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	valid from 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 battery of observations performed to investigate on a single problem identified on a specimen or group of specimens.
Context	Parent nodes of template element with id 1.3.6.1.4.1.19376.1.8.1.3.6
Label	PaLM Suppl. 2.0‑3: 6.3.5.2 Problem organizer
Classification	CDA Entry Level Template
Open/Closed	Open (other than defined elements are allowed)
Used by / Uses	Used by 0 transactions and 7 templates, Uses 10 templates Used by as Name Version 1.3.6.1.4.1.19376.1.3.10.3.1 Containment Additional Specified Observation Section (2.0) 2016‑11‑13 14:28:08 1.3.6.1.4.1.19376.1.8.1.1.1 Anatomic Pathology Structured Report Content Module (2.0) 2014‑05‑13 11:57:57 1.3.6.1.4.1.19376.1.8.1.2.1 Containment Clinical Information Section (2.0) 2014‑05‑13 14:38:08 1.3.6.1.4.1.19376.1.8.1.2.2 Containment Intraoperative Observation Section (2.0) 2014‑05‑13 19:29:16 1.3.6.1.4.1.19376.1.8.1.2.3 Containment Macroscopic Observation Section (2.0) 2014‑05‑13 11:57:09 1.3.6.1.4.1.19376.1.8.1.2.4 Containment Microscopic Observation Section (2.0) 2014‑05‑13 14:25:17 1.3.6.1.4.1.19376.1.8.1.2.5 Containment Diagnostic Conclusion Section (2.0) 2014‑05‑13 19:31:26 Uses as Name Version 1.3.6.1.4.1.19376.1.8.1.4.2 Containment CDA author IHE DYNAMIC 1.3.6.1.4.1.19376.1.8.1.4.6 Containment CDA Informant(Header&Body) APSR2 (2.0) DYNAMIC 1.3.6.1.4.1.19376.1.8.1.4.7 Containment Additional participant in an entry APSR (Body) DYNAMIC 1.3.6.1.4.1.19376.1.3.3.1.7 Containment Laboratory Performer (2008) DYNAMIC 1.3.6.1.4.1.19376.1.3.10.9.1 Include X Specimen Identified DYNAMIC 1.3.6.1.4.1.19376.1.8.1.4.10 Containment Embedded Image IHE DYNAMIC 2.16.840.1.113883.10.12.307 Containment CDA RegionOfInterest DYNAMIC 1.3.6.1.4.1.19376.1.5.3.1.4.2 Containment Annotation Comment (2008) 2008‑08‑08 1.3.6.1.4.1.19376.1.8.1.4.9 Containment AP Observation Entry (2.0) DYNAMIC 1.3.6.1.4.1.19376.1.3.1.6 Containment Laboratory Observation (2008) DYNAMIC
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' (dynamic) -->   </author>  <informant>     <!-- template 1.3.6.1.4.1.19376.1.8.1.4.6 'CDA Informant(Header&Body) APSR2' (dynamic) -->   </informant>  <participant>     <!-- template 1.3.6.1.4.1.19376.1.8.1.4.7 'Additional participant in an entry APSR (Body)' (dynamic) -->   </participant>  <performer>     <!-- template 1.3.6.1.4.1.19376.1.3.3.1.7 'CDA Performer IHE (Body)' (dynamic) -->   </performer>  <!-- include template 1.3.6.1.4.1.19376.1.3.10.9.1 'X Specimen Identified' (dynamic) 0..* R -->   <component typeCode="COMP" contextConductionInd="true">     <sequenceNumber value="1"/>    <seperatableInd value="false"/>    <!-- template 2.16.840.1.113883.10.12.307 'CDA RegionOfInterest' (dynamic) -->   </component>  <component typeCode="COMP" contextConductionInd="true">     <sequenceNumber value="1"/>    <seperatableInd value="false"/>    <!-- template 1.3.6.1.4.1.19376.1.5.3.1.4.2 'Annotation Comment (IHE)' (dynamic) -->   </component>  <component typeCode="COMP" contextConductionInd="true">     <sequenceNumber value="1"/>    <seperatableInd value="false"/>    <!-- template 1.3.6.1.4.1.19376.1.8.1.4.9 'AP Observation Entry' (dynamic) -->   </component>  <component typeCode="COMP" contextConductionInd="true">     <sequenceNumber value="1"/>    <seperatableInd value="false"/>    <!-- template 1.3.6.1.4.1.19376.1.3.1.6 'Laboratory Observation' (dynamic) -->   </component></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"/>    <seperatableInd value="false"/>    <!-- template 1.3.6.1.4.1.19376.1.8.1.4.9 'AP Observation Entry' (dynamic) -->   </component></organizer>
