant exposure to achieve multi-vendor consensus. This included through two FHIR Connectathons (September 2022 and January 2023) and regular weekly engagement. Vendors and organizations participating in this process include: + <p>Note that C-CDA → FHIR mappings had a significant exposure to achieve multi-vendor consensus. This has included four FHIR Connectathons (9/2022, 1/2023, 5/2023, 9/2023) and regular weekly engagements. Vendors and organizations participating in this process include: <ul> <li>Cerner (Oracle)</li> <li>Diameter Health (Availity)</li> @@ -28,21 +28,6 @@ Bi-directional automated transform is possible in constrained use cases but is n Our roadmap prioritizes USCDI, so we strive to map items in the respective standards that support USCDI. As elements are added to new versions of USCDI, we may map them in advance, especially when we are already engaged in a related domain. We also may omit or defer maps for elements that are both difficult and of dubious use, i.e., items that are not in USCDI and are deprecated or omitted from later editions of either specification. -For FHIR-to-C-CDA maps, our source scope is US Core 4. For targets, we use the following priority: -1. C-CDA 2.1 -2. C-CDA Companion Guide -3. CDA - -For C-CDA-to-FHIR maps, our source scope is C-CDA 2.1 support for USCDI 1. For targets, we use the following priority for targets, trying to map as high up on the list as possible -1. US Core 4 Profiles -2. FHIR Core -3. FHIR Core Extensions -4. Extensions from other US Core releases -5. Extensions that pre-adopt Core FHIR properties <br/> - and, in cases where none of these suffice but the element is critical we reserve the option of -6. Defining new assets (extensions, Observations) - - We employed several tactics to meet our goals. Standards developers drafted maps based on the respective specifications, and these were reviewed by stakeholders both offline and at public, regularly scheduled meetings. These meetings included implementors, terminologists, regulatory and public health representatives, and strategists, who engaged in realignment, consensus-seeking, and reformatting of the maps for a variety of audiences. Difficult questions were escalated to the work groups responsible for the specifications. Issues and their resolutions were logged in the publicly accessible project site. In addition, the project team employed the example-based approach through Connectathons with vendors and experts in the standards community. The approach involves sharing inbound examples among the vendors, comparing the outbound artifacts generated by these vendors, and discussing with the group to achieve alignment in best practice recommendations. Our team has been focused on the generated artifacts, regardless of the transformation technologies, so any vendor is empowered to achieve the same transformation results. Note that, to date, the Connectathons have addresses only the CDA-to-FHIR cases, though two implementers have provided feedback on the FHIR-to-CDA cases. diff --git a/input/pagecontent/mappingGuidance.md b/input/pagecontent/mappingGuidance.md index 781daaa..10117e3 100644 --- a/input/pagecontent/mappingGuidance.md +++ b/input/pagecontent/mappingGuidance.md @@ -584,6 +584,15 @@ In this publication, we include a mapping between missing data concepts. **Impor - [NullFlavor (CDA) → Data Absent Reason code (FHIR)](./ConceptMap-CF-NullFlavorDataAbsentReason.html) - [Data Absent Reason code (FHIR) → NullFlavor (CDA)](./ConceptMap-FC-DataAbsentReasonNullFlavor.html) +### Note Text +The CDA Comment Activity template is used for text notes accompanied by their author. The FHIR Annotation datatype can capture text and an author as well. + +|C-CDA|FHIR|Notes| +|:-------|:------|:---------| +|text|text|| +|author/time|time|| +|author/assignedAuthor|authorReference|Ideally this is a PractitionerRole, which can then support both Pracitioner (name) and Organization, if necessary.| + ### Narrative Text The CDA section narrative text is an authoritative portion of the document and must be preserved when transforming to FHIR. When creating a FHIR Composition resource (or converting a FHIR Composition back into CDA), this is a straightforward mapping between CDA's `section/text` and the FHIR Composition `section.text` field. There is a slight difference in allowed elements - CDA defines a limited set of elements in its NarrativeBlock schema, and FHIR limits narratives to a subset of XHTML - but these two fields can generally be mapped 1:1. These differences are described below. From 0204c1cc5ea7c16f2bca2703244dc60475b9d738 Mon Sep 17 00:00:00 2001 From: jlyle1 <jay@lyle.net> Date: Thu, 14 Nov 2024 15:46:37 -0500 Subject: [PATCH 106/112] links on comment paragraph --- input/pagecontent/mappingGuidance.md | 2 +- 1 file changed, 1 insertion(+), 1 deletion(-) diff --git a/input/pagecontent/mappingGuidance.md b/input/pagecontent/mappingGuidance.md index 10117e3..471bf01 100644 --- a/input/pagecontent/mappingGuidance.md +++ b/input/pagecontent/mappingGuidance.md @@ -585,7 +585,7 @@ In this publication, we include a mapping between missing data concepts. **Impor - [Data Absent Reason code (FHIR) → NullFlavor (CDA)](./ConceptMap-FC-DataAbsentReasonNullFlavor.html) ### Note Text -The CDA Comment Activity template is used for text notes accompanied by their author. The FHIR Annotation datatype can capture text and an author as well. +The CDA [Comment Activity](https://build.fhir.org/ig/HL7/CDA-ccda/StructureDefinition-CommentActivity.html) template is used for text notes accompanied by their author. The FHIR [Annotation](https://hl7.org/fhir/R4/datatypes.html#annotation) datatype can capture text and an author as well. |C-CDA|FHIR|Notes| |:-------|:------|:---------| From e9d2b487a76072cddbf0faf550c28f6680244110 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Thu, 14 Nov 2024 15:04:34 -0600 Subject: [PATCH 107/112] Update examples for encounters/social hx --- input/pagecontent/CF-encounters.md | 135 ++++++++++++++++++-- input/pagecontent/CF-social.md | 194 +++++++++++++++++++---------- 2 files changed, 252 insertions(+), 77 deletions(-) diff --git a/input/pagecontent/CF-encounters.md b/input/pagecontent/CF-encounters.md index 0575966..a66949f 100644 --- a/input/pagecontent/CF-encounters.md +++ b/input/pagecontent/CF-encounters.md @@ -24,20 +24,139 @@ Encounter Activities in the Encounters Section (or elsewhere in the document, su |**[Encounter Diagnosis](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-EncounterDiagnosis.html)** <sup>(b)</sup><br/>/entryRelationship/act[code/@code="29308-4"]/observation|**[Encounter Diagnosis](https://hl7.org/fhir/us/core/StructureDefinition-us-core-condition-encounter-diagnosis.html)**<br/>&<br/>.diagnosis.condition|The observation maps identically to [CDA → FHIR Problems](./CF-problems.html).