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ActRelationshipType      [2.16.840.1.113883.5.1002]

Description:

The source is an excerpt from the target.

Lvl- Typ Concept Code
  Head Code-defined Value Set
Print Name Definition, Properties, Relationships
0-S ART act relationship type

Definition:

Description: A directed association between a source Act and a target Act.

Usage Note: This code should never be transmitted in an instance as the value of ActRelationship.typeCode (attribute)

Concept Relationships:
  Generalizes (derived): COMP OUTC PERT SEQL VALUE _ActRelationshipConditional

1-S COMP
 v:ActRelationshipHasComponent
has component

Definition:

A collection of sub-services as steps or subtasks performed for the source service. Services may be performed sequentially or concurrently.

Concept Relationships:
  Specializes: ART
  Generalizes (derived): ARR CTRLV DEP

Concept Properties:   conductible: false   isDocumentCharacteristic: false   Name:Act:inboundRelationship:ActRelationship: componentOf   Name:Act:outboundRelationship:ActRelationship: component   Sort:Act:inboundRelationship:ActRelationship: E________   Sort:Act:outboundRelationship:ActRelationship: E________

2-L . . ARR
. .   v:ActRelationshipArrival
arrival

Definition:

The relationship that links to a Transportation Act (target) from another Act (source) indicating that the subject of the source Act entered into the source Act by means of the target Transportation act.

Concept Relationships:
  Specializes: COMP

Concept Properties:   isDocumentCharacteristic: false   Name:Act:inboundRelationship:ActRelationship: arrivalFor   Name:Act:outboundRelationship:ActRelationship: arrivedBy   Sort:Act:inboundRelationship:ActRelationship: EB_______   Sort:Act:outboundRelationship:ActRelationship: EB_______

2-L . . CTRLV
. .   v:ActRelationshipHasControlVariable
has control variable

Definition:

A relationship from an Act to a Control Variable. For example, if a Device makes an Observation, this relates the Observation to its Control Variables documenting the device's settings that influenced the observation.

Concept Relationships:
  Specializes: COMP

Concept Properties:   isDocumentCharacteristic: false   Name:Act:inboundRelationship:ActRelationship: controlVariableFor   Name:Act:outboundRelationship:ActRelationship: controlVariable   Sort:Act:inboundRelationship:ActRelationship: EA_______   Sort:Act:outboundRelationship:ActRelationship: EA_______

2-L . . DEP
. .   v:ActRelationshipDeparture
departure

Definition:

The relationship that links to a Transportation Act (target) from another Act (source) indicating that the subject of the source Act departed from the source Act by means of the target Transportation act.

Concept Relationships:
  Specializes: COMP

Concept Properties:   isDocumentCharacteristic: false   Name:Act:inboundRelationship:ActRelationship: departureFor   Name:Act:outboundRelationship:ActRelationship: departedBy   Sort:Act:inboundRelationship:ActRelationship: EC_______   Sort:Act:outboundRelationship:ActRelationship: EC_______

1-S OUTC
 v:ActRelationshipOutcome
has outcome

Definition:

An observation that should follow or does actually follow as a result or consequence of a condition or action (sometimes called "post-conditional".) Target must be an observation as a goal, risk or any criterion. For complex outcomes a conjunction attribute (AND, OR, XOR) can be used. An outcome link is often inverted to describe an outcome assessment.

Concept Relationships:
  Specializes: ART
  Generalizes (derived): GOAL RISK _ActRelationsipObjective

Concept Properties:   appliesTo: condition or action   conductible: false   howApplies: outcome   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: outcomeOf   Name:Act:outboundRelationship:ActRelationship: outcome   Sort:Act:inboundRelationship:ActRelationship: A________   Sort:Act:outboundRelationship:ActRelationship: A________

2-L . . GOAL
. .   v:ActRelationshipHasGoal
has goal

Definition:

A goal that one defines given a patient's health condition. Subsequently planned actions aim to meet that goal. Source is an observation or condition node, target must be an observation in goal mood.