Item DT Card Conf Description Label hl7:organizer 0 … * R Problem organizer groups the battery of observations performed to investigate on a single problem identified on a specimen or a group of specimens.  PaLM…izer @classCode cs 1 … 1 F BATTERY @moodCode cs 1 … 1 F EVN hl7:templateId II 1 … 1 M PaLM…izer @root uid 1 … 1 F 1.3.6.1.4.1.19376.1.8.1.3.6 hl7:id II 0 … * R PaLM…izer hl7:code CD CNE 0 … 1 R Problem PaLM…izer @code CONF 1 … 1 F 75326-9 @codeSystem 1 … 1 F 2.16.840.1.113883.6.1 (Logical Observation Identifier Names and Codes) @codeSystemName 1 … 1 F LOINC @displayName 1 … 1 F Problem hl7:component 0 … 1 R Coding of the Problem reported PaLM…izer @typeCode cs 1 … 1 F COMP hl7:observation CD CWE 0 … 1 R PaLM…izer hl7:code CD CWE 1 … 1 R PaLM…izer @code CONF 1 … 1 F 75326-9 @codeSystem 1 … 1 F 2.16.840.1.113883.6.1 (Logical Observation Identifier Names and Codes) @codeSystemName 1 … 1 F LOINC @displayName 1 … 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…izer   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…izer @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 CWE 0 … * R PaLM…izer @code CONF 1 … 1 F << 91723000 @codeSystem 1 … 1 F 2.16.840.1.113883.6.96 (SNOMED Clinical Terms) @codeSystemName 1 … 1 F SNOMED-CT @displayName 1 … 1 F all values from Anatomical structure hl7:value CE CWE 0 … 1 R Code of the problem reported PaLM…izer   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 shall be drawn from value set 1.3.6.1.4.1.19376.1.3.11.7 Problem Type (DYNAMIC) hl7:statusCode CS CNE 1 … 1 M PaLM…izer   Constraint 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.   CONF The value of @code shall be drawn from value set 1.3.6.1.4.1.19376.1.3.11.2 ActStatusAbortedCompleted (DYNAMIC) 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…izer 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 CDA author IHE (DYNAMIC) PaLM…izer   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 CDA Informant(Header&Body) APSR2 (DYNAMIC) PaLM…izer 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 APSR (Body) (DYNAMIC) PaLM…izer   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 (DYNAMIC) PaLM…izer Included 0 … * R from 1.3.6.1.4.1.19376.1.3.10.9.1 X Specimen Identified (DYNAMIC) 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 2.0‑3: 6.3.6.9 X Specimen identified @typeCode cs 0 … 1 F SPC hl7:specimenRole 1 … 1 M PaLM Suppl. APSR 2.0‑3: 6.3.6.9 X Specimen identified @classCode cs 0 … 1 F SPEC hl7:id II 1 … 1 R Specimen ID, coming from the LIS PaLM Suppl. APSR 2.0‑3: 6.3.6.9 X Specimen identified 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 IHE (DYNAMIC) PaLM…izer @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…izer hl7:seperatableInd BL 0 … 1 PaLM…izer 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 (DYNAMIC) PaLM…izer @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…izer hl7:seperatableInd BL 0 … 1 PaLM…izer 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 Annotation Comment (2008‑08‑08) PaLM…izer @typeCode cs 1 … 1 F COMP @context​Conduction​Ind bl 0 … 1 F true hl7:sequenceNumber INT 0 … 1 PaLM…izer hl7:seperatableInd BL 0 … 1 PaLM…izer hl7:component 0 … * R Any kind of AP observation, for complex observation templates, e.g. for TNM, ICD-O-3, or Assessment scales can 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 (DYNAMIC) PaLM…izer @typeCode cs 1 … 1 F COMP @context​Conduction​Ind bl 0 … 1 F true hl7:sequenceNumber INT 0 … 1 PaLM…izer hl7:seperatableInd BL 0 … 1 PaLM…izer hl7:component 0 … * C Laboratory observation Contains 1.3.6.1.4.1.19376.1.3.1.6 Laboratory Observation (DYNAMIC) PaLM…izer @typeCode cs 1 … 1 F COMP @context​Conduction​Ind bl 0 … 1 F true hl7:sequenceNumber INT 0 … 1 PaLM…izer hl7:seperatableInd BL 0 … 1 PaLM…izer