<br/>Since this is an encounter diagnosis, the `Observation.category` should be set to `encounter-diagnosis`. -### Example: EncompassingEncounter +### Example: Encounter -<table><tr><th>CDA Example</th><th>FHIR Resource</th></tr> +<table><tr><th>CDA Encounter</th><th>FHIR Encounter Resource</th></tr> <tr><td> -... +<div id="cda" class="border codeArea"><<span class="field">encounter</span> <span class="attrib">classCode=</span><span class="value">"ENC"</span> <span class="attrib">moodCode=</span><span class="value">"EVN"</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.49"</span> <span class="attrib">extension=</span><span class="value">"2015-08-01"</span>/> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.49"</span>/> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"<mark class="color10">2a620155-9d11-439e-92b3-5d9815ff4de8</mark>"</span>/> + <<span class="field">code</span> <span class="attrib">code=</span><span class="value">"<mark class="color11"><mark class="color11">99213</mark></mark>"</span> <span class="attrib">displayName=</span><span class="value">"<mark class="color12">Office outpatient visit 15 minutes</mark>"</span> + <span class="attrib">codeSystemName=</span><span class="value">"CPT"</span> <span class="attrib">codeSystem=</span><span class="value">"<mark class="color13">2.16.840.1.113883.6.12</mark>"</span> + <span class="attrib">codeSystemVersion=</span><span class="value">"4"</span>> + <<span class="field">originalText</span>> + <<span class="field">reference</span> <span class="attrib">value=</span><span class="value">"#Encounter1_type"</span>/> + </<span class="field">originalText</span>> + </<span class="field">code</span>> + <<span class="field">text</span>> + <<span class="field">reference</span> <span class="attrib">value=</span><span class="value">"#Encounter1"</span>/> + </<span class="field">text</span>> + <<span class="field">effectiveTime</span> <span class="attrib">value=</span><span class="value">"<mark class="color14">201208151000-0800</mark>"</span>/> + <span class="comment"><!-- Maps to reference: <mark class="color16">Practitioner/62f17e2ae0231200076884d4</mark> --></span> + <<span class="field">performer</span>> + <<span class="field">assignedEntity</span>> + ... + </<span class="field">assignedEntity</span>> + </<span class="field">performer</span>> + <<span class="field">entryRelationship</span> <span class="attrib">typeCode=</span><span class="value">"REFR"</span>> + <<span class="field">act</span> <span class="attrib">classCode=</span><span class="value">"ACT"</span> <span class="attrib">moodCode=</span><span class="value">"EVN"</span>> + <span class="comment"><!-- Encounter Diagnosis --></span> + <span class="comment"><!-- Creates reference: <mark class="color17">Condition/62f17e2aa2392d0008fbb232</mark> --></span> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.80"</span> <span class="attrib">extension=</span><span class="value">"2015-08-01"</span> /> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.80"</span>/> + <<span class="field">code</span> <span class="attrib">code=</span><span class="value">"29308-4"</span> <span class="attrib">displayName=</span><span class="value">"<mark class="color15">Diagnosis</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"2.16.840.1.113883.6.1"</span> + <span class="attrib">codeSystemName=</span><span class="value">"LOINC"</span>/> + <<span class="field">entryRelationship</span> <span class="attrib">typeCode=</span><span class="value">"SUBJ"</span>> + ... + </<span class="field">entryRelationship</span>> + </<span class="field">act</span>> + </<span class="field">entryRelationship</span>> +</<span class="field">encounter</span>></div> </td><td> -... +<div id="fhir" class="border codeArea">{ + "<span class="field">resourceType</span>": "<span class="value">Encounter</span>", + "<span class="field">id</span>": "<span class="value">62f17e2aa2392d0008fbb224</span>", + "<span class="field">identifier</span>": [{ + "<span class="field">value</span>": "<span class="value">urn:uuid:<mark class="color10">2a620155-9d11-439e-92b3-5d9815ff4de8</mark></span>", + "<span class="field">system</span>": "<span class="value">urn:ietf:rfc:3986</span>" + }], + "<span class="field">status</span>": "<span class="value">finished</span>", + "<span class="field">class</span>": { + "<span class="field">system</span>": "<span class="value">http://terminology.hl7.org/CodeSystem/v3-ActCode</span>", + "<span class="field">code</span>": <mark class="color11">"AMB"</mark>, + "<span class="field">display</span>": "<span class="value">ambulatory</span>" + }, + "<span class="field">type</span>": [{ + "<span class="field">coding</span>": [{ + "<span class="field">system</span>": "<span class="value"><mark class="color13">http://www.ama-assn.org/go/cpt</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color11">99213</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color12">Office outpatient visit 15 minutes</mark></span>" + }], + "<span class="field">text</span>": "<span class="value">Office outpatient visit</span>" + }], + "<span class="field">subject</span>": { "reference": "<span class="value">Patient/62f17e29b7532c0009e217b7</span>" }, + "<span class="field">participant</span>": [{ + "<span class="field">individual</span>": { + "<span class="field">reference</span>": "<span class="value"><mark class="color16">Practitioner/62f17e2ae0231200076884d4</mark></span>" + } + }], + "<span class="field">period</span>": { + "<span class="field">start</span>": "<span class="value"><mark class="color14">2012-08-15T10:00:00-08:00</mark></span>" + }, + "<mark class="color15">diagnosis</mark>": [{ + "<span class="field">condition</span>": { + "<span class="field">reference</span>": "<span class="value"><mark class="color17">Condition/62f17e2aa2392d0008fbb232</mark></span>" + } + }] +}</div> </td></tr></table> -### Example: Encounter Activity +### Example: EncompassingEncounter -<table><tr><th>CDA Example</th><th>FHIR Resource</th></tr> +<table><tr><th>CDA EncompassingEncounter Example</th><th>FHIR Encounter Resource</th></tr> <tr><td> -... +<div id="cda" class="border codeArea"><<span class="field">encompassingEncounter</span>> + <<span class="field">id</span> <span class="attrib">root=</span><span class="value">"<mark class="color10">2a620155-9d11-439e-92b3-5d9815ff4de8</mark>"</span>/> + <<span class="field">code</span> <span class="attrib">code=</span><span class="value">"<mark class="color11"><mark class="color11">99213</mark></mark>"</span> <span class="attrib">displayName=</span><span class="value">"<mark class="color12">Office outpatient visit 15 minutes</mark>"</span> + <span class="attrib">codeSystemName=</span><span class="value">"CPT"</span> <span class="attrib">codeSystem=</span><span class="value">"<mark class="color13">2.16.840.1.113883.6.12</mark>"</span> + <span class="attrib">codeSystemVersion=</span><span class="value">"4"</span> /> + <<span class="field">effectiveTime</span>> + <<span class="field">low</span> <span class="attrib">value=</span><span class="value">"<mark class="color14">20120815100000-0800</mark>"</span> /> + <<span class="field">high</span> <span class="attrib">value=</span><span class="value">"<mark class="color15">20120815101500-0800</mark>"</span> /> + </<span class="field">effectiveTime</span>> + <span class="comment"><!-- Maps to reference: <mark class="color16">Practitioner/62f17e2ae0231200076884d4</mark> --></span> + <<span class="field">participant</span>> + ... + </<span class="field">participant</span>> + <span class="comment"><!