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ALLERGY_Examples_in_empty_CCD.xml
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ALLERGY_Examples_in_empty_CCD.xml
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<?xml version="1.0"?>
<?xml-stylesheet type="text/xsl" href="CDA.xsl"?>
<!-- This is an empty C-CDA skeleton which will be used by HL7 CDA Example Task Force -->
<!-- This document was based on prior work by Lisa Nelson and Brian Weiss. contact John D'Amore with questions -->
<!-- See http://wiki.hl7.org/index.php?title=CDA_Example_Task_Force -->
<ClinicalDocument xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
xsi:schemaLocation="urn:hl7-org:v3 ../90%20HL7/00%20Standard%20-%20C-CDA/20130409%20C-CDA%20R1dot1_2012JUL/Updated_CDA_Schema_Files_Extension_Support/CDA_Schema_Files/infrastructure/cda/CDA_SDTC.xsd"
xmlns="urn:hl7-org:v3"
xmlns:cda="urn:hl7-org:v3"
xmlns:sdtc="urn:hl7-org:sdtc">
<realmCode code="US"/>
<typeId root="2.16.840.1.113883.1.3" extension="POCD_HD000040"/>
<templateId root="2.16.840.1.113883.10.20.22.1.1"/>
<!-- C-CDA -->
<templateId root="2.16.840.1.113883.10.20.22.1.2"/>
<!-- CCD -->
<id root="2.16.840.1.113883.3.3208.101.1" extension="20130607100315-CCDA-CCD"/>
<code codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" code="34133-9" displayName="Summarization of Episode Note"/>
<title>Empty CCD Skeleton That Validates on TTT. Note this was based on work by Lisa Nelson and Brian Weiss</title>
<effectiveTime value="20130607000000-0000"/>
<confidentialityCode code="N" codeSystem="2.16.840.1.113883.5.25"/>
<languageCode code="en-US"/>
<recordTarget>
<patientRole>
<id root="2.16.840.1.113883.3.3208.101.2" extension="20130607100800-Patient1"/>
<addr use="HP">
<streetAddressLine>1111 StreetName St.</streetAddressLine>
<city>Silver Spring</city>
<state>MD</state>
<postalCode>20901</postalCode>
<country>US</country>
</addr>
<telecom value="tel:+1(301)111-1111" use="HP"/>
<patient>
<name use="L">
<given>Patient</given>
<family>One</family>
</name>
<administrativeGenderCode code="M" codeSystem="2.16.840.1.113883.5.1" displayName="Male" codeSystemName="AdministrativeGender"/>
<birthTime value="19300911"/>
<maritalStatusCode code="M" displayName="Married" codeSystem="2.16.840.1.113883.5.2" codeSystemName="MaritalStatus"/>
<raceCode code="2106-3" displayName="White"
codeSystem="2.16.840.1.113883.6.238"
codeSystemName="OMB Standards for Race and Ethnicity"/>
<ethnicGroupCode code="2186-5" displayName="Not Hispanic or Latino"
codeSystem="2.16.840.1.113883.6.238"
codeSystemName="OMB Standards for Race and Ethnicity"/>
<languageCommunication>
<languageCode code="eng"/>
<modeCode code="ESP" displayName="Expressed spoken" codeSystem="2.16.840.1.113883.5.60" codeSystemName="LanguageAbilityMode"/>
<proficiencyLevelCode code="E" displayName="Excellent" codeSystem="2.16.840.1.113883.5.61" codeSystemName="LanguageAbilityProficiency"/>
</languageCommunication>
</patient>
</patientRole>
</recordTarget>
<author>
<time value="20130607000000"/>
<assignedAuthor>
<id extension="22222" root="2.16.840.1.113883.4.6"/>
<code code="207QA0505X" codeSystem="2.16.840.1.113883.6.101"
displayName="Adult Medicine" codeSystemName="NUCC"/>
<addr use="HP">
<streetAddressLine>2222 StreetName St.</streetAddressLine>
<city>Silver Spring</city>
<state>MD</state>
<postalCode>20901</postalCode>
<country>US</country>
</addr>
<telecom value="tel:+1(301)222-2222" use="WP"/>
<assignedPerson>
<name>
<given>Doctor</given>
<family>Second</family>
<suffix>MD</suffix>
</name>
</assignedPerson>
</assignedAuthor>
</author>
<dataEnterer>
<assignedEntity>
<id extension="33333" root="2.16.840.1.113883.4.6"/>
<code code="364SA2200X" displayName="Adult Health" codeSystem="2.16.840.1.113883.6.101" codeSystemName="NUCC"/>
<addr use="WP">
<streetAddressLine>3333 StreetName St.</streetAddressLine>
<city>Silver Spring</city>
<state>MD</state>
<postalCode>20901</postalCode>
<country>US</country>
</addr>
<telecom value="tel:+1(301)333-3333" use="WP"/>
