1.3.6.1.4.1.19376.1.8.1.3.6/static-2015-08-13T102455

Id	1.3.6.1.4.1.19376.1.8.1.3.6	Effective Date	2015‑08‑13 10:24:55
Status	Draft	Version Label	2.0
Name	ProblemOrganizer	Display Name	Problem Organizer
Description Template CDA Organizer (prototype, directly derived from POCD_RM000040 MIF) The problem organizer groups the various observations performed and assocciated images to investigate on a single problem identified on one or more specimens
Context	Parent nodes of template element with id 1.3.6.1.4.1.19376.1.8.1.3.6
Label	PaLM Suppl. 2.1‑3: 6.3.4.2 Problem organizer
Classification	CDA Entry Level Template
Open/Closed	Open (other than defined elements are allowed)
Associated with	Associated with 2 concepts Id Name Data Set psr-data​element-39  Problem Organizer  APSR 2.0 psr-data​element-86  Problem ID  APSR 2.0
Uses	Uses 11 templates Uses as Name Version 1.3.6.1.4.1.19376.1.8.1.4.2 Containment Author (2.0) 2016‑06‑21 14:02:11 1.3.6.1.4.1.19376.1.8.1.4.6 Containment Informant (2.0) 2016‑07‑08 11:22:58 1.3.6.1.4.1.19376.1.8.1.4.7 Containment Additional participant in an entry (2.0) 2016‑07‑12 18:44:06 1.3.6.1.4.1.19376.1.3.3.1.7 Containment Laboratory Performer (2017) 2008‑08‑08 1.3.6.1.4.1.19376.1.3.10.9.1 Include X Specimen Identified (2.0) 2014‑12‑22 15:54:30 1.3.6.1.4.1.19376.1.8.1.4.9 Containment AP Observation Entry (2.0) 2014‑05‑14 17:09:54 1.3.6.1.4.1.19376.1.3.1.6 Containment Laboratory Observation (2017) 2008‑08‑08 1.3.6.1.4.1.19376.1.8.1.4.10 Containment Embedded Image 2016‑06‑22 16:08:01 2.16.840.1.113883.10.12.307 Containment CDA RegionOfInterest 2005‑09‑07 1.3.6.1.4.1.19376.1.5.3.1.4.2 Containment IHE Comment Entry (2014) 2013‑12‑20 2.16.840.1.113883.10.12.324 Containment CDA Reference 2005‑09‑07
Relationship	Specialization: template 2.16.840.1.113883.10.12.305 (2005‑09‑07)
Example	generated example <organizer classCode="BATTERY" moodCode="EVN">   <templateId root="1.3.6.1.4.1.19376.1.8.1.3.6"/>  <id root="1.2.3.999" extension="--example only--"/>  <code code="75326-9" codeSystem="2.16.840.1.113883.6.1" displayName="Problem">     <qualifier>       <name code="116677004" codeSystem="2.16.840.1.113883.6.96" displayName=" Associated topography (attribute)"/>      <value nullFlavor="cs" code="all children of "362981000"" codeSystem="2.16.840.1.113883.6.96" displayName="all values from 91723000 (Anatomical structure)"/>    </qualifier>  </code>  <component typeCode="COMP">     <observation>       <code code="75326-9" codeSystem="2.16.840.1.113883.6.1" displayName="Problem">         <value code="115597007" displayName="Description of specimen character (procedure)" codeSystem="2.16.840.1.113883.6.96"/>      </code>    </observation>  </component>  <statusCode code="completed"/>  <effectiveTime>     <low value="20170131165954"/>  </effectiveTime>  <author>     <!-- template 1.3.6.1.4.1.19376.1.8.1.4.2 'CDA author IHE' (2016-06-21T14:02:11) -->   </author>  <informant>     <!-- template 1.3.6.1.4.1.19376.1.8.1.4.6 'CDA Informant(Header&Body) APSR2' (2016-07-08T11:22:58) -->   </informant>  <participant>     <!-- template 1.3.6.1.4.1.19376.1.8.1.4.7 'Additional participant in an entry APSR (Body)' (2016-07-12T18:44:06) -->   </participant>  <performer>     <!-- template 1.3.6.1.4.1.19376.1.3.3.1.7 'Laboratory Performer' (2008-08-08T00:00:00) -->   </performer>  <!-- include template 1.3.6.1.4.1.19376.1.3.10.9.1 'X Specimen Identified' (2014-12-22T15:54:30) 0..* R -->   <component typeCode="COMP" contextConductionInd="true">     <sequenceNumber value="1"/>    <!-- template 1.3.6.1.4.1.19376.1.8.1.4.10 'Embedded Image IHE' (2016-06-22T16:08:01) -->   </component>  <component typeCode="COMP" contextConductionInd="true">     <sequenceNumber value="1"/>    <!