-- Maps to reference: <mark class="color17">Location/sdLoc</mark> --></span> + <<span class="field">location</span>> + ... + </<span class="field">location</span>> +</<span class="field">encompassingEncounter</span>></div> </td><td> -... +<div id="fhir" class="border codeArea">{ + "<span class="field">resourceType</span>": "<span class="value">Encounter</span>", + "<span class="field">id</span>": "<span class="value">62f17e2aa2392d0008fbb224</span>", + "<span class="field">identifier</span>": [{ + "<span class="field">value</span>": "<span class="value">urn:uuid:<mark class="color10">2a620155-9d11-439e-92b3-5d9815ff4de8</mark></span>", + "<span class="field">system</span>": "<span class="value">urn:ietf:rfc:3986</span>" + }], + "<span class="field">status</span>": "<span class="value">finished</span>", + "<span class="field">class</span>": { + "<span class="field">system</span>": "<span class="value">http://terminology.hl7.org/CodeSystem/v3-ActCode</span>", + "<span class="field">code</span>": <mark class="color11">"AMB"</mark>, + "<span class="field">display</span>": "<span class="value">ambulatory</span>" + }, + "<span class="field">type</span>": [{ + "<span class="field">coding</span>": [{ + "<span class="field">system</span>": "<span class="value"><mark class="color13">http://www.ama-assn.org/go/cpt</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color11">99213</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color12">Office outpatient visit 15 minutes</mark></span>" + }] + }], + "<span class="field">subject</span>": { "reference": "<span class="value">Patient/62f17e29b7532c0009e217b7</span>" }, + "<span class="field">location</span>": [{ + "<span class="field">location</span>": { "reference": "<span class="value"><mark class="color17">Location/sdLoc</mark></span>" } + }], + "<span class="field">participant</span>": [{ + "<span class="field">individual</span>": { "reference": "<span class="value"><mark class="color16">Practitioner/62f17e2ae0231200076884d4</mark></span>" } + }], + "<span class="field">period</span>": { + "<span class="field">start</span>": "<span class="value"><mark class="color14">2012-08-15T10:00:00-08:00</mark></span>", + "<span class="field">end</span>": "<span class="value"><mark class="color15">2012-08-15T10:15:00-08:00</mark></span>" + } +} +</div> </td></tr></table> \ No newline at end of file diff --git a/input/pagecontent/CF-social.md b/input/pagecontent/CF-social.md index a1743f9..73d96c4 100644 --- a/input/pagecontent/CF-social.md +++ b/input/pagecontent/CF-social.md @@ -31,12 +31,12 @@ This maps to US Core version 6's Simple Observation. Previous versions of US Cor Additional fields, such as `.interpretationCode`, `.referenceRange`, `.performer` are not documented in C-CDA but can be mapped in the same manner as [Results](./CF-results.html). ### C-CDA Smoking Status / Tobacco Use to FHIR Observation -In C-CDA 3.0, the Smoking Status - MU and Tobacco Use templates were merged into a single template to better match US Core's Smoking Status template. +In C-CDA 3.0, the Smoking Status - MU and Tobacco Use templates were merged into a single template to better match the [US Core V7](https://hl7.org/fhir/us/core/STU7/StructureDefinition-us-core-smokingstatus.html) Smoking Status template. In general, the mapping follows the standard Social History mapping above, but additional caveats are noted below. -|C-CDA<br/>[Smoking Status - MU](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-SmokingStatusMeaningfulUse.html) (Deprecated)<br/>[Tobacco Use](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-TobaccoUse.html) (Decprecated)<br/>[Smoking Status](https://build.fhir.org/ig/HL7/CDA-ccda/StructureDefinition-SmokingStatus.html) (C-CDA 3.0)²|FHIR<br/>[Smoking Status Observation](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-smokingstatus.html)|Transform Steps| +|C-CDA<br/>[Smoking Status - MU](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-SmokingStatusMeaningfulUse.html) (Deprecated)<br/>[Tobacco Use](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-TobaccoUse.html) (Decprecated)<br/>[Smoking Status](https://build.fhir.org/ig/HL7/CDA-ccda/StructureDefinition-SmokingStatus.html) (C-CDA 3.0)²|FHIR<br/>[Smoking Status Observation (US Core 4)](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-smokingstatus.html)|Transform Steps| |:----|:----|:----| -|/code|.code|Prior to US Core 7, the code should be `72166-2 (Tobacco smoking status NCIS)`, but this is an extensible value set.<br/>In US Core 7, the value set remains extensible, but contains the same 4 concepts allowed in the C-CDA R3.0's Smoking Status value set. -|/effectiveTime|.effectiveDateTime<br/>or<br/>.effectivePeriod|Smoking Status - MU required a timestamp; Tobacco Use required a time range; Smoking Status (3.0) combines the two templates into one and allows for either. +|/code|.code|Prior to US Core 7, the code in FHIR should be `72166-2 (Tobacco smoking status NCIS)`, but this is an extensible value set, so other codes used in the older C-CDA templates may be used.<br/>In US Core 7, the value set remains extensible, but contains the same 4 concepts allowed in the C-CDA R3.0's Smoking Status value set. +|/effectiveTime|.effectiveDateTime<br/>or<br/>.effectivePeriod|Smoking Status - MU required a timestamp; Tobacco Use required a time range; Smoking Status (3.0) combines the two templates into one and allows for either.<br/>When mapping to US Core be aware of the requirements around effectiveTime. In v7, time can be either a period or a single value. Prior to v7, the Smoking Status Observation only allowed a single timestamp. If Mapping a C-CDA Tobacco Use template that contains a date range, use one of the following approaches:<br/>- Map to the US Core 7 version of the Smoking Status Observation<br/>- Map to a generic FHIR observation (i.e. do not assert conformance with US Core)<br/>- Omit the effectiveTime high value or create a non-conformant US Core Smoking Status Observation ### C-CDA Pregnancy Observation to FHIR Pregnancy Status Observation In US Core, Pregnancy Observation was first defined in version 6. @@ -67,71 +67,60 @@ The following is a comparison between C-CDA and FHIR Smoking Status Observations <table><tr><th>CDA Example</th><th>FHIR Resource</th></tr> <tr><td> -<div id="cda" class="border codeArea"> -<<span class="field">entry</span>> - <<span class="field">observation</span> <span class="attrib">classCode=</span><span class="value">"OBS"</span> <span class="attrib">moodCode=</span><span class="value">"EVN"</span>> - <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.78"</span>/> - <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.78"</span> - <span class="attrib">extension=</span><span class="value">"2014-06-09"</span>/> - <<span class="field">id</span> <span class="attrib">extension=</span><span class="value">"<mark class="color10">123456789</mark>"</span> <span class="attrib">root=</span><span class="value">"<mark class="color11">2.16.840.1.113883.19</mark>"</span> /> - <<span class="field">code</span> - <span class="attrib">code=</span><span class="value">"<mark class="color12">72166-2</mark>"</span> - <span class="attrib">codeSystem=</span><span class="value">"<mark class="color13">2.16.840.1.113883.6.1</mark>"</span> - <span class="attrib">displayName=</span><span class="value">"<mark class="color14">Tobacco smoking status NHIS</mark>"</span>/> - <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"completed"</span>/> - <<span class="field">effectiveTime</span> <span