<assignedPerson>
<name>
<given>Nurse</given>
<family>Tertiary</family>
</name>
</assignedPerson>
</assignedEntity>
</dataEnterer>
<custodian>
<assignedCustodian>
<representedCustodianOrganization>
<id extension="44444" root="2.16.840.1.113883.4.6"/>
<name>CDA PRO Fictional Hospital</name>
<telecom value="tel:+1(301)444-4444" use="WP"/>
<addr use="WP">
<streetAddressLine>4444 StreetName St.</streetAddressLine>
<city>Silver Spring</city>
<state>MD</state>
<postalCode>20901</postalCode>
<country>US</country>
</addr>
</representedCustodianOrganization>
</assignedCustodian>
</custodian>
<legalAuthenticator>
<time value="20130607000000"/>
<signatureCode code="S"/>
<assignedEntity>
<id root="2.16.840.1.113883.3.3208.101.3" extension="20130607102400-Authenticator1"/>
<addr use="WP">
<streetAddressLine>5555 StreetName St.</streetAddressLine>
<city>Silver Spring</city>
<state>MD</state>
<postalCode>20901</postalCode>
<country>US</country>
</addr>
<telecom value="tel:+1(301)555-5555" use="WP"/>
<assignedPerson>
<name>
<given>Physician</given>
<family>Fifthly</family>
<suffix>MD</suffix>
</name>
</assignedPerson>
</assignedEntity>
</legalAuthenticator>
<documentationOf>
<serviceEvent classCode="PCPR">
<effectiveTime>
<low value="19330316"/>
<high value="20130607"/>
</effectiveTime>
<performer typeCode="PRF">
<assignedEntity>
<id extension="66666" root="2.16.840.1.113883.4.6"/>
<code code="207RC0000X" codeSystem="2.16.840.1.113883.6.101" codeSystemName="NUCC"
displayName="Cardiovascular Disease"/>
<addr>
<streetAddressLine>6666 StreetName St.</streetAddressLine>
<city>Silver Spring</city>
<state>MD</state>
<postalCode>20901</postalCode>
<country>US</country>
</addr>
<telecom value="tel:+1(301)666-6666" use="WP"/>
<assignedPerson>
<name>
<given>Heartly</given>
<family>Sixer</family>
<suffix>MD</suffix>
</name>
</assignedPerson>
</assignedEntity>
</performer>
</serviceEvent>
</documentationOf>
<!-- CDA Body -->
<component>
<structuredBody>
<!-- Allergies Section -->
<component>
<section>
<templateId root="2.16.840.1.113883.10.20.22.2.6.1"/>
<!-- Allergies (entries required) section template -->
<code code="48765-2" codeSystem="2.16.840.1.113883.6.1"/>
<title>Allergies, Adverse Reactions and Alerts</title>
<text>
<table>
<thead>
<tr>
<th>Allergen</th>
<th>Reaction</th>
<th>Reaction Severity</th>
<th>Documentation Date</th>
<th>Start Date</th>
</tr>
</thead>
<tbody>
<tr ID="allergy1">
<td ID="allergy1allergen">Cat hair</td>
<td ID="allergy1reaction">Rash</td>
<td ID="allergy1reactionseverity">Moderate</td>
<td>Jan 4 2014</td>
<td>1998</td>
</tr>
<tr ID="allergy2">
<td ID="allergy2allergen">Penicillin</td>
<td ID="allergy2reaction">Anaphylaxis</td>
<td ID="allergy2reactionseverity">Severe</td>
<td>Jan 4 2014</td>
<td>2006</td>
</tr>
<tr ID="allergy3">
<td ID="allergy3allergen">Penicillins (drug class)</td>
<td ID="allergy3reaction">Anaphylaxis</td>
<td ID="allergy3reactionseverity">Severe</td>
<td>Jan 4 2014</td>
<td>2006</td>
</tr>
<tr ID="allergy4">
<td ID="allergy4allergen">Latex</td>
<td ID="allergy4reaction">Anaphylaxis</td>
<td ID="allergy4reactionseverity">Severe</td>
<td>Jan 4 2014</td>
<td>Jan 3 2014</td>
</tr>
<tr ID="allergy5">
<td ID="allergy5allergen">Egg</td>
<td ID="allergy5reaction">Hives</td>
<td ID="allergy5reactionseverity">Moderate</td>
<td>Jan 4 2014</td>
<td>1998</td>
</tr>
<tr ID="allergy6">
<td ID="allergy6allergen">Epineprhine</td>
<td>
<content ID="allergy6reaction">Ventricular tachycardia</content>
<br />
<content ID="allergy6reaction2">Tremor</content>
</td>
<td>
<content ID="allergy6reactionseverity">Severe</content>
<br />
<content ID="allergy6reactionseverity2">Moderate</content>
</td>
<td>Jan 4 2014</td>
<td>Jan 3 2014</td>
</tr>
</tbody>
</table>
</text>
<entry typeCode="DRIV">
<act classCode="ACT" moodCode="EVN">
<!-- ** Allergy problem act ** -->
<templateId root="2.16.840.1.113883.10.20.22.4.30"/>
<id root="4a2ac5fc-0c85-4223-baee-c2e254803974" />
<code code="CONC" codeSystem="2.16.840.1.113883.5.6"/>
