|
|
| (5 dazwischenliegende Versionen von 2 Benutzern werden nicht angezeigt) |
| Zeile 1: |
Zeile 1: |
| − | Nachfolgend ein Beispieldokument:
| + | {{DocumentPart}} |
| − | | + | ==Beispiel== |
| − | <syntaxhighlight lang="xml" valid="true" line="1" highlight="2-3">
| + | XML-Materialien: Schemas, Schematron und XML-Beispieldokumente sowie zugehörige Stylesheets finden sich auf den Publikationsseiten von HL7 Deutschland unter http://hl7de.art-decor.org oder direkt unter der [http://hl7de.art-decor.org/index.php?prefix=vomgt- Materialienseite des Projekts]. |
| − | <?xml version="1.0" encoding="UTF-8"?>
| |
| − | <?xml-stylesheet type="text/xsl" href="eau.xslt"?>
| |
| − | <?xml-model href="../../abde-runtime-develop/abde-abplus.sch" type="application/xml" schematypens="http://purl.oclc.org/dsdl/schematron"?>
| |
| − | <ClinicalDocument xmlns="urn:hl7-org:v3" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:pharm="urn:ihe:pharm:medication" xsi:schemaLocation="urn:hl7-org:v3 ../schemas/CDA.xsd">
| |
| − | <realmCode code="DE"/>
| |
| − | <typeId root="2.16.840.1.113883.1.3" extension="POCD_HD000040"/>
| |
| − | <templateId root="1.2.276.0.76.10.1020"/>
| |
| − | <id root="1.2.276.0.76.3645.239" extension="di-b02e97c1-3cea-4ed4-80cd-5d8a7386cee2" />
| |
| − | <code code="xERST_END" codeSystem="2.16.840.1.113883.6.1" displayName="Arbeitsunfähigkeitserst-/-endbescheinigung"/>
| |
| − | <title>eAU vom 25. Oktober 2017</title>
| |
| − | <effectiveTime value="20171025123415"/>
| |
| − | <confidentialityCode code="N" codeSystem="2.16.840.1.113883.5.25"/>
| |
| − | <languageCode code="de-DE"/>
| |
| − | <setId root="1.2.276.0.76.3645.239" extension="si-b8a7b265-4e20-4177-8cfb-149491b8003a"/>
| |
| − | <versionNumber value="1"/>
| |
| − | <recordTarget>
| |
| − | <patientRole>
| |
| − | <id extension="1543627549" root="1.2.276.0.76.4.1"/>
| |
| − | <addr>
| |
| − | <streetAddressLine>Riedemannweg 59</streetAddressLine>
| |
| − | <postalCode>13627</postalCode>
| |
| − | <city>Berlin</city>
| |
| − | </addr>
| |
| − | <telecom use="HP" value="tel:030.456.345345"/>
| |
| − | <patient>
| |
| − | <name>
| |
| − | <given>Paul</given>
| |
| − | <family>Pappel</family>
| |
| − | </name>
| |
| − | <administrativeGenderCode code="M" codeSystem="2.16.840.1.113883.5.1"/>
| |
| − | <birthTime value="19551217"/>
| |
| − | <birthplace>
| |
| − | <place>
| |
| − | <addr>
| |
| − | <city>Sassnitz</city>
| |
| − | </addr>
| |
| − | </place>
| |
| − | </birthplace>
| |
| − | </patient>
| |
| − | </patientRole>
| |
| − | </recordTarget>
| |
| − | <author>
| |
| − | <!--- author -->
| |
| − | <time value="20151104"/>
| |
| − | <assignedAuthor>
| |
| − | <id extension="ied8984938" root="2.16.840.1.113883.3.67.933"/>
| |
| − | <assignedPerson>
| |
| − | <name>
| |
| − | <prefix qualifier="AC">Dr. med.</prefix>
| |
| − | <given>Theo</given>
| |
| − | <family>Phyllin</family>
| |
| − | </name>
| |
| − | </assignedPerson>
| |
| − | <representedOrganization>
| |
| − | <id extension="1443984938" root="BSNR"/>
| |
| − | <name>Praxis Dr. med. Phyllin</name>
| |
| − | <telecom use="WP" value="tel:0214.2127070"/>
| |
| − | <telecom use="WP" value="tel:0214.212707122"/>
| |
| − | <addr>
| |
| − | <streetName>Krankenhausstraße</streetName>
| |
| − | <houseNumber>240</houseNumber>
| |
| − | <postalCode>51371</postalCode>
| |
| − | <city>Leverkusen</city>
| |
| − | </addr>
| |
| − | </representedOrganization>
| |
| − | </assignedAuthor>
| |
| − | </author>
| |
| − | <custodian>
| |
| − | <assignedCustodian>
| |
| − | <representedCustodianOrganization classCode="ORG" determinerCode="INSTANCE">
| |
| − | <id extension="M345" root="1.2.276.0.58"/>
| |
| − | <name>Praxis Dr. med. Phyllin</name>
| |
| − | <telecom use="WP" value="tel:0214.2127070"/>