Concept Relationships:
  Specializes: OUTC

Concept Properties:   appliesTo: observation, condition   howApplies: goal   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: goalOf   Name:Act:outboundRelationship:ActRelationship: goal   Sort:Act:inboundRelationship:ActRelationship: AB_______   Sort:Act:outboundRelationship:ActRelationship: AB_______

2-L . . RISK
. .   v:ActRelationshipHasRisk
has risk

Definition:

A noteworthy undesired outcome of a patient's condition that is either likely enough to become an issue or is less likely but dangerous enough to be addressed.

Concept Relationships:
  Specializes: OUTC

Concept Properties:   appliesTo: observation, condition   howApplies: risk   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: riskOf   Name:Act:outboundRelationship:ActRelationship: risk   Sort:Act:inboundRelationship:ActRelationship: AA_______   Sort:Act:outboundRelationship:ActRelationship: AA_______

2-A . . _ActRelationsipObjective
. .   v:ActRelationshipObjective
Act Relationsip Objective

Definition:

The target act is a desired outcome of the source act. Source is any act (typically an intervention). Target must be an observation in criterion mood.

Concept Relationships:
  Specializes: OUTC
  Generalizes (derived): OBJC OBJF

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: goalOf   Name:Act:outboundRelationship:ActRelationship: goal   Sort:Act:inboundRelationship:ActRelationship: AC_______   Sort:Act:outboundRelationship:ActRelationship: AC_______

3-L . . . OBJC
. . .   v:ActRelationshipHasContinuingObjective
has continuing objective

Definition:

A desired state that a service action aims to maintain. E.g., keep systolic blood pressure between 90 and 110 mm Hg. Source is an intervention service. Target must be an observation in criterion mood.

Concept Relationships:
  Specializes: _ActRelationsipObjective

Concept Properties:   appliesTo: service   howApplies: criterion   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: maintenanceGoalOf   Name:Act:outboundRelationship:ActRelationship: maintenanceGoal   Sort:Act:inboundRelationship:ActRelationship: ACA______   Sort:Act:outboundRelationship:ActRelationship: ACA______

3-L . . . OBJF
. . .   v:ActRelationshipHasFinalObjective
has final objective

Definition:

A desired outcome that a service action aims to meet finally. Source is any service (typically an intervention). Target must be an observation in criterion mood.

Concept Relationships:
  Specializes: _ActRelationsipObjective

Concept Properties:   appliesTo: service   howApplies: criterion   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: finalGoalOf   Name:Act:outboundRelationship:ActRelationship: finalGoal   Sort:Act:inboundRelationship:ActRelationship: ACB______   Sort:Act:outboundRelationship:ActRelationship: ACB______

1-S PERT
 v:ActRelationshipPertains
has pertinent information

Definition:

This is a very unspecific relationship from one item of clinical information to another. It does not judge about the role the pertinent information plays.

Concept Relationships:
  Specializes: ART
  Generalizes (derived): AUTH CAUS COVBY DRIV ELNK EVID EXACBY EXPL ITEMSLOC LIMIT META MFST NAME PREV REFR REFV RELVBY SPRT SUBJ SUMM _ActClassTemporallyPertains _ActRelationshipAccounting

Concept Properties:   appliesTo: any service   conductible: true   howApplies: any service   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: pertainsTo   Name:Act:outboundRelationship:ActRelationship: pertinentInformation   Sort:Act:inboundRelationship:ActRelationship: D________   Sort:Act:outboundRelationship:ActRelationship: D________

2-L . . AUTH
. .   v:ActRelationshipAuthorizedBy
authorized by

Definition:

A relationship in which the target act authorizes or certifies the source act.

Concept Relationships:
  Specializes: PERT

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: authorizationOf   Name:Act:outboundRelationship:ActRelationship: authorization   Sort:Act:inboundRelationship:ActRelationship: DH_______   Sort:Act:outboundRelationship:ActRelationship: DH_______

2-L . . CAUS
. .   v:ActRelationshipIsEtiologyFor
is etiology for

Definition:

Description: An assertion that an act was the cause of another act.This is stronger and more specific than the support link. The source (cause) is typically an observation, but may be any act, while the target may be any act.