<statusCode code="active"/>
<!-- This is the time stamp for when the allergy was first documented as a concern-->
<effectiveTime>
<low value="20140104123506+0500"/>
</effectiveTime>
<entryRelationship typeCode="SUBJ" inversionInd="true">
<observation classCode="OBS" moodCode="EVN">
<!-- allergy observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.7"/>
<id root="4a2ac5fc-0c85-4223-baee-c2e254803974"/>
<code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
<statusCode code="completed"/>
<!-- This is the time stamp for the biological onset of the allergy. -->
<!-- Just the year is shown since a specific month and date was not reported -->
<effectiveTime>
<low value="1998"/>
</effectiveTime>
<!-- This specifies that the allergy is to a substance (cat hair) in contrast to other allergies (drug) -->
<value xsi:type="CD" code="419199007" displayName="allergy to substance" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT"></value>
<participant typeCode="CSM">
<participantRole classCode="MANU">
<playingEntity classCode="MMAT">
<!-- UNII is used to report allergen of a substance -->
<code code="1564HD0N96" displayName="Cat hair" codeSystem="2.16.840.1.113883.4.9" codeSystemName="UNII">
<originalText>
<reference value="#allergy1allergen"/>
</originalText>
</code>
</playingEntity>
</participantRole>
</participant>
<entryRelationship typeCode="MFST" inversionInd="true">
<observation classCode="OBS" moodCode="EVN">
<!-- Reaction Observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.9"/>
<id root="0506c036-adfb-4e6e-b9e1-eea76177ead5"/>
<!-- This code was not specified in C-CDA IG 1.1 although using ASSERTION aligns with C-CDA IG 2.0-->
<code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
<text>
<reference value="#allergy1reaction"/>
</text>
<statusCode code="completed"/>
<effectiveTime>
<low value="1998"/>
</effectiveTime>
<value xsi:type="CD" code="64144002" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Rash"/>
<entryRelationship typeCode="SUBJ" inversionInd="true">
<observation classCode="OBS" moodCode="EVN">
<!-- Severity Observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.8"/>
<code code="SEV" codeSystem="2.16.840.1.113883.5.4" codeSystemName="ActCode"/>
<text>
<reference value="#allergy1reactionseverity"/>
</text>
<statusCode code="completed"/>
<value xsi:type="CD" code="6736007" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="moderate"/>
</observation>
</entryRelationship>
</observation>
</entryRelationship>
<!-- Note that severity may also be specified for observation and has SHOULD conformance in C-CDA 1.1 -->
<!-- We have only included allergy severity to a specific reaction as outlined in HL7 Patient Care Committee materials-->
</observation>
</entryRelationship>
</act>
</entry>
<entry typeCode="DRIV">
<act classCode="ACT" moodCode="EVN">
<!-- ** Allergy problem act ** -->
<templateId root="2.16.840.1.113883.10.20.22.4.30"/>
<id root="4a2ac5fc-0c85-4223-baee-c2e254803974" />
<code code="CONC" codeSystem="2.16.840.1.113883.5.6"/>
<statusCode code="active"/>
<!-- This is the time stamp for when the allergy was first documented as a concern-->
<effectiveTime>
<low value="20140104123506+0500"/>
</effectiveTime>
<entryRelationship typeCode="SUBJ" inversionInd="true">
<observation classCode="OBS" moodCode="EVN">
<!-- allergy observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.7"/>
<id root="4a2ac5fc-0c85-4223-baee-c2e254803974"/>
<code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
<statusCode code="completed"/>
<!-- This is the time stamp for the biological onset of the allergy. -->
<!-- Just the year is shown since a specific month and date was not reported -->
<effectiveTime>
<low value="2006"/>
</effectiveTime>
<!-- This specifies that the allergy is to a medication in contrast to other allergies (substance) -->
<value xsi:type="CD" code="416098002" displayName="drug allergy" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT"></value>