| |
| − | <addr>
| |
| − | <streetName>Krankenhausstraße</streetName>
| |
| − | <houseNumber>240</houseNumber>
| |
| − | <postalCode>51371</postalCode>
| |
| − | <city>Leverkusen</city>
| |
| − | </addr>
| |
| − | </representedCustodianOrganization>
| |
| − | </assignedCustodian>
| |
| − | </custodian>
| |
| − | <legalAuthenticator typeCode="LA" contextControlCode="OP">
| |
| − | <time value="20171004"/>
| |
| − | <signatureCode code="S"/>
| |
| − | <assignedEntity>
| |
| − | <!-- nur als ID (identisch zu author) -->
| |
| − | <id extension="ied8984938" root="2.16.840.1.113883.3.67.933"/>
| |
| − | </assignedEntity>
| |
| − | </legalAuthenticator>
| |
| − | <component>
| |
| − | <structuredBody>
| |
| − | <!-- Versicherung Section -->
| |
| − | <component typeCode="COMP" >
| |
| − | <section>
| |
| − | <templateId root="xxxxxx"/>
| |
| − | <code code="48768-0" codeSystem="2.16.840.1.113883.6.1"/>
| |
| − | <title>Versicherung</title>
| |
| − | <!-- Versicherung/Coverage -->
| |
| − | <entry>
| |
| − | <act classCode="ACT" moodCode="EVN">
| |
| − | <templateId/>
| |
| − | <id/>
| |
| − | <code code="48768-6" codeSystem="2.16.840.1.113883.6.1" />
| |
| − | <statusCode code="completed"/>
| |
| − | <entryRelationship typeCode="COMP">
| |
| − | <!-- Versicherungspolicy -->
| |
| − | <act classCode="ACT" moodCode="EVN">
| |
| − | <templateId root="VERSICHERUNG" />
| |
| − | <code code="VERSICHERUNG" codeSystem="2.16.840.1.113883.3.88.12.3221.5.2" />
| |
| − | <statusCode code="completed"/>
| |
| − | <!-- Payer Information -->
| |
| − | <performer>
| |
| − | <assignedEntity>
| |
| − | <id extension="Kassen-ID-47" />
| |
| − | <addr>
| |
| − | <streetAddressLine>AOK-Weg 1459</streetAddressLine>
| |
| − | <postalCode>10111</postalCode>
| |
| − | <city>Berlin</city>
| |
| − | </addr>
| |
| − | <representedOrganization>
| |
| − | <name>Versicherung AOK Berlin</name>
| |
| − | </representedOrganization>
| |
| − | </assignedEntity>
| |
| − | </performer>
| |
| − | <!-- Guarantor -->
| |
| − | <!--
| |
| − | <performer modeCode="WRITTEN" />
| |
| − | -->
| |
| − | <!-- Versicherung -->
| |
| − | <participant typeCode="COV">
| |
| − | <time>
| |
| − | <high value="20181231"/>
| |
| − | </time>
| |
| − | <participantRole>
| |
| − | <!-- Versichertenstatus -->
| |
| − | <code code="1"/>
| |
| − | </participantRole>
| |
| − | </participant>
| |
| − | <!-- Versicherter -->
| |
| − | <participant typeCode="HLD">
| |
| − | <participantRole>
| |
| − | <id root="xxxxxxxxx" extension="VNR=4711" />
| |
| − | </participantRole>
| |
| − | </participant>
| |
| − | <entryRelationship typeCode="COMP" >
| |
| − | <!-- Person Group Observation -->
| |
| − | <observation classCode="OBS" moodCode="EVN" >
| |
| − | <templateId root="PRSNGRP" />
| |
| − | <code code="PRSNGRP" codeSystem="2.16.840.1.113883.3.88.12.3221.5.2" />
| |
| − | <!-- aus S_KBV_PERSONENGRUPPE -->
| |
| − | <value xsi:type="CD" code="4" codeSystem="1.2.276.0.76.11.151" displayName="SOZ"/>
| |
| − | </observation>
| |
| − | </entryRelationship>
| |
| − | <entryRelationship typeCode="COMP" >
| |
| − | <!-- DMP Observation -->
| |
| − | <observation classCode="OBS" moodCode="EVN">
| |
| − | <templateId root="DMP" />
| |
| − | <code code="DMP" codeSystem="2.16.840.1.113883.3.88.12.3221.5.2" />
| |
| − | <!-- aus S_KBV_DMP -->
| |
| − | <value xsi:type="CD" code="D" codeSystem="1.2.276.0.76.11.138"/>
| |
| − | </observation>
| |
| − | </entryRelationship>
| |
| − | <entryRelationship typeCode="COMP" >
| |
| − | <!-- DMP Observation -->
| |
| − | <observation classCode="OBS" moodCode="EVN">
| |
| − | <templateId root="ASV" />
| |
| − | <code code="ASV" codeSystem="2.16.840.1.113883.3.88.12.3221.5.2" />
| |
| − | <!-- aus S_KBV_ASV -->
| |
