DRAFT HL7 Reference Information Model

Link to Subjects
Link to Stewardship and Class interests and DIMs
This data model was HTML encoded by software prepared for the JWG-CDM. Comments on presentation links or any bugs encountered may be addressed to:
beeler@mayo.edu
(George Beeler).

Identifications:

Organization: Health Level Seven
Version: V 0-83 19971121
Developed by: Modeling and Methodology

Subjects in: DRAFT HL7 Reference Information Model

Subject Area: RIM_Clinical_pathway_master

A collection of master tables related to clinical pathways.

Subject Area: RIM_Guarantor_contract

A collection of classes related to a guarantor contract.

Subject Area: RIM_Healthcare_benefit_plan

A collection of classes related to healthcare benefit plans.

Subject Area: RIM_Healthcare_finances

A collection of subject areas related to the financial aspects of Healthcare.

Subject Area: RIM_Healthcare_service_provider

A collection of classes related to Healthcare service providers.

Subject Area: RIM_Healthcare_stakeholders

A collection of subject areas related to healthcare stakeholders.

Subject Area: RIM_Master_tables

A collection of classes designated used as reference classes to master tables.

Subject Area: RIM_Observation_service_catalog_item

A collection of classes describing observation service types.

Subject Area: RIM_Organization

A collection of classes related to organizational stakeholders.

Subject Area: RIM_Patient

A collection of subject areas related to patients.

Subject Area: RIM_Patient_billing_account

A collection of classes related to the patient billing account.

Subject Area: RIM_Patient_clinical_pathway

A collection of classes related to patient specific clinical pathways or treatment plans.

Subject Area: RIM_Patient_encounter

A collection of classes related to patient encounters.

Subject Area: RIM_Patient_encounters

A collection of subject areas related to patient encounters and patient services

Subject Area: RIM_Patient_service_event

A collection of classes related to the patient service events.

Subject Area: RIM_Patient_service_location

A collection of classes related to location of patient services.

Subject Area: RIM_Patient_service_order

A collection of classes related to patient service orders.

Subject Area: RIM_Person

A collection of classes related to person stakeholder.

Subject Area: RIM_Pharmacy_service_event

A collection of services related to pharmacy treatment service events.

Subject Area: RIM_Scheduling

Subject Area: RIM_Service_catalog_item

A collection of classes related to service catalog items.

Subject Area: RIM_Stakeholder

A collection of classes in related to stakeholders.

Subject Area: All_Classes

  • Advance_directive
  • Advance_directive_witness
  • Appointment
  • Appointment_contact_person
  • Appointment_request
  • Authentication
  • Bad_debt_billing_account
  • Bad_debt_collection_agency
  • Billing_information_item
  • Certification_second_opinion
  • Champus_coverage
  • Clinical_document_header
  • Clinical_observation
  • Clinical_observation_provider
  • Collected_specimen_sample
  • Contact_person
  • Diagnostic_related_group
  • Dietary_order
  • Disability
  • Document_recipient
  • Durable_medical_equipment
  • Durable_medical_equipment_group
  • Durable_medical_equipment_request
  • Durable_medical_equipment_slot
  • Employee
  • Employer
  • Encounter_drg
  • Encounter_practitioner
  • Episode
  • Financial_transaction
  • Goal
  • Guarantor
  • Guarantor_contract
  • Health_benefit_plan_purchaser
  • Health_chart
  • Health_chart_deficiency
  • Healthcare_benefit_plan
  • Healthcare_benefit_service
  • Healthcare_coverage_benefit
  • Healthcare_document_authenticator
  • Healthcare_provider_organization
  • Healthcare_service_provider
  • Identifier_issuing_authority
  • Individual_healthcare_practitioner
  • Individual_healthcare_provider_group
  • Individual_healthcare_provider_request
  • Individual_healthcare_provider_slot
  • Inpatient_encounter
  • Insurance_certification
  • Insurance_certification_contact
  • Insurer
  • Location_encounter_role
  • Master_calculated_observation
  • Master_categorical_observation
  • Master_continuous_observation
  • Master_goal
  • Master_observation_service
  • Master_problem
  • Master_reflex_service
  • Master_service
  • Master_specimen_requirement
  • Master_treatment_service
  • Medicaid_coverage
  • Medicare_coverage
  • Notary_public
  • Observation_order
  • Observation_relationship
  • Order_healthcare_practitioner
  • Organization
  • Originator
  • Pathway
  • Pathway_master
  • Patient
  • Patient_admission
  • Patient_allergy
  • Patient_arrival
  • Patient_billing_account
  • Patient_clinical_item
  • Patient_clinical_item_source
  • Patient_death
  • Patient_departure
  • Patient_diagnosis
  • Patient_encounter
  • Patient_information_disclosure
  • Patient_information_recipient
  • Patient_problem
  • Patient_referral
  • Patient_service_event
  • Patient_service_location
  • Patient_service_location_group
  • Patient_service_location_request
  • Patient_service_location_slot
  • Patient_service_order
  • Patient_slot
  • Person
  • Person_alternate_name
  • Person_birth_event
  • Person_employment
  • Preauthorization
  • Primary_care_provider_assignment
  • Problem
  • Procedure
  • Producer_Of_Master_Service
  • Reported_patient_accident
  • Resource_request
  • Resource_slot
  • Risk_management_incident
  • Schedule
  • Service_event_provider
  • Service_event_specimen
  • Service_request
  • Stakeholder
  • Stakeholder_affiliate
  • Stakeholder_affiliation
  • Stakeholder_identifier
  • Transcriptionist
  • Treatment_service_administration
  • Treatment_service_dispense
  • Treatment_service_event
  • Treatment_service_give
  • Treatment_service_order
  • Treatment_service_order_revision
  • Description of: DRAFT HL7 Reference Information Model

    This draft HL7 Reference Information Model (RIM) is the result of the second HL7 RIM harmonization cycle. RIM change proposals from several HL7 Technical Committees were reviewed and acted upon during a RIM Harmonization Meeting held November 13 & 14, 1997 in Atlanta, Georgia.

    The updated version of the HL7 RIM will be provided to the Technical Committees and Special Interest Groups of HL7 for their use during the January 1998 Working Group meeting.

    Comments on this model should be addressed to the co-chairs of the Methodology and Modeling Committee and/or sent to the M&M e-mail list at hl7-mnm@mayo.edu


    Classes in: DRAFT HL7 Reference Information Model

    Class: Advance_directive

    Description of: Advance_directive

    Class steward is Information Management (Medical Records)
    An authoritative instruction or direction of a patient regarding their healthcare or the disposition of their remains.

    Attribute definitions for: Advance_directive

    competence_ind

    An indication as to whether the patient was mentally competent when completing the advance directive.

    directive_cd

    A code depicting the nature of the advance directive.

    disclosure_level_cd

    The level of disclosure allowed for this advance directive.

    life_quality_desc

    A free for text describing quality of life preference of the patient to be used in making intervention decisions.

    mortuary_preference_nm

    The name of the patient's preferred mortuary.

    notarization_dt

    The date the advance directive was notarized.

    Connection definitions for: Advance_directive

    is_notarized_by (1,1) :: Notary_public :: notarizes (0,M)

    has_as_a_witness (0,M) :: Advance_directive_witness :: is_witness_for (0,M)

    Class: Advance_directive_witness

    Description of: Advance_directive_witness

    Class steward is Information Management (Medical Records)
    A person that is witness to a patient's advance directive.

    Connection definitions for: Advance_directive_witness

    is_witness_for (0,M) :: Advance_directive :: has_as_a_witness (0,M)

    is_a_role_of (1,1) :: Person :: takes_on_role_of (0,1)

    Class: Appointment

    Description of: Appointment

    Class steward is Inter-Enterprise (ADT/Finance/Inter-Enterprise)
    Interested committees Patient Administration
    A planned patient encounter set for a specific time and place.

    Attribute definitions for: Appointment

    appointment_disposition_cd

    A code depicting the disposition of the appointment (e.g., pending, canceled, rescheduled, . . .).

    appointment_duration_qty

    Amount of time allotted for the appointment. In cases of repeating appointments, this field describes the duration of one instance of the appointment.

    Rationale: Currently in 2.3

    OpenIssue:

    |ARQ^9^00868^Appointment Duration| |SCH^9^00868^Appointment Duration|

    appointment_reason_cd

    The reason that the appointment is to take place.

    Rationale: Currently in 2.3

    OpenIssue:

    |ARQ^7^00866^Appointment Reason| |SCH^7^00866^Appointment Reason|

    appointment_request_reason_cd

    A code depicting the reason the appointment is being requested.

    appointment_timing_tq

    The scheduled appointment’s timing and quantity as scheduled by the filler application.

    Rationale: Currently in 2.3

    OpenIssue:

    |SCH^11^00884^Appointment Timing Quantity|

    appointment_type_cd

    Code for the type of appointment

    Rationale: Currently in 2.3

    OpenIssue:

    |ARQ^8^00867^Appointment Type| |SCH^8^00867^Appointment Type|

    cancellation_dttm

    The date and time the appointment was canceled.

    cancellation_reason_cd

    A code depicting why the appointment was canceled.

    estimated_duration_amt

    The amount of time the scheduled encounter is expected to last.

    event_reason_code

    Code for the reason that the notification event was triggered. It may describe the cancel reason, the delete reason, the discontinue reason, the add reason, the block reason or others.

    Rationale: Currently in 2.3

    OpenIssue:

    |ARQ^4^00863^Placer Group Number| |SCH^4^00863^Placer Group Number|

    expected_end_dttm

    The expected end date and time of the patient encounter

    expected_service_desc

    Text providing the service(s) expected to be provided in the scheduled encounter.

    expected_start_dttm

    The expected date and time for the start of a patient encounter.

    id

    A unique identifier assigned to an appointment.

    occurance_id

    Uniquely identifies an individual occurrence (a child) of a parent repeating schedule appointment.

    Rationale: Currently in 2.3

    OpenIssue: might turn into a recurse relationship on the class

    |ARQ^3^00862^Occurrence Number| |SCH^3^00862^Occurrence Number|

    overbook_ind

    An indication as to whether the appointment is an overbook.

    scheduling_begin_dttm

    The data and time the scheduling of the appointment began.

    scheduling_completed_dttm

    The date and time the scheduling of the appointment was completed.

    scheduling_status_cd

    A code depicting the status of scheduling the appointment.

    status_cd

    Code describing the status of the appointment with respect to the filler application.

    Rationale: Currently in 2.3

    OpenIssue:

    |AIG^13^00889^Filler Status Code| |AIL^11^00889^Filler Status Code| |AIP^11^00889^Filler Status Code| |AIS^9^00889^Filler Status Code| |SCH^22^00889^Filler Status Code|

    urgency_cd

    A code depicting the urgency to be seen by a healthcare provider.

    visit_type_cd

    A code used to classify a visit.

    wait_list_priority_nbr

    The priority assigned to an appointment request placed on a wait list.

    Connection definitions for: Appointment

    reserves (0,m) :: Resource_slot :: is_reserved_by (0,m)

    involves (0,m) :: Appointment_contact_person :: participates_in (1,1)

    are_booked_in (1,m) :: Schedule :: contains (0,m)

    schedules (1,M) :: Patient_encounter :: is_scheduled_by (0,M)

    Class: Appointment_contact_person

    Description of: Appointment_contact_person

    Class steward is Inter-Enterprise (ADT/Finance/Inter-Enterprise)
    The person responsible for requesting, entering, or filling the scheduling of a requested appointment

    Rationale: Currently in 2.3

    OpenIssue: This looks like a participation role. Reexamine.

    Attribute definitions for: Appointment_contact_person

    role_cd

    Role that a contact person plays relative to an appointment request

    Rationale: Currently in 2.3 as itemized person information for each role

    OpenIssue:

    Connection definitions for: Appointment_contact_person

    involves (1,1) :: Contact_person :: participates_in (0,m)

    participates_in (1,1) :: Appointment :: involves (0,m)

    Class: Appointment_request

    Description of: Appointment_request

    Class steward is Inter-Enterprise (ADT/Finance/Inter-Enterprise)
    A request for the booking of an appointment.

    Rationale: Separates an appointment from a request for an appointment.

    OpenIssue:

    Attribute definitions for: Appointment_request

    appointment_rqst_reason_cd

    The reason that the appointment is to take place. Examples are: ROUTINE, WALKIN, CHECKUP, FOLLOWUP, EMERGENCY.

    Rationale: Currently in 2.3

    OpenIssue: It appears that this att has the potential to be used for two types of codes that should be mutually exclusive (local site specific code, and the other is a service code) combining an administrative reason with the thing to be performed

    |ARQ^7^00866^Appointment Reason| |SCH^7^00866^Appointment Reason|

    appointment_rqst_type_cd

    The type of appointment request. Examples are: NORMAL, TENTATIVE, COMPLETE.

    Rationale: Currently in 2.3

    OpenIssue:

    |ARQ^8^00867^Appointment Type| |SCH^8^00867^Appointment Type|

    equip_selection_criteria_pv

    Parameters and preferences regarding the selection of an appropriate resource for an appointment. The first component of this field is a code identifying the parameter or preference and the second component is the actual data value for that parameter.

    Rationale: Currently in 2.3

    OpenIssue: Proposed data type that accommodates parameter, value pairs where the pairs are drawn from a user defined table.

    |APR^2^00909^Resource Selection Criteria|

    id

    Unique identifier for an appointment request.

    Rationale: Separates appointment from its request.

    OpenIssue:

    |ARQ^1^00860^Placer Appointment ID| |SCH^1^00860^Placer Appointment ID|

    location_selection_criteria_pv

    Parameters and preferences regarding the selection of an appropriate location for the appointment.

    Rationale: Currently in 2.3

    OpenIssue: Proposed data type that accommodates parameter, value pairs where the pairs are drawn from a user defined table.

    |APR^3^00910^Location Selection Criteria|

    occurance_id :: EI

    Uniquely identifies an individual occurrence (a child) of a parent repeating schedule appointment.

    Rationale: Currently in 2.3

    OpenIssue: Probably do ot need this class, could make a recursive relationship on Appointment_request

    |ARQ^3^00862^Occurrence Number| |SCH^3^00862^Occurrence Number|

    priority_cd

    The urgency of the request.

    Rationale: Currently in 2.3

    OpenIssue:

    |ARQ^12^00871^Priority|

    repeating_interval_duration_qty

    How long the appointment repetitions should continue, once they have begun.

    Rationale: Currently in 2.3

    OpenIssue:

    |ARQ^14^00873^Repeating Interval Duration|

    requested_ri

    The interval between repeating appointments.

    Rationale: Currently in 2.3

    OpenIssue: May require a new data type or attribute group. Talk to CQ about the need for a repeating interval datatype

    |ARQ^13^00872^Repeating Interval|

    rqst_event_reason_cd

    A code describing the cancel reason, the delete reason, the discontinue reason, the add reason, or any other code describing the reason for a specific request event.

    Rationale: Currently in 2.3

    OpenIssue:

    |ARQ^6^00865^Request Event Reason|

    rqsted_duration_qty

    The amount of time being requested for the appointment.

    Rationale: Currently in 2.3

    OpenIssue:

    |ARQ^9^00868^Appointment Duration| |SCH^9^00868^Appointment Duration|

    start_dr

    The date and time that the appointment is requested to begin in the form of a date/time range.

    Rationale: Currently in 2.3

    OpenIssue: Proposed new attribute type not currently supported. Needs to be proposed to CQ for the DT/AT work.

    |ARQ^11^00870^Requested Start Date/Time Range|

    time_selection_criteria_pv

    Parameters and preferences regarding the selection of an appropriate time slot for an appointment.

    Rationale: Currently in 2.3

    OpenIssue: Proposed data type that accommodates parameter, value pairs where the pairs are drawn from a user defined table. Needs new attribute type mapping to DT:PV

    |APR^1^00908^Time Selection Criteria|

    Connection definitions for: Appointment_request

    requests (0,m) :: Service_request :: is_requested_by (1,1)

    requests (0,m) :: Resource_request :: is_requested_by (1,1)

    Class: Authentication

    Description of: Authentication

    Class steward is Information Management (Medical Records)
    All instances that record information related to the relationship between a Health Chart Document Header and the Authenticator of the document.

    Rationale:

    OpenIssue:

    Attribute definitions for: Authentication

    authentication_dt :: DT

    This records the date that the contents of the healthcare document were verified by the authenticator.

    Rationale:

    OpenIssue:

    type_cd

    Code indicating the type of authentication that was carried out for the document

    Rationale:

    OpenIssue:

    Connection definitions for: Authentication

    is_related_to (1,1) :: Clinical_document_header :: is_related_to (0,m)

    is_related_to (1,1) :: Healthcare_document_authenticator :: is_related_to (0,m)

    Class: Bad_debt_billing_account

    Description of: Bad_debt_billing_account

    Class steward is Patient Administration
    A billing account that has been turned over for bad debt collection.

    Attribute definitions for: Bad_debt_billing_account

    bad_debt_recovery_amt :: NM

    The amount recovered on a bad debt patient account.

    |PV1^33^00163^Bad Debt Recovery Amount|

    bad_debt_transfer_amt :: NM

    The amount of the patient billing account that was turned over to bad debt for collection.

    |PV1^32^00162^Bad Debt Transfer Amount|

    transfer_to_bad_debt_dt :: DT

    The date the patient billing account was transferred to bad debt status.

    |PV1^30^00160^Transfer to Bad Debt Date|

    transfer_to_bad_debt_reason_cd :: IS

    A code depicting the reason the patient billing account was transferred to bad debts.

    |PV1^29^00159^Transfer to Bad Debt Code|

    Connection definitions for: Bad_debt_billing_account

    is_assigned_to (1,1) :: Bad_debt_collection_agency :: is_assigned (0,M)

    Class: Bad_debt_collection_agency

    Description of: Bad_debt_collection_agency

    Class steward is Patient Administration
    A role assumed by an organization stakeholder. This role is assigned one or more bad debt billing account.

    Connection definitions for: Bad_debt_collection_agency

    is_a_role_of (1,1) :: Organization :: takes_on_role_of (0,1)

    is_assigned (0,M) :: Bad_debt_billing_account :: is_assigned_to (1,1)

    Class: Billing_information_item

    Description of: Billing_information_item

    Class steward is Patient Administration
    Billing account information particular to the national uniform billing form.

    Attribute definitions for: Billing_information_item

    condition_cd :: IS

    A code depicting a condition.

    |UB1^7^00536^Condition Code (35-39)| |UB1^12^00541^Spec Program Indicator (44) | |UB2^3^00555^Condition Code (24-30)|

    occurrence_cd :: CM

    A code depicting a event.

    |UB1^16^00545^Occurrence (28 32) | |UB2^7^00559^Occurrence Code & Date (32-35)|

    occurrence_dt :: CM

    The date of the event depicted in occurrence code.

    |UB2^7^00559^Occurrence Code & Date (32-35)|

    occurrence_span_cd :: CM

    A code depicting an event which occurs over a span of time.

    |UB1^13^00542^PSRO/UR Approval Indicator (87) | |UB1^17^00546^Occurrence Span (33) | |UB2^8^00560^Occurrence Span Code/Dates (36)|

    occurrence_span_from_dt :: CM

    The from date of the event depicted in occurrence span code.

    |UB1^14^00543^PSRO/UR Approved Stay Fm (88) | |UB1^18^00547^Occur Span Start Date(33) | |UB2^8^00560^Occurrence Span Code/Dates (36)|

    occurrence_span_thru_dt :: CM

    The end date of the event depicted in occurrence span code.

    |UB1^15^00544^PSRO/UR Approved Stay To (89) | |UB1^19^00548^Occur Span End Date (33) | |UB2^8^00560^Occurrence Span Code/Dates (36)|

    quantity_amt :: NM

    A quantitative value on a bill. The value is qualified by quantity type code.

    |UB1^3^00532^Blood Furnished Pints Of (40) | |UB1^4^00533^Blood Replaced Pints (41) | |UB1^5^00534^Blood Not Replaced Pints(42) | |UB1^6^00535^Co Insurance Days (25) | |UB1^8^00537^Covered Days (23) | |UB1^9^00538^Non Covered Days (24) | |UB1^11^00540^Number Of Grace Days (90) | |UB2^2^00554^Co-Insurance Days (9)| |UB2^4^00556^Covered Days (7)| |UB2^5^00557^Non-Covered Days (8)| |UB2^17^00815^Special Visit Count|

    quantity_type_cd

    A code qualifying the quantity amount information on a bill (e.g., Blood furnished, blood not replaced, blood replaced, coinsurance day, covered day, non-covered day, grace day, special visit, . . .).

    value_amt :: CM

    A value amount qualified by value code.

    |UB1^10^00539^Value Amount & Code (46-49)| |UB2^6^00558^Value Amount & Code|

    value_cd :: CM

    A code qualifying the billing information value amount.

    |UB1^10^00539^Value Amount & Code (46-49)| |UB2^6^00558^Value Amount & Code|

    Connection definitions for: Billing_information_item

    pertains_to (1,1) :: Patient_billing_account :: has (0,M)

    Class: Certification_second_opinion

    Description of: Certification_second_opinion

    Class steward is Patient Administration
    An alternate medical opinion rendered for an insurance certification.

    Attribute definitions for: Certification_second_opinion

    effective_dt :: DT

    The date that the second opinion was obtained.

    |IN3^22^00523^Second Opinion Date|

    status_cd :: IS

    A code that depicts the status of the second opinion.

    |IN3^23^00524^Second Opinion Status | |IN3^24^00525^Second Opinion Documentation Received|

    Connection definitions for: Certification_second_opinion

    is_provided_by (1,1) :: Individual_healthcare_practitioner :: provides (0,M)

    provides_opinion_on (1,1) :: Insurance_certification :: includes (0,M)

    Class: Champus_coverage

    Description of: Champus_coverage

    Class steward is Patient Administration
    A type of insurance coverage provided to military veterans and federal workers.

    Attribute definitions for: Champus_coverage

    handicapped_program_cd :: CE

    A code depicting the handicapped program in which the patient is enrolled.

    |IN2^65^00805^Military Handicapped Program |

    non_avail_cert_on_file_ind :: ID

    A indication as to whether the champus non-avail certification is on file.

    |IN2^18^00489^Champus Non-Avail Cert on File|

    retirement_dt :: DT

    The date of retirement for the person covered by Champus.

    |IN2^17^00488^Champus Retire Date|

    station_id :: ST

    The identifier of the Champus station.

    |IN2^13^00484^Champus Station|

    Class: Clinical_document_header

    Description of: Clinical_document_header

    Class steward is Information Management (Medical Records)
    Documentation of a health related factor concerning a patient. See the class Document Header in the MDR 2300 model.

    Attribute definitions for: Clinical_document_header

    authentication_dt

    The date the document was authenticated.

    availability_status_cd

    A code depicting the availability of the document.

    change_reason_cd

    A code depicting the reason for the latest change to the document.

    completion_status_cd

    A code depicting the completion status of the document.

    confidentiality_status_cd

    A code depicting the confidentiality status of the document.

    content_presentation_cd

    A code indicating how the content of the document is to be presented.

    document_header_creation_dt

    The specific date that the document header was created..

    file_nm

    The name on an electronic file containing the document.

    id

    A unique identifier assigned to the document.

    last_edit_dt

    The date the document was last edited.

    origination_dt

    The date the information in the document was originated.

    reporting_priority_code :: ID

    The reporting priority of the clinical result.

    |OM1^26^00611^Reporting Priority|

    results_report_dttm :: TS

    The date and time the clinical observation results are issued.

    Rationale: closer to language used in V2.3

    |OBR^22^00255^Results Rpt/Status Chng - Date/Time|

    storage_status_cd

    A code depicting the storage status of the document.

    transcription_dt

    The date the information in the document was transcribed.

    type_cd

    A code depicting the document type.

    Connection definitions for: Clinical_document_header

    may_refer_to (0,M) :: Clinical_observation :: referred_to_in (0,M)

    Rationale: This relationship implements one of the critical business rules for this TC. A document is a construct with a single header and several observations. (Note, the relationship is optional because a document can be initially created with only the header). The Medical Records and Orders/Results TCs place great importance in the notion that the construct, observation, is shared by both groups. That is, it has the same definition when information is being retrieved for analysis and review, as it does when that information is recorded. This instance connection, to the document header allows observations to be organized for retrieval.

    OpenIssue: May not have correct cardinality since there is some disagreement on the precise nature of the many-to-many connections between these two entities. This needs to be cleaned up with the general fix of the connections between the Chart_document_header and the components of the order and its observations.

    is_parent_document_for (0,M) :: Clinical_document_header :: has_as_a_parent_document (0,1)

    has_been_originated_by (0,1) :: Originator :: of (0,M)

    is_transcribed_by (0,1) :: Transcriptionist :: transcribes (0,M)

    has_as_a_parent_document (0,1) :: Clinical_document_header :: is_parent_document_for (0,M)

    is_related_to (0,1) :: Patient_service_order :: may_be_referred_to_in (0,M)

    Rationale:

    OpenIssue: If we have the linkage between patient service event and healthcare chart document header right, this might not be needed as it duplicates existing connections. This is pending joint work between Information Management, Orders/Observations, and Patient Care committees.

    may_be_contained_in (0,1) :: Health_chart :: contains (0,M)

    has_been_received_by (0,1) :: Document_recipient :: of (0,M)

    is_related_to (0,m) :: Authentication :: is_related_to (1,1)

    documents (0,M) :: Patient_service_event :: is_document_by (0,M)

    Class: Clinical_observation

    Description of: Clinical_observation

    Class steward is Orders/Observation
    Interested committees Information Management (Medical Records)
    The information or record secured by an act or instance of viewing or noting a fact or occurrence for some health related purpose.

    Attribute definitions for: Clinical_observation

    abnormal_result_ind

    An indication that the observation results are abnormal.

    clinical_observation_id

    Unique identifier for a clinical observation on a specific patient.

    Rationale: primary key. Needed for establishing relationships to other classes.

    OpenIssue:

    last_observed_normal_values_dttm :: TS

    This field contains the date and time of changes in the observation methods that would make values obtained from the old method not comparable with those obtained from the new method.

    Rationale: alignment with V2.3

    OpenIssue: This is being returned to committee to be reworked to remove the inconsistency between the name and the definition.

    |OBX^12^00580^Date Last Obs Normal Values|

    nature_of_abnormal_testing_cd :: ID

    Indicates the type of control population against which the observation was tested for abnormalcy. control population might be age based, sex based, race based, or a generic normal range.

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |OBX^10^00578^Nature of Abnormal Test|

    observation_begin_dttm :: TS

    This field is the clinically relevant begin date/time of the observation. In the case of observations taken directly from a subject, it is the actual date and time the observation was obtained. In the case of a specimen-associated study, this field shall represent the date and time the specimen was collected or obtained.