<participant typeCode="CSM">
<participantRole classCode="MANU">
<playingEntity classCode="MMAT">
<!-- RxNorm is used to report specific drug allergies. Note to use NDF-RT for drug classes -->
<!-- Best practice is to report drug allergies at ingredient level (e.g. penicillin) not at the adminsitration level (e.g. 10mg tablet)-->
<code code="7980" displayName="penicillin" codeSystem="2.16.840.1.113883.6.88" codeSystemName="RxNorm">
<originalText>
<reference value="#allergy2allergen"/>
</originalText>
</code>
</playingEntity>
</participantRole>
</participant>
<entryRelationship typeCode="MFST" inversionInd="true">
<observation classCode="OBS" moodCode="EVN">
<!-- Reaction Observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.9"/>
<id root="0506c036-adfb-4e6e-b9e1-eea76177ead5"/>
<!-- This code was not specified in C-CDA IG 1.1 although using ASSERTION aligns with C-CDA IG 2.0-->
<code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
<text>
<reference value="#allergy2reaction"/>
</text>
<statusCode code="completed"/>
<effectiveTime>
<low value="2006"/>
</effectiveTime>
<value xsi:type="CD" code="39579001" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Anaphylaxis"/>
<entryRelationship typeCode="SUBJ" inversionInd="true">
<observation classCode="OBS" moodCode="EVN">
<!-- Severity Observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.8"/>
<code code="SEV" codeSystem="2.16.840.1.113883.5.4" codeSystemName="ActCode"/>
<text>
<reference value="#allergy2reactionseverity"/>
</text>
<statusCode code="completed"/>
<value xsi:type="CD" code="24484000" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Severe"/>
</observation>
</entryRelationship>
</observation>
</entryRelationship>
<!-- Note that severity may also be specified for observation and has SHOULD conformance in C-CDA 1.1 -->
<!-- We have only included allergy severity to a specific reaction as outlined in HL7 Patient Care Committee materials-->
</observation>
</entryRelationship>
</act>
</entry>
<entry typeCode="DRIV">
<act classCode="ACT" moodCode="EVN">
<!-- ** Allergy problem act ** -->
<templateId root="2.16.840.1.113883.10.20.22.4.30"/>
<id root="4a2ac5fc-0c85-4223-baee-c2e254803974" />
<code code="CONC" codeSystem="2.16.840.1.113883.5.6"/>
<statusCode code="active"/>
<!-- This is the time stamp for when the allergy was first documented as a concern-->
<effectiveTime>
<low value="20140104123506+0500"/>
</effectiveTime>
<entryRelationship typeCode="SUBJ" inversionInd="true">
<observation classCode="OBS" moodCode="EVN">
<!-- allergy observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.7"/>
<id root="4a2ac5fc-0c85-4223-baee-c2e254803974"/>
<code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
<statusCode code="completed"/>
<!-- This is the time stamp for the biological onset of the allergy. -->
<!-- Just the year is shown since a specific month and date was not reported -->
<effectiveTime>
<low value="2006"/>
</effectiveTime>
<!-- This specifies that the allergy is to a medication in contrast to other allergies (substance) -->
<value xsi:type="CD" code="416098002" displayName="drug allergy" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT"></value>
<participant typeCode="CSM">
<participantRole classCode="MANU">
<playingEntity classCode="MMAT">
<!-- NDF-RT is used to report drug class allergies. Note to use RxNorm for specific drugs -->
<code code="N0000011281" displayName="penicillins" codeSystem="2.16.840.1.113883.3.26.1.5" codeSystemName="NDF-RT">
<originalText>
<reference value="#allergy3allergen"/>
</originalText>
</code>
</playingEntity>
</participantRole>
</participant>
<entryRelationship typeCode="MFST" inversionInd="true">
<observation classCode="OBS" moodCode="EVN">
<!-- Reaction Observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.9"/>
<id root="0506c036-adfb-4e6e-b9e1-eea76177ead5"/>
<!-- This code was not specified in C-CDA IG 1.1 although using ASSERTION aligns with C-CDA IG 2.0-->
<code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