Examples:

  • a growth of Staphylococcus aureus may be considered the cause of an abscess
  • contamination of the infusion bag was deemed to be the cause of the infection that the patient experienced
  • lack of staff on the shift was deemed to be a supporting factor (proximal factor) causing the patient safety incident where the patient fell out of bed because the bed-sides had not been put up which caused the night patient to fall out of bed

Concept Relationships:
  Specializes: PERT

Concept Properties:   appliesTo: cause   howApplies: effect   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: cause   Name:Act:outboundRelationship:ActRelationship: causeOf   Sort:Act:inboundRelationship:ActRelationship: DD_______   Sort:Act:outboundRelationship:ActRelationship: DD_______

2-L . . COVBY
. .   v:ActRelationshipCoveredBy
covered by

Definition:

A relationship in which the source act is covered by or is under the authority of a target act. A financial instrument such as an Invoice Element is covered by one or more specific instances of an Insurance Policy.

Concept Relationships:
  Specializes: PERT

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: coverageOf   Name:Act:outboundRelationship:ActRelationship: coverage   Sort:Act:inboundRelationship:ActRelationship: DP_______   Sort:Act:outboundRelationship:ActRelationship: DP_______

2-L . . DRIV
. .   v:ActRelationshipIsDerivedFrom
is derived from

Definition:

Associates a derived Act with its input parameters. E.G., an anion-gap observation can be associated as being derived from given sodium-, (potassium-,), chloride-, and bicarbonate-observations. The narrative content (Act.text) of a source act is wholly machine-derived from the collection of target acts.

Concept Relationships:
  Specializes: PERT

Concept Properties:   appliesTo: output parameter   howApplies: input parameter   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: derivation   Name:Act:outboundRelationship:ActRelationship: derivedFrom   Sort:Act:inboundRelationship:ActRelationship: DF_______   Sort:Act:outboundRelationship:ActRelationship: DF_______

2-L . . ELNK
. .   v:ActRelationshipEpisodelink
episodeLink

Definition:

Expresses an association that links two instances of the same act over time, indicating that the instance are part of the same episode, e.g. linking two condition nodes for episode of illness; linking two encounters for episode of encounter.

Concept Relationships:
  Specializes: PERT

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: linkedBy   Name:Act:outboundRelationship:ActRelationship: links   Sort:Act:inboundRelationship:ActRelationship: BG_______   Sort:Act:outboundRelationship:ActRelationship: BG_______

2-L . . EVID
. .   v:ActRelationshipProvidesEvidenceFor
provides evidence for

Definition:

Indicates that the target Act provides evidence in support of the action represented by the source Act. The target is not a 'reason' for the source act, but rather gives supporting information on why the source act is an appropriate course of action. Possible targets might be clinical trial results, journal articles, similar successful therapies, etc.

Rationale: Provides a mechanism for conveying clinical justification for non-approved or otherwise non-traditional therapies.

Concept Relationships:
  Specializes: PERT

Concept Properties:   isDocumentCharacteristic: true

2-L . . EXACBY
. .   v:ActRelationshipExacerbatredBy
exacerbated by

Definition:

Description:The source act is aggravated by the target act. (Example "chest pain" EXACBY "exercise")

Concept Relationships:
  Specializes: PERT

2-L . . EXPL
. .   v:ActRelationshipHasExplanation
has explanation

Definition:

This is the inversion of support. Used to indicate that a given observation is explained by another observation or condition.

