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 11 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 (2017) 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 IHE Comment Entry (2014) DYNAMIC 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 (2017) DYNAMIC 2.16.840.1.113883.10.12.324 Containment CDA Reference 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 'IHE Comment Entry' (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>  <reference>     <!-- template 2.16.840.1.113883.10.12.324 'CDA Reference' (dynamic) -->   </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"/>    <seperatableInd value="false"/>    <!-- template 1.3.6.1.4.1.19376.1.8.1.4.9 'AP Observation Entry' (dynamic) -->   </component>  <reference>     <!-- template 2.16.840.1.113883.10.12.324 'CDA Reference' (dynamic) -->   </reference></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 Suppl. 2.0‑3: 6.3.5.2 Problem organizer @classCode cs 1 … 1 F BATTERY @moodCode cs 1 … 1 F EVN hl7:templateId II 1 … 1 M PaLM Suppl. 2.0‑3: 6.3.5.2 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. 2.0‑3: 6.3.5.2 Problem organizer hl7:code CD required 0 … 1 R Problem PaLM Suppl. 2.0‑3: 6.3.5.2 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:component 0 … 1 R Coding of the Problem reported PaLM Suppl. 2.0‑3: 6.3.5.2 Problem organizer @typeCode cs 1 … 1 F COMP hl7:observation 0 … 1 R PaLM Suppl. 2.0‑3: 6.3.5.2 Problem organizer hl7:code CD extensible 1 … 1 R PaLM Suppl. 2.0‑3: 6.3.5.2 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. 2.0‑3: 6.3.5.2 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. 2.0‑3: 6.3.5.2 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. 2.0‑3: 6.3.5.2 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. 2.0‑3: 6.3.5.2 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 shall be drawn from value set 1.3.6.1.4.1.19376.1.3.11.7 Problem Type (DYNAMIC) hl7:statusCode CS required 1 … 1 M PaLM Suppl. 2.0‑3: 6.3.5.2 Problem organizer   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 (DYNAMIC) Error: Cannot find value set "1.3.6.1.4.1.19376.1.3.11.2" 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. 2.0‑3: 6.3.5.2 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 CDA author IHE (DYNAMIC) PaLM Suppl. 2.0‑3: 6.3.5.2 Problem organizer where [hl7:author [hl7:templateId ​[@root​=​'1.3.6.1.4.1.19376.1.8.1.4.2']]]   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 Suppl. 2.0‑3: 6.3.5.2 Problem organizer where [hl7:templateId ​[@root​=​'1.3.6.1.4.1.19376.1.8.1.4.6']] 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 Suppl. 2.0‑3: 6.3.5.2 Problem organizer where [hl7:templateId ​[@root​=​'1.3.6.1.4.1.19376.1.8.1.4.7']]   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 Suppl. 2.0‑3: 6.3.5.2 Problem organizer where [hl7:templateId ​[@root​=​'1.3.6.1.4.1.19376.1.3.3.1.7']] 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 Suppl. 2.0‑3: 6.3.5.2 Problem organizer where [hl7:observationMedia [hl7:templateId ​[@root​=​'1.3.6.1.4.1.19376.1.8.1.4.10']]] @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. 2.0‑3: 6.3.5.2 Problem organizer hl7:seperatableInd BL 0 … 1 PaLM Suppl. 2.0‑3: 6.3.5.2 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 (DYNAMIC) PaLM Suppl. 2.0‑3: 6.3.5.2 Problem organizer where [@typeCode='COMP'] [hl7:regionOfInterest [hl7:templateId ​[@root​=​'2.16.840.1.113883.10.12.307']]] @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. 2.0‑3: 6.3.5.2 Problem organizer hl7:seperatableInd BL 0 … 1 PaLM Suppl. 2.0‑3: 6.3.5.2 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 (DYNAMIC) PaLM Suppl. 2.0‑3: 6.3.5.2 Problem organizer where [@typeCode='COMP'] [hl7:act [hl7:templateId ​[@root​=​'2.16.840.1.113883.10.20.1.40'] and hl7:templateId [@root='1.3.6.1.4.1.19376.1.5.3.1.4.2']]] @typeCode cs 1 … 1 F COMP @context​Conduction​Ind bl 0 … 1 F true hl7:sequenceNumber INT 0 … 1 PaLM Suppl. 2.0‑3: 6.3.5.2 Problem organizer hl7:seperatableInd BL 0 … 1 PaLM Suppl. 2.0‑3: 6.3.5.2 Problem organizer 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 (DYNAMIC) PaLM Suppl. 2.0‑3: 6.3.5.2 Problem organizer where [@typeCode='COMP'] [hl7:observation [hl7:templateId ​[@root​=​'1.3.6.1.4.1.19376.1.8.1.4.9']]] @typeCode cs 1 … 1 F COMP @context​Conduction​Ind bl 0 … 1 F true hl7:sequenceNumber INT 0 … 1 PaLM Suppl. 2.0‑3: 6.3.5.2 Problem organizer hl7:seperatableInd BL 0 … 1 PaLM Suppl. 2.0‑3: 6.3.5.2 Problem organizer hl7:component 0 … * C Laboratory observation Contains 1.3.6.1.4.1.19376.1.3.1.6 Laboratory Observation (DYNAMIC) PaLM Suppl. 2.0‑3: 6.3.5.2 Problem organizer where [@typeCode='COMP'] [hl7:observation [hl7:templateId ​[@root​=​'1.3.6.1.4.1.19376.1.3.1.6']]] @typeCode cs 1 … 1 F COMP @context​Conduction​Ind bl 0 … 1 F true hl7:sequenceNumber INT 0 … 1 PaLM Suppl. 2.0‑3: 6.3.5.2 Problem organizer hl7:seperatableInd BL 0 … 1 PaLM Suppl. 2.0‑3: 6.3.5.2 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 (DYNAMIC) PaLM Suppl. 2.0‑3: 6.3.5.2 Problem organizer