<text>
<reference value="#allergy3reaction"/>
</text>
<statusCode code="completed"/>
<effectiveTime>
<low value="2006"/>
</effectiveTime>
<value xsi:type="CD" code="39579001" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Anaphylaxis"/>
<entryRelationship typeCode="SUBJ" inversionInd="true">
<observation classCode="OBS" moodCode="EVN">
<!-- Severity Observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.8"/>
<code code="SEV" codeSystem="2.16.840.1.113883.5.4" codeSystemName="ActCode"/>
<text>
<reference value="#allergy3reactionseverity"/>
</text>
<statusCode code="completed"/>
<value xsi:type="CD" code="24484000" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Severe"/>
</observation>
</entryRelationship>
</observation>
</entryRelationship>
<!-- Note that severity may also be specified for observation and has SHOULD conformance in C-CDA 1.1 -->
<!-- We have only included allergy severity to a specific reaction as outlined in HL7 Patient Care Committee materials-->
</observation>
</entryRelationship>
</act>
</entry>
<entry typeCode="DRIV">
<act classCode="ACT" moodCode="EVN">
<!-- ** Allergy problem act ** -->
<templateId root="2.16.840.1.113883.10.20.22.4.30"/>
<id root="0abffc67-af4e-4345-b917-eed43f641b93" />
<code code="CONC" codeSystem="2.16.840.1.113883.5.6"/>
<statusCode code="active"/>
<!-- This is the time stamp for when the allergy was first documented as a concern-->
<effectiveTime>
<low value="20140104123506+0500"/>
</effectiveTime>
<entryRelationship typeCode="SUBJ" inversionInd="true">
<observation classCode="OBS" moodCode="EVN">
<!-- allergy observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.7"/>
<id root="0abffc67-af4e-4345-b917-eed43f641b93"/>
<code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
<statusCode code="completed"/>
<!-- This is the time stamp for the biological onset of the allergy. -->
<!-- This documents that the allergy began at given year month and day, although hour and minute not specified-->
<effectiveTime>
<low value="20140103"/>
</effectiveTime>
<!-- This specifies that the allergy is a propensity to adverse reactions to substance -->
<value xsi:type="CD" code="418038007" displayName="Propensity to adverse reactions to substance (disorder)" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT"></value>
<participant typeCode="CSM">
<participantRole classCode="MANU">
<playingEntity classCode="MMAT">
<!-- UNII is used to report allergen of a substance -->
<code code="2LQ0UUW8IN" displayName="Natural Latex Rubber" codeSystem="2.16.840.1.113883.4.9" codeSystemName="UNII">
<originalText>
<reference value="#allergy4allergen"/>
</originalText>
</code>
</playingEntity>
</participantRole>
</participant>
<entryRelationship typeCode="MFST" inversionInd="true">
<observation classCode="OBS" moodCode="EVN">
<!-- Reaction Observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.9"/>
<id root="14d1b466-feee-4f4d-a82e-a03754327e1a"/>
<!-- This code was not specified in C-CDA IG 1.1 although using ASSERTION aligns with C-CDA IG 2.0-->
<code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
<text>
<reference value="#allergy4reaction"/>
</text>
<statusCode code="completed"/>
<effectiveTime>
<low value="20140103"/>
</effectiveTime>
<value xsi:type="CD" code="39579001" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Anaphylaxis"/>
<entryRelationship typeCode="SUBJ" inversionInd="true">
<observation classCode="OBS" moodCode="EVN">
<!-- Severity Observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.8"/>
<code code="SEV" codeSystem="2.16.840.1.113883.5.4" codeSystemName="ActCode"/>
<text>
<reference value="#allergy4reactionseverity"/>
</text>
<statusCode code="completed"/>
<value xsi:type="CD" code="24484000" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="severe"/>
</observation>
</entryRelationship>
</observation>
</entryRelationship>
<!-- Note that severity may also be specified for observation and has SHOULD conformance in C-CDA 1.1 -->