    Rationale: This is the definition that has been developed by the committee and balloted. This is the field that is wanted in the message, not separate fields for the specimen collection time and the time of the observation. Often, an interim time is chosen as "clinically relevant". There would be too much overhead in maintaining separate fields for all the possible interim times.

    |OBX^14^00582^Date/Time of the Observation|

    observation_end_dttm :: TS

    This field is the clinically relevant end date/time of the observation. In the case of observations taken directly from a subject, it is the actual date and time the observation was obtained. In the case of a specimen-associated study, this field shall represent the date and time the specimen was collected or obtained.

    Rationale: This is the definition that has been developed by the committee and balloted. This is the field that is wanted in the message, not separate fields for the specimen collection time and the time of the observation. Often, an interim time is chosen as "clinically relevant". There would be too much overhead in maintaining separate fields for all the possible interim times.

    |OBX^14^00582^Date/Time of the Observation|

    observation_method_cd

    A code indicating the method employed in conducting the observation.

    observation_status_cd :: ID

    The status of the clinical result of the observation.

    |OBR^25^00258^Result Status| |OBX^11^00579^Observ Result Status|

    observation_status_dttm

    The effective date and time of the clinical result.

    observation_sub_id :: ST

    A sub-group identifier for the observation used to group related observations.

    |OBX^13^00581^User Defined Access Checks|

    observation_value_txt :: Varies

    Observation value.

    |OBX^5^00573^Observation Value|

    probability_number :: NM

    The degree of certainty in the clinical observation expressed as a percentage.

    Rationale: closer to language used in V2.3

    |OBX^9^00577^Probability|

    references_range_text :: ST

    )OR b) > lower limit (if no upper limit, e.g., >10) a) lower limit-upper limit (when both lower and upper limits are defined, e.g., for potassium 3.5 - 4.5) OR c) < upper limit (if no lower limit, e.g., <15FOR ALPHABETIC VALUES: the normal value may be reported in this location When the observation quantifies the amount of a toxic substance, then the upper limit of the range identifies the toxic limit. If the observation quantifies a drug, the lower limits identify the lower therapeutic bounds and the upper limits represent the upper therapeutic bounds above which toxic side effects are common.FOR NUMERIC VALUES

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |OBX^7^00575^References Range|

    universal_service_identifier_suffix_txt :: CE

    Indicates that the observation is a specific one of the standard narrative report components for the Universal_service_identifier. Examples: Diagnostic Impression (IMP), Gross or General Description (GDT).

    Rationale: previously unmatched V2.3 field component

    OpenIssue:

    |OBX^3^00571^Observation Identifier|

    user_defined_access_check_txt :: ST

    Results-dependent codes for classifying the observation at the receiving system.

    Rationale: V2.3 definition specifies that these are code

    OpenIssue: Note that this is being returned to committee to be fixed.

    |OBX^13^00581^User Defined Access Checks|

    value_type_cd :: ID

    A qualifier of the observation value.

    |OBX^2^00570^Value Type| |OM3^7^00570^Value Type|

    value_units_code :: CE

    Unit of measure in which the observation value is reported. When an observationÕs value is measured on a continuous scale, one must report the measurement units within the units field of the OBX segment. Units have a data type of CE. ISO+ abbr.

    Rationale: RT: previously unmatched V2.3 field, see recommendation R037

    OpenIssue:

    |OBX^6^00574^Units|

    Connection definitions for: Clinical_observation

    has_as_participant (1,M) :: Clinical_observation_provider :: is_participant_for (1,1)

    is_an_observation_of (1,1) :: Master_observation_service :: is_observed_by (0,M)

    is_parent_of (0,M) :: Patient_service_order :: has_as_parent_result (0,1)

    Rationale: to support concept of Parent Result in OBR

    OpenIssue:

    referred_to_in (0,M) :: Clinical_document_header :: may_refer_to (0,M)

    Rationale: This relationship implements one of the critical business rules for this TC. A document is a construct with a single header and several observations. (Note, the relationship is optional because a document can be initially created with only the header). The Medical Records and Orders/Results TCs place great importance in the notion that the construct, observation, is shared by both groups. That is, it has the same definition when information is being retrieved for analysis and review, as it does when that information is recorded. This instance connection, to the document header allows observations to be organized for retrieval.

    OpenIssue: May not have correct cardinality since there is some disagreement on the precise nature of the many-to-many connections between these two entities. This needs to be cleaned up with the general fix of the connections between the Chart_document_header and the components of the order and its observations.

    used_to_infer (0,m) :: Observation_relationship :: inferred_from (1,m)

    may_occur_during (0,1) :: Patient_service_event :: may_result_in (0,M)

    Rationale: Some observations (eg. those forwarded from other institutions) may come from "Service events" of no interest to the recipient. The requirement that each observation have a Service Event should therefore be removed from the model.

    OpenIssue:

    is_concluded_from (0,m) :: Observation_relationship :: concludes (1,1)

    is_on_behalf_of (0,1) :: Patient :: is_subject_of (0,M)

    Rationale: Some observations (eg. those forwarded from other institutions) may come from "Service events" of no interest to the recipient. The requirement that each observation have a Service Event should therefore be removed from the model.

    OpenIssue:

    Class: Clinical_observation_provider

    Description of: Clinical_observation_provider

    Class steward is Orders/Observation
    An association between a Healthcare service provider and a clinical observation.

    Attribute definitions for: Clinical_observation_provider

    clinical_observation_id

    An identifier of the clinical observation from the perspective of the associated healthcare participant.

    participation_type_cd

    The type of participation the provider assumes in relation to the observation.

    Connection definitions for: Clinical_observation_provider

    is_participant_for (1,1) :: Clinical_observation :: has_as_participant (1,M)

    has_as_participant (1,1) :: Healthcare_service_provider :: participates_as (0,M)

    Class: Collected_specimen_sample

    Description of: Collected_specimen_sample

    Class steward is Orders/Observation
    A sample of a substance or material for examination or study (a urine specimen; a tissue specimen).

    Attribute definitions for: Collected_specimen_sample

    body_site_cd :: CM

    The anatomical source for the collected item.

    Rationale: more specific to related component of V2.3 field

    |OBR^15^00249^Specimen Source|

    collection_body_site_modifier_cd :: CM

    The site modifier for the body site from which the specimen was obtained. For example, the site could be anticubital foss, and the site modifier "right".

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OBR^15^00249^Specimen Source|

    collection_end_dttm :: TS

    The date and time the analyzed object collection ended.

    |OBR^8^00242^Observation End Date/Time|

    collection_method_modifier_cd :: CM

    coded modifier for the method of collection of a specimen.

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OBR^15^00249^Specimen Source|

    collection_scheduled_dttm

    The date and time the analyzed object is scheduled to be collected.

    collection_start_dttm :: TS

    The date and time the analyzed object collection started.

    |OBR^7^00241^Observation Date/Time|

    collection_volume_amt :: CQ

    The amount of specimen collected.

    |OBR^9^00243^Collection Volume|

    condition_cd :: CE

    A description of the condition of the collected specimen.

    Rationale: V2.3 field is CE datatype

    |OBR^39^01030^Collector’s Comment|

    handling_cd

    A code indicating the action taken after collection of the sample (e.g., air-dried, refrigerated overnight, maintained at body heat, centrifuged immediately, maintained on ice, . . .).

    id

    Unique identifier of the analyzed object.

    method_of_collection_desc

    A description of the method used to collect the analyzed object.

    number_of_sample_containers_qty :: NM

    Number_of_sample_containers_quantityIdentifies the number of containers for a given sample. For sample receipt verification purposes; may be different from the total number of samples which accompany the order.

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |OBR^37^01028^Number Of Sample Containers|

    specimen_additive_txt :: CM

    A code depicting an additive used with the analyzed object to aid in the analysis.

    Rationale: related V2.3 field component is TX datatype

    |OBR^15^00249^Specimen Source|

    specimen_danger_cd

    A code depicting dangers associated with the analyzed object.

    specimen_source_cd :: CM

    A code indicating the source of the analyzed object.

    |OBR^15^00249^Specimen Source|

    transport_logistics_cd :: CE

    transport_logistics_codethe means by which a sample reaches the diagnostic service provider

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |OBR^38^01029^Transport Logistics Of Collected Sample|

    Connection definitions for: Collected_specimen_sample

    is_sourced_from (0,1) :: Patient :: is_source_for (0,M)

    is_collected_by (1,1) :: Stakeholder :: collects (0,M)

    is_source_for (0,M) :: Service_event_specimen :: is_sourced_from (1,1)

    Class: Contact_person

    Description of: Contact_person

    Class steward is Patient Administration

    Attribute definitions for: Contact_person

    contact_reason_cd :: IS

    A code indicating the reason the contact should be used (e.g., contact my employer if patient is unable to work).

    |GT1^47^00747^Contact Reason| |IN2^51^00791^Employer Contact Reason | |IN2^54^00794^Insured’s Contact Person Reason | |IN2^57^00797^Insurance Co. Contact Reason | |NK1^29^00747^Contact Reason|

    Connection definitions for: Contact_person

    is_a_contact_for (0,1) :: Insurer :: has_as_a_contact (0,M)

    is_a_contact_for (0,1) :: Guarantor :: has_as_a_contact (0,M)

    is_a_contact_for (0,1) :: Patient :: has_as_a_contact (0,M)

    is_a_contact_for (0,1) :: Health_benefit_plan_purchaser :: has_as_a_contact (0,M)

    is_a_contact_for (0,1) :: Employer :: has_as_a_contact (0,M)

    is_a_role_of (1,1) :: Person :: takes_on_role_of (0,1)

    participates_in (0,m) :: Appointment_contact_person :: involves (1,1)

    Class: Diagnostic_related_group

    Description of: Diagnostic_related_group

    Class steward is Patient Administration
    A broad categorization, based upon included procedures and diagnoses, that applies to a Healthcare event as a whole. Used for grouping and evaluating Healthcare encounters with respect to duration of care and cost.

    <see FIN2301:DRG_Master_File>

    Attribute definitions for: Diagnostic_related_group

    base_rate_amt

    <see FIN2301:DRG_Master_File>

    capital_reimbursement_amt

    <see FIN2301:DRG_Master_File>

    cost_weight_amt

    <see FIN2301:DRG_Master_File>

    id :: CE

    A unique identifier assigned to the diagnostic related group.

    |DG1^8^00382^Diagnostic Related Group| |DRG^1^00382^Diagnostic Related Group|

    major_diagnostic_category_cd

    <see FIN2301:DRG_Master_File>

    operating_reimbursement_amt

    <see FIN2301:DRG_Master_File>

    reimbursement_amt

    <see FIN2301:DRG_Master_File>

    standard_day_qty

    <see FIN2301:DRG_Master_File; Standard_Day_Stay>

    standard_total_charge_amt

    <see FIN2301:DRG_Master_File>

    trim_high_day_qty

    <see FIN2301:DRG_Master_File>

    trim_low_day_qty

    <see FIN2301:DRG_Master_File>

    Connection definitions for: Diagnostic_related_group

    is_assigned_as (0,M) :: Encounter_drg :: is_an_assignment_of (1,1)

    Class: Dietary_order

    Description of: Dietary_order

    Class steward is Orders/Observation
    An authoritative direction or instruction concerning the system or course of diet for a patient.

    Attribute definitions for: Dietary_order

    diet_type_cd :: ID

    A code identifying a special diet type for a patient.

    |ODS^1^00269^Type| |PV1^38^00168^Diet Type|

    dietary_instruction_desc :: ST

    Instructive description of the dietary order.

    |ODS^4^00272^Text Instruction| |ODT^3^00272^Text Instruction|

    dietary_tray_type_cd :: CE

    A code for the type of dietary tray.

    |ODT^1^00273^Tray Type|

    service_period_cd :: CE

    A code identifying the service period for a diet order.

    |ODS^2^00270^Service Period| |ODT^2^00270^Service Period|

    service_type_cd :: CE

    An identifier of the dietary plan.

    Rationale: related V2.3 field is CE datatype. this is not an identifier.

    OpenIssue:

    |ODS^3^00271^Diet, Supplement, or Preference Code|

    Class: Disability

    Description of: Disability

    Class steward is Patient Administration
    Information about non-permanent disabilities. (Permanent disabilities are represented by Person.disability_cd.)

    Rationale: DB1 segment

    OpenIssue: How should this be associated with the Patient_encounter class? See DB1-4

    Attribute definitions for: Disability

    effective_dt :: DT

    The date that this administrative disability became effective.

    Rationale: DB1-5

    OpenIssue:

    return_to_work_auth_dt :: DT

    The date the person was authorized to return to work.

    Rationale: DB1-7

    OpenIssue:

    termination_dt :: DT

    The date that this disability ended.

    Rationale: DB1-6

    OpenIssue:

    unable_to_work_effective_dt :: DT

    The date the person was unable to work due to this disability.

    Rationale: DB1-8

    OpenIssue:

    Connection definitions for: Disability

    pertains_to (1,1) :: Patient :: has (0,M)

    Rationale: 2.3 abstract message def

    OpenIssue:

    Class: Document_recipient

    Description of: Document_recipient

    Class steward is Information Management (Medical Records)

    Rationale: Identity of the receiver is a key piece of information associated with a document. For reasons stated in another request, the TC would like this instance connection to be associated with an attribute of the patient care document header class.

    OpenIssue:

    Connection definitions for: Document_recipient

    of (0,M) :: Clinical_document_header :: has_been_received_by (0,1)

    is_a (1,1) :: Stakeholder :: may_act_as_a (0,1)

    Class: Durable_medical_equipment

    Description of: Durable_medical_equipment

    Class steward is Inter-Enterprise (ADT/Finance/Inter-Enterprise)
    A tangible material item used to perform a Healthcare Service.

    Rationale: Currently in 2.3

    OpenIssue: Who is the logical steward - not really a scheduling class.

    Attribute definitions for: Durable_medical_equipment

    id

    A unique identifier for a specific piece of equipment.

    Rationale: Currently in 2.3

    OpenIssue:

    |AIG^2^00897^Resource ID|

    Connection definitions for: Durable_medical_equipment

    belongs_to (0,m) :: Durable_medical_equipment_group :: contains (1,m)

    is_requested_by (0,m) :: Durable_medical_equipment_request :: requests (1,1)

    Whole-part definitions for: Durable_medical_equipment

    is scheduled by (0,m) :: Durable_medical_equipment_slot :: is a scheduleable unit for (1,1)

    Class: Durable_medical_equipment_group

    Description of: Durable_medical_equipment_group

    Class steward is Inter-Enterprise (ADT/Finance/Inter-Enterprise)
    A pool of like-type equipment available for scheduling purposes.

    Rationale: Currently in 2.3

    OpenIssue:

    Attribute definitions for: Durable_medical_equipment_group

    id

    Unique identifier for the group

    Rationale: Currently in 2.3

    OpenIssue:

    |AIG^4^00899^Resource Group| |AIP^4^00899^Resource Group|

    Connection definitions for: Durable_medical_equipment_group

    is_requested_by (0,m) :: Durable_medical_equipment_request :: may_request (0,1)

    contains (1,m) :: Durable_medical_equipment :: belongs_to (0,m)

    Class: Durable_medical_equipment_request

    Description of: Durable_medical_equipment_request

    Class steward is Inter-Enterprise (ADT/Finance/Inter-Enterprise)
    Request information about equipment that is controlled by a schedule

    Rationale: Specializes the request by type of resource

    OpenIssue:

    Attribute definitions for: Durable_medical_equipment_request

    quantity

    The quantity of the specified resource or resource type.

    Rationale: Currently in 2.3

    OpenIssue: We would like better )more explanatory) names for attributes that are meaningful by themselves without the class prefix. Needs to be addressed by MnM in the style guide more clearly.

    |AIG^5^00900^Resource Quantity|

    Connection definitions for: Durable_medical_equipment_request

    may_request (0,1) :: Durable_medical_equipment_group :: is_requested_by (0,m)

    requests (1,1) :: Durable_medical_equipment :: is_requested_by (0,m)

    Class: Durable_medical_equipment_slot

    Description of: Durable_medical_equipment_slot

    Class steward is Inter-Enterprise (ADT/Finance/Inter-Enterprise)
    An allocation of time defined when a specific piece of medical equipment is available for use for a healthcare service.

    Rationale: future

    OpenIssue:

    Whole-part definitions for: Durable_medical_equipment_slot

    is a scheduleable unit for (1,1) :: Durable_medical_equipment :: is scheduled by (0,m)

    Class: Employee

    Description of: Employee

    Class steward is Patient Administration
    An employed person.

    Connection definitions for: Employee

    is_employee_in (0,M) :: Person_employment :: has_as_employee (1,1)

    is_a_role_of (1,1) :: Person :: takes_on_role_of (0,1)

    Class: Employer

    Description of: Employer

    Class steward is Patient Administration
    A person or organization which employs persons.

    Attribute definitions for: Employer

    effective_dt

    The date the organization assumes the role of employer.

    termination_dt

    The date the organization's role as employer is terminated.

    Connection definitions for: Employer

    has_as_a_contact (0,M) :: Contact_person :: is_a_contact_for (0,1)

    is_employer_of (0,M) :: Person_employment :: has_as_employer (1,1)

    is_a_role_of (1,1) :: Stakeholder :: takes_on_role_of (0,1)

    Class: Encounter_drg

    Description of: Encounter_drg

    Class steward is Patient Administration
    A broad categorization, based primarily upon included procedures and diagnoses, that applies to the Healthcare event as a whole. Used for grouping and evaluating Healthcare encounters with respect to duration of care and cost.

    Attribute definitions for: Encounter_drg

    approval_ind :: ID

    An indication that the DRG assignment has been approved by a reviewing entity.

    |DG1^9^00383^DRG Approval Indicator| |DRG^3^00383^DRG Approval Indicator|

    assigned_dttm :: TS

    The date and time the DRG was assigned to the encounter.

    |DRG^2^00769^DRG Assigned Date/Time |

    confidential_ind :: ID

    An indication as to whether the DRG assigned to this encounter contains a confidential diagnosis.

    |DG1^18^00767^Confidential Indicator| |DRG^10^00767^Confidential Indicator|

    cost_outlier_amt :: CP

    The amount of the encounter cost that is beyond the standard cost amount for the assigned DRG.

    |DG1^13^00387^Outlier Cost| |DRG^7^00387^Outlier Cost|

    desc

    A description providing additional information about the assignment of the DRG to the encounter.

    grouper_review_cd :: IS

    A code indicating that the grouper results have been reviewed and approved.

    |DG1^10^00384^DRG Grouper Review Code| |DRG^4^00384^DRG Grouper Review Code|

    grouper_version_id

    The version and type of the grouper used to derive the DRG.

    outlier_days_qty :: NM

    The number of days beyond the standard day count for the assigned DRG.

    |DG1^12^00386^Outlier Days| |DRG^6^00386^Outlier Days|

    outlier_reimbursement_amt :: CP

    The portion of the total reimbursement amount designated for reimbursement of outlier days or costs.

    |DRG^9^00771^Outlier Reimbursement|

    outlier_type_cd

    A code depicting the type of outlier (day, cost) associated with the encounter DRG.

    Connection definitions for: Encounter_drg

    is_assigned_by (1,1) :: Organization :: assigns (0,M)

    is_assigned_to (1,1) :: Inpatient_encounter :: is_assigned (0,M)

    is_an_assignment_of (1,1) :: Diagnostic_related_group :: is_assigned_as (0,M)

    Class: Encounter_practitioner

    Description of: Encounter_practitioner

    Class steward is Patient Administration
    An association between a Healthcare practitioner and a patient encounter.

    Attribute definitions for: Encounter_practitioner

    participation_type_cd

    A code depicting the role of the type of participation the healthcare practitioner assumes in the encounter (e.g. attending physician, admitting physician, consulting physician, referring physician).

    Connection definitions for: Encounter_practitioner

    is_associated_with (1,1) :: Patient_encounter :: has_as_participant (1,M)

    is_participant_for (1,1) :: Individual_healthcare_practitioner :: participates_as (0,M)

    Class: Episode

    Description of: Episode

    Class steward is Patient Administration
    A collection or a series of Healthcare encounters for a patient.

    Attribute definitions for: Episode

    desc

    Episode of care descriptive text.

    episode_type_cd

    A code indicating the type of episode. The type code is dependent upon the reason for collection of patient encounters.

    id

    A unique identifier assigned to the episode of care.

    list_closed_ind

    An indication that the list of encounters associated with the episode is a closed list.

    outcome_txt

    Text describing the outcome of the episode of care.

    recurring_service_ind

    An indication that the episode represents a recurring patient service.

    Connection definitions for: Episode

    is_defined_by (0,1) :: Patient_diagnosis :: defines (0,1)

    specfies (0,m) :: Problem :: specified_in (0,1)

    Whole-part definitions for: Episode

    has_parts (1,M) :: Patient_encounter :: is_part_of (1,1)

    Class: Financial_transaction

    Description of: Financial_transaction

    Class steward is Patient Administration
    A charge, credit, or adjustment to charges in a patient's billing account.

    Attribute definitions for: Financial_transaction

    alternate_desc :: ST

    An alternate description of the transaction.

    |FT1^9^00363^Transaction Description - Alt|

    assigned_patient_location_cd :: PL

    A code depicted the location type used for billing.

    |FT1^16^00133^Assigned Patient Location| |PV1^3^00133^Assigned Patient Location|

    desc :: ST

    Explanatory text concerning a financial transaction.

    |FT1^8^00362^Transaction Description|

    extended_amt :: CP

    The transaction amount derived from multiplying the unit amount by the number of units.

    |FT1^11^00365^Transaction Amount - Extended|

    fee_schedule_cd :: IS

    A code depicting the fee schedule used for this financial transaction.

    |FT1^17^00370^Fee Schedule|

    insurance_amt :: CP

    The amount of the financial transaction that is applicable to the associated Healthcare benefit plan.

    |FT1^15^00369^Insurance Amount|

    posting_dt :: TS

    The posting date of the financial transaction.

    |FT1^5^00359^Transaction Posting Date|

    qty :: NM

    transaction quantity.

    |FT1^10^00364^Transaction Quantity|

    transaction_batch_id :: ST

    A unique identifier assigned to the batch in which this transaction belongs.

    |FT1^3^00357^Transaction Batch ID|

    transaction_cd :: CE

    A code depicting the financial action covered in the transaction.

    |FT1^7^00361^Transaction Code|

    transaction_dt :: TS

    The date of the transaction.

    |FT1^4^00358^Transaction Date|

    transaction_id :: ST

    A identifier assigned to the transaction for control purposes.

    |FT1^2^00356^Transaction ID| |UB2^12^00564^Document Control Number|

    transaction_type_cd :: IS

    A code depicting the transaction type (e.g., credit, charge, payment, adjustment, ...).

    |FT1^6^00360^Transaction Type|

    unit_amt :: CP

    The amount associated with one transaction unit.

    |FT1^12^00366^Transaction Amount - Unit|

    unit_cost_amt :: CP

    The unit price of transaction. The cost of a single item.

    |FT1^22^00374^Unit Cost|

    Connection definitions for: Financial_transaction

    is_entered_by (1,1) :: Person :: enters (0,M)

    is_associated_with (0,1) :: Healthcare_benefit_plan :: is_associated_with (0,M)

    is_associated_with (1,1) :: Patient_billing_account :: has (0,M)

    is_categorized_by (0,1) :: Organization :: categorizes (0,M)

    pertains_to (1,1) :: Patient_service_event :: is_associated_with (0,M)

    Class: Goal

    Description of: Goal

    Class steward is Patient Care
    A pathway goal specific to a particular patient.

    Attribute definitions for: Goal

    action_cd

    Event code for why the object is included.

    Rationale: Conformance with v 2.3

    OpenIssue:

    |GOL^1^00816^Action Code| |PRB^1^00816^Action Code| |PTH^1^00816^Action Code| |ROL^2^00816^Action Code|

    action_dttm

    Event date time

    Rationale: Conformance with v 2.3

    OpenIssue:

    |GOL^2^00817^Action Date/Time| |PRB^2^00817^Action Date/Time|

    classification_cd

    A code used to categorize patient pathway goals.

    current_review_status_cd

    A code depicting the review status of the patient pathway goal.

    current_review_status_dttm

    The date/time of the most recent review of the patient pathway goal.

    episode_of_care_id

    Episode of Care

    Rationale: Conformance with v 2.3

    OpenIssue:

    established_dttm

    The date/time the patient goal is initially created.

    evaluation_cd

    A code depicting the progress towards achievement of the goal (e.g., achieved, ahead of schedule, delayed, failed to achieve, . . .).

    evaluation_comment_txt

    Comment text associated with the goal evaluation.

    expected_achievement_dttm

    Date goal is expected to be achieved

    Rationale: Conformance with v 2.3

    OpenIssue:

    goal_list_priority_num

    Priority of the goal within the scope of the entire goal list.

    Rationale: Conformance with v 2.3

    OpenIssue:

    |GOL^6^00821^Master Goal List Number|

    instance_id

    A unique identifier assigned to the patient pathway goal.

    life_cycle_dttm

    The effective date/time of the most recently assigned goal life cycle.

    life_cycle_status_cd

    A code indicating the state of the goal (e.g., active, canceled, inactive, suspended, . . .).

    management_discipline_cd

    A code indicating the caregiver disciplines responsible for managing a patient pathway goal.

    next_review_dttm

    The date/time of the next scheduled goal review.

    previous_review_dttm

    The second most recent date/time the goal was reviewed.

    review_interval_cd

    A code indication the review interval for the patient pathway goal.

    target_txt

    Text description of who/what the goal target is.

    Rationale: Conformance with v 2.3

    OpenIssue:

    target_type_cd

    A code used to identify the individual or group for whom the goal has been established for the benefit of a particular patient (e.g., family group, family member, patient, . . .).

    Connection definitions for: Goal

    is_an_instance_of (1,1) :: Master_goal :: is_instanciated_by (0,M)

    pertains_to (1,1) :: Patient :: has (0,M)

    is_targeted_by (0,M) :: Pathway :: targets (0,M)

    Class: Guarantor

    Description of: Guarantor

    Class steward is Patient Administration
    The person or organization assuming financial responsibility for some or all of the charges in a patient billing account.

    Attribute definitions for: Guarantor

    financial_class_cd

    A code depicting the classification of the financial status of the guarantor.

    household_annual_income_amt :: CP

    The combined annual income of all members of the guarantor's household.

    |GT1^27^00778^Guarantor Household Annual Income|

    household_size_qty :: NM

    The number of people living at the guarantor's primary residence.

    |GT1^28^00779^Guarantor Household Size|

    Connection definitions for: Guarantor

    guarantees_payment_under (1,M) :: Guarantor_contract :: has_payment_guaranteed_by (1,1)

    is_a_role_of (1,1) :: Stakeholder :: takes_on_role_of (0,1)

    has_as_a_contact (0,M) :: Contact_person :: is_a_contact_for (0,1)

    Class: Guarantor_contract

    Description of: Guarantor_contract

    Class steward is Patient Administration
    A contract held by a stakeholder which specifies the financial responsibility of the stakeholder for a patient billing account.