class="attrib">value=</span><span class="value">"201406061032-0500"</span>/> - <<span class="field">value</span> <span class="attrib">xsi:type=</span><span class="value">"CD"</span> - <span class="attrib">code=</span><span class="value">"<mark class="color15">449868002</mark>"</span> - <span class="attrib">codeSystem=</span><span class="value">"<mark class="color16">2.16.840.1.113883.6.96</mark>"</span> - <span class="attrib">codeSystemName=</span><span class="value">"<mark class="color16"><mark class="color16">SNOMED</mark> CT</mark>"</span> - <span class="attrib">displayName=</span><span class="value">"<mark class="color17">Current every day smoker</mark>"</span>/> - </<span class="field">observation</span>> -</<span class="field">entry</span>></div> +<div id="cda" class="border codeArea"><<span class="field">observation</span> <span class="attrib">classCode=</span><span class="value">"OBS"</span> <span class="attrib">moodCode=</span><span class="value">"EVN"</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.78"</span>/> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.22.4.78"</span> + <span class="attrib">extension=</span><span class="value">"2014-06-09"</span>/> + <<span class="field">id</span> + <span class="attrib">extension=</span><span class="value">"<mark class="color10">123456789</mark>"</span> + <span class="attrib">root=</span><span class="value">"<mark class="color11">2.16.840.1.113883.19</mark>"</span> /> + <<span class="field">code</span> + <span class="attrib">code=</span><span class="value">"<mark class="color12">72166-2</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color13">2.16.840.1.113883.6.1</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color14">Tobacco smoking status NHIS</mark>"</span>/> + <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"completed"</span>/> + <<span class="field">effectiveTime</span> <span class="attrib">value=</span><span class="value">"<mark class="color15">20140606153200+0000</mark>"</span>/> + <<span class="field">value</span> <span class="attrib">xsi:type=</span><span class="value">"CD"</span> + <span class="attrib">code=</span><span class="value">"<mark class="color16">449868002</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color17">2.16.840.1.113883.6.96</mark>"</span> + <span class="attrib">codeSystemName=</span><span class="value">"<mark class="color17"><mark class="color17">SNOMED</mark> CT</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color18">Current every day smoker</mark>"</span>/> +</<span class="field">observation</span>> +</div> </td><td> <div id="fhir" class="border codeArea">{ - "<span class="field">fullUrl</span>": "<span class="value">http://fhir:3447/4_0_0/Observation/62f17e2aa2392d0008fbb23a</span>", - "<span class="field">resource</span>": { - "<span class="field">resourceType</span>": "<span class="value">Observation</span>", - "<span class="field">id</span>": "<span class="value">62f17e2aa2392d0008fbb23a</span>", - "<span class="field">language</span>": "<span class="value">en-US</span>", - "<span class="field">identifier</span>": [{ - "<span class="field">system</span>": "<span class="value">urn:oid:<mark class="color11">2.16.840.1.113883.19</mark></span>", - "<span class="field">value</span>": "<span class="value"><mark class="color10">123456789</mark></span>" - }], - "<span class="field">status</span>": "<span class="value">final</span>", - "<span class="field">category</span>": [{ - "<span class="field">coding</span>": [ - { - "<span class="field">system</span>": "<span class="value">http://terminology.hl7.org/CodeSystem/observation-category</span>", - "<span class="field">code</span>": "<span class="value">social-history</span>", - "<span class="field">display</span>": "<span class="value">Social History</span>" - }] - }], - "<span class="field">code</span>": { - "<span class="field">coding</span>": [ - { - "<span class="field">system</span>": "<span class="value"><mark class="color13">http://loinc.org</mark></span>", - "<span class="field">code</span>": "<span class="value"><mark class="color12">72166-2</mark></span>", - "<span class="field">display</span>": "<span class="value"><mark class="color14">Tobacco smoking status NHIS</mark></span>" - }] - }, - "<span class="field">subject</span>": { - "<span class="field">reference</span>": "<span class="value">Patient/62f17e29b7532c0009e217b7</span>" - }, - "<span class="field">effectiveDateTime</span>": "<span class="value">2014-06-06T15:32:00.000Z</span>", - "<span class="field">issued</span>": "<span class="value">2014-06-06T15:32:00.000Z</span>", - "<span class="field">performer</span>": [ - { - "<span class="field">reference</span>": "<span class="value">Practitioner/62f17e2ae0231200076884d5</span>" - }], - "<span class="field">valueCodeableConcept</span>": { - "<span class="field">coding</span>": [ - { - "<span class="field">system</span>": "<span class="value"><mark class="color16">http://www.snomed.org/</mark></span>", - "<span class="field">code</span>": "<span class="value"><mark class="color15">449868002</mark></span>", - "<span class="field">display</span>": "<span class="value"><mark class="color17">Current every day smoker</mark></span>" - }] - }} + "<span class="field">resourceType</span>": "<span class="value">Observation</span>", + "<span class="field">id</span>": "<span class="value">62f17e2aa2392d0008fbb23a</span>", + "<span class="field">identifier</span>": [{ + "<span class="field">system</span>": "<span class="value">urn:oid:<mark class="color11">2.16.840.1.113883.19</mark></span>", + "<span class="field">value</span>": "<span class="value"><mark class="color10">123456789</mark></span>" + }], + "<span class="field">status</span>": "<span class="value">final</span>", + "<span class="field">category</span>": [{ + "<span class="field">coding</span>": [{ + "<span class="field">system</span>": "<span class="value">http://terminology.hl7.org/CodeSystem/observation-category</span>", + "<span class="field">code</span>": "<span class="value">social-history</span>", + "<span class="field">display</span>": "<span class="value">Social History</span>" + }] + }], + "<span class="field">code</span>": { + "<span class="field">coding</span>": [{ + "<span class="field">system</span>": "<span class="value"><mark class="color13">http://loinc.org</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color12">72166-2</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color14">Tobacco smoking status NHIS</mark></span>" + }] + }, + "<span class="field">subject</span>": { + "<span class="field">reference</span>": "<span class="value">Patient/62f17e29b7532c0009e217b7</span>" + }, + "<span class="field">effectiveDateTime</span>": "<span class="value"><mark class="color15">2014-06-06T15:32:00.000Z</mark></span>", + "<span class="field">valueCodeableConcept</span>": { + "<span class="field">coding</span>": [{ + "<span class="field">system</span>": "<span class="value"><mark class="color17">http://www.snomed.org/</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color16">449868002</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color18">Current every day smoker</mark></span>" + }] + } }</div> </td></tr></table> @@ -140,7 +129,74 @@ The following is a comparison between C-CDA and FHIR Smoking Status Observations <table><tr><th>CDA Example</th><th>FHIR Resource</th></tr> <tr><td> -... +<div id="cda" class="border codeArea"><<span class="field">observation</span> <span class="attrib">classCode=</span><span class="value">"OBS"</span> <span class="attrib">moodCode=</span><span class="value">"EVN"</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.15.3.8"</span>/> + <<span class="field">id</span> <span class="attrib">extension=</span><span class="value">"<mark class="color10">123456789</mark>"</span> <span class="attrib">root=</span><span class="value">"<mark class="color11">2.16.840.1.113883.19</mark>"</span>/> + <span class="comment"><!