-- template 2.16.840.1.113883.10.12.307 'CDA RegionOfInterest' (2005-09-07T00:00:00) -->   </component>  <component typeCode="COMP" contextConductionInd="true">     <sequenceNumber value="1"/>    <!-- template 1.3.6.1.4.1.19376.1.5.3.1.4.2 'IHE Comment Entry' (2013-12-20T00:00:00) -->   </component>  <component typeCode="COMP" contextConductionInd="true">     <sequenceNumber value="1"/>    <!-- template 1.3.6.1.4.1.19376.1.8.1.4.9 'AP Observation Entry' (2014-05-14T17:09:54) -->   </component>  <component typeCode="COMP" contextConductionInd="true">     <sequenceNumber value="1"/>    <!-- template 1.3.6.1.4.1.19376.1.3.1.6 'Laboratory Observation' (2008-08-08T00:00:00) -->   </component>  <reference>     <!-- template 2.16.840.1.113883.10.12.324 'CDA Reference' (2005-09-07T00:00:00) -->   </reference></organizer>
Example	example for use case #1, problem: invasive breast cancer <organizer classCode="BATTERY" moodCode="EVN">   <templateId root="1.3.6.1.4.1.19376.1.8.1.3.6"/>  <id root="1.3.6.1.4.1.19376.1.8.9.1" extension="A7102400008_Problem1"/>  <code code="75326-9" codeSystem="2.16.840.1.113883.6.1" displayName="Problem"/>  <statusCode code="completed"/>  <effectiveTime>     <low value="201001041605-0500"/>  </effectiveTime>  <!--The problem is expressed by the result of the observation having the same code as organizer/code-->   <component>     <observation classCode="OBS" moodCode="EVN">       <code code="75326-9" codeSystem="2.16.840.1.113883.6.1" displayName="Problem"/>      <value code="C50.9" codeSystem="2.16.840.1.113883.6.3" displayName="Malignant neoplasm of breast, unspecified" codeSystemDisplayName="ICD-10"/>    </observation>  </component>  <component typeCode="COMP" contextConductionInd="true">     <sequenceNumber value="1"/>    <!-- template 1.3.6.1.4.1.19376.1.8.1.4.9 'AP Observation Entry' (2014-05-14T17:09:54) -->   </component>  <reference>     <!-- template 2.16.840.1.113883.10.12.324 'CDA Reference' (2005-09-07T00:00:00) -->   </reference></organizer>
Item DT Card Conf Description Label hl7:organizer 0 … * R Problem organizer groups the observations and images investigating a single problem  related to one or more specimens PaLM Suppl. 2.1‑3: 6.3.4.2 Problem organizer   psr-data​element-39  Problem Organizer  APSR 2.0 @classCode cs 1 … 1 F BATTERY @moodCode cs 1 … 1 F EVN hl7:templateId II 1 … 1 M PaLM Suppl. 2.1‑3: 6.3.4.2 Problem organizer @root uid 1 … 1 F 1.3.6.1.4.1.19376.1.8.1.3.6 hl7:id II 0 … * R PaLM Suppl. 2.1‑3: 6.3.4.2 Problem organizer   psr-data​element-86  Problem ID  APSR 2.0 hl7:code CD (required) 0 … 1 R Problem PaLM Suppl. 2.1‑3: 6.3.4.2 Problem organizer @code CONF 0 … 1 F 75326-9 @codeSystem 0 … 1 F 2.16.840.1.113883.6.1 (Logical Observation Identifier Names and Codes) @codeSystemName 0 … 1 F LOINC @displayName 0 … 1 F Problem hl7:statusCode CS (required) 1 … 1 M The status of the organizer is  "completed"  if the battery of observations for this problem has been performed. It is  "aborted"  in case some of the intended observations could not be achieve and have been aborted, and appear as such below the organizer.  PaLM Suppl. 2.1‑3: 6.3.4.2 Problem organizer   Constraint @code shall be "completed" or @code shall be "aborted"   CONF The value of @code shall be drawn from value set 2.16.840.1.113883.1.11.15933 ActStatus (2014‑03‑26) hl7:effectiveTime IVL_TS 1 … 1 M Organizer time. The period of time (possibly reduced to a point in time) during which the information was collected and assembled.  PaLM Suppl. 