    Attribute definitions for: Guarantor_contract

    billing_hold_ind :: ID

    A indicator used to determine whether or not a system should suppress printing of the guarantor's bills.

    |GT1^22^00773^Guarantor Billing Hold Flag|

    billing_media_cd :: ID

    A code depicting the allowable mediums for billing under this guarantor contract.

    |PV2^32^00733^Billing Media Code|

    charge_adjustment_cd :: CE

    A code depicting which adjustments should be made to this guarantor's charges.

    |GT1^26^00777^Guarantor Charge Adjustment Code|

    contract_duration_cd :: NM

    A code specifying the duration of the contract.

    |PV1^27^00157^Contract Period|

    contract_type_cd :: IS

    Code identifying the type of contract entered into by the guarantor for the purpose of settling outstanding account balances.

    |GT1^10^00414^Guarantor Type| |PV1^24^00154^Contract Code|

    effective_dt :: DT

    The date the guarantor contract becomes effective.

    |GT1^13^00417^Guarantor Date - Begin| |PV1^25^00155^Contract Effective Date|

    interest_rate_amt :: IS

    The rate of interest for this guarantor contract.

    |PV1^28^00158^Interest Code|

    periodic_payment_amt :: NM

    Amount to be paid by the guarantor each period.

    |PV1^26^00156^Contract Amount|

    priority_ranking_cd :: CX

    A code indicating the relative priority of this guarantor contract for a given patient billing account.

    |GT1^15^00419^Guarantor Priority| |GT1^29^00780^Guarantor Employer ID Number|

    separate_bill_ind :: ID

    An indication as to whether the baby in a delivery patient stay should be billed separately.

    |PD1^9^00761^Separate Bill|

    termination_dt :: DT

    The date the guarantor contract is no longer in effect.

    |GT1^14^00418^Guarantor Date - End|

    Connection definitions for: Guarantor_contract

    has_coverage_affirmed_by (0,M) :: Insurance_certification :: affirms_insurance_coverage_for (1,1)

    provides_payment_guarantee_for (0,M) :: Patient_billing_account :: has_payment_guaranteed_by (0,M)

    has_payment_guaranteed_by (1,1) :: Guarantor :: guarantees_payment_under (1,M)

    Class: Health_benefit_plan_purchaser

    Description of: Health_benefit_plan_purchaser

    Class steward is Patient Administration
    A person or organization which is a purchaser of a health benefit plan.

    Connection definitions for: Health_benefit_plan_purchaser

    has_as_a_contact (0,M) :: Contact_person :: is_a_contact_for (0,1)

    is_a_role_of (1,1) :: Stakeholder :: takes_on_role_of (0,1)

    is_the_purchaser_of (0,M) :: Healthcare_benefit_plan :: has_as_purchaser (1,1)

    Class: Health_chart

    Description of: Health_chart

    Class steward is Information Management (Medical Records)
    A record of health related events, facts, and related data for a particular patient.

    Attribute definitions for: Health_chart

    health_chart_id

    An identifier designated for the health chart.

    health_chart_type_cd

    A classification code for the health chart (e.g., inpatient, outpatient, mental health, . . .).

    status_cd

    The current status of the health chart.

    Connection definitions for: Health_chart

    belongs_to (1,1) :: Patient :: has (0,M)

    is_housed_at (1,1) :: Patient_service_location :: houses (0,M)

    has_an_assessment_of (0,M) :: Health_chart_deficiency :: is_assessed_against (1,1)

    contains (0,M) :: Clinical_document_header :: may_be_contained_in (0,1)

    Class: Health_chart_deficiency

    Description of: Health_chart_deficiency

    Class steward is Information Management (Medical Records)
    This class captures a record of deficiencies in the Health record. <See the class Deficiency in model MDR2300>

    Attribute definitions for: Health_chart_deficiency

    assessment_dt

    The date the chart deficiency was determined.

    desc

    A description of the health chart discrepancy.

    level_cd

    A code depicting the level of discrepancy found in the health chart.

    type_cd

    A code identifying the type of deficiency identified.

    Connection definitions for: Health_chart_deficiency

    is_assessed_against (1,1) :: Health_chart :: has_an_assessment_of (0,M)

    Class: Healthcare_benefit_plan

    Description of: Healthcare_benefit_plan

    Class steward is Patient Administration
    A collection of health benefits.

    Attribute definitions for: Healthcare_benefit_plan

    agreement_type_cd :: IS

    A code serving as an additional refinement of an insurance plan. (e.g., standard, unified, maternity, . . .).

    |IN1^31^00456^Type of Agreement Code|

    assignment_of_benefits_ind :: IS

    An indication as to whether the insured agreed to assign the insurance benefits to the healthcare provider.

    |IN1^20^00445^Assignment of Benefits|

    baby_coverage_ind :: ID

    An indication of the existence of baby coverage under the insurance plan.

    |IN2^19^00490^Baby Coverage|

    benefit_desc

    A description of the healthcare benefit.

    benefit_plan_id :: IS

    An identifier for the healthcare coverage benefit plan.

    |IN1^46^00471^Prior Insurance Plan ID|

    benefit_plan_nm

    The name of the benefit plan.

    benefit_plan_type_cd :: IS

    A code classifying the benefit plan type (e.g., commercial, Medicare, Medicaid, . . .).

    |DRG^8^00770^DRG Payor| |IN1^15^00440^Plan Type|

    benefits_coordination_ind :: IS

    An indication as to whether this insurance works in conjunction with other insurance plans, or if it provides independent coverage and payment of benefits regardless of other insurance that might be available to the patient.

    |IN1^21^00446^Coordination of Benefits|

    blood_deductible_amt :: ST

    The deductible amount for blood.

    |IN2^21^00492^Blood Deductible|

    cob_priority_nbr :: ST

    The priority sequence for an insurance plan that works in conjunction with other insurance.

    |IN1^22^00447^Coord of Ben. Priority|

    combine_baby_bill_ind :: ID

    An indication as to whether charges for a baby should be combined with charges for the mother.

    |IN2^20^00491^Combine Baby Bill|

    copay_limit_ind :: ID

    An indication as to whether the patient has reached the copay limit.

    |IN2^67^00807^Copay Limit Flag|

    coverage_type_cd

    A code identifying the type of insurance coverage, or what type of services are covered for the purposes of a billing system.

    daily_deductible_amt :: CM

    The amount of the daily deductible for this insurance plan.

    |IN2^30^00501^Daily Deductible|

    effective_dt :: DT

    The date the healthcare coverage first becomes effective.

    |IN1^12^00437^Plan Effective Date|

    eligibility_source_cd :: IS

    A code depicting the source of information about the insured's eligibility for benefits (e.g., insurance company, employer, insured presented policy, insured presented card, signed statement on file, verbal information, none, . . .).

    |IN2^27^00498^Eligibility Source|

    expiration_dt :: DT

    The last date of service that the insurance will cover or be responsible for.

    |IN1^13^00438^Plan Expiration Date|

    group_benefit_ind

    A indication as to whether the healthcare coverage is a group contract.

    mail_claim_party_cd :: IS

    A code indicating the party to which the claim should be mailed (e.g., employer, guarantor, insurance company, patient, . . .).

    |IN2^5^00476^Mail Claim Party|

    non_covered_insurance_cd :: ST

    A code depicting the reason why a service is not covered.

    |IN2^24^00495^Non-Covered Insurance Code|

    plan_id :: IS

    An identifier of an healthcare benefit plan.

    |IN1^35^00460^Company Plan Code|

    policy_amount_class_cd

    The code classifying the amount (e.g. AT-Amount, PC-Percentage, LM-Limit)

    Rationale: IN2-29

    OpenIssue:

    |IN2^29^00500^Policy Type/Amount|

    policy_amt :: DT

    The benefit limit amount or percentage.

    Rationale: IN2-29

    OpenIssue:

    |IN2^29^00500^Policy Type/Amount|

    policy_category_cd

    The policy category code (e.g., ANC-ancillary, MMD-major medical)

    Rationale: IN2-29

    OpenIssue:

    |IN2^29^00500^Policy Type/Amount|

    policy_deductible_amt :: CP

    The deductible amount specified by the insurance plan.

    |IN1^37^00462^Policy Deductible|

    policy_id :: ST

    The identifier for the healthcare coverage policy.

    |IN1^36^00461^Policy Number|

    policy_limit_day_qty :: NM

    The maximum number of days that the insurance policy will cover.

    |IN1^39^00464^Policy Limit - Days|

    policy_scope_cd :: IS

    A code depicting the extent of the coverage for a participating member (e.g., single, family, . . .).

    |IN2^59^00799^Policy Scope |

    policy_source_cd :: IS

    A code indicating how the policy information was obtained.

    |IN2^60^00800^Policy Source |

    release_information_cd :: IS

    A code describing what information, if any, a provider can release about a patient.

    |IN1^27^00452^Release Information Code|

    report_of_eligibility_dt

    The date a report of eligibility (ROE) was received.

    Rationale: IN1-26

    OpenIssue: should it be placed in Preauthorization.authorized_period_begin_dt instead? If so then Healthcare_benefit_plan.report_of_eligibility_ind should be moved to that class as well.

    |IN1^26^00451^Rpt of Eligibility Date|

    report_of_eligibility_ind :: ID

    A indication of whether the insurance carrier send a report of eligibility identifying the benefits the patient is eligible for.

    |IN1^25^00450^Rpt of Eigibility Flag|

    room_coverage_type_amount_cd :: CM

    A rate for a given room type.

    |IN2^28^00499^Room Coverage Type/Amount|

    status_cd :: IS

    A code depicting the status of the healthcare coverage.

    |IN2^16^00487^Champus Status|

    termination_dt

    The date the healthcare coverage is no longer in effect.

    Connection definitions for: Healthcare_benefit_plan

    governs (0,M) :: Primary_care_provider_assignment :: is_governed_by (0,1)

    has_as_purchaser (1,1) :: Health_benefit_plan_purchaser :: is_the_purchaser_of (0,M)

    is_for (1,1) :: Patient :: has (0,M)

    is_associated_with (0,M) :: Financial_transaction :: is_associated_with (0,1)

    is_validated_by (0,M) :: Insurance_certification :: provides_validation_for (1,1)

    is_offered_by (1,1) :: Insurer :: offers (0,M)

    Whole-part definitions for: Healthcare_benefit_plan

    has_parts (0,M) :: Healthcare_coverage_benefit :: is_part_of (1,1)

    Class: Healthcare_benefit_service

    Description of: Healthcare_benefit_service

    Class steward is Patient Administration
    A level of coverage for a selected class of Healthcare services.

    Attribute definitions for: Healthcare_benefit_service

    access_protocol_desc

    Description of the access protocol for the benefit service type.

    capitation_ind

    An indication that the benefit service is a capitated service.

    coinsurance_ind

    An indication that coinsurance is applicable for the benefit service.

    coinsurance_pct

    The coinsurance percentage for the benefit service.

    copayment_amt

    The copayment amount for the benefit service.

    deductible_amt

    The benefit service deductible amount.

    lower_coverage_limit_amt

    The lower coverage limit.

    pay_cap_limit_amt

    The payment limit on the benefit service.

    pcp_referral_ind

    An indicator that the benefit service provided by a non primary provider must have a referral from a primary care provider to be covered.

    primary_care_provider_ind

    An indicator that the benefit service must be provided by a primary care provider to be covered.

    review_ind :: CM

    A indication that the benefit service will be subject to review prior to payment.

    |IN3^20^00521^Pre-Certification Req/Window|

    upper_coverage_limit_amt

    The upper limit of the benefit coverage.

    Connection definitions for: Healthcare_benefit_service

    provides_coverage_for (1,M) :: Master_service :: is_covered_by (0,M)

    Whole-part definitions for: Healthcare_benefit_service

    is_part_of (1,1) :: Healthcare_coverage_benefit :: has_parts (0,M)

    Class: Healthcare_coverage_benefit

    Description of: Healthcare_coverage_benefit

    Class steward is Patient Administration
    A defined level of healthcare insurance coverage.

    Attribute definitions for: Healthcare_coverage_benefit

    annual_limit_amt

    The annual limit amount for the Healthcare coverage benefit.

    benefit_desc

    A textual description of the benefit.

    benefit_product_nm

    The name of the benefit product.

    dependent_coverage_ind

    An indication as to whether the benefit includes dependent coverage.

    dependent_coverage_limit_amt

    The limit on the dependent coverage amount.

    effective_dttm

    The date and time the benefit becomes effective.

    lifetime_limit_amt

    The lifetime limit amount for the Healthcare coverage benefit.

    termination_dttm

    The date the benefit is no longer in effect.

    Whole-part definitions for: Healthcare_coverage_benefit

    has_parts (0,M) :: Healthcare_benefit_service :: is_part_of (1,1)

    is_part_of (1,1) :: Healthcare_benefit_plan :: has_parts (0,M)

    Class: Healthcare_document_authenticator

    Description of: Healthcare_document_authenticator

    Class steward is Information Management (Medical Records)

    Rationale: Identity of the authenticator is a key piece of information associated with a document.

    OpenIssue:

    Connection definitions for: Healthcare_document_authenticator

    is_related_to (0,m) :: Authentication :: is_related_to (1,1)

    is_a (1,1) :: Stakeholder :: takes_on_role_of (0,1)

    Class: Healthcare_provider_organization

    Description of: Healthcare_provider_organization

    Class steward is Patient Administration

    Connection definitions for: Healthcare_provider_organization

    is_a_role_of (1,1) :: Organization :: takes_on_role_of (0,1)

    provides_patient_services_at (0,M) :: Patient_service_location :: provides_services_on_behalf_of (1,M)

    Class: Healthcare_service_provider

    Description of: Healthcare_service_provider

    Class steward is Patient Administration
    An organization or person responsible for the provision of healthcare services to an individual, or involved in the provision of healthcare related services.

    Attribute definitions for: Healthcare_service_provider

    board_certification_type_cd

    The type of board certification held by the healthcare provider.

    board_certified_ind

    An indication that the healthcare provider is board certified.

    certification_dt

    The date of certification.

    effective_dt

    The date the stakeholder assumes the role of healthcare service provider.

    license_id

    The unique identifier assigned to the healthcare service providers license.

    recertification_dt

    The date recertification is required.

    specialty_cd

    A code depicting the particular subject area or branch of medical science, as practiced by a Healthcare practitioner.

    termination_dt

    The date the stakeholder is no longer in the role of Healthcare service provider.

    Connection definitions for: Healthcare_service_provider

    participates_as (0,M) :: Producer_Of_Master_Service :: has_as_participant (1,1)

    participates_as (0,M) :: Service_event_provider :: includes_the_participation_of (1,1)

    participates_as (0,M) :: Clinical_observation_provider :: has_as_participant (1,1)

    identifies (0,M) :: Patient_clinical_item :: is_identified_by (1,1)

    Class: Identifier_issuing_authority

    Description of: Identifier_issuing_authority

    Class steward is Patient Administration
    A role assumed by an organization stakeholder. This role issues identifiers.

    Attribute definitions for: Identifier_issuing_authority

    effective_dt

    The date the organization assumes the role of issuing authority for identifiers.

    termination_dt

    The date the organization is no longer in the role of issuing authority for identifiers.

    Connection definitions for: Identifier_issuing_authority

    issues (0,M) :: Stakeholder_identifier :: is_issued_by (1,1)

    is_a_role_of (1,1) :: Organization :: takes_on_role_of (0,1)

    Class: Individual_healthcare_practitioner

    Description of: Individual_healthcare_practitioner

    Class steward is Patient Administration
    A person in the role of a healthcare provider.

    Attribute definitions for: Individual_healthcare_practitioner

    desc

    Free form text description of the healthcare practitioner.

    fellowship_field_cd

    The fellowship field of a physician.

    graduate_school_nm

    The name of the graduate school attended by the healthcare practitioner.

    graduation_dt

    The date of graduation from graduated school.

    position_cd

    A code indicating the position of a healthcare practitioner in an healthcare organization (e.g., head of department, trainee, hospital consultant, . . .).

    practitioner_type_cd

    A code indicating the type of healthcare professional (e.g., medical doctor, nurse, pharmacist, laboratory worker, . . .).

    primary_care_ind

    An indication that the healthcare practitioner is a primary care provider.

    residency_field_cd

    The physician residency code.

    Connection definitions for: Individual_healthcare_practitioner

    belongs_to (0,m) :: Individual_healthcare_provider_group :: contains (1,m)

    participates_as (0,M) :: Order_healthcare_practitioner :: includes_the_participation_of (1,1)

    is_requested_by (0,m) :: Individual_healthcare_provider_request :: requests (1,1)

    provides (0,M) :: Certification_second_opinion :: is_provided_by (1,1)

    participates_in (0,M) :: Primary_care_provider_assignment :: has_as_care_provider (1,1)

    is_a_role_of (1,1) :: Person :: takes_on_role_of (0,1)

    participates_as (0,M) :: Encounter_practitioner :: is_participant_for (1,1)

    is_the_primary_provider_for (0,M) :: Patient :: has_a_primary_provider (0,1)

    Whole-part definitions for: Individual_healthcare_practitioner

    is scheduled by (0,m) :: Individual_healthcare_provider_slot :: is a scheduleable unit for (1,1)

    Class: Individual_healthcare_provider_group

    Description of: Individual_healthcare_provider_group

    Class steward is Inter-Enterprise (ADT/Finance/Inter-Enterprise)
    A pool of like-type providers available for scheduling purposes.

    Rationale: Currently in 2.3

    OpenIssue: v2.3 seems to allow different resource types to belong to the same group Is this information contained in the Master Files?

    Attribute definitions for: Individual_healthcare_provider_group

    id

    Unique identifier for the group

    Rationale: Currently in 2.3

    OpenIssue:

    |AIG^4^00899^Resource Group| |AIP^4^00899^Resource Group|

    Connection definitions for: Individual_healthcare_provider_group

    is_requested_by (0,m) :: Individual_healthcare_provider_request :: may_request (0,1)

    contains (1,m) :: Individual_healthcare_practitioner :: belongs_to (0,m)

    Class: Individual_healthcare_provider_request

    Description of: Individual_healthcare_provider_request

    Class steward is Inter-Enterprise (ADT/Finance/Inter-Enterprise)
    Interested committees Orders/Observation
    Request information about specific personnel that are controlled by a schedule.

    Rationale: Specializes the request by type of resource

    OpenIssue:

    Connection definitions for: Individual_healthcare_provider_request

    may_request (0,1) :: Individual_healthcare_provider_group :: is_requested_by (0,m)

    requests (1,1) :: Individual_healthcare_practitioner :: is_requested_by (0,m)

    Class: Individual_healthcare_provider_slot

    Description of: Individual_healthcare_provider_slot

    Class steward is Inter-Enterprise (ADT/Finance/Inter-Enterprise)
    An allocation of time defined when a provider is available to perform a healthcare service.

    Rationale: future

    OpenIssue:

    Whole-part definitions for: Individual_healthcare_provider_slot

    is a scheduleable unit for (1,1) :: Individual_healthcare_practitioner :: is scheduled by (0,m)

    Class: Inpatient_encounter

    Description of: Inpatient_encounter

    Class steward is Patient Administration
    A patient encounter involving an admission to an inpatient facility.

    Attribute definitions for: Inpatient_encounter

    actual_days_qty :: NM

    The number of actual days of an inpatient stay. The actual days quantity can not be calculated from the admission and discharge dates because of possible leaves of absence.

    |PV2^11^00712^Actual Length of Inpatient Stay|

    estimated_days_qty :: NM

    The estimated number of days in an inpatient encounter.

    |PV2^10^00711^Estimated Length of Inpatient Stay|

    Connection definitions for: Inpatient_encounter

    is_preceded_by (1,1) :: Patient_admission :: preceded (1,1)

    is_terminated_by (0,1) :: Patient_departure :: terminates (1,1)

    is_assigned (0,M) :: Encounter_drg :: is_assigned_to (1,1)

    Class: Insurance_certification

    Description of: Insurance_certification

    Class steward is Patient Administration
    An affirmation by an insurance company that it will pay for a specified service.

    Attribute definitions for: Insurance_certification

    appeal_reason_cd :: CE

    A code depicting the reason an appeal was made on a non-concur for certification.

    |IN3^17^00518^Appeal Reason|

    certification_day_qty :: CM

    A count of the number of days for which this certification is valid.

    |IN3^11^00512^Days|

    effective_dt :: DT

    The date that this certification becomes effective.

    |IN3^6^00507^Certification Date/Time| |IN3^9^00510^Certification Begin Date|

    id :: CX

    A unique identifier for the certification assigned by the certification agency.

    |IN3^2^00503^Certification Number|

    insurance_verification_dttm :: TS

    The data and time the insurance coverage was verified.

    |IN1^29^00454^Verification Date/Time|

    modification_dttm :: TS

    The date/time that the certification was modified.

    |IN3^7^00508^Certification Modify Date/Time|

    non_concur_cd :: CE

    A code depicting the denied request.

    |IN3^12^00513^Non-Concur Code/Description|

    non_concur_effective_dttm :: TS

    The date of the non-concurrence classification.

    |IN3^13^00514^Non-Concur Effective Date/Time|

    penalty_amt :: CM

    The dollar amount of the penalty that will be assessed if the precertification is not performed.

    |IN3^5^00506^Penalty|

    termination_dt :: DT

    The date the certification ends.

    |IN3^10^00511^Certification End Date|

    Connection definitions for: Insurance_certification

    has_as_a_contact (1,M) :: Insurance_certification_contact :: is_a_contact_for (1,1)

    provides_validation_for (1,1) :: Healthcare_benefit_plan :: is_validated_by (0,M)

    affirms_insurance_coverage_for (1,1) :: Guarantor_contract :: has_coverage_affirmed_by (0,M)

    includes (0,M) :: Certification_second_opinion :: provides_opinion_on (1,1)

    is_issued_by (1,1) :: Insurer :: issues (0,M)

    Class: Insurance_certification_contact

    Description of: Insurance_certification_contact

    Class steward is Patient Administration
    A person or organization which acts as a contact for insurance certifications.

    Attribute definitions for: Insurance_certification_contact

    participation_type_cd

    A code depicting the type of certification contact. (e.g., certification agency, certification operator, approving party, physician reviewer, . . .).

    Connection definitions for: Insurance_certification_contact

    is_a_role_of (1,1) :: Stakeholder :: takes_on_role_of (0,1)

    is_a_contact_for (1,1) :: Insurance_certification :: has_as_a_contact (1,M)

    Class: Insurer

    Description of: Insurer

    Class steward is Patient Administration
    A role assumed by a organization stakeholder underwriting a Healthcare benefit plan.

    Attribute definitions for: Insurer

    effective_dt

    The date the organization assumes the role of insurer.

    termination_dt

    The date the organization is no longer in the role of insurer.

    Connection definitions for: Insurer

    issues (0,M) :: Insurance_certification :: is_issued_by (1,1)

    issues (0,M) :: Preauthorization :: is_issued_by (1,1)

    offers (0,M) :: Healthcare_benefit_plan :: is_offered_by (1,1)

    is_a_role_of (1,1) :: Organization :: takes_on_role_of (0,1)

    has_as_a_contact (0,M) :: Contact_person :: is_a_contact_for (0,1)

    Class: Location_encounter_role

    Description of: Location_encounter_role

    Class steward is Patient Administration
    An association between a patient encounter and a location.

    Attribute definitions for: Location_encounter_role

    accommodation_cd :: CE

    A code depicting the type of accommodation associated with this patient encounter.

    |PV2^2^00182^Accommodation Code|

    effective_dttm

    Date the association between the patient encounter and the facility location becomes effective.

    location_role_cd :: PL

    A code depicting the relationship of the facility location to the patient encounter.

    |FT1^16^00133^Assigned Patient Location| |PV1^3^00133^Assigned Patient Location| |PV1^6^00136^Prior Patient Location| |PV1^11^00141^Temporary Location| |PV1^42^00172^Pending Location| |PV1^43^00173^Prior Temporary Location| |PV2^1^00181^Prior Pending Location|

    status_cd

    The status of location encounter role.

    termination_dttm

    Date the association between the facility location and the patient encounter ends.

    transfer_reason_cd :: CE

    A code depicting the reason for the patient transfer.

    |PV2^4^00184^Transfer Reason|

    transfer_reason_desc

    Descriptive text providing the reason for a transfer associated with the patient encounter.

    usage_approved_ind

    A indication that use of the location has been approved.

    Connection definitions for: Location_encounter_role

    pertains_to (1,1) :: Patient_encounter :: has (1,M)

    pertains_to (1,1) :: Patient_service_location :: has (0,M)

    Class: Master_calculated_observation

    Description of: Master_calculated_observation

    Class steward is Orders/Observation
    A test/observation service for which continuous value results are generated.

    Attribute definitions for: Master_calculated_observation

    absolute_range_numeric_condition_desc :: CM

    Specifies the special conditions for an absolute range (range of possible results) for "numeric" observations/tests . Each reference range applies to different categories of patients according to age, sex, race, and other conditions. Results outside this range are not possible.

    Rationale: required by components of V2.3 field

    |OM2^8^00633^Absolute Range for Ordinal & Continuous Obs|

    absolute_range_numeric_high_age_amt :: CM

    Specifies the upper age limit for an absolute range (range of possible results) for "numeric" observations/tests . Each reference range applies to different categories of patients according to age, sex, race, and other conditions. Results outside this range are not possible.

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM2^8^00633^Absolute Range for Ordinal & Continuous Obs|

    absolute_range_numeric_high_gestation_age_amt :: CM

    Specifies the upper limit of gestational age for an absolute range (range of possible results) for "numeric" observations/tests . Each reference range applies to different categories of patients according to age, sex, race, and other conditions. Results outside this range are not possible.

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM2^8^00633^Absolute Range for Ordinal & Continuous Obs|

    absolute_range_numeric_high_value_nm :: CM

    Specifies the upper limit for an absolute range (range of possible results) for "numeric" observations/tests . Each reference range applies to different categories of patients according to age, sex, race, and other conditions. Results outside this range are not possible.

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM2^8^00633^Absolute Range for Ordinal & Continuous Obs|

    absolute_range_numeric_low_age_amt :: CM

    Specifies the lower age limit for an absolute range (range of possible results) for "numeric" observations/tests . Each reference range applies to different categories of patients according to age, sex, race, and other conditions. Results outside this range are not possible.

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM2^8^00633^Absolute Range for Ordinal & Continuous Obs|

    absolute_range_numeric_low_gestation_age_amt :: CM

    Specifies the lower limit of gestational age for an absolute range (range of possible results) for "numeric" observations/tests . Each reference range applies to different categories of patients according to age, sex, race, and other conditions. Results outside this range are not possible.

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM2^8^00633^Absolute Range for Ordinal & Continuous Obs|

    absolute_range_numeric_low_value_nm :: CM

    Specifies the lower limit for an absolute range (range of possible results) for "numeric" observations/tests . Each reference range applies to different categories of patients according to age, sex, race, and other conditions. Results outside this range are not possible.

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM2^8^00633^Absolute Range for Ordinal & Continuous Obs|

    absolute_range_numeric_race_subspecies_txt :: CM

    Specifies the race or sub-species for an absolute range (range of possible results) for "numeric" observations/tests . Each reference range applies to different categories of patients according to age, sex, race, and other conditions. Results outside this range are not possible.