Concept Relationships:
  Specializes: PERT

Concept Properties:   howApplies: explaining observation or condition   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: explanationFor   Name:Act:outboundRelationship:ActRelationship: explanation   Sort:Act:inboundRelationship:ActRelationship: DI_______   Sort:Act:outboundRelationship:ActRelationship: DI_______

2-L . . ITEMSLOC
. .   v:ActRelationshipItemsLocated
items located

Definition:

Items located

Concept Relationships:
  Specializes: PERT

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: itemStorageFor   Name:Act:outboundRelationship:ActRelationship: itemStorage   Sort:Act:inboundRelationship:ActRelationship: DR_______   Sort:Act:outboundRelationship:ActRelationship: DR_______

2-L . . LIMIT
. .   v:ActRelationshipLimitedBy
limited by

Definition:

A relationship that limits or restricts the source act by the elements of the target act. For example, an authorization may be limited by a financial amount (up to $500). Target Act must be in EVN.CRIT mood.

Concept Relationships:
  Specializes: PERT

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: limitationOf   Name:Act:outboundRelationship:ActRelationship: limitation   Sort:Act:inboundRelationship:ActRelationship: DQ_______   Sort:Act:outboundRelationship:ActRelationship: DQ_______

2-L . . META
. .   v:ActRelationshipHasMetadata
has metadata

Definition:

Definition: Indicates that the attributes and associations of the target act provide metadata (for example, identifiers, authorship, etc.) for the source act.

Constraint: Source act must have either a mood code that is not "EVN" (event) or its "isCriterion" attribute must set to "true". Target act must be an Act with a mood code of EVN and with isCriterionInd attribute set to "true".

Concept Relationships:
  Specializes: PERT

Concept Properties:   conductible: false   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: metadataFor   Name:Act:outboundRelationship:ActRelationship: metadata   Sort:Act:inboundRelationship:ActRelationship: DZ_______   Sort:Act:outboundRelationship:ActRelationship: AA_______

2-L . . MFST
. .   v:ActRelationshipIsManifestationOf
is manifestation of

Definition:

An assertion that a new observation may be the manifestation of another existing observation or action. This assumption is attributed to the same actor who asserts the manifestation. This is stronger and more specific than an inverted support link. For example, an agitated appearance can be asserted to be the manifestation (effect) of a known hyperthyroxia. This expresses that one might not have realized a symptom if it would not be a common manifestation of a known condition. The target (cause) may be any service, while the source (manifestation) must be an observation.

Concept Relationships:
  Specializes: PERT

Concept Properties:   appliesTo: manifestation   howApplies: cause   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: manifestation   Name:Act:outboundRelationship:ActRelationship: manifestationOf   Sort:Act:inboundRelationship:ActRelationship: DE_______   Sort:Act:outboundRelationship:ActRelationship: DE_______

2-L . . NAME
. .   v:ActRelationshipAssignsName
assigns name

Definition:

Used to assign a "name" to a condition thread. Source is a condition node, target can be any service.

Concept Relationships:
  Specializes: PERT

Concept Properties:   appliesTo: condition thread   howApplies: name   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: assignedConditionName   Name:Act:outboundRelationship:ActRelationship: conditionNamed   Sort:Act:inboundRelationship:ActRelationship: DJ_______   Sort:Act:outboundRelationship:ActRelationship: DJ_______

2-L . . PREV
. .   v:ActRelationshipHasPreviousInstance
has previous instance
Previous instance

Definition:

A relationship in which the target act is a predecessor instance to the source act. Generally each of these instances is similar, but no identical. In healthcare coverage it is used to link a claim item to a previous claim item that might have claimed for the same set of services.

Concept Relationships:
  Specializes: PERT

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: successor   Name:Act:outboundRelationship:ActRelationship: predecessor   Sort:Act:inboundRelationship:ActRelationship: DC_______   Sort:Act:outboundRelationship:ActRelationship: DC_______

2-S . . REFR
. .   v:ActRelationshipRefersTo
refers to

Definition:

A relationship in which the target act is referred to by the source act. This permits a simple reference relationship that distinguishes between the referent and the referee.

Concept Relationships:
  Specializes: PERT
  Generalizes (derived): USE

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: referencedBy   Name:Act:outboundRelationship:ActRelationship: reference   Sort:Act:inboundRelationship:ActRelationship: DK_______   Sort:Act:outboundRelationship:ActRelationship: DK_______

3-L . . . USE
. . .   v:ActRelationshipUses
uses

Definition:

Indicates that the source act makes use of (or will make use of) the information content of the target act.