2.1‑3: 6.3.4.2 Problem organizer hl7:author 0 … * C Author Source: PaLM Suppl. APSR 2.0-3: 6.3.6.2 Contains 1.3.6.1.4.1.19376.1.8.1.4.2 Author (2016‑06‑21 14:02:11) PaLM Suppl. 2.1‑3: 6.3.4.2 Problem organizer where [hl7:author]   Constraint The author SHALL be present if it is different from the main author of the report. For instance the author could be the ordering physician contributing to the Clinical Information section, inside a report authored by the pathologist. hl7:informant 0 … * R Informant The informant is an actor (person and organization) who provided some of the clinical information carried by this organizer. Source: PaLM Suppl. APSR 2.0-3: 6.3.6.5 Contains 1.3.6.1.4.1.19376.1.8.1.4.6 Informant (2016‑07‑08 11:22:58) PaLM Suppl. 2.1‑3: 6.3.4.2 Problem organizer hl7:participant 0 … * R Transcriptionist, Device, Responsible, Validator Source: PaLM Suppl. APSR 2.0-3: 6.3.6.6 Contains 1.3.6.1.4.1.19376.1.8.1.4.7 Additional participant in an entry (2016‑07‑12 18:44:06) PaLM Suppl. 2.1‑3: 6.3.4.2 Problem organizer where [hl7:participantRole]   Constraint participationType "ENT", "DEV", "RESP", "AUTHEN" hl7:performer 0 … 1 C Performing lab. The performing laboratory is present at this level only if this particular problem on this particular specimen was investigated by a (subcontractor) distinct laboratory from the one issuing the consolidated report Source: PaLM TF-3: 6.3.2.20 Contains 1.3.6.1.4.1.19376.1.3.3.1.7 Laboratory Performer (2008‑08‑08) PaLM Suppl. 2.1‑3: 6.3.4.2 Problem organizer where [hl7:assignedEntity] Included 0 … * R from 1.3.6.1.4.1.19376.1.3.10.9.1 X Specimen Identified (2014‑12‑22 15:54:30) Specimen identification outside an AP observation for differentiating or restituting the problem type Source: PaLM Suppl. APSR 2.0-3: 6.3.6.9 hl7:specimen 0 … * R Required in XD-LAB when more than one specimen is documented at this level. Always required in APSR. PaLM Suppl. APSR 2.1‑3: 6.3.5.7 X Specimen identified   psr-data​element-17  Specimen identification  APSR 2.0 @typeCode cs 0 … 1 F SPC hl7:specimenRole 1 … 1 M PaLM Suppl. APSR 2.1‑3: 6.3.5.7 X Specimen identified @classCode cs 0 … 1 F SPEC hl7:id II 1 … 1 R Specimen ID, coming from the LIS PaLM Suppl. APSR 2.1‑3: 6.3.5.7 X Specimen identified   psr-data​element-95  Parent ID  APSR 2.0 psr-data​element-67  Block ID  APSR 2.0 psr-data​element-66  Part ID  APSR 2.0 psr-data​element-98  Specimen ID  APSR 2.0 psr-data​element-68  Tissue section ID  APSR 2.0 hl7:component 0 … 1 R Coding of the Problem reported PaLM Suppl. 2.1‑3: 6.3.4.2 Problem organizer @typeCode cs 1 … 1 F COMP hl7:observation 0 … 1 R PaLM Suppl. 2.1‑3: 6.3.4.2 Problem organizer hl7:code CD (extensible) 1 … 1 R PaLM Suppl. 2.1‑3: 6.3.4.2 Problem organizer @code CONF 0 … 1 F 75326-9 @codeSystem 0 … 1 F 2.16.840.1.113883.6.1 (Logical Observation Identifier Names and Codes) @codeSystemName 0 … 1 F LOINC @displayName 0 … 1 F Problem hl7:qualifier CR 0 … * R Optional qualifier for separate problems with identical problem type in one specimen, e.g. a urothelial bladder cancer Invasive cancer) and a prostate cancer (invasive cancer) in one cystoprostatectomy specimen. The anatomic structure is able to differentiate. PaLM Suppl. 2.1‑3: 6.3.4.2 Problem organizer   Example Problem in urinary bladder in cystoprostatectomy specimen <qualifier>   <name code="116677004" codeSystem="2.16.840.1.113883.6.96" displayName="Associated topography (attribute)" codeSystemName="SNOMED-CT"/>  <value code="302512001" codeSystem="2.16.840.1.113883.6.96" displayName=" Entire urinary bladder (body structure)" codeSystemName="SNOMED-CT"/></qualifier> hl7:name CV 0 … 1 R PaLM Suppl. 