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM2^8^00633^Absolute Range for Ordinal & Continuous Obs|

    absolute_range_numeric_sex_txt :: CM

    Specifies the gender for an absolute range (range of possible results) for "numeric" observations/tests . Each reference range applies to different categories of patients according to age, sex, race, and other conditions. Results outside this range are not possible.

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM2^8^00633^Absolute Range for Ordinal & Continuous Obs|

    absolute_range_numeric_species_txt :: CM

    Specifies the species for an absolute range (range of possible results) for "numeric" observations/tests . Each reference range applies to different categories of patients according to age, sex, race, and other conditions. Results outside this range are not possible.

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM2^8^00633^Absolute Range for Ordinal & Continuous Obs|

    corresponding_SI_unit_of_measure_cd :: CE

    The SI units of measure, when these differ from the customary units of measure

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |OM2^4^00629^Corresponding SI Units of Measure|

    critical_range_numeric_condition_desc :: CM

    Specifies the special conditions for a critical range for "numeric" observations/tests . Each reference range applies to different categories of patients according to age, sex, race, and other conditions.

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM2^7^00632^Critical Range for Ordinal & Continuous Obs|

    critical_range_numeric_high_age_amt :: CM

    Specifies the upper age limit for a critical range for "numeric" observations/tests . Each reference range applies to different categories of patients according to age, sex, race, and other conditions.

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM2^7^00632^Critical Range for Ordinal & Continuous Obs|

    critical_range_numeric_high_gestation_age_amt :: CM

    Specifies the upper limit of gestational age for a critical range for "numeric" observations/tests . Each reference range applies to different categories of patients according to age, sex, race, and other conditions.

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM2^7^00632^Critical Range for Ordinal & Continuous Obs|

    critical_range_numeric_high_value_nm :: CM

    Specifies the upper limit for a critical range for "numeric" observations/tests . Each reference range applies to different categories of patients according to age, sex, race, and other conditions.

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM2^7^00632^Critical Range for Ordinal & Continuous Obs|

    critical_range_numeric_low_age_amt :: CM

    Specifies the lower age limit for a critical range for "numeric" observations/tests . Each reference range applies to different categories of patients according to age, sex, race, and other conditions.

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM2^7^00632^Critical Range for Ordinal & Continuous Obs|

    critical_range_numeric_low_gestation_age_amt :: CM

    Specifies the lower limit of gestational age for a critical range for "numeric" observations/tests . Each reference range applies to different categories of patients according to age, sex, race, and other conditions.

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM2^7^00632^Critical Range for Ordinal & Continuous Obs|

    critical_range_numeric_low_value_nm :: CM

    Specifies the lower limit for a critical range for "numeric" observations/tests . Each reference range applies to different categories of patients according to age, sex, race, and other conditions.

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM2^7^00632^Critical Range for Ordinal & Continuous Obs|

    critical_range_numeric_race_subspecies_txt :: CM

    Specifies the race or sub-species for a critical range for "numeric" observations/tests . Each reference range applies to different categories of patients according to age, sex, race, and other conditions.

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM2^7^00632^Critical Range for Ordinal & Continuous Obs|

    critical_range_numeric_sex_txt :: CM

    Specifies the gender for a critical range for "numeric" observations/tests . Each reference range applies to different categories of patients according to age, sex, race, and other conditions.

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM2^7^00632^Critical Range for Ordinal & Continuous Obs|

    critical_range_numeric_species_txt :: CM

    Specifies the species for a critical range for "numeric" observations/tests . Each reference range applies to different categories of patients according to age, sex, race, and other conditions.

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM2^7^00632^Critical Range for Ordinal & Continuous Obs|

    customary_unit_of_measure :: CE

    The customary units of measure for a tests/observation that has numeric values

    Rationale: V2.3 field is not part of an amount/UOM combination.

    OpenIssue:

    |OM2^2^00627^Units of Measure|

    delta_check_numeric_change_computation_method_txt :: CM

    Specifies the computational method for change determination for controlling delta check warnings for numeric data. More than one delta check rule can apply.

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM2^9^00634^Delta Check Criteria|

    delta_check_numeric_change_threshold_nm :: CM

    Specifies the change threshold information for controlling delta check warnings for numeric data. More than one delta check rule can apply

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM2^9^00634^Delta Check Criteria|

    delta_check_numeric_high_value_nm :: CM

    Specifies the high value information for controlling delta check warnings for numeric data. More than one delta check rule can apply.

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM2^9^00634^Delta Check Criteria|

    delta_check_numeric_low_value_nm :: CM

    Specifies the low value information for controlling delta check warnings. More than one delta check rule can apply.

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM2^9^00634^Delta Check Criteria|

    delta_check_numeric_retention_days_qty :: CM

    Specifies the retention time information for controlling delta check warnings for numeric data. More than one delta check rule can apply.

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM2^9^00634^Delta Check Criteria|

    length_and_decimal_precision_nm :: NM

    A specification of the total length and the number of decimal positions for numerically valued single observations.

    Rationale: related V2.3 field is a number, not an amount

    |OM2^3^00628^Range of Decimal Precision|

    minimum_meaningful_increment_nm :: NM

    The smallest meaningful difference between reported values; the effective resolution of the measuring instrument or technique for continuous data, or the smallest discrete interval that can occur for discrete data.

    Rationale: this is a pure number. the units are the same as for the reported values. they are not respecified here.

    |OM2^10^00635^Minimum Meaningful Increments|

    reference_range_numeric_condition_desc :: CM

    Specifies the special conditions for a reference (normal) range for "numeric" observations/tests . Each reference range applies to different categories of patients according to age, sex, race, and other conditions

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM2^6^00631^Reference (Normal) Range - Ordinal & Continuous Ob|

    reference_range_numeric_high_age_amt :: CM

    Specifies the upper limit of age for a reference (normal) range for "numeric" observations/tests . Each reference range applies to different categories of patients according to age, sex, race, and other conditions

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM2^6^00631^Reference (Normal) Range - Ordinal & Continuous Ob|

    reference_range_numeric_high_gestation_age_amt :: CM

    Specifies the upper limit of the gestation age for a reference (normal) range for "numeric" observations/tests . Each reference range applies to different categories of patients according to age, sex, race, and other conditions

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM2^6^00631^Reference (Normal) Range - Ordinal & Continuous Ob|

    reference_range_numeric_high_value_nm :: CM

    Specifies the upper limit of the range for a reference (normal) range for "numeric" observations/tests . Each reference range applies to different categories of patients according to age, sex, race, and other conditions

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM2^6^00631^Reference (Normal) Range - Ordinal & Continuous Ob|

    reference_range_numeric_low_age_amt :: CM

    Specifies the lower limit of age for a reference (normal) range for "numeric" observations/tests . Each reference range applies to different categories of patients according to age, sex, race, and other conditions

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM2^6^00631^Reference (Normal) Range - Ordinal & Continuous Ob|

    reference_range_numeric_low_gestation_age_amt :: CM

    Specifies the lower limit of gestation age for a reference (normal) range for "numeric" observations/tests . Each reference range applies to different categories of patients according to age, sex, race, and other conditions

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM2^6^00631^Reference (Normal) Range - Ordinal & Continuous Ob|

    reference_range_numeric_low_value_nm :: CM

    Specifies the low value for a reference (normal) range for "numeric" observations/tests . Each reference range applies to different categories of patients according to age, sex, race, and other conditions

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM2^6^00631^Reference (Normal) Range - Ordinal & Continuous Ob|

    reference_range_numeric_race_subspecies_txt :: CM

    Specifies the race or sub-species for a reference (normal) range for "numeric" observations/tests . Each reference range applies to different categories of patients according to age, sex, race, and other conditions

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM2^6^00631^Reference (Normal) Range - Ordinal & Continuous Ob|

    reference_range_numeric_sex_txt :: CM

    Specifies the gender for a reference (normal) range for "numeric" observations/tests . Each reference range applies to different categories of patients according to age, sex, race, and other conditions

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM2^6^00631^Reference (Normal) Range - Ordinal & Continuous Ob|

    reference_range_numeric_species_txt :: CM

    Specifies the species for a reference (normal) range for "numeric" observations/tests . Each reference range applies to different categories of patients according to age, sex, race, and other conditions.

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM2^6^00631^Reference (Normal) Range - Ordinal & Continuous Ob|

    si_conversion_factor_txt :: TX

    A factor for converting customary units to SI units. Can be specified as an equation or a multiplier.

    Rationale: related V2.3 field is TX datatype

    |OM2^5^00630^SI Conversion Factor|

    Class: Master_categorical_observation

    Description of: Master_categorical_observation

    Class steward is Orders/Observation
    A test/observation service for which categorical values results are generated.

    Attribute definitions for: Master_categorical_observation

    abnormal_result_cd :: CE

    A list of the text answers that are abnormal for the test.

    Rationale: Clarity, or better representation of V2.3 element name

    |OM3^5^00639^Abnormal Text/Codes for Categorical Observations|

    allowed_value_type_cd

    The allowed data type for a single categorical observation.

    Rationale: closer to V2.3 name

    |OBX^2^00570^Value Type| |OM3^7^00570^Value Type|

    critical_result_cd :: CE

    A list of coded results that are critically abnormal for this observation.

    Rationale: Clarity, or better representation of V2.3 element name

    |OM3^6^00640^Critical Text Codes for Categorical Observations|

    normal_result_cd :: CE

    Normal text/codes for categorical observation.

    Rationale: Clarity, or better representation of V2.3 element name

    |OM3^4^00638^Normal Text/Codes for Categorical Observations|

    preferred_coding_system_cd :: CE

    Preferred coding system for observations whose categorical responses are taken from a specified table of codes.

    |OM3^2^00636^Preferred Coding System|

    valid_answer_cd

    a list of valid coded answers

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |OM3^3^00637^Valid Coded "Answers"|

    Class: Master_continuous_observation

    Description of: Master_continuous_observation

    Class steward is Orders/Observation
    A test/observation service for which calculated results are generated.

    Attribute definitions for: Master_continuous_observation

    derivation_rule_desc :: TX

    A specification of the derivation rules for determining patient variables that are derived from one or more other patient variables.

    |OM6^2^00657^Derivation Rule|

    Class: Master_goal

    Description of: Master_goal

    Class steward is Patient Care
    A master table of goals for a clinical pathway.

    Attribute definitions for: Master_goal

    classification_cd

    A classification code for the goal master.

    desc

    A description of the goal master.

    id

    A unique identifier for the goal master.

    initial_review_interval_cd

    A code indicating the interval used to calculate the next goal review date.

    management_discipline_cd

    A code depicting the goal caregiver discipline responsible for managing the specific goal.

    Connection definitions for: Master_goal

    is_instanciated_by (0,M) :: Goal :: is_an_instance_of (1,1)

    Class: Master_observation_service

    Description of: Master_observation_service

    Class steward is Orders/Observation
    A type of service catalog item specific to observation services.

    Attribute definitions for: Master_observation_service

    instrument_id :: CE

    The unique identifier assigned to the type of instrument required for the observation service type.

    |OM1^13^00598^Identity of Instrument Used to Perfrom this Study|

    permitted_data_type_cd :: ID

    A code depicting the permitted format of the observation value.

    |OM1^3^00588^Permitted Data Types|

    processing_time_qty :: NM

    The usual length of time (in minutes) between the start of a test process and its completion.

    Rationale: alignment of definition with V2.3. the definition specifies unit of measure to be minutes.

    |OM1^24^00609^Processing Time|

    specimen_required_ind :: ID

    An indication that a specimen is required for this observation service type.

    |OM1^4^00589^Specimen Required|

    typical_turnaround_time_qty :: NM

    The typical processing time for a single test/observation. This field indicates the time from the delivery of a specimen or transport of a patient to a diagnostic service and the completion of the study. It includes the usual waiting time. The units are measured in minutes.

    Rationale: alignment of definition with V2.3. the definition specifies unit of measure to be minutes.

    |OM1^23^00608^Typical Turn-Around Time|

    Connection definitions for: Master_observation_service

    has (0,M) :: Master_specimen_requirement :: is_specified_for (1,1)

    is_basis_for (0,M) :: Master_observation_service :: has_as_basis (0,M)

    is_observed_by (0,M) :: Clinical_observation :: is_an_observation_of (1,1)

    has_as_basis (0,M) :: Master_observation_service :: is_basis_for (0,M)

    Class: Master_problem

    Description of: Master_problem

    Class steward is Patient Care
    A master file of problems for which clinical pathways are developed.

    Attribute definitions for: Master_problem

    classification_cd

    A classification code for the problem master.

    desc

    A description of the problem master.

    id

    A unique identifier for the problem master.

    management_discipline_cd

    A code for a default caregiver discipline responsible for managing the problem.

    persistence_ind

    The default perseverance of a master problem.

    Connection definitions for: Master_problem

    is_instanciated_as (0,M) :: Problem :: is_an_instance_of (1,1)

    Class: Master_reflex_service

    Description of: Master_reflex_service

    Class steward is Orders/Observation
    Condition of an observation service which may trigger the execution of another observation service.

    Attribute definitions for: Master_reflex_service

    reflex_testing_trigger_rules_desc :: TX

    A description of the rules that trigger reflex testing for a service catalog item.

    |OM1^35^00620^Rules that Trigger Reflex Testing|

    Connection definitions for: Master_reflex_service

    is_referenced_by (1,1) :: Master_service :: references (0,M)

    references (1,1) :: Master_service :: is_referenced_by (0,M)

    Class: Master_service

    Description of: Master_service

    Class steward is Orders/Observation
    An individual test observation, test observation battery or panel, individual medication, diet, or procedure.

    Attribute definitions for: Master_service

    allowable_processing_priority_cd :: ID

    one of the available priorities for performing the observation or test

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |OM1^25^00610^Processing Priority|

    allowable_reporting_priority_cd :: ID

    the available priorities for reporting the test results when the user is asked to specify the reporting priority independent of the processing priority

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |OM1^26^00611^Reporting Priority|

    billing_reference_txt

    The service catalog item billing reference information.

    challenge_information_txt :: TX

    information for classifying observations by the challenge component of the test, if a challenge does speciate the observation, for example, tests that include a glucose challenge.

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |OM1^44^00939^Challenge Information|

    confidentiality_cd :: IS

    A code depicting the level of confidentiality associated with the service catalog item.

    |OM1^30^00615^Confidentiality Code|

    effective_dt

    The date the service catalog item is effective.

    factors_that_may_affect_observation_desc :: TX

    Text description of the foods, diagnosis, drugs, or other conditions that may influence the interpretation of the observation including information about the direction of the effect, and any recommendation about altering the diet, conditions, or drugs before initiating the test observation.

    Rationale: alignment with V2.3 language

    |OM1^32^00617^Interpretation of Observations| |OM1^39^00624^Factors that may Effect the Observation|

    fee_amt

    The service catalog fee amount.

    fixed_canned_message_cd :: CE

    the codes and a fixed text message that is always associated with the test described by this service catalog item

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |OM1^36^00621^Fixed Canned Message|

    imaging_measurement_modality_cd :: CE

    the modality used to classify the observations, e.g., radiograph, ultrasound, CT scan, NMR, etc. Especially important for imaging studies.

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |OM1^47^00942^Modality of Imaging Measurement|

    incompatible_change_dttm :: TS

    the date and time of the last change in the test procedure that would make previous results incompatible with new results, e.g., the last time that normal reference range or units changed for a numeric test/observation.

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |OM1^22^00607^Effective Date/Time of Change in Test Procedure th|

    instrument_identifier_coding_system_name :: CE

    contains the coding system name for the code identifying the instrument or device that is used to generate this observation or battery

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM1^13^00598^Identity of Instrument Used to Perfrom this Study|

    instrument_identifier_name :: CE

    contains the code identifying the instrument or device that is used to generate this observation or battery

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM1^13^00598^Identity of Instrument Used to Perfrom this Study|

    interpretation_considerations_desc :: TX

    the clinical information about interpreting test results. Examples are the conditions (drugs) that may cause false abnormals, and the information about the sensitivity and specificity of the test for diagnoses

    Rationale: OM1/Interpretation of Observations and OM1 /Factors that may Effect the Observation contain different information.

    OpenIssue:

    |OM1^32^00617^Interpretation of Observations|

    kind_of_quantity_observed_cd :: CE

    the underlying kind of property measured by this service catalog item. distinguishes concentrations from total amounts, molar concentrations from mass concentrations, partial pressures from colors, and so forth

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |OM1^42^00937^Kind of Quantity Observed|

    last_update_dttm :: TS

    contains the date and time that the last of any field change was made and in the source record corresponding to the service catalog item.

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |OM1^21^00606^Date/Time Stamp for Any Change in Def Attri for Ob|

    method_cd :: CE

    A code depicting the service catalog item method.

    |OM1^14^00599^Coded Representation of Method|

    method_desc :: TX

    A textual description of the service catalog item method.

    |OM1^41^00626^Description of Test Methods|

    nature_of_service_cd :: IS

    A code used to classify the service catalog item (e.g., test battery, functional procedure or study, single test value, multiple test batteries, functional procedures as an orderable unit, single test value calculated from other independent observations, ...).

    Rationale: alignment with V2.3 language

    |OM1^18^00603^Nature of Test/Observation|

    observation_id_suffix_txt :: ST

    The expected suffixes for tests or procedures that produce a type which uses observation ID suffixes following the test/observation ID code. For example, a chest x-ray may use the suffixes IMP, REC, DEV, or others

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |OM5^3^00656^Observation ID Suffixes|

    orderable_service_ind :: ID

    An indication that the service catalog item is an orderable service.

    |OM1^12^00597^Orderability|

    patient_preparation_desc :: TX

    A description of special patient preparation, diet, or medications for this service catalog item.

    |OM1^37^00622^Patient Preparation|

    point_versus_interval_cd :: CE

    classifies this service catalog item as measuring the patient's state either at a point in time (e.g., spot urines, random urines, serum potassium), or averaged over a interval of time (e.g., concentration, total amount, or clearance over a 24-hour collection).

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |OM1^43^00938^Point Versus Interval|

    portable_device_ind :: ID

    An indication that a portable device may be use for the test or observation service catalog item.

    |OM1^15^00600^Portable|

    preferred_ordering_method_txt

    Free form text describing the preferred ordering method for the service catalog item.

    preferred_scheduling_method_txt

    Free form text describing the preferred scheduling method for the service catalog item.

    procedure_medication_cd :: CE

    The identifier of a medication treatment that may be needed as part of a procedure service catalog item. Examples are radioactive iodine for a thyroid screen, and methacholine for a methacholine spirometry challenge.

    Rationale: V2.3 field is CE datatype

    |OM1^38^00623^Procedure Medication|

    report_display_order_txt :: ST

    defines the sort order in which this observation is presented in a standard report or display that contains the many observations

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |OM1^20^00605^Report Display Order|

    required_credentials_desc

    A description of the credentials required for the service catalog item.

    service_alternate_id :: CE

    An alternate unique identifier for the service catalog item.

    Rationale: specific to this usage

    |OM1^7^00592^Other Test/Observation IDs for the Observation|

    service_alternate_identifier_coding_system_name :: CE

    coding system name for an alias code/identifier for this service.

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM1^7^00592^Other Test/Observation IDs for the Observation|

    service_alternate_identifier_name :: CE

    an alias code/identifier for this service.

    Rationale: required by components of V2.3 field

    OpenIssue:

    |OM1^7^00592^Other Test/Observation IDs for the Observation|

    service_alternate_name_use_cd :: CE

    use for which an alternate service name is created, eg. long name, short name, name for reports, report subheader.

    Rationale: to retain distinction among multiple alternate names in V2.3 standard

    OpenIssue:

    |OM1^19^00604^Report Subheader|

    service_alternate_nm :: ST

    An alternate name for the catalog item.

    Rationale: specific to this usage

    |OM1^8^00593^Other Names| |OM1^10^00595^Preferred Short Name or Mnemonic for Observation|

    service_contraindication_code :: CE

    A code for a diagnosis or problem for which the service catalog item is a contraindication or of possible danger.

    Rationale: alignment with V2.3 language

    |OM1^33^00618^Contraindications to Observations|

    service_desc :: CE

    A description of the service catalog item.

    Rationale: specific to this usage

    |OM1^6^00591^Observation Description|

    service_performance_schedule_cd :: ST

    A code indicating the maximum service interval for the service catalog item.

    Rationale: alignment with V2.3 language

    |OM1^40^00625^Test/Observation Performance Schedule|

    service_primary_nm :: ST

    The primary or preferred name of the service catalog item.

    Rationale: specific to this usage

    |OM1^9^00594^Preferred Report Name for the Observation| |OM1^11^00596^Preferred Long Name for the Observation|

    service_requirement_desc

    A free form description of the service requirements for the service catalog item.

    service_type_cd

    A code used to categorize the service catalog item.

    standard_time_to_perform_dttm :: TS

    The norm for performing the service across organizational provider and client base.

    Rationale:

    OpenIssue:

    target_anatomic_site_cd :: CE

    formally indicates the site of the observation (to make it easy for a system to find all tests related to one anatomic site). It can be used to classify the observation by target site of the examination. For example, "heart" might be recorded as the target of the electrocardiogram, cardiac echo, and thallium exercise test.

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |OM1^46^00941^Target Anatomic Site of Test|

    target_of_service_cd :: CE1

    Object which is target of the service.

    Rationale: This is not necessarily the patient.

    OpenIssue: In order to make this consistent, Orders must move Processing_time and Typical_turnaround_time from the Master_observation_service to this class. Note that it would also be nice to have a better definition.

    universal_service_id :: CE

    The primary or preferred unique identifier for the service catalog item.

    Rationale: alignment with V2.3 language (in general discussion of this concept)

    |AIS^2^00238^Universal Service Identifier| |OBR^4^00238^Universal Service Identifier| |OBX^3^00571^Observation Identifier| |RXO^1^00292^Requested Give Code|

    universal_service_identifier_coding_system_name :: CE

    name of the coding system for the universal service identifier

    Rationale: required by components of V2.3 field

    OpenIssue:

    |RXD^2^00335^Dispense/Give Code|

    universal_service_identifier_name :: CE

    name for the service catalog item

    Rationale: required by components of V2.3 field

    OpenIssue:

    |RXD^2^00335^Dispense/Give Code|

    Connection definitions for: Master_service

    includes (0,M) :: Master_service :: is_included_in (0,M)

    is_delivered_during (0,M) :: Patient_service_event :: delivers (1,1)

    is_recommended_by (0,M) :: Pathway_master :: recommends (0,M)

    references (0,M) :: Master_reflex_service :: is_referenced_by (1,1)

    is_covered_by (0,M) :: Healthcare_benefit_service :: provides_coverage_for (1,M)

    is_produced_by (0,m) :: Producer_Of_Master_Service :: produces (0,1)

    Rationale: support use of Producer ID in V2.3 OM1

    OpenIssue:

    is_instantiated_as (0,M) :: Patient_service_order :: is_an_instance_of (1,1)

    is_included_in (0,M) :: Master_service :: includes (0,M)

    is_referenced_by (0,M) :: Master_reflex_service :: references (1,1)

    Class: Master_specimen_requirement

    Description of: Master_specimen_requirement

    Class steward is Orders/Observation
    A specification of specimen requirements for test/observation service catalog items which require a specimen.

    Attribute definitions for: Master_specimen_requirement

    additive_cd :: CE

    A code for the additive required for the collected specimen used in the associated observation service type.

    |OM4^7^00647^Additive|

    container_desc :: TX

    A description of the container requirements for a specimen collected for the observation service type. The description includes specification of the physical appearance, including color of tube tops, shape, and material composition (e.g., red top glass tube).

    |OM4^3^00643^Container Description|

    container_preparation_desc :: TX

    The special processing that should be applied to the container (e.g., add acidifying tablets before sending).

    Rationale: differentiates this from preparation of other specimen-related items (eg. the specimen itself).

    |OM4^8^00648^Preparation|

    container_volume_amt :: NM

    A specification of the containers volume capacity.

    |OM4^4^00644^Container Volume|

    derived_specimen_cd :: ID

    A code identifying derived specimens relative to the observation service type. For some diagnostic studies the initial specimen is processed to produce results. The process also produces new "specimens" and these are studied by a second order process.

    |OM4^2^00642^Derived Specimen|

    minimum_collection_volume_amt :: CQ

    The amount of specimen needed by the most specimen sparing method.

    |OM4^11^00651^Minimum Collection Volume|

    normal_collection_volume_amt :: CQ

    A specification of the normal specimen volume required. This is the amount used by the normal methods and provides enough specimens to repeat the procedure at least once.

    |OM4^10^00650^Normal Collection Volume|

    special_handling_desc :: TX

    Special handling requirements for the collected specimen.

    |OM4^9^00649^Special Handling Requirements|

    specimen_priorities_cd :: ID

    The allowed priorities for obtaining the specimen.

    |OM4^13^00653^Specimen Priorities|

    specimen_retention_time_amt :: CQ

    The usual time that a specimen for this observation service type is retained after the observation is completed.

    |OM4^14^00654^Specimen Retention Time|

    specimen_type_cd :: CE

    A code identifying the specimen required by the observation service type.

    Rationale: Clarity, or better representation of V2.3 element name

    |OM4^6^00646^Specimen|

    Connection definitions for: Master_specimen_requirement

    is_specified_for (1,1) :: Master_observation_service :: has (0,M)

    Class: Master_treatment_service

    Description of: Master_treatment_service

    Class steward is Orders/Observation
    An item in the formulary.

    Attribute definitions for: Master_treatment_service

    dea_level_cd

    The drug enforcement agency level for the pharmacy treatment service.

    drug_category_cd

    The drug category code of the pharmacy treatment service.

    formulary_status_cd

    A code depicting the formulary status of a dispensed medication.

    Rationale: should be determined in the catalog, not at each dispense

    medication_form_cd

    A code depicting the form of the medication comprising the pharmacy treatment service.

    pharmaceutical_class_cd

    The pharmaceutical class of the pharmacy treatment service.

    route_cd

    A code depicting the administration route for the pharmacy treatment service.

    therapeutic_class_cd

    A code depicting the therapeutic class of the pharmacy treatment service.

    Connection definitions for: Master_treatment_service

    is_delivered_during (0,m) :: Treatment_service_administration :: delivers (0,1)

    Rationale: link medication given to service catalog

    OpenIssue:

    is_dispensed_during (0,m) :: Treatment_service_dispense :: dispenses (0,1)

    Rationale: link medication dispensed to service catalog

    OpenIssue:

    is_ordered_on (0,m) :: Treatment_service_order_revision :: orders (0,1)

    Rationale: link medication on pharmacy_service_order_item to service catalog

    OpenIssue:

    Class: Medicaid_coverage

    Description of: Medicaid_coverage

    Class steward is Patient Administration
    A type of healthcare coverage provided by a state medicaid program.