UsageNotes: A usage relationship only makes sense if the target act is authored and occurs independently of the source act. Otherwise a simpler relationship such as COMP would be appropriate.

Rationale: There is a need when defining a clinical trial protocol to indicate that the protocol makes use of other protocol or treatment specifications. This is stronger than the assertion of "references". References may exist without usage, and in a clinical trial protocol is common to assert both: what other specifications does this trial use and what other specifications does it merely reference.

Concept Relationships:
  Specializes: REFR

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: usedBy   Name:Act:outboundRelationship:ActRelationship: uses   Sort:Act:inboundRelationship:ActRelationship: DKA______   Sort:Act:outboundRelationship:ActRelationship: DKA______

2-L . . REFV
. .   v:ActRelationshipHasReferenceValues
has reference values

Definition:

Reference ranges are essentially descriptors of a class of result values assumed to be "normal", "abnormal", or "critical." Those can vary by sex, age, or any other criterion. Source and target are observations, the target is in criterion mood. This link type can act as a trigger in case of alarms being triggered by critical results.

Concept Relationships:
  Specializes: PERT

Concept Properties:   howApplies: range   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: referenceRangeFor   Name:Act:outboundRelationship:ActRelationship: referenceRange   Sort:Act:inboundRelationship:ActRelationship: DL_______   Sort:Act:outboundRelationship:ActRelationship: DL_______

2-L . . RELVBY
. .   v:ActRelationshipRelievedBy
relieved by

Definition:

Description:The source act is wholly or partially alleviated by the target act. (Example "chest pain" RELVBY "sublingual nitroglycerin administration")

Concept Relationships:
  Specializes: PERT

2-S . . SPRT
. .   v:ActRelationshipHasSupport
has support

Definition:

Used to indicate that an existing service is suggesting evidence for a new observation. The assumption of support is attributed to the same actor who asserts the observation. Source must be an observation, target may be any service (e.g., to indicate a status post).

Concept Relationships:
  Specializes: PERT
  Generalizes (derived): SPRTBND

Concept Properties:   howApplies: supporting evidence   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: supportOf   Name:Act:outboundRelationship:ActRelationship: support   Sort:Act:inboundRelationship:ActRelationship: DA_______   Sort:Act:outboundRelationship:ActRelationship: DA_______

3-L . . . SPRTBND
. . .   v:ActRelationshipHasBoundedSupport
has bounded support

Definition:

A specialization of "has support" (SPRT), used to relate a secondary observation to a Region of Interest on a multidimensional observation, if the ROI specifies the true boundaries of the secondary observation as opposed to only marking the approximate area. For example, if the start and end of an ST elevation episode is visible in an EKG, this relation would indicate the ROI bounds the "ST elevation" observation -- the ROI defines the true beginning and ending of the episode. Conversely, if a ROI simply contains ST elevation, but it does not define the bounds (start and end) of the episode, the more general "has support" relation is used. Likewise, if a ROI on an image defines the true bounds of a "1st degree burn", the relation "has bounded support" is used; but if the ROI only points to the approximate area of the burn, the general "has support" relation is used.

Concept Relationships:
  Specializes: SPRT

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: boundedSupportOf   Name:Act:outboundRelationship:ActRelationship: boundedSupport   Sort:Act:inboundRelationship:ActRelationship: DAA______   Sort:Act:outboundRelationship:ActRelationship: DAA______

2-L . . SUBJ
. .   v:ActRelationshipHasSubject
has subject

Definition:

Relates an Act to its subject Act that the first Act is primarily concerned with.

Examples

  1. The first Act may be a ControlAct manipulating the subject Act

  2. The first act is a region of interest (ROI) that defines a region within the subject Act.

  3. The first act is a reporting or notification Act, that echos the subject Act for a specific new purpose.

Constraints

An Act may have multiple subject acts.

