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	Closed (only 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
Used by / Uses	Used by 7 templates, Uses 12 templates Used by Template id 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 Template id as Name Version 1.3.6.1.4.1.19376.1.8.1.4.2 Containment CDA author 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 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 1.3.6.1.4.1.19376.1.3.10.4.2 Containment TNM Stage Observation (2.0) DYNAMIC 1.3.6.1.4.1.19376.1.3.10.4.3 Containment ICD-O-3 Typing and Grading Observation (2.0) 2015‑11‑29 17:03:18 1.3.6.1.4.1.19376.1.3.10.4.4 Containment Assessment Scales Observation for Scoring Systems APSR2 (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 1.3.6.1.4.1.19376.1.3.10.4.2 'TNM Stage Observation' (dynamic) -->   </component>  <component typeCode="COMP" contextConductionInd="true">     <sequenceNumber value="1"/>    <seperatableInd value="false"/>    <!-- template 1.3.6.1.4.1.19376.1.3.10.4.3 'ICD-O-3 Typing and Grading Observation' (2015-11-29T17:03:18) -->   </component>  <component typeCode="COMP" contextConductionInd="true">     <sequenceNumber value="1"/>    <seperatableInd value="false"/>    <!-- template 1.3.6.1.4.1.19376.1.3.10.4.4 'Assessment Scales Observation for Scoring Systems APSR2' (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, 1st problem <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 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 0 … 1 F EVN   Associated with concepts: psr-data​element-39 Problem Organizer APSR 2.0 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 … 1 R PaLM Suppl. 2.0‑3: 6.3.5.2 Problem organizer   Associated with concepts: psr-data​element-86 Problem ID APSR 2.0 hl7:code CD CNE 0 … 1 R Problem The problem type code is unconstrained at this stage. PaLM Suppl. 2.0‑3: 6.3.5.2 Problem organizer @code CONF 1 … 1 F 75326-9 @codeSystem 1 … 1 F 2.16.840.1.113883.6.1 (Logical Observation Identifier Names and Codes) @displayName 1 … 1 F Problem @codeSystemName 1 … 1 F LOINC 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 a 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 … * R PaLM Suppl. 2.0‑3: 6.3.5.2 Problem organizer @displayName cs 0 … 1 F Associated topography (attribute) @code cs 0 … 1 F 116677004 @codeSystem oid 0 … 1 F 2.16.840.1.113883.6.96 hl7:value CD CWE 0 … * PaLM Suppl. 2.0‑3: 6.3.5.2 Problem organizer @nullFlavor cs 0 … 1   @code CONF 1 … 1 F all children of "362981000" @codeSystem 1 … 1 F 2.16.840.1.113883.6.96 (SNOMED Clinical Terms) @displayName 1 … 1 F all values from 91723000 (Anatomical structure) @codeSystemName 1 … 1 F SNOMED-CT hl7:component 0 … 1 R Coding of the Problem reported PaLM Suppl. 2.0‑3: 6.3.5.2 Problem organizer @typeCode cs 0 … 1 F COMP hl7:observation CD 0 … 1 R PaLM Suppl. 2.0‑3: 6.3.5.2 Problem organizer hl7:code CD CNE 1 … 1 R PaLM Suppl. 2.0‑3: 6.3.5.2 Problem organizer @code CONF 1 … 1 F 75326-9 @codeSystem 1 … 1 F 2.16.840.1.113883.6.1 (Logical Observation Identifier Names and Codes) @displayName 1 … 1 F Problem @codeSystemName 1 … 1 F LOINC hl7:value CE 0 … 1 R PaLM Suppl. 2.0‑3: 6.3.5.2 Problem organizer   CONF The value of @code shall be drawn from value set 1.3.6.1.4.1.19376.1.3.11.7 Problem Type (DYNAMIC)   Example for use case #1, 1st problem (invasive cancer) <value xsi:type="CD" code="C50.9" codeSystem="2.16.840.1.113883.6.3" displayName="Malignant neoplasm of mammary gland" codeSystemName="ICD-10"/> hl7:statusCode CS CNE 1 … 1 R PaLM Suppl. 2.0‑3: 6.3.5.2 Problem organizer   Constraint "completed" or "aborted" 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 2.16.840.1.113883.1.11.15933 ActStatus (DYNAMIC) hl7:effectiveTime IVL_TS 1 … 1 R 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 (DYNAMIC) PaLM Suppl. 2.0‑3: 6.3.5.2 Problem organizer   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 … * 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 hl7:participant 0 … * 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   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 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   Associated with concepts: psr-data​element-17 Specimen identification APSR 2.0 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   Associated with concepts: psr-data​element-68 Tissue section ID APSR 2.0 psr-data​element-98 Specimen ID APSR 2.0 psr-data​element-66 Part ID APSR 2.0 psr-data​element-67 Block ID APSR 2.0 psr-data​element-95 Parent ID APSR 2.0 hl7:component 0 … * Region of interest This organizer may carry an image focusing on the problem, either directly embedded or encapsulated within a region of interest. Contains 2.16.840.1.113883.10.12.307 CDA RegionOfInterest (DYNAMIC) PaLM Suppl. 2.0‑3: 6.3.5.2 Problem organizer @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 … * 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 @typeCode cs 0 … 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 Any kind of AP observation 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 @typeCode cs 0 … 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 … 1 C In Cancer related problems here a UICC-TNM observation may be used Source: PaLM Suppl. APSR 2.0-3: 6.3.6.10 Contains 1.3.6.1.4.1.19376.1.3.10.4.2 TNM Stage Observation (DYNAMIC) PaLM Suppl. 2.0‑3: 6.3.5.2 Problem organizer @typeCode cs 0 … 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 … 1 C In Cancer related problems here an ICD-O-Typing & Grading observation may be used Source: PaLM Suppl. APSR 2.0-3: 6.3.6.11 Contains 1.3.6.1.4.1.19376.1.3.10.4.3 ICD-O-3 Typing and Grading Observation (2015‑11‑29 17:03:18) PaLM Suppl. 2.0‑3: 6.3.5.2 Problem organizer @typeCode cs 0 … 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 Assistent scale observation Source: PaLM Suppl. APSR 2.0-3: 6.3.6.12 Contains 1.3.6.1.4.1.19376.1.3.10.4.4 Assessment Scales Observation for Scoring Systems APSR2 (DYNAMIC) PaLM Suppl. 2.0‑3: 6.3.5.2 Problem organizer @typeCode cs 0 … 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 @typeCode cs 0 … 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