    Attribute definitions for: Medicaid_coverage

    aid_category_cd

    A code depicting the category of aid which make this person eligible for medicaid (e.g., aged, blind, disabled, families with dependent children, ...)

    case_id :: ST

    An identifier assigned to a medicaid family for administration as a case.

    |IN2^8^00479^Medicaid Case Number|

    effective_dt

    The date medicaid coverage becomes effective.

    termination_dt

    The date medicaid coverage terminates.

    Class: Medicare_coverage

    Description of: Medicare_coverage

    Class steward is Patient Administration
    A type of Healthcare coverage provided by the federal Medicare program.

    Attribute definitions for: Medicare_coverage

    effective_dt

    The date the person's medicare coverage becomes effective.

    eligibility_cd

    A code depicting the person's medicare eligibility type (e.g., age, disability, ESRD, ...).

    id :: ST

    A person's medicare coverage identifier (HICN).

    |IN2^6^00477^Medicare Health Ins Card Number|

    lifetime_res_delay_day_qty :: NM

    A delay prior to lifetime reserve days.

    |IN1^34^00459^Delay Before L. R. Day|

    lifetime_reserve_day_qty :: NM

    The number of lifetime reserve days remaining.

    |IN1^33^00458^Lifetime Reserve Days|

    medicare_coverage_type_cd

    A code indicating the type of medicare coverage (e.g., hospital, professional,...).

    program_type_cd

    A code depicting the medicare reimbursement type (e.g., GPPP Cost, GPPP Risk, PPS, ...).

    renal_cd

    A code indicating the renal status of the person's medicare coverage.

    termination_dt

    The date the person's medicare coverage is no longer in effect.

    Class: Notary_public

    Description of: Notary_public

    Class steward is Information Management (Medical Records)
    A role of a person that authenticates the signature of a party.

    Attribute definitions for: Notary_public

    effective_dt

    The date upon which the person assumed the role of notary public.

    notary_county_cd

    The county in which the notary is licensed.

    notary_state_cd

    The state in which the notary is licensed.

    termination_dt

    Date on which the person is no longer in the role of notary public.

    Connection definitions for: Notary_public

    is_a_role_of (1,1) :: Person :: takes_on_role_of (0,1)

    notarizes (0,M) :: Advance_directive :: is_notarized_by (1,1)

    Class: Observation_order

    Description of: Observation_order

    Class steward is Orders/Observation
    An authoritative direction or instruction concerning an observation service for a patient.

    Attribute definitions for: Observation_order

    patient_hazard_code :: CE

    Code and/or text indicating any known or suspected patient or specimen hazards.

    Rationale: to capture patient hazards that would be indicated in related V2.3 field.

    OpenIssue:

    |OBR^12^00246^Danger Code|

    reason_for_study_cd :: CE

    Text or code describing the reason for the observation order.

    Rationale: V2.3 field is CE datatype

    |OBR^31^00263^Reason For Study|

    relevant_clinical_information_txt :: ST

    Additional clinical information about the patient or specimen, such as the suspected diagnosis and clinical findings on requests for interpreted diagnostic studies.

    Rationale: : better alignment with V2.3

    |OBR^13^00247^Relevant Clinical Info.|

    reporting_priority_cd

    A code indicating the reporting priority of the patient service order.

    specimen_action_cd :: ID

    A code identifying the action to be taken with respect to the specimen.

    |OBR^11^00245^Specimen Action Code|

    Class: Observation_relationship

    Description of: Observation_relationship

    Class steward is Orders/Observation
    Interested committees Patient Care
    Observations have relationships to other observations.

    Rationale:

    OpenIssue: Need to examine the use and definition of Sub-ID on Clinical_observation class in order to see if it is still needed in light of the newly supported recursive relationships.

    Attribute definitions for: Observation_relationship

    relationship_type_cd

    Type of relationship

    Rationale:

    OpenIssue:

    Connection definitions for: Observation_relationship

    concludes (1,1) :: Clinical_observation :: is_concluded_from (0,m)

    inferred_from (1,m) :: Clinical_observation :: used_to_infer (0,m)

    Class: Order_healthcare_practitioner

    Description of: Order_healthcare_practitioner

    Class steward is Orders/Observation
    An association between a Healthcare practitioner and an Order.

    Attribute definitions for: Order_healthcare_practitioner

    participation_type_cd

    A code indicating the type of participation the Healthcare participant's assumes in connection to the order (e.g., Placer, Filler, Recipient of results, ...).

    Connection definitions for: Order_healthcare_practitioner

    is_for (1,1) :: Patient_service_order :: has (1,M)

    includes_the_participation_of (1,1) :: Individual_healthcare_practitioner :: participates_as (0,M)

    Class: Organization

    Description of: Organization

    Class steward is Patient Administration
    A type of stakeholder. A group of persons organized for some end or work; association. The administrative personnel or apparatus of a business.

    Attribute definitions for: Organization

    organization_name_type_cd :: XON

    A code that represents the type of name i.e., legal name, display name

    Rationale: to support XON datatype

    OpenIssue:

    |IN2^70^00810^Insured Employer Organization Name And ID|

    organization_nm :: XON

    The name of an organization.

    |GT1^16^00420^Guarantor Employer Name| |GT1^21^00425^Guarantor Organization| |IN1^4^00429^Insurance Company Name| |IN1^9^00434^Group Name| |IN1^11^00436^Insured's Group Emp ID| |IN2^3^00474^Insured's Employer Name| |IN2^12^00483^Champus Organization| |IN2^70^00810^Insured Employer Organization Name And ID| |IN3^18^00519^Certification Agency| |NK1^13^00202^Organization Name|

    standard_industry_class_cd

    The standard industry class code of the organization.

    Connection definitions for: Organization

    categorizes (0,M) :: Financial_transaction :: is_categorized_by (0,1)

    has_as_a_subdivision (0,M) :: Organization :: is_a_subdivision_of (0,1)

    takes_on_role_of (0,1) :: Insurer :: is_a_role_of (1,1)

    takes_on_role_of (0,1) :: Bad_debt_collection_agency :: is_a_role_of (1,1)

    takes_on_role_of (0,1) :: Identifier_issuing_authority :: is_a_role_of (1,1)

    assigns (0,M) :: Encounter_drg :: is_assigned_by (1,1)

    takes_on_role_of (0,1) :: Healthcare_provider_organization :: is_a_role_of (1,1)

    is_a_subdivision_of (0,1) :: Organization :: has_as_a_subdivision (0,M)

    Class: Originator

    Description of: Originator

    Class steward is Information Management (Medical Records)

    Rationale: Identity of the originator (is the person starting the chart - normally there is one and only one) is a key piece of information associated with a document. For reasons stated in another request, the TC would like this instance connection to be associated with an attribute of the patient care document header class.

    OpenIssue:

    Connection definitions for: Originator

    is_a (1,1) :: Stakeholder :: takes_on_role_of (0,1)

    of (0,M) :: Clinical_document_header :: has_been_originated_by (0,1)

    Class: Pathway

    Description of: Pathway

    Class steward is Patient Care
    A Clinical pathway, or treatment plan, established for a particular patient.

    Attribute definitions for: Pathway

    established_dttm

    The date the patient pathway was established.

    instance_id

    A unique identifier assigned to the patient pathway.

    life_cycle_status_cd

    A code depicting the life cycle states of the patient pathway (e.g., active, suspended, complete, canceled, delayed, scheduled, . . .).

    life_cycle_status_change_dttm

    The date and time the life cycle status indicated by the life cycle status code is in effect.

    Connection definitions for: Pathway

    targets (0,M) :: Problem :: is_targeted_by (1,M)

    is_an_instance_of (0,1) :: Pathway_master :: is_instanciated_by (0,M)

    pertains_to (1,1) :: Patient :: has (1,M)

    targets (0,M) :: Goal :: is_targeted_by (0,M)

    requires (0,M) :: Patient_service_event :: is_required_by (0,M)

    Class: Pathway_master

    Description of: Pathway_master

    Class steward is Patient Care
    A reference table of pathway specification that are not specific to a particular patient.

    Attribute definitions for: Pathway_master

    desc

    A description of the clinical pathway master.

    id

    A unique identifier for a clinical pathway.

    Connection definitions for: Pathway_master

    recommends (0,M) :: Master_service :: is_recommended_by (0,M)

    is_instanciated_by (0,M) :: Pathway :: is_an_instance_of (0,1)

    Class: Patient

    Description of: Patient

    Class steward is Patient Administration
    A person who may receive, is receiving, or has received Healthcare services.

    Attribute definitions for: Patient

    ambulatory_status_cd :: IS

    Condition of a patient. (e.g., pregnant, hearing impaired, . . .).

    |GT1^34^00145^Ambulatory Status| |IN2^32^00145^Ambulatory Status| |NK1^18^00145^Ambulatory Status| |PV1^15^00145^Ambulatory Status|

    birth_order_number :: NM

    For newborn patients in a multiple birth the order this patient was born in.

    Rationale: field is to contain the ordinal birth position, not a code for the position. V2.3 field is datatype NM.

    |PID^25^00128^Birth Order|

    classification_cd :: CM

    A classifying code for patients.

    |FT1^18^00148^Patient Type| |PV1^18^00148^Patient Type| |PV1^20^00150^Financial Class|

    living_arrangement_cd :: IS

    A code depicting the living arrangements of a person (e.g., Alone, Family, Relatives, Institution, . . .).

    |GT1^37^00742^Living Arrangement| |IN2^35^00742^Living Arrangement| |NK1^21^00742^Living Arrangement| |PD1^2^00742^Living Arrangement|

    living_dependency_cd :: IS

    A code depicting the nature of a dependency that may exist between one stakeholder and another.

    |GT1^33^00755^Living Dependency| |IN2^31^00755^Living Dependency| |NK1^17^00755^Living Dependency| |PD1^1^00755^Living Dependency|

    multiple_birth_ind :: ID

    A indication as to whether the patient is part of a multiple birth.

    |PID^24^00127^Multiple Birth Indicator|

    newborn_baby_ind :: ID

    A indication that the patient is a newborn baby.

    |PV2^36^00737^Newborn Baby Indicator|

    organ_donor_ind :: IS

    An indication that the patient is an organ donor.

    |PD1^8^00760^Organ Donor|

    preferred_pharmacy_id

    The preferred pharmacy of the patient.

    triage_classification_cd

    The triage classification of the patient.

    Connection definitions for: Patient

    is_subject_of (0,M) :: Clinical_observation :: is_on_behalf_of (0,1)

    Rationale: Some observations (eg. those forwarded from other institutions) may come from "Service events" of no interest to the recipient. The requirement that each observation have a Service Event should therefore be removed from the model.

    OpenIssue:

    has (0,M) :: Healthcare_benefit_plan :: is_for (1,1)

    is_a_role_of (1,1) :: Person :: takes_on_role_of (0,1)

    has_a_primary_provider (0,1) :: Individual_healthcare_practitioner :: is_the_primary_provider_for (0,M)

    participates_in (0,1) :: Primary_care_provider_assignment :: has_as_care_recipient (1,1)

    has (1,M) :: Pathway :: pertains_to (1,1)

    has (0,1) :: Patient_death :: pertains_to (1,1)

    is_involved_in (1,M) :: Patient_encounter :: involves (1,1)

    is_source_for (0,M) :: Collected_specimen_sample :: is_sourced_from (0,1)

    has (0,M) :: Patient_clinical_item :: pertains_to (1,1)

    has (0,M) :: Goal :: pertains_to (1,1)

    has_as_a_contact (0,M) :: Contact_person :: is_a_contact_for (0,1)

    may_be_the_subject_of (0,M) :: Patient_service_order :: has_as_subject (0,1)

    has (0,M) :: Disability :: pertains_to (1,1)

    Rationale: 2.3 abstract message def

    OpenIssue:

    has (0,M) :: Patient_billing_account :: belongs_to (1,1)

    has_as_primary_facility (0,1) :: Patient_service_location :: is_primary_facility_for (0,M)

    has (0,M) :: Patient_information_disclosure :: pertains_to (1,1)

    has (0,M) :: Health_chart :: belongs_to (1,1)

    Whole-part definitions for: Patient

    is scheduled by (0,m) :: Patient_slot :: is a scheduleable unit for (1,1)

    Class: Patient_admission

    Description of: Patient_admission

    Class steward is Patient Administration
    The beginning of an inpatient encounter.

    Attribute definitions for: Patient_admission

    admission_dttm :: TS

    The date and time of the patient was admitted into an inpatient facility.

    |PV1^44^00174^Admit Date/Time|

    admission_reason_cd :: CE

    A code depicting the reason for the inpatient admission.

    |PV2^3^00183^Admit Reason|

    admission_referral_cd

    A code depicting the type of referral associated with this inpatient admission.

    admission_source_cd :: IS

    A code indicating the source category associated with this inpatient encounter.

    |PV1^14^00144^Admit Source|

    admission_type_cd :: IS

    A code indicating the circumstance under which the patient was or will be admitted.

    |PV1^4^00134^Admission Type|

    patient_valuables_desc :: ST

    Text describing the patient valuables left for safe keeping.

    |PV2^5^00185^Patient Valuables|

    pre_admit_test_ind :: IS

    An indication that pre-admission tests are required for this inpatient encounter.

    |PV1^12^00142^Preadmit Test Indicator|

    readmission_ind :: IS

    An indication that the inpatient encounter is a readmission.

    |PV1^13^00143^Readmission Indicator|

    valuables_location_desc :: ST

    Descriptive text identifying where valuables of patient is located.

    |PV2^6^00186^Patient Valuables Location|

    Connection definitions for: Patient_admission

    preceded (1,1) :: Inpatient_encounter :: is_preceded_by (1,1)

    Class: Patient_allergy

    Description of: Patient_allergy

    Class steward is Orders/Observation
    An abnormal reaction of a patient to an allergen.

    Attribute definitions for: Patient_allergy

    allergen_id :: CE

    An identifier of the allergen which causes the allergic reaction.

    |AL1^1^00203^Set ID - AL1| |AL1^3^00205^Allergy Code/Mnemonic/ Description|

    allergy_cd :: CE

    An identification code for the patient condition.

    |AL1^3^00205^Allergy Code/Mnemonic/ Description|

    allergy_reaction_cd :: ST

    A code specifying an allergic reaction.

    |AL1^5^00207^Allergy Reaction|

    allergy_reaction_description_txt :: ST

    Free form textual description of a patient medical condition.

    |AL1^5^00207^Allergy Reaction|

    allergy_severity_cd :: IS

    A code indicating the general severity of the patient condition (e.g., severe, moderate, mild, . . .).

    |AL1^4^00206^Allergy Severity|

    allergy_type_cd :: IS

    A code indicating the general allergy category (e.g., drug, food, pollen, . . .).

    |AL1^2^00204^Allergy Type|

    Class: Patient_arrival

    Description of: Patient_arrival

    Class steward is Patient Administration
    The arrival of a patient at the location of care for a patient encounter.

    Attribute definitions for: Patient_arrival

    acuity_level_cd

    A code depicting the acuteness of the patients medical condition upon arrival.

    arrival_dttm

    The date and time of the patient arrival at the care location.

    arrival_type_cd

    A code classifying the types of patient arrivals.

    medical_service_id

    A unique identifier assigned to the medical service anticipated in the patient encounter.

    source_of_arrival_cd

    A code depicting the source of arrival.

    transport_mode_cd

    A code depicting the mode of transportation used to transport the patient to the care location.

    Connection definitions for: Patient_arrival

    precedes (1,1) :: Patient_encounter :: is_preceded_by (0,1)

    Class: Patient_billing_account

    Description of: Patient_billing_account

    Class steward is Patient Administration
    A financial account established for a patient to track the billable amount for services received by the patient and payment made for those services.

    Attribute definitions for: Patient_billing_account

    account_id :: CK

    The unique identifier of a patient account.

    |BLG^3^00236^Account ID| |MRG^3^00213^Prior Patient Account Number| |PID^18^00121^Patient Account Number|

    adjustment_cd :: IS

    A code depicting the type of adjustment applied to the patient billing account.

    |PV2^30^00731^Patient Charge Adjustment Code|

    authorization_information_txt :: CM

    The authorization number or code received from the insurance company.

    |IN1^14^00439^Authorization Information|

    billing_status_cd :: IS

    A code indicating the status of billing.

    |IN1^32^00457^Billing Status| |PV1^41^00171^Account Status|

    certification_required_ind :: ID

    A indicator as to whether a certification is required.

    |IN3^4^00505^Certification Required|

    current_unpaid_balance_amt :: NM

    The current unpaid balance of a patient account.

    |PV1^46^00176^Current Patient Balance|

    delete_dt :: DT

    The date the patient billing account was deleted.

    |PV1^35^00165^Delete Account Date|

    deleted_account_reason_cd :: IS

    A code depicting the reason a patient billing account has been deleted.

    |PV1^34^00164^Delete Account Indicator|

    expected_insurance_plan_qty

    A count of the number of insurance plans expected to provide insurance coverage for this patient account.

    expected_payment_source_cd

    A code indicating the expected payment source.

    notice_of_admission_dt :: DT

    The date a notice of admission was sent.

    |IN1^24^00449^Notice of Admission Date|

    notice_of_admission_ind :: ID

    A indicator documenting whether the insurance company requires a written notice of admission.

    |IN1^23^00448^Notice of Admission Flag|

    patient_financial_class_cd

    A code depicting a category for the source of payment.

    price_schedule_id :: IS

    A reference to the unique identifier of the price schedule to be used for charges in the patient billing account.

    |PV1^21^00151^Charge Price Indicator|

    purge_status_cd :: IS

    A code depicting the purge status of the patient billing account.

    |PV2^16^00717^Purge Status Code|

    purge_status_dt :: DT

    The date the patient billing account was purged.

    |PV2^17^00718^Purge Status Date|

    report_of_eligibility_dt

    The date a report of eligibility was received.

    retention_ind

    A indicator to control the purge of the patient billing account and related data.

    signature_on_file_dt :: DT

    The date authorization to bill was obtained.

    |PV2^28^00729^Signature on File Date|

    special_program_cd :: IS

    A code indicating a special program governing the billing account.

    |PV2^18^00719^Special Program Code|

    stoploss_limit_ind :: ID

    A indicator identifying whether the patient has reached the stoploss limit established in the contract master.

    |IN2^68^00808^Stoploss Limit Flag|

    suspend_charges_ind :: ID

    An indicator as to whether charges should be suspended for a patient.

    |IN2^66^00806^Suspend Flag|

    total_adjustment_amt :: NM

    The total amount of the adjustment made to the patient billing account.

    |PV1^48^00178^Total Adjustments|

    total_charge_amt :: NM

    The total charge amount of the patient billing account.

    |PV1^47^00177^Total Charges|

    total_payment_amt :: NM

    The total of the payments made on a patient billing account.

    |PV1^49^00179^Total Payments|

    Connection definitions for: Patient_billing_account

    belongs_to (1,1) :: Patient :: has (0,M)

    has_charges_for (0,M) :: Patient_service_event :: is_charged_to (0,1)

    has_payment_guaranteed_by (0,M) :: Guarantor_contract :: provides_payment_guarantee_for (0,M)

    is_billed_from (0,M) :: Patient_service_order :: is_billed_to (0,1)

    Rationale: supports use of BLG segment in the ORM message

    OpenIssue: Open issue: needs joint work with OO-PAFM

    is_the_prior_account_for (0,1) :: Patient_billing_account :: has_as_a_prior_account (0,1)

    has (0,M) :: Financial_transaction :: is_associated_with (1,1)

    has_as_a_prior_account (0,1) :: Patient_billing_account :: is_the_prior_account_for (0,1)

    has (0,M) :: Billing_information_item :: pertains_to (1,1)

    Class: Patient_clinical_item

    Description of: Patient_clinical_item

    Class steward is Orders/Observation
    Information about a patient, relevant to the health or treatment of that patient, that is recorded by or on behalf of a Healthcare practitioner.

    ISSUE: the specializations of patient clinical items may be duplicates of information found elsewhere in the model. Of particular concern is the apparent overlap between diagnosis, patient condition, patient problem, and patient pathway problem.

    Attribute definitions for: Patient_clinical_item

    assessment_dttm :: DT

    The date and time the clinical state item was identified.

    |AL1^6^00208^Identification Date|

    employment_related_ind

    An indication that the patient condition is employment related.

    id

    A unique identifier for the clinical state item.

    Connection definitions for: Patient_clinical_item

    is_identified_by (1,1) :: Healthcare_service_provider :: identifies (0,M)

    pertains_to (1,1) :: Patient :: has (0,M)

    is_present_in (1,M) :: Patient_encounter :: has (0,M)

    is_obtained_from (0,1) :: Patient_clinical_item_source :: is_the_source_of (0,M)

    Class: Patient_clinical_item_source

    Description of: Patient_clinical_item_source

    Class steward is Orders/Observation
    A stakeholder that is the source of information concerning a patient clinical item.

    Connection definitions for: Patient_clinical_item_source

    is_a_role_of (1,1) :: Stakeholder :: takes_on_role_of (0,1)

    is_the_source_of (0,M) :: Patient_clinical_item :: is_obtained_from (0,1)

    Class: Patient_death

    Description of: Patient_death

    Class steward is Patient Administration
    The act of dying; the end of life; the total and permanent cessation of all the vital functions of a patient.

    Attribute definitions for: Patient_death

    death_certificate_id

    The identifier assigned to the death certificate.

    death_certificate_recorded_dt

    The date that the death certificate is recorded.

    death_classification_cd

    A major classification of the cause of death.

    death_dttm

    The date and time of death.

    death_location_nm

    The name of the location where the death occurred.

    death_notification_source_nm

    The name of the source providing the death notification.

    death_verification_cd

    A code identifying the source type used for verification.

    death_verification_dt

    The date the death information is verified.

    death_verification_nm

    Name of the person providing verification of death.

    Connection definitions for: Patient_death

    pertains_to (1,1) :: Patient :: has (0,1)

    Class: Patient_departure

    Description of: Patient_departure

    Class steward is Patient Administration
    The end of a inpatient encounter.

    Attribute definitions for: Patient_departure

    discharge_disposition_cd :: IS

    A code depicting the disposition of the patient following discharge.

    |PV1^36^00166^Discharge Disposition|

    discharge_dttm

    The date and time that the patient is discharged from an inpatient facility.

    discharge_location_id :: IS

    An identifier assigned to the discharge location.

    |PV1^37^00167^Discharged to Location|

    expected_discharge_disp_cd :: IS

    A code depicting the expected disposition of the patient upon discharge.

    |PV2^27^00728^Expected Discharge Disposition|

    Connection definitions for: Patient_departure

    terminates (1,1) :: Inpatient_encounter :: is_terminated_by (0,1)

    Class: Patient_diagnosis

    Description of: Patient_diagnosis

    Class steward is Patient Care
    The decision reached from the process of determining by examination the nature and circumstances of a diseased condition.

    Attribute definitions for: Patient_diagnosis

    attestation_dttm :: TS

    The date and time the diagnosis physician attests to the validity of the diagnosis.

    |DG1^19^00768^Attestation Date/Time|

    classification_type_cd :: IS

    A primary classification of diagnosis.

    |DG1^17^00766^Diagnosis Classification|

    confidential_ind :: ID

    An indication that the diagnosis is confidential.

    |DG1^18^00767^Confidential Indicator| |DRG^10^00767^Confidential Indicator|

    desc

    Free form description of the diagnosis.

    determination_dttm

    Date and time the diagnosis was determined.

    diagnosis_cd :: CE

    A unique identifier designating the diagnosis.

    |FT1^19^00371^Diagnosis Code| |PR1^15^00772^Associated Diagnosis Code|

    diagnosis_onset_dttm :: TS

    The date the decease indicated in the diagnosis became present in the patient.

    |DG1^5^00379^Diagnosis Date/Time|

    diagnosis_phase_cd

    The diagnostic phase code.

    identification_cd :: ID

    The diagnosis identification code.

    |DG1^2^00376^Diagnosis Coding Method|

    relative_priority_nbr :: NM

    The relative priority of the diagnosis.

    |DG1^15^00389^Diagnosis/DRG Priority|

    rule_out_dttm

    The data and time the diagnosis was ruled out.

    ruled_out_reason_txt

    The reason the diagnosis was ruled out.

    severity_cd

    A code depicting the severity of the diagnosis.

    type_cd :: IS

    A classification type of diagnosis (e.g., admitting, working, discharge, . . .).

    |DG1^6^00380^Diagnosis/DRG Type|

    Connection definitions for: Patient_diagnosis

    defines (0,1) :: Episode :: is_defined_by (0,1)

    is_assigned_to (1,1) :: Patient_encounter :: has_assigned_to_it (0,M)

    Class: Patient_encounter

    Description of: Patient_encounter

    Class steward is Patient Administration
    An interaction between a patient and a Healthcare participant for the purpose of providing patient services or assessing the health status of a patient.

    Attribute definitions for: Patient_encounter

    administrative_outcome_txt

    Type of further action, if any, planned as part of the care of the patient (e.g., appointment given, appointment to be given, admission arranged, patient admitted, . . .).

    cancellation_reason_cd

    A code depicting the reason for cancellation of an encounter.

    desc :: ST

    A textual description of the patient encounter.

    |PV2^12^00713^Visit Description|

    encounter_classification_cd :: IS

    A classification of a patient encounter.

    |PV2^7^00187^Visit User Code|

    end_dttm :: TS

    The date and time that the patient encounter ends.

    |PV1^45^00175^Discharge Date/Time|

    expected_insurance_plan_qty :: NM

    A count of the number of insurance plans that may provide Healthcare benefit coverage for this patient encounter.

    |PV2^20^00721^Expected Number of Insurance Plans|

    first_similar_illness_dt :: DT

    The date the patient first experienced a similar illness. Used to determine pre-existing conditions

    |PV2^29^00730^First Similar Illness Date|

    follow_up_type_cd :: IS

    A code indicating the type of follow-up required after completion of the patient encounter.

    |PV1^10^00140^Hospital Service|

    id :: CX

    A unique identifier assigned to the patient encounter.

    |PV1^19^00149^Visit Number| |PV1^50^00180^Alternate Visit ID|

    patient_classification_cd :: IS

    A classification of the patient.

    |FT1^18^00148^Patient Type| |PV1^2^00132^Patient Class| |PV1^18^00148^Patient Type|

    priority_cd :: IS

    A code depicting the relative priority of the patient encounter.

    |PV2^25^00726^Visit Priority Code|

    purpose_cd

    A code depicting the purpose of the patient encounter.

    record_signing_dttm

    The data and time the documentation of the patient encounter is signed.

    special_courtesies_ind :: IS

    An indication as to whether or not the patient is to be extended special courtesies.

    |PV1^22^00152^Courtesy Code|

    start_dttm

    The date and time that the patient encounter begins.

    status_cd :: IS

    A code depicting the status of the patient encounter.

    |PV2^24^00725^Patient Status Code|

    transport_requirement_cd

    A code depicting the type of transportation required or arranged for the transport of the patient (e.g., stretcher, wheelchair, ambulance, taxi, . . .).

    urgency_cd

    A code depicting the urgency of the patient encounter.