-- ASSERTION maps to: <mark class="color19">82810-3</mark> --></span> + <<span class="field">code</span> <span class="attrib">code=</span><span class="value">"ASSERTION"</span> <span class="attrib">codeSystem=</span><span class="value">"2.16.840.1.113883.5.4"</span>/> + <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"completed"</span>/> + <<span class="field">effectiveTime</span>> + <<span class="field">low</span> <span class="attrib">value=</span><span class="value">"<mark class="color12">20220824103952+0000</mark>"</span>/> + </<span class="field">effectiveTime</span>> + <<span class="field">value</span> <span class="attrib">xsi:type=</span><span class="value">"CD"</span> <span class="attrib">code=</span><span class="value">"<mark class="color13">77386006</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"<mark class="color14">pregnant</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color15">2.16.840.1.113883.6.96</mark>"</span>/> + <<span class="field">entryRelationship</span> <span class="attrib">typeCode=</span><span class="value">"REFR"</span>> + <<span class="field">observation</span> <span class="attrib">classCode=</span><span class="value">"OBS"</span> <span class="attrib">moodCode=</span><span class="value">"EVN"</span>> + <<span class="field">templateId</span> <span class="attrib">root=</span><span class="value">"2.16.840.1.113883.10.20.15.3.1"</span>/> + <<span class="field">code</span> + <span class="attrib">code=</span><span class="value">"<mark class="color16">11778-8</mark>"</span> + <span class="attrib">codeSystem=</span><span class="value">"<mark class="color17">2.16.840.1.113883.6.1</mark>"</span> + <span class="attrib">displayName=</span><span class="value">"Estimated date of delivery"</span>/> + <<span class="field">text</span>> + <<span class="field">reference</span> <span class="attrib">value=</span><span class="value">"#dod"</span> /> + </<span class="field">text</span>> + <<span class="field">statusCode</span> <span class="attrib">code=</span><span class="value">"completed"</span>/> + <<span class="field">value</span> <span class="attrib">xsi:type=</span><span class="value">"TS"</span> <span class="attrib">value=</span><span class="value">"<mark class="color18">2023-02-14</mark>"</span> /> + </<span class="field">observation</span>> + </<span class="field">entryRelationship</span>> +</<span class="field">observation</span>></div> </td><td> -... +<div id="fhir" class="border codeArea">{ + "<span class="field">resourceType</span>": "<span class="value">Observation</span>", + "<span class="field">id</span>": "<span class="value">pregnancy-status</span>", + "<span class="field">identifier</span>": [{ + "<span class="field">system</span>": "<span class="value">urn:oid:<mark class="color11">2.16.840.1.113883.19</mark></span>", + "<span class="field">value</span>": "<span class="value"><mark class="color10">123456789</mark></span>" + }], + "<span class="field">status</span>": "<span class="value">final</span>", + "<span class="field">category</span>": [{ + "<span class="field">coding</span>": [{ + "<span class="field">system</span>": "<span class="value">http://terminology.hl7.org/CodeSystem/observation-category</span>", + "<span class="field">code</span>": "<span class="value">social-history</span>", + "<span class="field">display</span>": "<span class="value">Social History</span>" + }] + }], + "<span class="field">code</span>": { + "<span class="field">coding</span>": [{ + "<span class="field">system</span>": "<span class="value"><mark class="color17">http://loinc.org</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color19">82810-3</mark></span>", + "<span class="field">display</span>": "<span class="value">Pregnancy status</span>" + }] + }, + "<span class="field">subject</span>": { "reference": "<span class="value">Patient/example</span>" }, + "<span class="field">effectiveDateTime</span>": "<span class="value"><mark class="color12">2022-08-24T10:39:52Z</mark></span>", + "<span class="field">valueCodeableConcept</span>": { + "<span class="field">coding</span>": [{ + "<span class="field">system</span>": "<span class="value"><mark class="color15">http://snomed.info/sct</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color13">77386006</mark></span>", + "<span class="field">display</span>": "<span class="value"><mark class="color14">Pregnant</mark></span>" + }] + }, + "<span class="field">component</span>": [{ + "<span class="field">code</span>": { + "<span class="field">coding</span>": [{ + "<span class="field">system</span>": "<span class="value"><mark class="color17">http://loinc.org</mark></span>", + "<span class="field">code</span>": "<span class="value"><mark class="color16">11778-8</mark></span>", + "<span class="field">display</span>": "<span class="value">Delivery date Estimated</span>" + }] + }, + "<span class="field">valueDateTime</span>": "<span class="value"><mark class="color18">2023-02-14</mark></span>" + }] +}</div> </td></tr></table> \ No newline at end of file From 238f9c712f0bddb09bae52a70576ffbd1e54aa65 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Mon, 18 Nov 2024 09:02:13 -0600 Subject: [PATCH 108/112] Remove random UUID --- input/pagecontent/CF-notes.md | 2 -- 1 file changed, 2 deletions(-) diff --git a/input/pagecontent/CF-notes.md b/input/pagecontent/CF-notes.md index 617b512..5982421 100644 --- a/input/pagecontent/CF-notes.md +++ b/input/pagecontent/CF-notes.md @@ -19,8 +19,6 @@ Clinical Notes may appear in their own section or as an entry in any open sectio |/entryRelationship[@typeCode=COMP]/encounter<br/>or<br/>Parent `<encounter>` element<br/>or<br/>`<encompassingEncounter>`|.context.encounter|C-CDA requires an encounter for notes, but allows for context conduction. If the Note Activity is in an entryRelationship chain that includes an Encounter Activity, use that. Otherwise, if the document contains an `<encompassingEncounter>`, that is the encounter for the note.<br/>[CDA → FHIR Encounters](CF-encounters.html) |/reference/externalDocument/id|.relatesTo.target.