2.1‑3: 6.3.4.2 Problem organizer @code cs 1 … 1 F 116677004 @codeSystem oid 1 … 1 F 2.16.840.1.113883.6.96 @displayName st 1 … 1 F Associated topography (attribute) hl7:value CD (extensible) 0 … * R PaLM Suppl. 2.1‑3: 6.3.4.2 Problem organizer @code CONF 0 … 1 F << 91723000 @codeSystem 0 … 1 F 2.16.840.1.113883.6.96 (SNOMED Clinical Terms) @codeSystemName 0 … 1 F SNOMED-CT @displayName 0 … 1 F all values from Anatomical structure hl7:value CE (extensible) 0 … 1 R Code of the problem reported PaLM Suppl. 2.1‑3: 6.3.4.2 Problem organizer   CONF @code shall be "any_code" @codeSystem shall be "2.16.840.1.113883.6.3" @codeSystemName shall be "any_code" @displayName shall be "ICD-10" or The value of @code should be drawn from value set 1.3.6.1.4.1.19376.1.3.11.7 Problem Type (2016‑07‑11 09:52:19) hl7:component 0 … * R Any kind of AP observation, for complex observations, e.g. for TNM, ICD-O-3, or Assessment scales, the appropriate templates may be used. Source: PaLM Suppl. APSR 2.0-3: 6.3.6.7 Contains 1.3.6.1.4.1.19376.1.8.1.4.9 AP Observation Entry (2014‑05‑14 17:09:54) PaLM Suppl. 2.1‑3: 6.3.4.2 Problem organizer where [hl7:observation [hl7:code [(@code = 'each_code_for_observable_entities_or_a_specific_procedure' and @codeSystem = '2.16.840.1.113883.6.1')]]] @typeCode cs 1 … 1 F COMP @context​Conduction​Ind bl 0 … 1 F true hl7:sequenceNumber INT 0 … 1 PaLM Suppl. 2.1‑3: 6.3.4.2 Problem organizer hl7:component 0 … * C Laboratory observation Contains 1.3.6.1.4.1.19376.1.3.1.6 Laboratory Observation (2008‑08‑08) PaLM Suppl. 2.1‑3: 6.3.4.2 Problem organizer where [hl7:observation] @typeCode cs 1 … 1 F COMP @context​Conduction​Ind bl 0 … 1 F true hl7:sequenceNumber INT 0 … 1 PaLM Suppl. 2.1‑3: 6.3.4.2 Problem organizer hl7:component 0 … * R Embedded image This organizer may carry an image focusing on the problem, either directly embedded or encapsulated within a region of interest. Contains 1.3.6.1.4.1.19376.1.8.1.4.10 Embedded Image (2016‑06‑22 16:08:01) PaLM Suppl. 2.1‑3: 6.3.4.2 Problem organizer where [hl7:observationMedia] @typeCode cs 0 … 1 F COMP @context​Conduction​Ind bl 0 … 1 F true   Constraint [@classCode="ROIOVL" and moodCode="EVN"] hl7:sequenceNumber INT 0 … 1 PaLM Suppl. 2.1‑3: 6.3.4.2 Problem organizer hl7:component 0 … * R Region of interest This organizer may carry an image focusing on the problem, either directly embedded or encapsulated within a region of interest. In the latter case by an entryRelationship @typeCode="SUBJ" Contains 2.16.840.1.113883.10.12.307 CDA RegionOfInterest (2005‑09‑07) PaLM Suppl. 2.1‑3: 6.3.4.2 Problem organizer where [hl7:regionOfInterest [hl7:code [@code = doc('include/voc-2.16.840.1.113883.1.11.16117-DYNAMIC.xml')//valueSet [1]/conceptList/*/@code or @nullFlavor]]] @typeCode cs 1 … 1 F COMP @context​Conduction​Ind bl 0 … 1 F true   Constraint [@classCode="ROIOVL" and moodCode="EVN"] hl7:sequenceNumber INT 0 … 1 PaLM Suppl. 2.1‑3: 6.3.4.2 Problem organizer hl7:component 0 … * R General comment on this particular problem  Source: PCC TF-2: 6.3.4.6 Contains 1.3.6.1.4.1.19376.1.5.3.1.4.2 IHE Comment Entry (2013‑12‑20) PaLM Suppl. 2.1‑3: 6.3.4.2 Problem organizer where [hl7:act [hl7:code [(@code = '48767-8' and @codeSystem = '2.16.840.1.113883.6.1')]]] @typeCode cs 1 … 1 F COMP @context​Conduction​Ind bl 0 … 1 F true hl7:sequenceNumber INT 0 … 1 PaLM Suppl. 2.1‑3: 6.3.4.2 Problem organizer hl7:reference 0 … * R Reference to an external document, or to external organizers, or to external observations, e.g. concerning molecular pathology or  genetic testing report Contains 2.16.840.1.113883.10.12.324 CDA Reference (2005‑09‑07) PaLM Suppl. 2.1‑3: 6.3.4.2 Problem organizer