    Connection definitions for: Patient_encounter

    has_assigned_to_it (0,M) :: Patient_diagnosis :: is_assigned_to (1,1)

    involves (1,1) :: Patient :: is_involved_in (1,M)

    involves (0,M) :: Patient_problem :: is_involved_in (1,M)

    is_authorized_by (0,1) :: Preauthorization :: authorizes (1,M)

    is_scheduled_by (0,M) :: Appointment :: schedules (1,M)

    precedes (0,1) :: Patient_encounter :: follows (0,M)

    has (0,M) :: Risk_management_incident :: pertains_to (1,1)

    has (1,M) :: Location_encounter_role :: pertains_to (1,1)

    is_preceded_by (0,1) :: Patient_arrival :: precedes (1,1)

    has (0,M) :: Patient_clinical_item :: is_present_in (1,M)

    follows (0,M) :: Patient_encounter :: precedes (0,1)

    has_as_participant (1,M) :: Encounter_practitioner :: is_associated_with (1,1)

    Whole-part definitions for: Patient_encounter

    is_part_of (1,1) :: Episode :: has_parts (1,M)

    has_parts (0,M) :: Person_birth_event :: is_part_of (1,1)

    has_parts (0,M) :: Patient_service_event :: is_part_of (1,1)

    Class: Patient_information_disclosure

    Description of: Patient_information_disclosure

    Class steward is Patient Administration
    A release of patient information to a third party.

    Attribute definitions for: Patient_information_disclosure

    disclosure_dttm

    The data and time of the disclosure.

    info_disclosed_desc

    Free form textual description of the information disclosed.

    info_requested_desc

    Free form text description of the requested information.

    reason_cd

    A code indicating why information about the patient was disclosed.

    requested_dttm

    Date the disclosed patient information was requested.

    urgency_cd

    A code indicating the priority of the request by a requester.

    Connection definitions for: Patient_information_disclosure

    pertains_to (1,1) :: Patient :: has (0,M)

    is_provided_to (1,1) :: Patient_information_recipient :: is_the_recipient_of (0,M)

    Class: Patient_information_recipient

    Description of: Patient_information_recipient

    Class steward is Patient Administration
    A role played by the stakeholder. This role is the recipient of patient information.

    Connection definitions for: Patient_information_recipient

    is_the_recipient_of (0,M) :: Patient_information_disclosure :: is_provided_to (1,1)

    is_a_role_of (1,1) :: Stakeholder :: takes_on_role_of (0,1)

    Class: Patient_problem

    Description of: Patient_problem

    Class steward is Patient Care
    The patient condition or complaint of the patient in a patient encounter.

    Attribute definitions for: Patient_problem

    currently_active_ind

    A indication that the patient problem is an active problem.

    id

    A unique identifier of the patient's problem.

    nm

    The name of the patient problem.

    prefix_qualifier_txt

    A prefix modifying the problem identified by the patient problem identifier.

    severity_cd

    A code depicting the severity of the patient's problem.

    suffix_qualifier_txt

    A prefix modifying the problem identified by the patient problem identifier.

    Connection definitions for: Patient_problem

    is_a (0,1) :: Problem :: is_a (1,1)

    is_involved_in (1,M) :: Patient_encounter :: involves (0,M)

    Class: Patient_referral

    Description of: Patient_referral

    Class steward is Inter-Enterprise (ADT/Finance/Inter-Enterprise)
    Interested committees Patient Administration
    An introduction of a patient from one caregiver to another caregiver or provider institution. The referral may authorize the patient to receive Healthcare services. A referral may authorize a specified quantity of a particular kind or level of service. A referral may also simply be a recommendation or introduction.

    Attribute definitions for: Patient_referral

    authorized_visits_qty

    The number of authorized referral visits.

    desc

    Free form text describing the referral.

    reason_txt

    Free form text providing the reason for the referral.

    Class: Patient_service_event

    Description of: Patient_service_event

    Class steward is Orders/Observation
    The rendering of a Healthcare service to a patient.

    ISSUE: Should there be an Observation Service Event specialization Patient Service Event?

    Attribute definitions for: Patient_service_event

    attestation_dt

    The date the service provider attests that the patient service was delivered as documented.

    attestation_due_dt

    The date attestation is due for this patient service.

    begin_dttm :: TS

    Date the patient service begins.

    |OBR^7^00241^Observation Date/Time| |RXA^3^00345^Date/Time Start of Administration|

    charge_to_practice_amt :: CM

    Monetary amount for the charge to the ordering entitiy for the studies performed when applicable.

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |OBR^23^00256^Charge To Practice|

    charge_to_practice_cd :: CM

    Charge code for the charge to the ordering entitiy for the studies performed when applicable.

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |OBR^23^00256^Charge To Practice|

    confidential_ind

    indicates whether patient considers this procedure to be confidential.

    consent_code :: CE

    A code depicting the type of consent that was obtained for permission to treat the patient. May not represent consent from the patient.

    |PR1^13^00403^Consent Code|

    declined_ind

    An indication that the patient service was declined.

    desc

    Text that describes the service performed along with relevant details of the service.

    end_dttm :: TS

    The end date and time for the patient service.

    |OBR^8^00242^Observation End Date/Time| |RXA^4^00346^Date/Time End of Administration|

    filler_id :: EI

    The patient service unique identifier This is often assigned by the filler, but may be assigned by other processes. This attribute must use the EI datatype in all messages.

    |FT1^23^00217^Filler Order Number| |OBR^3^00217^Filler Order Number| |ORC^3^00217^Filler Order Number| |TXA^15^00217^Filler Order Number|

    filler_order_status_cd :: ID

    Status of the fulfillment of an order. This status is originated by the filler. This is different from the status of the order itself, which is represented by ORC/ Order Control. This is NOT a trigger event.

    Rationale: represents the ORC order control code, not the ORC Order Status (status of order fulfillment by the filler).

    OpenIssue:

    |ORC^5^00219^Order Status|

    filler_order_status_dttm :: TS

    Indicates the date and time that a status, as defined in Order Status, is entered or changed. Note: Order Status represents the status of order fulfillment by the filler. This is different from Order Control Code, which reflects the status of the order from the placer's viewpoint.

    Rationale: to represent the use of this V2.3 field as the date and time of change in ORC/ order status.

    OpenIssue:

    |OBR^22^00255^Results Rpt/Status Chng - Date/Time|

    recurring_service_cd :: IS

    A code indicating a recurring service and the nature of the recursion.

    |PV2^31^00732^Recurring Service Code|

    results_status_cd :: ID

    Status of results for this event.

    Rationale: alignment with V2.3 name. missing definition in RIM08.

    OpenIssue:

    |OBR^25^00258^Result Status|

    scheduled_start_dttm :: TS

    The date the patient service is scheduled to begin.

    |OBR^36^00268^Scheduled Date/Time|

    service_event_desc

    A description of the service event.

    Connection definitions for: Patient_service_event

    is_associated_with (0,M) :: Financial_transaction :: pertains_to (1,1)

    has_as_participant (1,M) :: Service_event_provider :: is_participant_for (1,1)

    is_document_by (0,M) :: Clinical_document_header :: documents (0,M)

    is_performed_at (0,1) :: Patient_service_location :: is_location_for (0,M)

    Rationale: support references to facilities in OBR; the parts of a pharmacy_service_event may be performed at several locations, which will be represented by relationships from each of the parts.

    may_result_in (0,M) :: Clinical_observation :: may_occur_during (0,1)

    Rationale: Some observations (eg. those forwarded from other institutions) may come from "Service events" of no interest to the recipient. The requirement that each observation have a Service Event should therefore be removed from the model.

    OpenIssue:

    is_required_by (0,M) :: Pathway :: requires (0,M)

    fulfills (0,1) :: Patient_service_order :: is_fulfilled_by (0,M)

    uses (0,M) :: Service_event_specimen :: is_used_during (1,1)

    delivers (1,1) :: Master_service :: is_delivered_during (0,M)

    is_charged_to (0,1) :: Patient_billing_account :: has_charges_for (0,M)

    Whole-part definitions for: Patient_service_event

    is_part_of (1,1) :: Patient_encounter :: has_parts (0,M)

    Class: Patient_service_location

    Description of: Patient_service_location

    Class steward is Patient Administration
    A place where patient services are delivered.

    Attribute definitions for: Patient_service_location

    addr

    Address of the location.

    closing_dt

    Closing date of the location.

    description :: ST

    optional freetext description of the location

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |LOC^2^00944^Location Description|

    email_address :: XTN

    the e-mail address for the patient location, if any.

    Rationale: required by components of V2.3 field (XTN datatype)

    OpenIssue: this is not a location oriented data item

    |LOC^6^00949^Location Phone|

    id :: PL

    A unique identifier of a patient care location.

    |NPU^1^00209^Bed Location| |PV1^39^00169^Servicing Facility| |RXA^11^00353^Administered-at Location| |RXD^13^00299^Dispense/deliver-to Location| |RXE^8^00299^Dispense/deliver-to Location| |RXG^11^00299^Dispense/deliver-to Location| |RXO^8^00299^Dispense/deliver-to Location|

    licensed_bed_qty

    The number of licensed beds at the location.

    nm

    name of the location.

    opening_dt

    Opening date of the location.

    phon

    Phone at the location.

    service_specialty_cd

    The specialty code of the service.

    status_cd

    A code indicating the status of the location.

    type_cd

    A code indicating the type of patient care location (e.g., hospital, clinic, hospital ward, room, bed, . . .).

    Connection definitions for: Patient_service_location

    has (0,M) :: Location_encounter_role :: pertains_to (1,1)

    is_entry_location_for (0,m) :: Patient_service_order :: is_entered_at (1,1)

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    is_primary_facility_for (0,M) :: Patient :: has_as_primary_facility (0,1)

    is_included_in (0,1) :: Patient_service_location :: includes (0,M)

    belongs_to (0,M) :: Patient_service_location_group :: contains (1,m)

    receives_medication_dispense_recorded_on (0,M) :: Treatment_service_give :: records_dispense_to (1,1)

    Rationale: specify dispense location for individual give notices

    OpenIssue:

    receives_medication_delivery_specified_on (0,1) :: Treatment_service_order_revision :: specifies_medication_delivery_to (0,1)

    Rationale:

    OpenIssue: Orders committee asked for this to be connected to the class "Patient_service_order_revision", but there is no such class in the model.

    receives (0,M) :: Treatment_service_dispense :: is_dispensed_to (1,1)

    Rationale: specify location for individual dispenses

    OpenIssue:

    is_requested_by (0,m) :: Patient_service_location_request :: requests (1,1)

    is_location_for (0,M) :: Patient_service_event :: is_performed_at (0,1)

    Rationale: support references to facilities in OBR; the parts of a pharmacy_service_event may be performed at several locations, which will be represented by relationships from each of the parts.

    houses (0,M) :: Health_chart :: is_housed_at (1,1)

    includes (0,M) :: Patient_service_location :: is_included_in (0,1)

    provides_services_on_behalf_of (1,M) :: Healthcare_provider_organization :: provides_patient_services_at (0,M)

    Whole-part definitions for: Patient_service_location

    is scheduled by (0,m) :: Patient_service_location_slot :: is a scheduleable unit for (1,1)

    Class: Patient_service_location_group

    Description of: Patient_service_location_group

    Class steward is Inter-Enterprise (ADT/Finance/Inter-Enterprise)
    A pool of like-type locations available for scheduling purposes.

    Rationale: Currently in 2.3

    OpenIssue:

    Attribute definitions for: Patient_service_location_group

    id

    Unique identifier for the group

    Rationale: Currently in 2.3

    OpenIssue:

    |AIL^4^00905^Location Group|

    Connection definitions for: Patient_service_location_group

    is_requested_by (0,m) :: Patient_service_location_request :: may_request (0,1)

    contains (1,m) :: Patient_service_location :: belongs_to (0,M)

    Class: Patient_service_location_request

    Description of: Patient_service_location_request

    Class steward is Inter-Enterprise (ADT/Finance/Inter-Enterprise)
    Request information about specific locations that are controlled by a schedule

    Rationale: Specializes the request by type of resource

    OpenIssue: We must disambiguate the difference between Orders and Schedules

    Connection definitions for: Patient_service_location_request

    requests (1,1) :: Patient_service_location :: is_requested_by (0,m)

    may_request (0,1) :: Patient_service_location_group :: is_requested_by (0,m)

    Class: Patient_service_location_slot

    Description of: Patient_service_location_slot

    Class steward is Inter-Enterprise (ADT/Finance/Inter-Enterprise)
    An allocation of time defined when a specific location is available for use for a healthcare service.

    Rationale: future

    OpenIssue:

    Whole-part definitions for: Patient_service_location_slot

    is a scheduleable unit for (1,1) :: Patient_service_location :: is scheduled by (0,m)

    Class: Patient_service_order

    Description of: Patient_service_order

    Class steward is Orders/Observation
    An authoritative direction or instruction concerning Healthcare services for a patient.

    Attribute definitions for: Patient_service_order

    charge_type_cd :: ID

    A code identifying someone or something other than the patient to be billed for this service.

    |BLG^2^00235^Charge Type|

    clarification_phone :: XTN

    Telephone number to call for clarification of request or other information regarding the order

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |ORC^14^00228^Call Back Phone Number|

    end_condition_cd

    A code depicting a condition that when satisfied should end the series of service orders.

    entering_device_code :: CE

    Identifier of the physical device (terminal,PC) used to enter the order

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |ORC^18^00232^Entering Device|

    escort_required_indicator :: ID

    an indicator that the patient needs to be escorted to the diagnostic service department. Note: The nature of the escort requirements is captured in another attribute.

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |OBR^42^01033^Escort Required|

    expected_performance_time_qty

    Time expected to perform this service instance for the target.

    Rationale:

    OpenIssue:

    filler_order_id

    This attribute must use the EI datatype in all messages.

    Rationale: these are alternate keys to the class

    OpenIssue:

    |FT1^23^00217^Filler Order Number| |OBR^3^00217^Filler Order Number| |ORC^3^00217^Filler Order Number| |TXA^15^00217^Filler Order Number|

    filler_txt

    order_control_code :: ID

    A code indicating the status of the patient service order.

    Rationale: ORC/Order Control and OBR/Order Status need separate representation in the RIM. This RIM08 attribute was selected to represent the ORC field, and renamed accordingly.

    OpenIssue: should this name remain "status", or should the description be changed?

    |ORC^1^00215^Order Control|

    order_control_reason_code :: CE

    Explanation (either in coded or text form) of the reason for the order event.

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |ORC^16^00230^Order Control Code Reason|

    order_effective_datetime :: TS

    Date/time that the changes to the order took effect or are suppossed to take effect

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |ORC^15^00229^Order Effective Date/Time|

    order_group_id :: EI

    A composite identifier of a service order. Including the order id and the ordering application. Allows an order placing application to group sets of orders together and subsequently identify them. This attribute must use the EI datatype in all messages.

    Rationale: previously unmatched V2.3 field

    |ORC^4^00218^Placer Group Number|

    order_id :: EI

    A unique identifier for the patient service order.

    |FT1^23^00217^Filler Order Number| |OBR^2^00216^Placer Order Number| |OBR^3^00217^Filler Order Number| |ORC^2^00216^Placer Order Number| |ORC^3^00217^Filler Order Number| |TXA^14^00216^Placer Order Number| |TXA^15^00217^Filler Order Number|

    order_placed_dt :: TS

    The date the order was placed.

    |ORC^9^00223^Date/Time of Transaction|

    order_quantitytiming_qt

    A means of specifying when the service described by the order segment is to be performed and how frequently. It is a complex multicomponent field that can have repeats. If a specimen is required for the order, the Priority component contains specimen collection priority rather than processing priority)

    Rationale:

    OpenIssue:

    placer_order_id

    This attribute must use the EI datatype in all messages.

    Rationale: these are alternate keys to the class. renamed to match definition

    OpenIssue:

    |OBR^2^00216^Placer Order Number| |ORC^2^00216^Placer Order Number| |TXA^14^00216^Placer Order Number|

    placer_txt

    planned_patient_transport_code :: CE

    code or free text comments on special requirements for the transport of the patient to the diagnostic service department

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |OBR^43^01034^Planned Patient Transport Comment|

    report_results_to_phone :: XTN

    A phone number to be used to report results from the service order.

    Rationale: to differente this attribute from ORC/Call Back phone number, which has a different meaning both from this attribute, and from this attribute's related V2.3 field: OBR/ order callback phone.

    |OBR^17^00250^Order Callback Phone Number| |ORC^14^00228^Call Back Phone Number|

    response_requested_cd :: ID

    A code used to allow the placer application to determine the amount of information to be returned from the filler.

    |ORC^6^00220^Response Flag|

    service_body_site_code :: CM

    Body site where service is to be performed. Example sites are ears, arm, eye.

    Rationale: previously unmatched usage for V2.3 field

    OpenIssue:

    |OBR^15^00249^Specimen Source|

    service_body_site_modifier_code :: CM

    Site modifier describing the site where the service should be performed. For example, the site could be anticubital foss, and the site modifier "right."

    Rationale: previously unmatched usage for V2.3 field

    OpenIssue:

    |OBR^15^00249^Specimen Source|

    service_body_source_code :: CM

    Source name or code describing the site where the service should be performed. Example coded values are abscess, blood arterial, blood bag, burn, dose med or blood, ear, filter, gastric fluid, marrow, patient, tissue, urine

    Rationale: previously unmatched usage for V2.3 field

    OpenIssue: need to make the description a little bit clearer.

    |OBR^26^00259^Parent Result|

    target_of_service_cd

    Object which is target of the service

    Rationale: This is not necessarily the patient.

    OpenIssue: In order to make this consistent, Orders must move Processing_time and Typical_turnaround_time from the Master_observation_service to this class.

    transport_arranged_indicator :: ID

    indicator of whether transport arrangements are known to have been made.

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |OBR^41^01032^Transport Arranged|

    transport_arrangement_responsibility_code :: CE

    An indicator of who is responsible for arranging transport of the patient to the planned diagnostic service. Examples: Requester, Provider, Patient

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |OBR^40^01031^Transport Arrangement Responsibility|

    transport_mode_cd :: ID

    A code indicating how (or whether) to transport a patient.

    |OBR^30^00262^Transportation Mode|

    when_to_charge_datetime :: CM

    Date & time to charge for the ordered service.

    Rationale: required by components of V2.3 field

    OpenIssue:

    |BLG^1^00234^When to Charge|

    when_to_charge_text :: CM

    A code determining the timing of billing the charges associated with the order service item.

    Rationale: alignment with V2.3 component datatype

    |BLG^1^00234^When to Charge|

    Connection definitions for: Patient_service_order

    is_an_instance_of (1,1) :: Master_service :: is_instantiated_as (0,M)

    has_as_subject (0,1) :: Patient :: may_be_the_subject_of (0,M)

    is_fulfilled_by (0,M) :: Patient_service_event :: fulfills (0,1)

    is_parent_of (0,M) :: Patient_service_order :: is_child_of (0,1)

    targets (0,M) :: Problem :: is_the_target_of (0,M)

    may_be_referred_to_in (0,M) :: Clinical_document_header :: is_related_to (0,1)

    Rationale:

    OpenIssue: If we have the linkage between patient service event and healthcare chart document header right, this might not be needed as it duplicates existing connections. This is pending joint work between Information Management, Orders/Observations, and Patient Care committees.

    has (1,M) :: Order_healthcare_practitioner :: is_for (1,1)

    is_billed_to (0,1) :: Patient_billing_account :: is_billed_from (0,M)

    Rationale: supports use of BLG segment in the ORM message

    OpenIssue: Open issue: needs joint work with OO-PAFM

    is_entered_at (1,1) :: Patient_service_location :: is_entry_location_for (0,m)

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    has_as_parent_result (0,1) :: Clinical_observation :: is_parent_of (0,M)

    Rationale: to support concept of Parent Result in OBR

    OpenIssue:

    is_child_of (0,1) :: Patient_service_order :: is_parent_of (0,M)

    Class: Patient_slot

    Description of: Patient_slot

    Class steward is Inter-Enterprise (ADT/Finance/Inter-Enterprise)
    An allocation of time defined when a patient is available to receive a healthcare service.

    Rationale: future

    OpenIssue:

    Whole-part definitions for: Patient_slot

    is a scheduleable unit for (1,1) :: Patient :: is scheduled by (0,m)

    Class: Person

    Description of: Person

    Class steward is Patient Administration
    A type of stakeholder. An individual human being.

    Attribute definitions for: Person

    birth_dttm :: TS

    The date and time of a person's birth.

    |GT1^8^00412^Guarantor Date/Time of Birth| |IN1^18^00443^Insured's Date of Birth| |NK1^16^00110^Date/Time of Birth| |PID^7^00110^Date/Time of Birth| |STF^6^00110^Date/Time of Birth|

    birthplace_nm :: ST

    The place the person was born.

    |PID^23^00126^Birth Place|

    citizenship_country_cd :: IS

    The current citizenship of a person.

    |GT1^35^00129^Citizenship| |IN2^33^00129^Citizenship| |NK1^19^00129^Citizenship| |PID^26^00129^Citizenship|

    confidentiality_constraint_cd :: ID

    A code depicting the nature of publicity protections in place for this person.

    |GT1^38^00743^Publicity Indicator| |GT1^39^00744^Protection Indicator| |IN2^36^00743^Publicity Indicator| |IN2^37^00744^Protection Indicator| |NK1^22^00743^Publicity Indicator| |NK1^23^00744^Protection Indicator| |PV2^21^00722^Visit Publicity Code|

    deceased_dttm :: TS

    The date and time that a person's death occurred.

    |GT1^24^00775^Guarantor Death Date And Time| |PID^29^00740^Patient Death Date and Time|

    deceased_ind :: ID

    A indication that the person is dead.

    |GT1^25^00776^Guarantor Death Flag|

    disability_cd :: IS

    A code identifying a person disability.

    |GT1^52^00753^Handicap| |IN1^48^00753^Handicap| |NK1^36^00753^Handicap| |PD1^6^00753^Handicap|

    education_level_cd

    The amount of education a person achieved.

    ethnic_group_cd :: IS

    The ethnic group of the person.

    |GT1^44^00125^Ethnic Group| |IN2^42^00125^Ethnic Group| |NK1^28^00125^Ethnic Group| |PID^22^00125^Ethnic Group|

    gender_cd :: IS

    A code depicting the gender (sex) of a person.

    |GT1^9^00413^Guarantor Sex| |IN1^43^00468^Insured's Sex| |NK1^15^00111^Sex| |PID^8^00111^Sex| |STF^5^00111^Sex|

    language_cd :: CE

    A code identifying a language.

    |GT1^36^00118^Primary Language| |IN2^34^00118^Primary Language| |NK1^20^00118^Primary Language| |PID^15^00118^Primary Language|

    marital_status_cd :: IS

    A code depicting the marital status of a person.

    |GT1^30^00781^Guarantor Marital Status Code| |IN2^43^00119^Marital Status| |NK1^14^00119^Marital Status| |PID^16^00119^Marital Status| |STF^17^00119^Marital Status|

    military_branch_of_service_cd :: IS

    A person's military branch of service.

    |IN2^14^00485^Champus Service|

    military_rank_nm :: IS

    The name of a person's military rank.

    |IN2^15^00486^Champus Rank/Grade|

    military_status_cd :: CE

    The military status of a person.

    |PID^27^00130^Veterans Military Status|

    nationality_cd :: CE

    A code depicting the nationality of a person.

    |GT1^43^00739^Nationality| |IN2^41^00739^Nationality| |NK1^27^00739^Nationality| |PID^28^00739^Nationality|

    primary_name_representation_code :: XPN

    An indication of the representation of the primary name. This attriubute does not necessarily specify the character sets used. Current codes are defined for Ideographic, Alphabetic, Phonetic.

    Rationale: required by components of V2.3 field

    OpenIssue:

    |GT1^3^00407^Guarantor Name|

    primary_name_type_code :: XPN

    Represents the type of name, eg. Alias, Legal, Display ...

    Rationale: required by components of V2.3 field

    OpenIssue:

    |PID^5^00108^Patient Name|

    primary_prsnm :: XPN

    The primary name of a person.

    |DG1^16^00390^Diagnosing Clinician| |GT1^3^00407^Guarantor Name| |GT1^4^00408^Guarantor Spouse Name| |GT1^45^00748^Contact Person Name| |IN1^6^00431^Insurance Co. Contact Ppers| |IN1^16^00441^Name of Insured| |IN2^9^00480^Champus Sponsor Name| |IN2^23^00494^Special Coverage Approval Title| |IN2^49^00789^Employer Contact Person Name| |IN2^52^00792^Insured’s Contact Person’s Name| |IN3^3^00504^Certified By| |IN3^8^00509^Operator| |IN3^14^00515^Physician Reviewer| |IN3^15^00516^Certification Contact| |IN3^21^00522^Case Manager| |IN3^25^00526^Second Opinion Physician| |NK1^2^00191^Name| |NK1^30^00748^Contact Person Name| |PID^5^00108^Patient Name|

    race_cd :: IS

    A code depicting the race of a person.

    |IN2^71^00113^Race| |NK1^35^00113^Race| |PID^10^00113^Race|

    religious_affiliation_cd :: IS

    A person's religious preference.

    |GT1^41^00120^Religion| |IN2^39^00120^Religion| |NK1^25^00120^Religion| |PID^17^00120^Religion|

    student_ind :: IS

    An indicator that the person is a student.

    |GT1^40^00745^Student Indicator| |IN2^38^00745^Student Indicator| |NK1^24^00745^Student Indicator| |PD1^5^00745^Student Indicator|

    very_important_person_ind :: IS

    And indication that the person is an VIP.

    |PV1^16^00146^VIP Indicator|

    Connection definitions for: Person

    takes_on_role_of (0,1) :: Contact_person :: is_a_role_of (1,1)

    takes_on_role_of (0,1) :: Employee :: is_a_role_of (1,1)

    takes_on_role_of (0,1) :: Individual_healthcare_practitioner :: is_a_role_of (1,1)

    has (0,M) :: Person_alternate_name :: is_for (1,1)

    takes_on_role_of (0,1) :: Advance_directive_witness :: is_a_role_of (1,1)

    enters (0,M) :: Financial_transaction :: is_entered_by (1,1)

    takes_on_role_of (0,1) :: Notary_public :: is_a_role_of (1,1)

    has (0,1) :: Person_birth_event :: pertains_to (1,1)

    may_act_in_rhe_role_of (0,1) :: Transcriptionist :: is_identified_as (1,1)

    takes_on_role_of (0,1) :: Patient :: is_a_role_of (1,1)

    Class: Person_alternate_name

    Description of: Person_alternate_name

    Class steward is Patient Administration
    A additional name by which a person is or has been known.

    Attribute definitions for: Person_alternate_name

    effective_dt

    The effective date of the person's alternate name.

    name_representation_code :: XPN

    An indication of the representation of the person's name. This attriubute does not necessarily specify the character sets used. Current codes are defined for Ideographic, Alphabetic, Phonetic.