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| -4dc41c26-43a4-48d9-b17e-067890006b29 - ### Example <table><tr><th>CDA Note Activity Example</th><th>FHIR DocumentReference Resource</th></tr> From cd7809334d2e1d9177bc10c811785f47592b6b89 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Mon, 18 Nov 2024 09:56:04 -0600 Subject: [PATCH 109/112] Add some notes an example for organization --- input/pagecontent/CF-participations.md | 45 ++++++++++++++++++++++++-- 1 file changed, 43 insertions(+), 2 deletions(-) diff --git a/input/pagecontent/CF-participations.md b/input/pagecontent/CF-participations.md index eb8392f..9b56c53 100644 --- a/input/pagecontent/CF-participations.md +++ b/input/pagecontent/CF-participations.md @@ -86,13 +86,54 @@ Note when the only field populated is `<standardIndustryClassCode>`, the Organiz |/standardIndustryClassCode|/code|.type|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept) |/asOrganizationPartOf|/asOrganizationPartOf|.partOf|Recursive Organization reference +#### Example - CDA to FHIR Organization +Note - the CDA tag could be any number of organization tags like `<representedOrganization>`, `<scopingOrganization>`, etc. +<table><tr><th>CDA Organization</th><th>FHIR Organization</th></tr> +<tr><td> +<div id="cda" class="border codeArea"><<span class="field">Organization</span>> + <<span class="field">id</span> <span class="attrib">extension=</span><mark class="color10"><span class="value">"3"</span></mark> + <span class="attrib">root=</span><span class="value">"<mark class="color11">1.3.6.1.4.1.22812.3.2009316.3</mark>"</span> /> + <<span class="field">name</span>><mark class="color12">Primary Care Partners Test</mark></<span class="field">name</span>> + <<span class="field">telecom</span> <span class="attrib">use=</span><mark class="color13"><span class="value">"WP"</span></mark> + <span class="attrib">value=</span><span class="value">"tel:<mark class="color14">+1-(676)857-6769</mark>"</span> /> + <<span class="field">addr</span> <span class="attrib">use=</span><mark class="color13"><span class="value">"WP"</span></mark>> + <<span class="field">streetAddressLine</span>><mark class="color15">123 main street</mark></<span class="field">streetAddressLine</span>> + <<span class="field">city</span>><mark class="color16">Chicago</mark></<span class="field">city</span>> + <state<mark class="color17">>IL<</mark>/state> + <<span class="field">postalCode</span>><mark class="color18">60629</mark></<span class="field">postalCode</span>> + </<span class="field">addr</span>> +</<span class="field">Organization</span>></div> +</td><td> +<div id="fhir" class="border codeArea">{ + "<span class="field">resourceType</span>": "<span class="value">Organization</span>", + "<span class="field">identifier</span>": [{ + "<span class="field">value</span>": <mark class="color10">"3"</mark>, + "<span class="field">system</span>": "<span class="value">urn:oid:<mark class="color11">1.3.6.1.4.1.22812.3.2009316.3</mark></span>" + }], + "<span class="field">name</span>": "<span class="value"><mark class="color12">Primary Care Partners Test</mark></span>", + "<span class="field">address</span>": [{ + "<span class="field">use</span>": "<span class="value"><mark class="color13">work</mark></span>", + "<span class="field">line</span>": [ "<mark class="color15">123 main street</mark>" ], + "<span class="field">city</span>": "<span class="value"><mark class="color16">Chicago</mark></span>", + "<span class="field">state</span>": <mark class="color17">"IL"</mark>, + "<span class="field">postalCode</span>": "<span class="value"><mark class="color18">60629</mark></span>" + }], + "<span class="field">telecom</span>": [{ + "<span class="field">value</span>": "<span class="value"><mark class="color14">+1-(676)857-6769</mark></span>", + "<span class="field">use</span>": "<span class="value"><mark class="color13">work</mark></span>", + "<span class="field">system</span>": "<span class="value">phone</span>" + }], + "<span class="field">active</span>": true +}</div> +</td></tr></table> + ### CDA to FHIR Practitioner |[AssignedAuthor](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-AssignedAuthor.html)<br/>[AssignedEntity](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-AssignedEntity.html)<br/>[AssociatedEntity](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-AssociatedEntity.html)<br/>[ParticipantRole](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-ParticipantRole.html)|[Practitioner](https://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-practitioner.html)|Transform Steps| |:----|:----|:----| |/id|.identifier|[CDA id ↔ FHIR identifier](mappingGuidance.html#cda-id--fhir-identifier)| -|/code||[See Mapping code](#mapping-code)| -|/addr|.address|[CDA id ↔ FHIR address](mappingGuidance.html#cda-addr--fhir-address)| +|/code||See [See Mapping code](#mapping-code)<br/>In most cases, the presence of a `<code>` requires a PractitionerRole resource.| +|/addr|.address|[CDA id ↔ FHIR address](mappingGuidance.html#cda-addr--fhir-address)<br/>In FHIR this is a non-role-specific, such as a home address.<br/>If this represents a role address, this should go into PractitionerRole.address.| |/telecom|.telecom|[CDA id ↔ FHIR telecom](mappingGuidance.html#cda-telecom--fhir-telecom)| |**[Person](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-Person.html)<br/>[PlayingEntity](https://hl7.org/cda/stds/core/2.0.0-sd/StructureDefinition-PlayingEntity.html)**||Person is the CDA data type for `<assignedPerson>` and `<associatedPerson>`.| |//name|.name|[CDA name ↔ FHIR name](mappingGuidance.html#cda-name--fhir-name)| From fbc2e39e044c641fc5cce64d3f1bcc5218fdd3b3 Mon Sep 17 00:00:00 2001 From: jlyle1 <jay@lyle.net> Date: Mon, 18 Nov 2024 12:01:34 -0500 Subject: [PATCH 110/112] comment links; ballot note --- input/includes/stu-note.xml | 2 +- input/pagecontent/CF-allergies.md | 2 +- input/pagecontent/CF-immunizations.md | 2 +- input/pagecontent/CF-medications.md | 2 +- input/pagecontent/CF-problems.md | 2 +- input/pagecontent/CF-procedures.md | 2 +- input/pagecontent/mappingBackground.md | 2 +- input/pagecontent/mappingGuidance.md | 6 +++--- 8 files changed, 10 insertions(+), 10 deletions(-) diff --git a/input/includes/stu-note.xml b/input/includes/stu-note.xml index eac3b90..eecad0b 100644 --- a/input/includes/stu-note.xml +++ b/input/includes/stu-note.xml @@ -1,6 +1,6 @@ <div xmlns="http://www.w3.org/1999/xhtml" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"> <blockquote class="stu-note"> - <b>2024 Publication of C-CDA ↔ FHIR US Core Mapping</b> + <b>2025 Ballot of C-CDA ↔ FHIR US Core Mapping</b> <p>The current release of this IG adds relevant mapping content from <a href="https://jira.hl7.org/browse/PSS-1811">C-CDA ↔ FHIR mapping project</a> which was related to the original <a diff --git a/input/pagecontent/CF-allergies.md b/input/pagecontent/CF-allergies.md index fe40d98..bc16369 100644 --- a/input/pagecontent/CF-allergies.md +++ b/input/pagecontent/CF-allergies.md @@ -24,7 +24,7 @@ This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, plea |**[Reaction](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ReactionObservation.html)**<br/>/entryRelationship[@typeCode="MFST"]/observation/value³|.reaction.manifestation|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)<br/>Both use SNOMED clinical findings with minor valueSet definition differences |**[Severity](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-SeverityObservation.html)** (nested inside Reaction)<br/>/entryRelationship[@typeCode="MFST"]/observation/...<br/>   ...entryRelationship/observation[code/@code="SEV"]/value³|.reaction.severity|[CDA Severity value → FHIR Severity](./ConceptMap-CF-Severity.html)<br/>**Note:** CDA documents should not assign severity at the Allergy level.<br/><br/>In cases where CDA assigns severity only to the Allergy rather than the reaction, map the severity to FHIR reaction severity, even if there are more than one. This means assuming that the same severity applies to all child reactions.