Rationale

The ActRelationshipType "has subject" is similar to the ParticipationType "subject", Acts that primarily operate on physical subjects use the Participation, those Acts that primarily operate on other Acts (other information) use the ActRelationship.

Concept Relationships:
  Specializes: PERT

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: subjectOf   Name:Act:outboundRelationship:ActRelationship: subject   Sort:Act:inboundRelationship:ActRelationship: DB_______   Sort:Act:outboundRelationship:ActRelationship: DB_______

2-L . . SUMM
. .   v:ActRelationshipSummarizedBy
summarized by

Definition:

An act that contains summary values for a list or set of subordinate acts. For example, a summary of transactions for a particular accounting period.

Concept Relationships:
  Specializes: PERT

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: summaryOf   Name:Act:outboundRelationship:ActRelationship: summary   Sort:Act:inboundRelationship:ActRelationship: DM_______   Sort:Act:outboundRelationship:ActRelationship: DM_______

2-A . . _ActClassTemporallyPertains
. .   v:ActRelationshipTemporallyPertains
ActClassTemporallyPertains

Concept Relationships:
  Specializes: PERT
  Generalizes (derived): DURING OVERLAP _ActRelationshipTemporallyPertainsEnd _ActRelationshipTemporallyPertainsStart

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: temporallyRelatesTo   Name:Act:outboundRelationship:ActRelationship: temporallyRelatedInformation   Sort:Act:inboundRelationship:ActRelationship: DN_______   Sort:Act:outboundRelationship:ActRelationship: DN_______

3-L . . . DURING
. . .   v:ActRelationshipDuring
occurs during

Definition:

A relationship in which the source act's effective time is wholly within the target act's effective time (including end points, as defined in the act's effective times)

Concept Relationships:
  Specializes: TemporallyPertains _ActClassTemporallyPertains

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: spansOccurrenceOf   Name:Act:outboundRelationship:ActRelationship: occursDuring

3-L . . . OVERLAP
. . .   v:ActRelationshipOverlapsWith
overlaps with

Definition:

A relationship in which the source act's effective time overlaps the target act's effective time in any way.

Concept Relationships:
  Specializes: TemporallyPertains _ActClassTemporallyPertains

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: overlapsWith   Name:Act:outboundRelationship:ActRelationship: overlapsWith

3-A . . . _ActRelationshipTemporallyPertainsEnd
. . .   v:ActRelationshipTemporallyPertainsEnd
ActRelationshipTemporallyPertainsEnd

Definition:

Concept Relationships:
  Specializes: TemporallyPertains _ActClassTemporallyPertains
  Generalizes (derived): EAE EAS EBE EBS ECW ECWS

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: endTemporallyRelatedTo   Name:Act:outboundRelationship:ActRelationship: temporallyRelatedEndInformation

4-L . . . . EAE
. . . .   v:ActRelationshipEndsAfterEndOf
ends after end of

Definition:

Concept Relationships:
  Specializes: _ActRelationshipTemporallyPertainsEnd

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: endsBeforeEndOf   Name:Act:outboundRelationship:ActRelationship: endsAfterEndOf

4-S . . . . EAS
. . . .   v:ActRelationshipEndsAfterStartOf
ends after start of

Definition:

Concept Relationships:
  Specializes: _ActRelationshipTemporallyPertainsEnd
  Generalizes (derived): EDU

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: startsBeforeEndOf   Name:Act:outboundRelationship:ActRelationship: endsAfterStartOf

5-L . . . . . EDU
. . . . .   v:ActRelationshipEndsDuring
ends during

Definition:

A relationship in which the source act ends within the target act's effective time (including end points, as defined in the act's effective times)

Concept Relationships:
  Specializes: EAS

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: encompassesEndOf   Name:Act:outboundRelationship:ActRelationship: endsDuring

4-L . . . . EBE
. . . .   v:ActRelationshipEndsBeforeEnd
ends before end

Definition:

The source Act ends after the end of the target Act (i.e. if we say "ActOne EBE ActTwo", it means that ActOne ends before the end of ActTwo, therefore ActOne is the source and ActTwo is the target).