    Rationale: required by components of V2.3 field

    OpenIssue: may be part of an attribute type mapping to a compound datatype

    |PID^6^00109^Mother's Maiden Name|

    prsnm :: XPN

    Other names by which a person is known.

    |GT1^36^00118^Primary Language| |GT1^42^00746^Mother’s Maiden Name| |IN2^7^00478^Medicaid Case Name| |IN2^34^00118^Primary Language| |IN2^40^00746^Mother’s Maiden Name| |NK1^20^00118^Primary Language| |NK1^26^00746^Mother’s Maiden Name| |PID^15^00118^Primary Language|

    reason_cd

    A code indicating the reason the alternate person name is used.

    termination_dt

    The termination date of the person's alternate name.

    type_cd

    A code indicating the type of alternate name (e.g., nickname, alias, maiden name, legal, adopted, . . .).

    Connection definitions for: Person_alternate_name

    is_for (1,1) :: Person :: has (0,M)

    is_used_by (0,M) :: Stakeholder :: refers_to_person_by (0,M)

    Class: Person_birth_event

    Description of: Person_birth_event

    Class steward is Patient Administration
    The act or process of bearing or bringing forth offspring. The information contained in this pertains to the newborn (not the mother.)

    Attribute definitions for: Person_birth_event

    baby_detained_ind :: ID

    An indication that the baby in a person birth event is detained after the mother's discharge.

    |PV2^37^00738^Baby Detained Indicator|

    birth_certificate_id

    A unique identifier assigned to a person's birth certificate.

    birth_city_nm

    The name of the city the birth took place in.

    birth_country_cd

    A code depicting the country the birth occurred in.

    birth_method_cd

    A code depicting the method of birth (e.g., cesarian, vaginal, forceps, . . .).

    birth_order_nbr :: NM

    The ordinal position the person is born in a multiple-birth birth event.

    |PID^25^00128^Birth Order|

    birth_recorded_county_cd

    The county in which the person's birth record is recorded.

    birth_recorded_dt

    The date the birth event was recorded.

    birth_state_cd

    The state or province in which the birth event took place.

    delivery_dt :: TS

    The delivery date of the birth event.

    |NK1^16^00110^Date/Time of Birth| |PID^7^00110^Date/Time of Birth| |STF^6^00110^Date/Time of Birth|

    multiple_birth_ind :: ID

    An indication that the birth was a multiple birth event.

    |PID^24^00127^Multiple Birth Indicator|

    newborn_days_qty

    The number of days in a patient encounter in which there is a person birth event that is allocated to the newborn.

    stillborn_ind

    An indication that the baby in the birth event was stillborn.

    Connection definitions for: Person_birth_event

    pertains_to (1,1) :: Person :: has (0,1)

    Whole-part definitions for: Person_birth_event

    is_part_of (1,1) :: Patient_encounter :: has_parts (0,M)

    Class: Person_employment

    Description of: Person_employment

    Class steward is Patient Administration
    The state of being employed. An occupation by which a person earns a living; work; business.

    Attribute definitions for: Person_employment

    addr

    address of the person's work site.

    effective_dt :: DT

    The date the person's employment begins.

    |GT1^31^00782^Guarantor Hire Effective Date| |IN2^44^00787^Employment Start Date|

    hazard_exposure_txt

    The type of hazards a person is exposed to in their employment.

    job_class_cd :: CM

    A code depicting the job classification used by the employer for the job related to the person employment.

    |GT1^50^00786^Job Code/Class| |IN2^47^00786^Job Code/Class| |NK1^11^00200^Next of Kin Job/Associated Parties Code/Class| |STF^19^00786^Job Code/Class|

    job_title_nm :: ST

    The title of the job held.

    |GT1^49^00785^Job Title| |IN2^22^00493^Special Coverage Approval Name| |IN2^46^00785^Job Title| |NK1^10^00199^Next of Kin/Associated Parties Job Title| |STF^18^00785^Job Title|

    phon :: XTN

    The telephone number of a person at the persons place of service.

    |PID^14^00117^Phone Number - Business|

    protective_equipment_txt

    Protective equipment needed for employment.

    salary_amt

    A person's salary amount.

    salary_type_cd

    A salary type (e.g., hourly, annual, commission, . . .).

    status_cd :: IS

    A code depicting the status of the person's employment.

    |GT1^20^00424^Guarantor Employment Status| |GT1^53^00752^Job Status| |IN1^42^00467^Insured's Employment Status| |IN2^48^00752^Job Status| |NK1^34^00752^Job Status|

    termination_dt :: DT

    Date the person's employment ends.

    |GT1^32^00783^Employment Stop Date| |IN2^45^00783^Employment Stop Date|

    Connection definitions for: Person_employment

    has_as_employer (1,1) :: Employer :: is_employer_of (0,M)

    has_as_employee (1,1) :: Employee :: is_employee_in (0,M)

    Class: Preauthorization

    Description of: Preauthorization

    Class steward is Patient Administration
    An authorization for patient services by a third party prior to the delivery of the patient service.

    Attribute definitions for: Preauthorization

    authorized_encounters_amt

    The number of authorized encounters.

    authorized_period_begin_dt

    The date the authorized period begins.

    authorized_period_end_dt

    The end date of the authorized period.

    id

    A unique identifier assigned to the pre authorization.

    Rationale: IN1-28

    OpenIssue:

    |IN1^28^00453^Pre-Admit Cert (PAC)|

    issued_dttm

    The date and time the pre authorization is issued.

    requested_dttm

    The date and time the preauthorization was created.

    restriction_desc

    A description of restrictions associated with the preauthorization.

    status_cd

    A code depicting the status of a preauthorization.

    status_change_dttm

    The date and time of the last status change.

    Connection definitions for: Preauthorization

    is_issued_by (1,1) :: Insurer :: issues (0,M)

    authorizes (1,M) :: Patient_encounter :: is_authorized_by (0,1)

    Class: Primary_care_provider_assignment

    Description of: Primary_care_provider_assignment

    Class steward is Patient Administration

    Connection definitions for: Primary_care_provider_assignment

    has_as_care_provider (1,1) :: Individual_healthcare_practitioner :: participates_in (0,M)

    has_as_care_recipient (1,1) :: Patient :: participates_in (0,1)

    is_governed_by (0,1) :: Healthcare_benefit_plan :: governs (0,M)

    Class: Problem

    Description of: Problem

    Class steward is Patient Care
    A problem addressed by a patient pathway.

    Attribute definitions for: Problem

    action_cd

    Event reason for including the problem

    Rationale:

    OpenIssue:

    |GOL^1^00816^Action Code| |PRB^1^00816^Action Code| |PTH^1^00816^Action Code| |ROL^2^00816^Action Code|

    action_dttm

    Event date time

    Rationale:

    OpenIssue:

    |GOL^2^00817^Action Date/Time| |PRB^2^00817^Action Date/Time|

    actual_resolution_dttm

    The date the patient problem is resolved.

    classification_cd

    A code used to categorize the patient problem.

    confirmation_status_cd

    A code depicting the level of verification for the patient problem (e.g., confirmed, differential, provisional, rule-out, . . .).

    established_dttm

    Date time the problem was documented and thus established as a problem

    Rationale: Conformance with 2.3

    OpenIssue:

    |PRB^7^00842^Date/Time Problem Established|

    estimated_resolution_dttm

    The estimated date and time of the patient problem resolution.

    family_awareness_desc

    An indication of the patient's family or significant other's comprehension of the actual problem/prognosis.

    id

    A unique identifier assigned to the patient problem.

    individual_awareness_cd

    A indication of the patient's comprehension of the problem.

    life_cycle_status_dttm

    The effective data and time of the current problem status.

    lifecycle_status_cd

    A code depicting the current status of the problem (e.g., active, active-improving, active-stable, active-worsening, inactive, resolved, . . .).

    managment_discipline_cd

    A code depicting the caregiver discipline responsible for managing the patient problem.

    onset_desc

    A textual description of when the problem began.

    onset_dttm

    The date/time the patient problem began.

    persistence_cd

    A textual description of the perseverance of a master problem.

    probability_pct

    A quantitative numerical representation of the certainty that the problem exist for the patient.

    problem_certainty_txt

    A qualitative representation of the certainty of the problem (e.g., high, medium, low, . . .).

    problem_list_priority_num

    Priority of the problem within the scope of the entire problem list.

    Rationale: Conformance with 2.3

    OpenIssue:

    |PRB^6^00841^Master Problem List Number|

    prognosis_awareness_desc

    A indication of the patient's awareness of the prognosis for the problem.

    prognosis_desc

    A textual description of the prognosis for a patient problem.

    ranking_desc

    Prioritization of the problem (e.g., numeric ranking or the use of words such as primary, secondary, . . .).

    sensitivity_cd

    A code depicting the level of security or sensitivity surrounding the problem.

    Connection definitions for: Problem

    specified_in (0,1) :: Episode :: specfies (0,m)

    is_a (1,1) :: Patient_problem :: is_a (0,1)

    is_an_instance_of (1,1) :: Master_problem :: is_instanciated_as (0,M)

    is_the_target_of (0,M) :: Patient_service_order :: targets (0,M)

    is_targeted_by (1,M) :: Pathway :: targets (0,M)

    Class: Procedure

    Description of: Procedure

    Class steward is Orders/Observation
    A therapeutic or diagnostic intervention employed in response to a patient condition.

    Attribute definitions for: Procedure

    anaesthesia_cd :: IS

    A code identifying the anaesthesia used in a procedure.

    |PR1^9^00399^Anesthesia Code|

    anesthesia_minutes_qty :: NM

    A count of the anesthesia minutes involved in the procedure.

    |PR1^10^00400^Anesthesia Minutes|

    delay_reason_txt

    The reason for delay of the surgery patient service.

    incision_closed_dttm

    The data and time of the closing incision of the surgery patient service.

    incision_open_dttm

    The data and time of the opening incision of the surgery patient service.

    priority_number :: NM

    A number indicating the relative priority of the procedure to all other procedures provided in this encounter.

    |PR1^14^00404^Procedure Priority|

    procedure_cd :: CE

    A code used to identify a procedure.

    |FT1^25^00393^Procedure Code| |PR1^3^00393^Procedure Code|

    procedure_dttm :: TS

    The date/time of the procedure.

    |PR1^5^00395^Procedure Date/Time|

    procedure_functional_type_cd :: IS

    A code identifying the functional type of the procedure.

    |PR1^6^00396^Procedure Type|

    procedure_minute_qty :: NM

    The length of the procedure, measured in minutes.

    |PR1^7^00397^Procedure Minutes|

    Class: Producer_Of_Master_Service

    Description of: Producer_Of_Master_Service

    Class steward is Orders/Observation
    The person or organization that offers to provide this service to the patient.

    Rationale: support use of Producer ID in V2.3 OM1

    OpenIssue: General consensus that we would like a more robust definition. There is a question as to whether or not this has anything to do with being authorized to do the service. There is v2.3 ambiguity that we need to fix. Unclear if it is the name of a lab?

    Attribute definitions for: Producer_Of_Master_Service

    service_producing_department_type_cd :: CE

    field permits the sorting of observation orders and values by the providing service's department/section. The codes for this field should be taken from ASTM Table 15 (Diagnostic Service Codes)

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |OM1^16^00601^Observation Producing Department/Section|

    Connection definitions for: Producer_Of_Master_Service

    produces (0,1) :: Master_service :: is_produced_by (0,m)

    Rationale: support use of Producer ID in V2.3 OM1

    OpenIssue:

    has_as_participant (1,1) :: Healthcare_service_provider :: participates_as (0,M)

    Class: Reported_patient_accident

    Description of: Reported_patient_accident

    Class steward is Patient Administration
    An undesirable or unfortunate happening that occurs unintentionally and usually results in harm, injury, damage, or loss.

    Attribute definitions for: Reported_patient_accident

    accident_death_ind :: ID

    An indication that the accident resulted in death.

    Rationale: specific to this usage; alignment with V2.3 language

    |ACC^6^00814^Accident Death Indicator|

    accident_desc

    Free form textual description of the accident.

    accident_dttm :: TS

    The date and time the accident occurred.

    Rationale: alignment with V2.3 language

    |ACC^1^00527^Accident Date/Time|

    accident_location_desc :: ST

    A description of the location of the accident.

    Rationale: specific to this usage

    |ACC^3^00529^Accident Location|

    accident_state_cd :: CE

    The state in which the accident occurred.

    Rationale: state is a location (don't need both location and state in the name); specific to this usage

    |ACC^4^00812^Auto Accident State|

    accident_type_cd :: CE

    A code depicting the type of accident.

    |ACC^2^00528^Accident Code|

    job_related_accident_ind :: ID

    An indication that the accident is work related.

    Rationale: as modeled, this is a characteristic of the accident, which is not the same as an injury.

    |ACC^5^00813^Accident Job Related Indicator|

    Class: Resource_request

    Description of: Resource_request

    Class steward is Inter-Enterprise (ADT/Finance/Inter-Enterprise)
    Individual resource request information about various kinds of resources that are controlled by a schedule.

    Rationale: Currently in 2.3

    OpenIssue:

    Attribute definitions for: Resource_request

    allowable_substitutions_cd

    A code indicating whether the identified resource can be substituted with an equivalent resource.

    Rationale: Currently in 2.3

    OpenIssue:

    |AIG^12^00895^Allow Substitution Code| |AIL^10^00895^Allow Substitution Code| |AIP^10^00895^Allow Substitution Code| |AIS^8^00895^Allow Substitution Code|

    duration_qty

    The duration for which the resource is requested for this appointment, if it is different than the overall duration of the appointment

    Rationale: Currently in 2.3

    OpenIssue:

    |AIG^10^00893^Duration| |AIL^8^00893^Duration| |AIP^8^00893^Duration| |AIS^6^00893^Duration|

    start_dttm

    Date and time this resource is requested for the appointment.

    Rationale: Currently in 2.3

    OpenIssue:

    |AIG^7^01202^Start Date/Time| |AIL^5^01202^Start Date/Time| |AIP^5^01202^Start Date/Time| |AIS^3^01202^Start Date/Time|

    start_offset_qty

    The offset that this resource is requested for the appointment, expressed in units of time relative to the scheduled start date/time of the appointment.

    Rationale: Currently in 2.3

    OpenIssue:

    status_cd

    A code that describes the request status of scheduling a resource or activity, from the point of view of the filler application.

    Rationale: Currently in 2.3

    OpenIssue:

    |AIG^13^00889^Filler Status Code| |AIL^11^00889^Filler Status Code| |AIP^11^00889^Filler Status Code| |AIS^9^00889^Filler Status Code| |SCH^22^00889^Filler Status Code|

    Connection definitions for: Resource_request

    is_requested_by (1,1) :: Appointment_request :: requests (0,m)

    Class: Resource_slot

    Description of: Resource_slot

    Class steward is Inter-Enterprise (ADT/Finance/Inter-Enterprise)
    An allocation of time on a schedule for a resource that must be reserved prior to its use.

    Rationale: Currently in 2.3

    OpenIssue:

    Attribute definitions for: Resource_slot

    offset_qty

    Offset from start date and time when this allocated use will begin

    Rationale: future

    OpenIssue:

    quantity

    Number of slots allocated to a given purpose

    Rationale: future

    OpenIssue:

    resource_type_cd

    Type of resource controlled by this set of slots: provider, location, or equipment.

    Rationale: future

    OpenIssue:

    slot_state_cd

    Current status for this set of slots: available, booked, or blocked.

    Rationale: future

    OpenIssue:

    start_dttm

    Start date and time for this set of slots

    Rationale: future

    OpenIssue:

    Connection definitions for: Resource_slot

    is_reserved_by (0,m) :: Appointment :: reserves (0,m)

    Class: Risk_management_incident

    Description of: Risk_management_incident

    Class steward is Patient Administration
    An occurrence of an event pertaining or attaching to a patient encounter.

    Attribute definitions for: Risk_management_incident

    incident_cd

    A code depicting the incident type (e.g., body fluid exposure, equipment problem, inpatient fall, medication error, . . .).

    incident_dttm

    The date and time the incident occurred.

    incident_severity_cd

    A code depicting the potential impact of an incident on the quality of patient care.

    incident_type_cd

    A code depicting a classification of the incident type (e.g., preventable, user error, . . .).

    Connection definitions for: Risk_management_incident

    pertains_to (1,1) :: Patient_encounter :: has (0,M)

    Class: Schedule

    Description of: Schedule

    Class steward is Inter-Enterprise (ADT/Finance/Inter-Enterprise)
    The schedule in which appointments are booked. Used for instances in which filler applications maintain multiple schedules and when a particular resource or set of resources is controlled by more than one of those schedules

    Rationale: Currently in 2.3

    OpenIssue:

    Attribute definitions for: Schedule

    id

    Uniquue identifier for a Schedule.

    Rationale: Currently in 2.3

    OpenIssue: Needs to be further fleshed out. Is it needed as a class if it is this thin?

    |ARQ^5^00864^Schedule ID| |SCH^5^00864^Schedule ID|

    Connection definitions for: Schedule

    contains (0,m) :: Appointment :: are_booked_in (1,m)

    Class: Service_event_provider

    Description of: Service_event_provider

    Class steward is Orders/Observation
    An association between a healthcare service provider and a patient service event.

    Attribute definitions for: Service_event_provider

    participation_type_cd

    A code depicting the type of participation the healthcare service provider has in the patient service event.

    Connection definitions for: Service_event_provider

    includes_the_participation_of (1,1) :: Healthcare_service_provider :: participates_as (0,M)

    is_participant_for (1,1) :: Patient_service_event :: has_as_participant (1,M)

    Class: Service_event_specimen

    Description of: Service_event_specimen

    Class steward is Orders/Observation
    An association between an analyzed object and a service event.

    Attribute definitions for: Service_event_specimen

    analyzed_object_action_cd

    A code depicting the action taken upon the analyzed object in the context of a service event.

    specimen_received_dttm :: TS

    The data and time the specimen was received for use in the service event.

    |OBR^14^00248^Specimen Received Date/Time|

    Connection definitions for: Service_event_specimen

    is_used_during (1,1) :: Patient_service_event :: uses (0,M)

    is_sourced_from (1,1) :: Collected_specimen_sample :: is_source_for (0,M)

    Class: Service_request

    Description of: Service_request

    Class steward is Inter-Enterprise (ADT/Finance/Inter-Enterprise)
    Interested committees Patient Care
    Request information about various kinds of services that are controlled by a schedule.

    Rationale: Currently in 2.3

    OpenIssue: Should services be handled separately from resources? Make certin that resource requests for scheduling are different from ordered service requests in Orders.

    Attribute definitions for: Service_request

    allowable_substitutions_cd

    A code indicating whether the identified service can be substituted with an equivalent service.

    Rationale: Currently in 2.3

    OpenIssue:

    |AIG^12^00895^Allow Substitution Code| |AIL^10^00895^Allow Substitution Code| |AIP^10^00895^Allow Substitution Code| |AIS^8^00895^Allow Substitution Code|

    duration_qty

    The duration for which the service is requested for this appointment, if it is different than the overall duration of the appointment

    Rationale: Currently in 2.3

    OpenIssue:

    |AIG^10^00893^Duration| |AIL^8^00893^Duration| |AIP^8^00893^Duration| |AIS^6^00893^Duration|

    start_dttm

    Date and time this service is requested for the appointment.

    Rationale: Currently in 2.3

    OpenIssue:

    |AIG^7^01202^Start Date/Time| |AIL^5^01202^Start Date/Time| |AIP^5^01202^Start Date/Time| |AIS^3^01202^Start Date/Time|

    start_offset_qty

    The offset that this service is requested for the appointment, expressed in units of time relative to the scheduled start date/time of the appointment.

    Rationale: Currently in 2.3

    OpenIssue:

    |AIG^8^00891^Start Date/Time Offset| |AIL^6^00891^Start Date/Time Offset| |AIP^6^00891^Start Date/Time Offset| |AIS^4^00891^Start Date/Time Offset|

    status_cd

    A code that describes the request status of scheduling a service, from the point of view of the filler application.

    Rationale: Currently in 2.3

    OpenIssue:

    |AIG^13^00889^Filler Status Code| |AIL^11^00889^Filler Status Code| |AIP^11^00889^Filler Status Code| |AIS^9^00889^Filler Status Code| |SCH^22^00889^Filler Status Code|

    Connection definitions for: Service_request

    is_requested_by (1,1) :: Appointment_request :: requests (0,m)

    Class: Stakeholder

    Description of: Stakeholder

    Class steward is Patient Administration
    A person or organization that has an investment, share, or interest in healthcare.

    Attribute definitions for: Stakeholder

    addr :: XAD

    The address of a stakeholder.

    |GT1^5^00409^Guarantor Address| |GT1^17^00421^Guarantor Employer Address| |IN1^5^00430^Insurance Company Address| |IN1^19^00444^Insured's Address| |IN1^44^00469^Insured's Employer Address| |NK1^4^00193^Address| |OM1^28^00613^Address of Outside Site(s)| |PID^11^00114^Patient Address| |PID^12^00115^County Code|

    credit_rating_cd :: CE

    A code depicting the credit rating of a stakeholder.

    |GT1^23^00774^Guarantor Credit Rating Code| |PV1^23^00153^Credit Rating|

    email_address_txt

    The email address of a stakeholder.

    phon :: XTN

    The phone number of a stakeholder.

    |GT1^6^00410^Guarantor Ph Num- Home| |GT1^7^00411^Guarantor Ph Num-Business| |GT1^18^00422^Guarantor Employ Phone Number| |GT1^46^00749^Contact Person’s Telephone Number| |IN1^7^00432^Insurance Co Phone Number| |IN2^50^00790^Employer Contact Person Phone Number| |IN2^53^00793^Insured’s Contact Person Telephone Number| |IN2^58^00798^Insurance Co Contact Phone Number| |IN2^63^00803^Insured’s Telephone Number - Home| |IN2^64^00804^Insured’s Employer Telephone Number| |IN3^16^00517^Certification Contact Phone Number| |IN3^19^00520^Certification Agency Phone Number| |NK1^6^00195^Business Phone Number| |NK1^31^00749^Contact Person’s Telephone Number| |OM1^17^00602^Telephone Number of Section| |OM1^29^00614^Phone Number of Outside Site| |PID^13^00116^Phone Number - Home|

    type_cd

    A code depicting the type of stakeholder (e.g., person, organization, . . .).

    Connection definitions for: Stakeholder

    refers_to_person_by (0,M) :: Person_alternate_name :: is_used_by (0,M)

    may_act_as_a (0,1) :: Document_recipient :: is_a (1,1)

    takes_on_role_of (0,1) :: Patient_clinical_item_source :: is_a_role_of (1,1)

    takes_on_role_of (0,1) :: Insurance_certification_contact :: is_a_role_of (1,1)

    takes_on_role_of (0,1) :: Patient_information_recipient :: is_a_role_of (1,1)

    takes_on_role_of (0,1) :: Guarantor :: is_a_role_of (1,1)

    takes_on_role_of (0,1) :: Healthcare_document_authenticator :: is_a (1,1)

    takes_on_role_of (0,1) :: Originator :: is_a (1,1)

    collects (0,M) :: Collected_specimen_sample :: is_collected_by (1,1)

    takes_on_role_of (0,1) :: Stakeholder_affiliate :: is_a_role_of (1,1)

    participates_as_primary_in (0,M) :: Stakeholder_affiliation :: has_as_primary_participant (1,1)

    takes_on_role_of (0,1) :: Employer :: is_a_role_of (1,1)

    is_assigned (0,M) :: Stakeholder_identifier :: is_assigned_to (1,1)

    takes_on_role_of (0,1) :: Health_benefit_plan_purchaser :: is_a_role_of (1,1)

    Class: Stakeholder_affiliate

    Description of: Stakeholder_affiliate

    Class steward is Patient Administration
    A person or organization which has an affiliation with another stakeholder.

    Attribute definitions for: Stakeholder_affiliate

    family_relationship_cd :: CE

    A code indicating the familiar relationship that exist between the affiliated [person-]stakeholders (e.g., brother, sister, parent, spouse, . . .).

    |GT1^11^00415^Guarantor Relationship| |GT1^48^00784^Contact Relationship Code| |IN1^17^00442^Insured's Relationship to Patient| |IN2^62^00802^Guarantor’s Relationship To Insured| |IN2^72^00811^HCFA Patient Relationship to Insured| |NK1^3^00192^Relationship|

    Connection definitions for: Stakeholder_affiliate

    is_a_role_of (1,1) :: Stakeholder :: takes_on_role_of (0,1)

    participates_as_secondary_in (0,M) :: Stakeholder_affiliation :: has_as_secondary_participant (1,1)

    Class: Stakeholder_affiliation

    Description of: Stakeholder_affiliation

    Class steward is Patient Administration
    A association between one stakeholder and another.

    Attribute definitions for: Stakeholder_affiliation

    affiliation_type_cd :: CE

    A code indicating the nature of the affiliation between the associated stakeholders (e.g., employer, emergency contact, next of kin, . . .).

    |GT1^11^00415^Guarantor Relationship| |IN2^11^00482^Dependent of Champus Recipient| |NK1^7^00196^Contact Role|

    desc

    Description of the stakeholder affiliation.

    effective_dt :: DT

    The date the affiliation between the associated stakeholders begins.

    |IN2^55^00795^Relationship To The Patient Start Date| |NK1^8^00197^Start Date|

    termination_dt :: DT

    The date the affiliation between the associated stakeholders ends.

    |IN2^56^00796^Relationship To The Patient Stop Date| |NK1^9^00198^End Date|

    Connection definitions for: Stakeholder_affiliation

    has_as_primary_participant (1,1) :: Stakeholder :: participates_as_primary_in (0,M)

    has_as_secondary_participant (1,1) :: Stakeholder_affiliate :: participates_as_secondary_in (0,M)

    Class: Stakeholder_identifier

    Description of: Stakeholder_identifier

    Class steward is Patient Administration
    A unique identifier assigned to a person or organization.