<br/><br/>If severity is assigned at both levels, the reaction level should be used. |**[Criticality](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-CriticalityObservation.html)**<br/>/entryRelationship/observation[code/@code="82606-5"]/value³|.criticality|[CDA Criticality value → FHIR Criticality](./ConceptMap-CF-Criticality.html) -|**[Comment Activity](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text³|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|| +|**[Comment Activity](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text³|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|See [Comment → Annotation](mappingGuidance.html#comment--annotation)| 1\. XPath abbreviated for C-CDA Allergy Concern act as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="48765-2"]/entry/act/ diff --git a/input/pagecontent/CF-immunizations.md b/input/pagecontent/CF-immunizations.md index f3c3055..1c69e02 100644 --- a/input/pagecontent/CF-immunizations.md +++ b/input/pagecontent/CF-immunizations.md @@ -28,7 +28,7 @@ Mapping is from `@moodCode="EVN"` (i.e. historical) immunizations, not `INT` (fu |**[Immunization Refusal Reason](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ImmunizationRefusalReason.html)**<br/>/entryRelationship[@typeCode="RSON"]²/observation/code<br/>(only if code is from ValueSet [No Immunization Reason](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.1.11.19717/expansion/Latest))|.statusReason|[CDA refusal → FHIR statusReason](ConceptMap-CF-ImmunizationRefusal.html)<br/>Indicates the reason the immunization event was **not** performed. This is generally only used for the status of "not-done".| |**[Indication](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-Indication.html)**<br/>/entryRelationship[@typeCode="RSON"]²/observation/value<br/>(only if observation/code is from ValueSet [Problem Type](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.88.12.3221.7.2/expansion/Latest))|.reasonCode|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| |**[Reaction](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ReactionObservation.html)**<br/>/entryRelationship[@typeCode="MFST"]/observation/value|.reaction|It is recommended that reaction observation value be mapped to reaction detail (Observation) valueCodeable concept. Comments are welcome on how this may be best implemented. -|**[Comment Activity](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|| +|**[Comment Activity](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|See [Comment → Annotation](mappingGuidance.html#comment--annotation)| 1\. XPath abbrievated for C-CDA Immunization Activity as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="11369-6"]/entry/substanceAdministration<br/> diff --git a/input/pagecontent/CF-medications.md b/input/pagecontent/CF-medications.md index fba4dd2..01021b0 100644 --- a/input/pagecontent/CF-medications.md +++ b/input/pagecontent/CF-medications.md @@ -51,7 +51,7 @@ The C-CDA Example Search site maintains a document of [Common Medication Frequen |../effectiveTime/high|.dispenseRequest.validityPeriod.end|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)<br/>`low` would similarly map to `start`, but only high is called out in C-CDA.| |../repeatNumber|.dispenseRequest.numberOfRepeatsAllowed|**Caution:** in CDA, repeatNumber indicates total number of dispenses allowed. In FHIR, this field is exclusive of the original dispense. So the `numberOfRepeatsAllowed` will be one less than `repeatNumber`. |../quantity|.dispenseRequest.quantity|[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity) -|**[Comment Activity](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|| +|**[Comment Activity](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|See [Comment → Annotation](mappingGuidance.html#comment--annotation)| |/precondition|.asNeededBoolean = true|The presence of a precondition element indicates asNeededBoolean should be true.<br/>More complex maps may be possible with .asNeededCodeableConcept.| 1\. XPath abbrievated for C-CDA Medication Activity as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="10160-0"]/entry/substanceAdministration diff --git a/input/pagecontent/CF-problems.md b/input/pagecontent/CF-problems.md index e545a06..33ff1c7 100644 --- a/input/pagecontent/CF-problems.md +++ b/input/pagecontent/CF-problems.md @@ -24,7 +24,7 @@ Note that C-CDA includes a Concern wrapper act from which status may be read; mo |/author/time|.recordedDate|Earliest, if more than one<br/>[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates) |**[Problem Status](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ProblemStatus.html)**<br/>/entryRelationship/observation[code/@code="33999-4"]/value|.clinicalStatus|[CDA Problem Status Observation value → FHIR clinicalStatus](./ConceptMap-CF-ProblemStatus.html)| |**[Date of Diagnosis](https://www.hl7.org/ccdasearch/templates/2.16.840.1.113883.10.20.22.4.502.html)**<br/>/entryRelationship/act[code/@code="77975-1"]/effectiveTime|.extension:[assertedDate](http://hl7.org/fhir/StructureDefinition/condition-assertedDate)|[CDA ↔ FHIR Time/Dates](mappingGuidance.html#cda--fhir-timedates)<br/>See **[US CORE Condition](https://hl7.org/fhir/us/core/StructureDefinition-us-core-condition-problems-health-concerns.html#mandatory-and-must-support-data-elements)** for additional guidance| -|**[Comment Activity](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|| +|**[Comment Activity](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|See [Comment → Annotation](mappingGuidance.html#comment--annotation)| |**[Age Observation]()**<br/>/entryRelationship[@typeCode="SUBJ" and @inversionInd="true"]/observation[code/@code="445518008"]/value|.onsetAge|**CAUTION:** Only one of `onsetAge` or `onsetDateTime` may be present.<br/>[CDA ↔ FHIR Quantity](mappingGuidance.html#cda--fhir-quantity) |**Supporting Observations (e.g. [Assessment Scale Observation](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-AssessmentScaleObservation.html))**<br/>/entryRelationship[@typeCode="SPRT"]/observation|.evidence.detail|Create an Observation resource, mapping fields like `id`, `code`, `effectiveTime`, `value` similar to [Results](CF-results.html). If the CDA observation is an SDOH observation, use the [US Core Observation Screening Assessment](https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-observation-screening-assessment.html) profile. diff --git a/input/pagecontent/CF-procedures.md b/input/pagecontent/CF-procedures.md index e81c1ce..339ce22 100644 --- a/input/pagecontent/CF-procedures.md +++ b/input/pagecontent/CF-procedures.md @@ -23,7 +23,7 @@ C-CDA 2.1 describes three templates for Procedures: Procedure Activity Act, Proc |/performer/assignedEntity|.performer.actor|May map to Practitioner, PractitionerRole, or Organization<br/>onBehalfOf should not be used when actor is a Practitioner or PractitionerRole | |**[Service Delivery Location](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-ServiceDeliveryLocation.html)**<br/>/participant[@typeCode="LOC"]/participantRole|.location|| |**[Indication](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-Indication.html)**<br/>/entryRelationship[@typeCode="RSON"]/observation/value|.reasonCode|[CDA