<!-- We have only included allergy severity to a specific reaction as outlined in HL7 Patient Care Committee materials-->
</observation>
</entryRelationship>
</act>
</entry>
<entry typeCode="DRIV">
<act classCode="ACT" moodCode="EVN">
<!-- ** Allergy problem act ** -->
<templateId root="2.16.840.1.113883.10.20.22.4.30"/>
<id root="0fffb34f-c1e0-47c2-92af-c414a3ff21ec" />
<code code="CONC" codeSystem="2.16.840.1.113883.5.6"/>
<statusCode code="active"/>
<!-- This is the time stamp for when the allergy was first documented as a concern-->
<effectiveTime>
<low value="20140104123506+0500"/>
</effectiveTime>
<entryRelationship typeCode="SUBJ" inversionInd="true">
<observation classCode="OBS" moodCode="EVN">
<!-- allergy observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.7"/>
<id root="0fffb34f-c1e0-47c2-92af-c414a3ff21ec"/>
<code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
<statusCode code="completed"/>
<!-- This is the time stamp for the biological onset of the allergy. -->
<!-- Just the year is shown since a specific month and date was not reported -->
<effectiveTime>
<low value="1998"/>
</effectiveTime>
<!-- This specifies that the allergy is to a food in contrast to other allergies (drug) -->
<value xsi:type="CD" code="414285001" displayName="Food allergy (disorder)" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT"></value>
<participant typeCode="CSM">
<participantRole classCode="MANU">
<playingEntity classCode="MMAT">
<!-- UNII is used to report allergen of a food -->
<code code="291P45F896" displayName="Egg" codeSystem="2.16.840.1.113883.4.9" codeSystemName="UNII">
<originalText>
<reference value="#allergy5allergen"/>
</originalText>
</code>
</playingEntity>
</participantRole>
</participant>
<entryRelationship typeCode="MFST" inversionInd="true">
<observation classCode="OBS" moodCode="EVN">
<!-- Reaction Observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.9"/>
<id root="d89ce431-e0f1-4f8d-a81f-489b6ed91f09"/>
<!-- This code was not specified in C-CDA IG 1.1 although using ASSERTION aligns with C-CDA IG 2.0-->
<code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
<text>
<reference value="#allergy5reaction"/>
</text>
<statusCode code="completed"/>
<effectiveTime>
<low value="1998"/>
</effectiveTime>
<value xsi:type="CD" code="247472004" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Hives"/>
<entryRelationship typeCode="SUBJ" inversionInd="true">
<observation classCode="OBS" moodCode="EVN">
<!-- Severity Observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.8"/>
<code code="SEV" codeSystem="2.16.840.1.113883.5.4" codeSystemName="ActCode"/>
<text>
<reference value="#allergy5reactionseverity"/>
</text>
<statusCode code="completed"/>
<value xsi:type="CD" code="6736007" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="moderate"/>
</observation>
</entryRelationship>
</observation>
</entryRelationship>
<!-- Note that severity may also be specified for observation and has SHOULD conformance in C-CDA 1.1 -->
<!-- We have only included allergy severity to a specific reaction as outlined in HL7 Patient Care Committee materials-->
</observation>
</entryRelationship>
</act>
</entry>
<entry typeCode="DRIV">
<act classCode="ACT" moodCode="EVN">
<!-- ** Allergy problem act ** -->
<templateId root="2.16.840.1.113883.10.20.22.4.30"/>
<id root="57b4e23d-43c0-465d-b907-c653388ee14b" />
<code code="CONC" codeSystem="2.16.840.1.113883.5.6"/>
<statusCode code="active"/>
<!-- This is the time stamp for when the allergy was first documented as a concern-->
<effectiveTime>
<low value="20140104123506+0500"/>
</effectiveTime>
<entryRelationship typeCode="SUBJ" inversionInd="true">
<observation classCode="OBS" moodCode="EVN">
<!-- allergy observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.7"/>
<id root="57b4e23d-43c0-465d-b907-c653388ee14b"/>
<code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
<statusCode code="completed"/>
<!-- This is the time stamp for the biological onset of the allergy. -->