    Attribute definitions for: Stakeholder_identifier

    effective_dt

    The effective date of the identifier.

    identification_txt :: XON

    A unique identifier assigned to a stakeholder.

    |FT1^13^00367^Department Code| |FT1^20^00372^Performed By Code| |FT1^21^00373^Ordered By Code| |FT1^24^00765^Entered By Code| |GT1^2^00406^Guarantor Number| |GT1^12^00416^Guarantor SSN| |GT1^19^00423^Guarantor Employee ID Number| |GT1^29^00780^Guarantor Employer ID Number| |IN1^3^00428^Insurance Company ID| |IN1^8^00433^Group Number| |IN1^10^00435^Insured's Group Emp Name| |IN2^1^00472^Insured's Employee ID| |IN2^2^00473^Insured's Social Security Number| |IN2^4^00475^Employer Information Data| |IN2^10^00481^Champus ID Number| |IN2^25^00496^Payor ID| |IN2^26^00497^Payor Subscriber ID| |IN2^61^00801^Patient Member Number| |IN2^70^00810^Insured Employer Organization Name And ID| |MRG^1^00211^Prior Patient ID - Internal| |MRG^2^00212^Prior Alternate Patient ID| |MRG^4^00214^Prior Patient ID - External| |NK1^1^00190^Set ID - NK1| |NK1^12^00201^Next of Kin/Associated Parties Employee Number| |OBR^10^00244^Collector Identifier| |OBR^16^00226^Ordering Provider| |OBR^28^00260^Result Copies To| |OBR^32^00264^Principal Result Interpreter| |OBR^33^00265^Assistant Result Interpreter| |OBR^34^00266^Technician| |OBR^35^00267^Transcriptionist| |OBX^15^00583^Producer's ID| |OBX^16^00584^Responsible Observer| |OM1^5^00590^Producer ID| |ORC^10^00224^Entered By| |ORC^11^00225^Verified By| |ORC^12^00226^Ordering Provider| |ORC^17^00231^Entering Organization| |ORC^19^00233^Action By| |PID^2^00105^Patient ID (External ID)| |PID^3^00106^Patient ID (Internal ID)| |PID^4^00107^Alternate Patient ID - PID| |PID^6^00109^Mother's Maiden Name| |PID^19^00122^SSN Number - Patient| |PID^20^00123^Driver's License| |PR1^12^00402^Procedure Practitioner| |PV1^31^00161^Bad Debt Agency Code| |RXA^10^00352^Administering Provider| |RXD^10^00341^Dispensing Provider| |RXE^13^00305^Ordering Provider's DEA Number| |RXE^14^00306^Pharmacist Verifier ID| |RXO^14^00305^Ordering Provider's DEA Number| |RXO^15^00306^Pharmacist Verifier ID| |STF^22^00123^Driver's License|

    identifier_assigning_facility_name :: XCN

    name of the facility responsible for assigning a particular stakeholder identifier

    Rationale: required by components of V2.3 field

    OpenIssue:

    |DG1^16^00390^Diagnosing Clinician|

    identifier_assigning_facility_UID_txt :: XCN

    Universal Identifier (UID) for the stakeholder identifier assigning facility.

    Rationale: required by components of V2.3 field

    OpenIssue:

    |IN3^8^00509^Operator|

    identifier_assigning_facility_uid_type_txt :: XCN

    The one of the specifically enumerated schemes for constructing UIDÕs to which the UID for the assigning facility for the stankholder identifier belongs. The UID must follow the syntactic rules of the particular universal identifier scheme (defined by the UID type).

    Rationale: required by components of V2.3 field

    OpenIssue:

    |IN3^3^00504^Certified By|

    identifier_check_digit_txt

    A check digit assigned to the identifier based upon the identification text and the check digit scheme.

    identifier_check_digit_type_cd

    A code identifying the check digit scheme used for the identifier check digit.

    identifier_coding_system_name :: CE

    name of the coding system for a particular stakeholder identifier

    Rationale: required by components of V2.3 field

    OpenIssue:

    |FT1^13^00367^Department Code|

    identifier_source_table :: XCN

    User defined table which is the source for the stakeholder identifier.

    Rationale: required by components of V2.3 field

    OpenIssue:

    |DG1^16^00390^Diagnosing Clinician|

    identifier_type_cd

    A code identifying the type of identifier.

    issued_dt

    Date the identifier is issued.

    qualifying_information_txt :: CM

    information used to limit the applicability of a stakeholder identifier, such as the state or province in which the identifier is valid.

    Rationale: required by components of V2.3 field

    OpenIssue:

    |PRA^6^00690^Practitioner ID Numbers|

    source_table :: XCN

    User defined table which is the source for the stakeholder identifier.

    Rationale: required by components of V2.3 field

    OpenIssue:

    |PV1^8^00138^Referring Doctor|

    termination_dt

    The date the identification is no longer in effect.

    Connection definitions for: Stakeholder_identifier

    is_assigned_to (1,1) :: Stakeholder :: is_assigned (0,M)

    is_issued_by (1,1) :: Identifier_issuing_authority :: issues (0,M)

    Class: Transcriptionist

    Description of: Transcriptionist

    Class steward is Information Management (Medical Records)
    This field identifies the person transcribing the document. This is a conditional value; it is required on all transcribed documents.

    Rationale: TXA - 11(00924)

    OpenIssue:

    Connection definitions for: Transcriptionist

    is_identified_as (1,1) :: Person :: may_act_in_rhe_role_of (0,1)

    transcribes (0,M) :: Clinical_document_header :: is_transcribed_by (0,1)

    Class: Treatment_service_administration

    Description of: Treatment_service_administration

    Class steward is Orders/Observation
    Actual route of the administration of medication as part of a pharmacy treatment.

    Attribute definitions for: Treatment_service_administration

    actual_administration_PTcomp :: PTcomp

    Specification for one component of the administered medication or treatment.

    Rationale:

    OpenIssue:

    |RXC^4^00316^Component Units|

    actual_administration_PTrout :: PTrout

    The device used to administer the medication.

    |RXR^3^00311^Administration Device|

    administered_rate_txt :: ST

    The rate at which this medication was administered.

    Rationale: V2.3 field is ST datatype; Steward agreed that "rate" is a better understood term than "per_time_unit".

    |RXA^12^00354^Administered Per (Time Unit)|

    administration_begin_dttm :: TS

    If the order is for a continuous administration (such as an IV), and the rate is changed at a certain time after the start, a new pharmacy service administration is created when the rate changes. This field records the time the rate was changed.

    Rationale: to record begin times of individual administrations during a service event

    OpenIssue:

    |RXA^3^00345^Date/Time Start of Administration|

    administration_counter_qty :: NM

    A count of the number of times the medication is administered.

    Rationale: removes possible misinterpretation as quantity administered.

    |RXA^2^00344^Administration Sub-ID Counter|

    administration_end_dttm :: TS

    The date and time the medication administration ended. If null, the administration is assumed to be of no material length (ie. date/time start of administration is assumed to be date/time end of administration as well).

    Rationale: to record ending times of individual administrations during a service event

    OpenIssue:

    |RXA^4^00346^Date/Time End of Administration|

    completion_status_cd :: ID

    Status of treatment administration event

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |RXA^20^01223^Completion Status|

    Indication_code :: CE

    This field contains the identifier of the condition or problem for which the drug/treatment was prescribed.

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |RXA^19^01123^Indication| |RXD^21^01123^Indication| |RXG^22^01123^Indication| |RXO^20^01123^Indication|

    notes_from_administration_cd :: CE

    Free text notes from the provider administering the medication.

    Rationale: CE datatype in V2.3. alignment with V2.3 language. administration notes appears in two different V2.3 segments, with different meanings. this naming differentiates between the two meanings.

    |RXA^9^00351^Administration Notes| |RXG^9^00351^Administration Notes|

    substance_expiration_dttm :: TS

    the expiration date of the medical substance

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |RXA^16^01130^Substance Expiration Date| |RXD^19^01130^Substance Expiration Date| |RXG^20^01130^Substance Expiration Date|

    substance_lot_number_txt :: ST

    This field contains the lot number of the medical substance.

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |RXA^15^01129^Substance Lot Number| |RXD^18^01129^Substance Lot Number| |RXG^19^01129^Substance Lot Number|

    substance_manufacturer_cd :: CE

    This field contains the manufacturer of the medical substance administered

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |RXA^17^01131^Substance Manufacturer Name| |RXD^20^01131^Substance Manufacturer Name| |RXG^21^01131^Substance Manufacturer Name|

    substance_refusal_reason_cd :: CE

    This field contains the reason the patient refused the medical substance. Any entry in the field indicates that the patient did not take the substance

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |RXA^18^01136^Substance Refusal Reason|

    substitution_cd

    A code indicating the medication was a substitution for the one ordered.

    system_entry_dttm :: TS

    Date/time the administration information was entered into the source system. This field is used to detect instances where treatment administration information is inadvertently entered multiple times by providing a unique identification field. Under usual circumstances, this field would be provided automatically by the computer system rather than being entered by a person

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |RXA^22^01225^System Entry Date/Time|

    Connection definitions for: Treatment_service_administration

    references (1,1) :: Treatment_service_give :: is_referenced_on (0,M)

    delivers (0,1) :: Master_treatment_service :: is_delivered_during (0,m)

    Rationale: link medication given to service catalog

    OpenIssue:

    Whole-part definitions for: Treatment_service_administration

    is_part_of (1,1) :: Treatment_service_event :: has_parts (0,M)

    Class: Treatment_service_dispense

    Description of: Treatment_service_dispense

    Class steward is Orders/Observation
    Notification of a pharmacy treatment dispense.

    Attribute definitions for: Treatment_service_dispense

    dispense_counter_qty :: NM

    A count of the number of times the medication was dispensed.

    Rationale: removes possible misinterpretation as quantity dispensed

    |RXD^1^00334^Dispense Sub-ID| |RXG^2^00334^Dispense Sub-ID|

    dispense_notes_txt :: CE

    Free form text notes to the person dispensing the medication .

    Rationale: alignment with V2.3 language; althouth V2.3 field is CE datatype, CE no longer supports free text in V3.0

    |RXD^9^00340^Dispense Notes|

    dispense_package_method_cd :: ID

    the method by which treatment is dispensed, eg. Traditional, unit-dose, floor stock, automatic dispensing

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |RXD^24^01222^Dispense Package Method| |RXE^30^01222^Dispense Package Method|

    dispense_package_size_amt :: NM

    This field contains the size of package to be dispensed

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |RXD^22^01220^Dispense Package Size| |RXE^28^01220^Dispense Package Size|

    dispense_PTcomp :: PTcomp

    Specification for one component of the dispensed medication or treatment.

    Rationale:

    OpenIssue:

    |RXC^4^00316^Component Units|

    dispense_PTrout :: PTrout

    Specification for one route of administration for the dispensed medication or treatment. Specification includes route, site, administration device and administration method.

    Rationale:

    OpenIssue:

    |RXR^3^00311^Administration Device|

    dispensed_dttm :: TS

    The date and time the medication is dispensed.

    |RXD^3^00336^Date/Time Dispensed|

    indication_cd :: CE

    This field contains the identifier of the condition or problem for which the drug/treatment was prescribed.

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |RXA^19^01123^Indication| |RXD^21^01123^Indication| |RXG^22^01123^Indication| |RXO^20^01123^Indication|

    needs_human_review_ind :: ID

    An indicator that the pharmacist filling the order needs to pay special attention to provider instructions.

    |RXD^14^00307^Needs Human Review| |RXE^20^00307^Needs Human Review| |RXG^12^00307^Needs Human Review| |RXO^16^00307^Needs Human Review|

    rejection_reason_txt

    Free form text describing the reason the medication dispensement was rejected.

    substance_expiration_dt

    Expiration date of the medication.

    Rationale: alignment with V2.3 language

    substance_lot_identifier

    This field contains the lot number of the medical substance.

    Rationale: alignment with V2.3

    |RXA^15^01129^Substance Lot Number| |RXD^18^01129^Substance Lot Number| |RXG^19^01129^Substance Lot Number|

    substance_manufacturer_cd :: CE

    This field contains the manufacturer of the medical substance administered

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |RXA^17^01131^Substance Manufacturer Name| |RXD^20^01131^Substance Manufacturer Name| |RXG^21^01131^Substance Manufacturer Name|

    substitution_cd :: NM

    A code identifying the potential of being able to substitute another pharmaceutical.

    |RXA^1^00342^Give Sub-ID Counter| |RXG^1^00342^Give Sub-ID Counter|

    suppliers_special_dispensing_instruction_cd :: CE

    Special instructions from the pharmacy or treatment supplier to the provider administering the order.

    Rationale: makes this specific to a particular V2.3 field

    |RXD^15^00330^Pharmacy/Treatment Supplier's Special Dispensing I| |RXE^21^00330^Pharmacy/Treatment Supplier's Special Dispensing I|

    total_daily_dose_amt :: CQ

    The daily dose amount.

    Rationale: alignment with V2.3 language

    |RXD^12^00329^Total Daily Dose| |RXE^19^00329^Total Daily Dose|

    Connection definitions for: Treatment_service_dispense

    is_referenced_on (0,M) :: Treatment_service_give :: references (1,1)

    dispenses (0,1) :: Master_treatment_service :: is_dispensed_during (0,m)

    Rationale: link medication dispensed to service catalog

    OpenIssue:

    is_dispensed_to (1,1) :: Patient_service_location :: receives (0,M)

    Rationale: specify location for individual dispenses

    OpenIssue:

    Whole-part definitions for: Treatment_service_dispense

    is_part_of (1,1) :: Treatment_service_event :: has_parts (0,M)

    Class: Treatment_service_event

    Description of: Treatment_service_event

    Class steward is Orders/Observation
    A type of service event in which a pharmacy or treatment service is performed.

    Attribute definitions for: Treatment_service_event

    prescription_id :: ST

    An identifier assigned to the pharmacy treatment service event.

    |RXD^7^00325^Prescription Number| |RXE^15^00325^Prescription Number|

    refills_remaining_qty :: NM

    The number of refills remaining.

    Rationale: V2.3 field is NM datatype. there is no unit of measure to specify.

    |RXD^8^00326^Number of Refills Remaining| |RXE^16^00326^Number of Refills Remaining|

    Whole-part definitions for: Treatment_service_event

    has_parts (0,M) :: Treatment_service_give :: is_part_of (1,1)

    has_parts (0,M) :: Treatment_service_dispense :: is_part_of (1,1)

    has_parts (0,M) :: Treatment_service_administration :: is_part_of (1,1)

    Class: Treatment_service_give

    Description of: Treatment_service_give

    Class steward is Orders/Observation
    The issuing of a pharmacy or treatment give notice.

    Attribute definitions for: Treatment_service_give

    administration_desc :: NM

    Free form text.

    |RXA^2^00344^Administration Sub-ID Counter| |RXG^13^00343^Pharmacy/Treatment Supplier Special Administration|

    give_counter_qty :: NM

    A count of the number of administrations of the drug.

    Rationale: V2.3 field is NM datatype. there is no unit of measure to specify.

    |RXA^1^00342^Give Sub-ID Counter| |RXG^1^00342^Give Sub-ID Counter|

    give_per_time_unit_cd :: ST

    The time unit used to calculate the rate at which the pharmaceutical is to be administered.

    Rationale: this is a pure unit of measure, not an amount with an associated unit. V2.3 field is coded.

    |RXE^22^00331^Give Per (Time Unit)| |RXG^14^00331^Give Per (Time Unit)|

    give_PTcomp :: PTcomp

    Specification for one component of the medication or treatment in the pharmacy give notice.

    Rationale:

    OpenIssue:

    |RXC^5^01124^Component Strength|

    give_PTrout :: PTrout

    Specification for one route of administration for the medication or treatment in the pharmacy give notice. Specification includes route, site, administration device and administration method.

    Rationale:

    OpenIssue:

    |RXR^3^00311^Administration Device|

    give_quantitytiming_qt :: TQ

    A means of specifying when the service described by the give notice is to be performed and how frequently. It is a complex multicomponent field that can have repeats. This field contains the quantity/timing specification that refers to either a single scheduled give instruction only or to multiple give instructions. In the former case, RXG-1-give sub-ID counter is a positive integer greater than or equal to one (1). In the latter case, RXG-1-give sub-ID counter is zero (0). The quantity will always be 1. The pharmacy or treatment department has the "authority" (and/or necessity) to schedule dispense/give events. Hence, the pharmacy or treatment department has the responsibility to encode this scheduling information for the pharmacy service order item and pharmacy service give notice. The quantity/timing for the patient service order does not change: it always specifies the requested give/dispense schedule of the original order

    |OBR^27^00221^Quantity/Timing| |ORC^7^00221^Quantity/Timing| |RXE^1^00221^Quantity/Timing| |RXG^3^00221^Quantity/Timing|

    give_rate_amt :: ST

    The amount (number) of substance to be administered.

    |RXE^23^00332^Give Rate Amount| |RXG^15^00332^Give Rate Amount|

    indication_code :: CE

    This field contains the identifier of the condition or problem for which the drug/treatment was prescribed.

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |RXA^19^01123^Indication| |RXD^21^01123^Indication| |RXG^22^01123^Indication| |RXO^20^01123^Indication|

    max_give_amt :: NM

    The maximum ordered amount.

    |RXE^4^00319^Give Amount - Maximum| |RXG^6^00319^Give Amount - Maximum|

    min_give_amt :: NM

    The minimum order amount.

    |RXE^3^00318^Give Amount - Minimum| |RXG^5^00318^Give Amount - Minimum|

    needs_human_review_ind :: ID

    An indication that the pharmacist filling the order needs to pay special attention to the order notes.

    |RXD^14^00307^Needs Human Review| |RXE^20^00307^Needs Human Review| |RXG^12^00307^Needs Human Review| |RXO^16^00307^Needs Human Review|

    substance_expiration_dttm :: TS

    the expiration date of the medical substance

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |RXA^16^01130^Substance Expiration Date| |RXD^19^01130^Substance Expiration Date| |RXG^20^01130^Substance Expiration Date|

    substance_lot_number_txt :: ST

    This field contains the lot number of the medical substance.

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |RXA^15^01129^Substance Lot Number| |RXD^18^01129^Substance Lot Number| |RXG^19^01129^Substance Lot Number|

    substance_manufacturer_cd :: CE

    This field contains the manufacturer of the medical substance administered

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |RXA^17^01131^Substance Manufacturer Name| |RXD^20^01131^Substance Manufacturer Name| |RXG^21^01131^Substance Manufacturer Name|

    substitution_status_cd :: ID

    A code indicating the status of a drug substitution in a pharmacy service give.

    |RXD^11^00322^Substitution Status| |RXE^9^00322^Substitution Status| |RXG^10^00322^Substitution Status|

    supplier_special_administration_instruction_cd :: CE

    pharmacy/treatment supplier-generated special instructions to the provider administering the order.

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |RXG^13^00343^Pharmacy/Treatment Supplier Special Administration|

    Connection definitions for: Treatment_service_give

    references (1,1) :: Treatment_service_dispense :: is_referenced_on (0,M)

    records_dispense_to (1,1) :: Patient_service_location :: receives_medication_dispense_recorded_on (0,M)

    Rationale: specify dispense location for individual give notices

    OpenIssue:

    is_referenced_on (0,M) :: Treatment_service_administration :: references (1,1)

    Whole-part definitions for: Treatment_service_give

    is_part_of (1,1) :: Treatment_service_event :: has_parts (0,M)

    Class: Treatment_service_order

    Description of: Treatment_service_order

    Class steward is Orders/Observation
    An authoritative direction or instruction concerning the dispensement of medication to a patient.

    Attribute definitions for: Treatment_service_order

    dosage_txt

    The dosage to be administered.

    earliest_dispense_dt

    The earliest date the medication can be dispensed.

    Indication_cd :: CE

    This field contains the identifier of the condition or problem for which the drug/treatment was prescribed.

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |RXA^19^01123^Indication| |RXD^21^01123^Indication| |RXG^22^01123^Indication| |RXO^20^01123^Indication|

    non_form_authorized_ind

    An indication that a pharmacy order for an out of formulary item is authorized.

    providers_treatment_instruction_txt :: CE

    Free form instructional text for the pharmacy order.

    Rationale: makes this specific to a particular V2.3 field

    |RXE^7^00298^Provider's Administration Instructions| |RXO^6^00297^Provider's Pharmacy Instructions| |RXO^7^00298^Provider's Administration Instructions|

    rejection_reason_cd

    A reason code for rejection of a pharmacy order.

    requested_give_rate_amt :: CE

    the rate at which to administer treatment, as specified by the ordering physician

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |RXO^22^01219^Requested Give Rate Units|

    requested_give_strength_amt :: CE

    Specifies the strength of the medication as requested on the order, when it is not included in the Universal Service Identifier

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |RXO^19^01122^Requested Give Strength Units|

    substitution_allowed_ind :: ID

    An indicator that a substitution medication is allowed.

    |RXO^9^00300^Allow Substitutions|

    supplier_special_dispensing_instruction_cd :: CE

    the pharmacy or treatment supplier's provider-generated special instructions to the provider dispensing/administering the order

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |RXD^15^00330^Pharmacy/Treatment Supplier's Special Dispensing I| |RXE^21^00330^Pharmacy/Treatment Supplier's Special Dispensing I|

    verification_required_ind

    An indication that verification is required.

    Whole-part definitions for: Treatment_service_order

    has_parts (1,M) :: Treatment_service_order_revision :: is_part_of (1,1)

    Class: Treatment_service_order_revision

    Description of: Treatment_service_order_revision

    Class steward is Orders/Observation
    The collection of characteristics for a pharmacy treatment order that can be revised during the course of processing the order. Pharmacy encoding is an example of a process that may revise order characteristics. This "revisions" class allows tracking of changes made to the order, and representation of the order at any stage in its processing.

    Rationale: Class name changed to better represent usage. There is no sense in which the contents of this class represent an "item" of the pharmacy order.

    OpenIssue: Note that this is used to surface the information carred in the Pharmacy Encoded segment of v2.3, and this name ‘revision’ may need to be changed to be more appropriate.

    Attribute definitions for: Treatment_service_order_revision

    dispense_package_method_cd :: ID

    the method by which treatment is dispensed, eg. Traditional, unit-dose, floor stock, automatic dispensing

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |RXD^24^01222^Dispense Package Method| |RXE^30^01222^Dispense Package Method|

    dispense_package_size_amt :: NM

    This field contains the size of package to be dispensed

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |RXD^22^01220^Dispense Package Size| |RXE^28^01220^Dispense Package Size|

    give_indication_cd :: CE

    condition or problem for which the drug/treatment was prescribed

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |RXE^27^01128^Give Indication|

    give_per_time_unit_cd :: ST

    The number of gives per unit of time.

    |RXE^22^00331^Give Per (Time Unit)| |RXG^14^00331^Give Per (Time Unit)| |RXO^17^00308^Requested Give Per (Time Unit)|

    give_rate_amt :: ST

    The rate of give for the medication.

    |RXE^23^00332^Give Rate Amount| |RXG^15^00332^Give Rate Amount|

    last_refilled_dttm :: ID

    A indication that the pharmacy order required human review.

    |RXD^14^00307^Needs Human Review| |RXE^20^00307^Needs Human Review| |RXG^12^00307^Needs Human Review| |RXO^16^00307^Needs Human Review|

    max_give_amt :: NM

    The maximum amount of medication to be administered.

    |RXE^4^00319^Give Amount - Maximum| |RXG^6^00319^Give Amount - Maximum| |RXO^3^00294^Requested Give Amount - Maximum|

    min_give_amt :: NM

    The minimum amount of medication to be administered.

    |RXE^3^00318^Give Amount - Minimum| |RXG^5^00318^Give Amount - Minimum| |RXO^2^00293^Requested Give Amount - Minimum|

    needs_human_review_ind

    An indication that a pharmacy order for an out of formulary item is authorized.

    order_revision_PTcomp :: PTcomp

    Specification for one component of the ordered medication or treatment

    Rationale:

    OpenIssue:

    |RXC^4^00316^Component Units|

    order_revision_PTrout :: PTrout

    Specification for one route of administration for the ordered medication or treatment. Specification includes route, site, administration device and administration method.

    Rationale:

    OpenIssue:

    |RXR^2^00310^Site|

    order_revision_quantitytiming_qt :: TQ

    A means of specifying when the service described by the give notice is to be performed and how frequently. It is a complex multicomponent field that can have repeats. The pharmacy or treatment department has the "authority" (and/or necessity) to schedule dispense/give events. Hence, the pharmacy or treatment department has the responsibility to encode this scheduling information for the pharmacy service order item and pharmacy service give notice. The quantity/timing for the patient service order does not change: it always specifies the requested give/dispense schedule of the original order

    Rationale:

    OpenIssue:

    ordered_administration_method_cd :: CE

    The method to be used to administer the medication.

    |RXR^4^00312^Administration Method|

    prescription_id :: TQ

    The information about how many services to perform at one service time and how often the service times are repeated, and to fix duration of the request.

    |OBR^27^00221^Quantity/Timing| |ORC^7^00221^Quantity/Timing| |RXE^1^00221^Quantity/Timing| |RXG^3^00221^Quantity/Timing|

    providers_administration_instruction_cd :: CE

    the ordering provider's instructions to the patient or the provider administering the drug or treatment

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |RXE^7^00298^Provider's Administration Instructions| |RXO^7^00298^Provider's Administration Instructions|

    refills_allowed_qty :: NM

    The number of refills doses dispensed.

    |RXE^17^00327^Number of Refills/Doses Dispensed|

    refills_doses_dispensed_qty :: NM

    The number of refills remaining.

    |RXD^8^00326^Number of Refills Remaining| |RXE^16^00326^Number of Refills Remaining|

    refills_remaining_qty :: NM

    The number of refills remaining.

    |RXD^8^00326^Number of Refills Remaining| |RXE^16^00326^Number of Refills Remaining|

    substitution_status_cd :: ID

    Substitution status of the pharmacy order.

    |RXD^11^00322^Substitution Status| |RXE^9^00322^Substitution Status| |RXG^10^00322^Substitution Status|

    suppliers_dispensing_instruction_cd :: CE

    the pharmacy or treatment supplier's provider-generated special instructions to the provider dispensing/administering the order

    Rationale: previously unmatched V2.3 field

    OpenIssue:

    |RXD^15^00330^Pharmacy/Treatment Supplier's Special Dispensing I| |RXE^21^00330^Pharmacy/Treatment Supplier's Special Dispensing I|

    total_daily_dose_amt :: CQ

    the total daily dose for this particular pharmaceutical as expressed in terms of actual dispense units.

    Rationale: all RXE fields should appear in RIM08 Pharmacy_service_order_item

    OpenIssue:

    |RXD^12^00329^Total Daily Dose| |RXE^19^00329^Total Daily Dose|

    total_daily_dose_cd :: CQ

    Total daily dosage code.

    |RXD^12^00329^Total Daily Dose| |RXE^19^00329^Total Daily Dose|

    Connection definitions for: Treatment_service_order_revision

    orders (0,1) :: Master_treatment_service :: is_ordered_on (0,m)

    Rationale: link medication on pharmacy_service_order_item to service catalog

    OpenIssue:

    specifies_medication_delivery_to (0,1) :: Patient_service_location :: receives_medication_delivery_specified_on (0,1)

    Rationale:

    OpenIssue: Orders committee asked for this to be connected to the class "Patient_service_order_revision", but there is no such class in the model.

    Whole-part definitions for: Treatment_service_order_revision

    is_part_of (1,1) :: Treatment_service_order :: has_parts (1,M)

    Stewardship for: DRAFT HL7 Reference Information Model

    Subject Area: STW_C02_Control_Query

    Subject Area: STW_C03_Pt_admin_Finance

    Subject Area: STW_C04_Orders_observations

    Subject Area: STW_C09_Medical_records

    Subject Area: STW_C10_Inter_enterprise

    Subject Area: STW_C12_Patient_care

    Interested committee for: DRAFT HL7 Reference Information Model

    Subject Area: COI_C036_PAFM

    Subject Area: COI_C047_Orders_Observations

    Subject Area: COI_C09_Medical_records

    Subject Area: COI_C12_Patient_care

    DIM for: DRAFT HL7 Reference Information Model