coding ↔ FHIR CodeableConcept](mappingGuidance.html#cda-coding--fhir-codeableconcept)| -|**[Comment Activity](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note| +|**[Comment Activity](https://hl7.org/cda/us/ccda/3.0.0/StructureDefinition-CommentActivity.html)**<br/>/entryRelationship/act[code/@code="48767-8"]/text|**[Annotation](https://hl7.org/fhir/datatypes.html#Annotation)**<br/>.note|See [Comment → Annotation](mappingGuidance.html#comment--annotation)| 1\. XPath abbrievated for C-CDA Procedure as: <br/> ClinicalDocument/component/structuredBody/component/section[code/@code="47519-4"]/entry/procedure diff --git a/input/pagecontent/mappingBackground.md b/input/pagecontent/mappingBackground.md index 70b501c..5b9ceb4 100644 --- a/input/pagecontent/mappingBackground.md +++ b/input/pagecontent/mappingBackground.md @@ -5,7 +5,7 @@ In our first publication, we focused on the subset of domains that are recognize <div xmlns="http://www.w3.org/1999/xhtml" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"> <blockquote class="stu-note"> <b>Mapping Consensus</b> - <p>Note that C-CDA → FHIR mappings had a significant exposure to achieve multi-vendor consensus. This has included four FHIR Connectathons (9/2022, 1/2023, 5/2023, 9/2023) and regular weekly engagements. Vendors and organizations participating in this process include: + <p>Note that C-CDA → FHIR mappings had a significant exposure to achieve multi-vendor consensus. This has included several FHIR [Connectathons](https://confluence.hl7.org/display/CGP/Scope+and+Schedule) and regular weekly engagements. Vendors and organizations participating in this process include: <ul> <li>Cerner (Oracle)</li> <li>Diameter Health (Availity)</li> diff --git a/input/pagecontent/mappingGuidance.md b/input/pagecontent/mappingGuidance.md index 471bf01..706c624 100644 --- a/input/pagecontent/mappingGuidance.md +++ b/input/pagecontent/mappingGuidance.md @@ -584,12 +584,12 @@ In this publication, we include a mapping between missing data concepts. **Impor - [NullFlavor (CDA) → Data Absent Reason code (FHIR)](./ConceptMap-CF-NullFlavorDataAbsentReason.html) - [Data Absent Reason code (FHIR) → NullFlavor (CDA)](./ConceptMap-FC-DataAbsentReasonNullFlavor.html) -### Note Text +### Comment → Annotation The CDA [Comment Activity](https://build.fhir.org/ig/HL7/CDA-ccda/StructureDefinition-CommentActivity.html) template is used for text notes accompanied by their author. The FHIR [Annotation](https://hl7.org/fhir/R4/datatypes.html#annotation) datatype can capture text and an author as well. -|C-CDA|FHIR|Notes| +|C-CDA<br/>[Comment Activity](https://build.fhir.org/ig/HL7/CDA-ccda/StructureDefinition-CommentActivity.html)|FHIR <br/> [Annotation](https://hl7.org/fhir/R4/datatypes.html#annotation)|Notes| |:-------|:------|:---------| -|text|text|| +|text|text|See [C-CDA Entry/Text → FHIR Resource.text](mappingGuidance.html#c-cda-entrytext--fhir-resourcetext)| |author/time|time|| |author/assignedAuthor|authorReference|Ideally this is a PractitionerRole, which can then support both Pracitioner (name) and Organization, if necessary.| From 3919357a3e0900012fcd26ae9a677079588fb862 Mon Sep 17 00:00:00 2001 From: Benjamin Flessner <b.d.flessner@gmail.com> Date: Thu, 21 Nov 2024 10:05:57 -0600 Subject: [PATCH 111/112] Bump version to 1.3 --- input/hl7.fhir.us.ccda.xml | 4 ++-- publication-request.json | 4 ++-- 2 files changed, 4 insertions(+), 4 deletions(-) diff --git a/input/hl7.fhir.us.ccda.xml b/input/hl7.fhir.us.ccda.xml index 94c59d4..61b80bb 100644 --- a/input/hl7.fhir.us.ccda.xml +++ b/input/hl7.fhir.us.ccda.xml @@ -11,7 +11,7 @@ <valueCode value="cgp"/> </extension> <url value="http://hl7.org/fhir/us/ccda/ImplementationGuide/hl7.fhir.us.ccda"/> - <version value="1.2.0"/> + <version value="1.3.0"/> <name value="CCDAonFHIR"/> <title value="C-CDA on FHIR"/> <status value="active"/> @@ -980,7 +980,7 @@ </parameter> <parameter> <code value="releaselabel"/> - <value value="STU 1"/> + <value value="STU 1.3"/> </parameter> <parameter> <code value="copyrightyear"/> diff --git a/publication-request.json b/publication-request.json index 4baa771..2829a83 100644 --- a/publication-request.json +++ b/publication-request.json @@ -1,7 +1,7 @@ { "package-id" : "hl7.fhir.us.ccda", - "version" : "1.2.0", - "path" : "http://hl7.org/fhir/us/ccda/STU1.2", + "version" : "1.3.0", + "path" : "http://hl7.org/fhir/us/ccda/STU1.3", "mode": "milestone", "status" : "trial-use", "sequence" : "STU 1", From 83eab79513da209fe66bc66cbfce9e1983f7f9ee Mon Sep 17 00:00:00 2001 From: jlyle1 <jay@lyle.net> Date: Mon, 25 Nov 2024 15:32:02 -0500 Subject: [PATCH 112/112] pubrequest updates --- publication-request.json | 14 +++++++------- 1 file changed, 7 insertions(+), 7 deletions(-) diff --git a/publication-request.json b/publication-request.json index 4baa771..4eed9de 100644 --- a/publication-request.json +++ b/publication-request.json @@ -1,11 +1,11 @@ { "package-id" : "hl7.fhir.us.ccda", - "version" : "1.2.0", - "path" : "http://hl7.org/fhir/us/ccda/STU1.2", - "mode": "milestone", - "status" : "trial-use", - "sequence" : "STU 1", - "desc" : "The C-CDA on FHIR Implementation Guide is a US Realm Implementation Guide of the FHIR Specification addressing the key aspects of Consolidated CDA (C-CDA) required for Meaningful Use (MU). This IG publication release focuses on providing data mappings for problems, allergies, medications, immunization, patient and procedures (PAMI+). The clinical document header and document guidance from the earlier publications have not been updated since 2020.", - "descmd" : "The C-CDA on FHIR Implementation Guide is a US Realm Implementation Guide of the FHIR Specification addressing the key aspects of Consolidated CDA (C-CDA) required for Meaningful Use (MU). This IG publication release focuses on providing data mappings for problems, allergies, medications, immunization, patient and procedures (PAMI+). The clinical document header and document guidance from the earlier publications have not been updated since 2020.", + "version" : "1.3.0", + "path" : "http://hl7.org/fhir/us/ccda/STU1.3", + "mode": "working", + "status" : "ballot", + "sequence" : "STU 3", + "desc" : "The C-CDA on FHIR Implementation Guide is a US Realm Implementation Guide of the FHIR Specification addressing the key aspects of Consolidated CDA (C-CDA) required for Meaningful Use (MU). This IG publication release focuses on providing data mappings for problems, allergies, medications, immunization, patient and procedures (PAMI+), and results, vitals, encounters, and social determinants of health. The clinical document header and document guidance from the earlier publications have not been updated since 2020.", + "descmd" : "The C-CDA on FHIR Implementation Guide is a US Realm Implementation Guide of the FHIR Specification addressing the key aspects of Consolidated CDA (C-CDA) required for Meaningful Use (MU). This IG publication release focuses on providing data mappings for problems, allergies, medications, immunization, patient and procedures (PAMI+), and results, vitals, encounters, and social determinants of health. The clinical document header and document guidance from the earlier publications have not been updated since 2020.", "first": false } \ No newline at end of file