<!-- Just the year is shown since a specific month and date was not reported -->
<effectiveTime>
<low value="20140103"/>
</effectiveTime>
<!-- This specifies that the allergy is to a medication in contrast to other allergies (substance) -->
<value xsi:type="CD" code="59037007" displayName="Drug intolerance (disorder)" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT"></value>
<informant>
<assignedEntity>
<!-- This is a fictional OID and identifier for the patient. This should be adapted to local implementation -->
<id root="2.16.840.1.113883.3.3208.101.2" extension="20130607100800-Patient1"/>
<addr use="HP">
<streetAddressLine>1111 StreetName St.</streetAddressLine>
<city>Silver Spring</city>
<state>MD</state>
<postalCode>20901</postalCode>
<country>US</country>
</addr>
<telecom value="tel:+1(301)111-1111" use="HP"/>
<assignedPerson>
<name>
<given>Patient</given>
<family>One</family>
</name>
</assignedPerson>
</assignedEntity>
</informant>
<participant typeCode="CSM">
<participantRole classCode="MANU">
<playingEntity classCode="MMAT">
<!-- RxNorm is used to report specific drug allergies. Note to use NDF-RT for drug classes -->
<!-- Best practice is to report drug allergies at ingredient level (e.g. epinephrine) not at the adminsitration level (e.g. 0.3mL 0.5mg/mL Prefilled Syringe)-->
<code code="3992" displayName="epinephrine" codeSystem="2.16.840.1.113883.6.88" codeSystemName="RxNorm">
<originalText>
<reference value="#allergy6allergen"/>
</originalText>
</code>
</playingEntity>
</participantRole>
</participant>
<entryRelationship typeCode="MFST" inversionInd="true">
<observation classCode="OBS" moodCode="EVN">
<!-- Reaction Observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.9"/>
<id root="0506c036-adfb-4e6e-b9e1-eea76177ead5"/>
<!-- This code was not specified in C-CDA IG 1.1 although using ASSERTION aligns with C-CDA IG 2.0-->
<code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
<text>
<reference value="#allergy6reaction"/>
</text>
<statusCode code="completed"/>
<effectiveTime>
<low value="20140103"/>
</effectiveTime>
<value xsi:type="CD" code="25569003" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Ventricular tachycardia"/>
<entryRelationship typeCode="SUBJ" inversionInd="true">
<observation classCode="OBS" moodCode="EVN">
<!-- Severity Observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.8"/>
<code code="SEV" codeSystem="2.16.840.1.113883.5.4" codeSystemName="ActCode"/>
<text>
<reference value="#allergy6reactionseverity"/>
</text>
<statusCode code="completed"/>
<value xsi:type="CD" code="24484000" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Severe"/>
</observation>
</entryRelationship>
</observation>
</entryRelationship>
<!-- Note that multiple reactions may be recorded to the same substance ([0..*] cardinality in C-CDA 1.1)-->
<entryRelationship typeCode="MFST" inversionInd="true">
<observation classCode="OBS" moodCode="EVN">
<!-- Reaction Observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.9"/>
<id root="fea0b775-f3fe-4e0a-9c4f-4a5c235c2af0"/>
<!-- This code was not specified in C-CDA IG 1.1 although using ASSERTION aligns with C-CDA IG 2.0-->
<code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
<text>
<reference value="#allergy6reaction2"/>
</text>
<statusCode code="completed"/>
<effectiveTime>
<low value="20140103"/>
</effectiveTime>
<value xsi:type="CD" code="26079004" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Tremor"/>
<entryRelationship typeCode="SUBJ" inversionInd="true">
<observation classCode="OBS" moodCode="EVN">
<!-- Severity Observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.8"/>
<code code="SEV" codeSystem="2.16.840.1.113883.5.4" codeSystemName="ActCode"/>
<text>
<reference value="#allergy6reactionseverity2"/>
</text>
<statusCode code="completed"/>
<value xsi:type="CD" code="6736007" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Moderate"/>
</observation>
</entryRelationship>
</observation>