| − | <value xsi:type="CD" code="A" />
| |
| − | </observation>
| |
| − | </entryRelationship>
| |
| − | </act>
| |
| − | </entryRelationship>
| |
| − | </act>
| |
| − | </entry>
| |
| − | </section>
| |
| − | </component>
| |
| − | <!-- AU-Diagnose Section -->
| |
| − | <component>
| |
| − | <section>
| |
| − | <templateId root="xxxxxx"/>
| |
| − | <code code="AU-DIAGNOSIS" />
| |
| − | <title>AU-begründende Diagnosen</title>
| |
| − | <text>Der Patient will einfach nicht arbeiten!</text>
| |
| − | <entry>
| |
| − | <observation classCode="OBS" moodCode="EVN">
| |
| − | <code code="x47"/>
| |
| − | <statusCode code="completed"/>
| |
| − | </observation>
| |
| − | </entry>
| |
| − | <entry>
| |
| − | <observation classCode="OBS" moodCode="EVN">
| |
| − | <code code="x80"/>
| |
| − | <statusCode code="completed"/>
| |
| − | </observation>
| |
| − | </entry>
| |
| − | </section>
| |
| − | </component>
| |
| − | <!-- Findings Section -->
| |
| − | <component>
| |
| − | <section>
| |
| − | <templateId/>
| |
| − | <text>
| |
| − |
| |
| − | </text>
| |
| − | </section>
| |
| − | </component>
| |
| − | <!-- Accident/Unfall Section -->
| |
| − | <component>
| |
| − | <section>
| |
| − | <templateId/>
| |
| − | <code code="ACCIDENT"/>
| |
| − | <title>Unfall</title>
| |
| − | <entry>
| |
| − | <observation classCode="OBS" moodCode="EVN">
| |
| − | <templateId/>
| |
| − | <code code="ACCIDENT"/>
| |
| − | <statusCode code="completed"/>
| |
| − | <effectiveTime/>
| |
| − | <!-- aus S_KBV_01_Accident -->
| |
| − | <value xsi:type="CD" code="D-ARZT" codeSystem="1.2.276.0.76.3.1.135.8.11.4"/>
| |
| − | </observation>
| |
| − | </entry>
| |
| − | </section>
| |
| − | </component>
| |
| − | <!-- Treatment Section -->
| |
| − | <component>
| |
| − | <section>
| |
| − | <templateId/>
| |
| − | <code code="TREATMENT"/>
| |
| − | <title>Einleitung besonderer Maßnahmen</title>
| |
| − | <text>
| |
| − | keine Ahnung, was sonst noch zu tun ist
| |
| − | </text>
| |
| − | <!-- Treatment stufenweise Wiedereingliederung -->
| |
| − | <entry>
| |
| − | <observation classCode="OBS" moodCode="EVN">
| |
| − | <code code="EINGLIEDERUNG" />
| |
| − | <value xsi:type="BL" value="false"/>
| |
| − | </observation>
| |
| − | </entry>
| |
| − | <!-- Treatment Leistungen med. Reha Observation -->
| |
| − | <entry>
| |
| − | <observation classCode="OBS" moodCode="EVN">
| |
| − | <code code="REHA" />
| |
| − | <value xsi:type="BL" value="true"/>
| |
| − | </observation>
| |
| − | </entry>
| |
| − | </section>
| |
| − | </component>
| |
| − | <!-- Temporary Disablement Section -->
| |
| − | <component>
| |
| − | <section>
| |
| − | <templateId/>
| |
| − | <code code="TEMPDISABLE"/>
| |
| − | <title>Arbeitsunfähigkeit</title>
| |
| − | <entry>
| |
| − | <observation classCode="OBS" moodCode="EVN">
| |
| − | <code code="X-IATWRK" codeSystem="2.16.840.1.113883.6.1"/>
| |
| − | <text>
| |
| − | beliebiger Text
| |
| − | </text>
| |
| − | <statusCode code="completed"/>
| |
| − | <effectiveTime>
| |
| − | <!-- Zeitraum der Arbeitsunfähigkeit -->
| |
| − | <low value="20171018"/>
| |
| − | <high value="20171020"/>
| |
| − | </effectiveTime>
| |
| − | <value xsi:type="PQ" unit="%" value="100" />
| |
| − | <performer>
| |
| − | <!-- festgestellt am -->
| |
| − | <time value="20171019"/>
| |
| − | <assignedEntity>
| |
| − | <id/>
| |
| − | <assignedPerson>
| |
| − | <name>Hugo Müller</name>
| |
| − | </assignedPerson>
| |
| − | </assignedEntity>
| |
| − | </performer>
| |
| − | </observation>
| |
| − | </entry>
| |
| − | </section>
| |
| − | </component>
| |
| − | </structuredBody>
| |
| − | </component>
| |
| − | </ClinicalDocument>
| |
| − | | |
| − | </syntaxhighlight>
| |
| − | | |
| − | | |
| − | [[Kategorie:cdaeau|Beispiel]]
| |