</entryRelationship>
<!-- Note that severity may also be specified for observation and has SHOULD conformance in C-CDA 1.1 -->
<!-- We have only included allergy severity to a specific reaction as outlined in HL7 Patient Care Committee materials-->
</observation>
</entryRelationship>
</act>
</entry>
</section>
</component>
<!-- Medication Section -->
<component>
<!-- nullFlavor of NI indicates No Information.-->
<!-- Validator currently checks for entries even in case of nullFlavor - this will need to be updated if approved.-->
<section nullFlavor="NI">
<templateId root="2.16.840.1.113883.10.20.22.2.1.1"/>
<!-- Medication Section (entries required) -->
<code code="10160-0" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="History of Medication Use"/>
<title>MEDICATIONS</title>
<text>No Information</text>
</section>
</component>
<!-- Problem Section -->
<component>
<!-- nullFlavor of NI indicates No Information.-->
<!-- Validator currently checks for entries even in case of nullFlavor - this will need to be updated if approved.-->
<section nullFlavor="NI">
<!-- conforms to Problems section with entries required -->
<templateId root="2.16.840.1.113883.10.20.22.2.5.1"/>
<code code="11450-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"
displayName="PROBLEM LIST"/>
<title>PROBLEMS</title>
<text>No Information</text>
</section>
</component>
<!-- Procedures Section -->
<component>
<!-- nullFlavor of NI indicates No Information.-->
<!-- Validator currently checks for entries even in case of nullFlavor - this will need to be updated if approved.-->
<section nullFlavor="NI">
<templateId root="2.16.840.1.113883.10.20.22.2.7.1"/>
<!-- Procedures Section with Coded Entries Required-->
<code code="47519-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="History of Procedures"/>
<title>PROCEDURES</title>
<text>No Information</text>
</section>
</component>
<!-- Results Section -->
<component>
<!-- nullFlavor of NI indicates No Information.-->
<!-- Validator currently checks for entries even in case of nullFlavor - this will need to be updated if approved.-->
<section nullFlavor="NI">
<templateId root="2.16.840.1.113883.10.20.22.2.3.1"/>
<!-- Results Section with Coded Entries Required-->
<code code="30954-2" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Relevant diagnostic tests and/or laboratory data"/>
<title>RESULTS</title>
<text>No Information</text>
</section>
</component>
<!-- Plan of Care Section -->
<component>
<!-- nullFlavor of NI indicates No Information.-->
<!-- Validator currently checks for entries even in case of nullFlavor - this will need to be updated if approved.-->
<section nullFlavor="NI">
<templateId root="2.16.840.1.113883.10.20.22.2.10"/>
<!-- Plan of Care Section-->
<code code="18776-5" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Plan of Care"/>
<title>PLAN OF CARE</title>
<text>No Information</text>
</section>
</component>
<!-- Social History (with Smoking Status Observation) -->
<component>
<!-- nullFlavor of NI indicates No Information.-->
<!-- Validator currently checks for entries even in case of nullFlavor - this will need to be updated if approved.-->
<section nullFlavor="NI">
<templateId root="2.16.840.1.113883.10.20.22.2.17"/>
<!-- Social History Section -->
<code code="29762-2" codeSystem="2.16.840.1.113883.6.1" displayName="Social History"/>
<title>SOCIAL HISTORY</title>
<text>No Information</text>
</section>
</component>
<!-- Vital Signs Section (entries required) -->
<component>
<!-- nullFlavor of NI indicates No Information.-->
<!-- Validator currently checks for entries even in case of nullFlavor - this will need to be updated if approved.-->
<section nullFlavor="NI">
<templateId root="2.16.840.1.113883.10.20.22.2.4.1"/>
<!-- Vital Signs (entries required) -->
<code code="8716-3" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Vital Signs"/>
<title>VITAL SIGNS</title>
<text>No Information</text>
</section>
</component>
</structuredBody>
</component>
</ClinicalDocument>