Concept Relationships:
  Specializes: _ActRelationshipTemporallyPertainsEnd

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: endsAfterEndOf   Name:Act:outboundRelationship:ActRelationship: endsBeforeEndOf

4-L . . . . EBS
. . . .   v:ActRelationshipEndsBeforeStartOf
ends before start of

Definition:

Concept Relationships:
  Specializes: _ActRelationshipTemporallyPertainsEnd

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: startsAfterEndOf   Name:Act:outboundRelationship:ActRelationship: endsBeforeStartOf

4-S . . . . ECW
. . . .   v:ActRelationshipEndsConcurrentWith
ends concurrent with

Definition:

A relationship in which the source act's effective time ends with the end of the target act's effective time.

Concept Relationships:
  Specializes: _ActRelationshipTemporallyPertainsEnd
  Generalizes (derived): CONCURRENT

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: endsConcurrentlyWith   Name:Act:outboundRelationship:ActRelationship: endsConcurrentlyWith

5-L . . . . . CONCURRENT
. . . . .   v:ActRelationshipConcurrentWith
concurrent with

Definition:

A relationship in which the source act's effective time is the same as the target act's effective time.

Concept Relationships:
  Specializes: ECW SCW

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: isConcurrentWith   Name:Act:outboundRelationship:ActRelationship: isConcurrentWith

4-L . . . . ECWS
. . . .   v:ActRelationshipEndsConcurrentWithStart
ends concurrent with start

Definition:

The source Act ends when the target act starts (i.e. if we say "ActOne ECWS ActTwo", it means that ActOne ends when ActTwo starts, therefore ActOne is the source and ActTwo is the target).

Concept Relationships:
  Specializes: _ActRelationshipTemporallyPertainsEnd

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: startsConcurrentWithEndOf   Name:Act:outboundRelationship:ActRelationship: endsConcurrentWithStartOf

3-A . . . _ActRelationshipTemporallyPertainsStart
. . .   v:ActRelationshipTemporallyPertainsStart
ActRelationshipTemporallyPertainsStart

Definition:

Concept Relationships:
  Specializes: TemporallyPertains _ActClassTemporallyPertains
  Generalizes (derived): SAE SAS SBE SBS SCW SCWE

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: startTemporallyRelatedTo   Name:Act:outboundRelationship:ActRelationship: temporallyRelatedStartInformation   Sort:Act:inboundRelationship:ActRelationship: DNA______   Sort:Act:outboundRelationship:ActRelationship: DNA______

4-L . . . . SAE
. . . .   v:ActRelationshipStartsAfterEndOf
starts after end of

Definition:

Concept Relationships:
  Specializes: _ActRelationshipTemporallyPertainsStart

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: endsBeforeStartof   Name:Act:outboundRelationship:ActRelationship: startsAfterEndOf

4-S . . . . SAS
. . . .   v:ActRelationshipStartsAfterStartOf
starts after start of

Definition:

The source Act starts after the start of the target Act (i.e. if we say "ActOne SAS ActTwo", it means that ActOne starts after the start of ActTwo, therefore ActOne is the source and ActTwo is the target).

Concept Relationships:
  Specializes: _ActRelationshipTemporallyPertainsStart
  Generalizes (derived): SDU

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: startsBeforeStartOf   Name:Act:outboundRelationship:ActRelationship: startsAfterStartOf

5-L . . . . . SDU
. . . . .   v:ActRelationshipStartsDuring
starts during

Definition:

A relationship in which the source act starts within the target act's effective time (including end points, as defined in the act's effective times)

Concept Relationships:
  Specializes: SAS

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: encompassesStartOf   Name:Act:outboundRelationship:ActRelationship: startsDuring

4-L . . . . SBE
. . . .   v:ActRelationshipStartsBeforeEnd
starts before end

Definition:

The source Act starts after the end of the target Act (i.e. if we say "ActOne SBE ActTwo", it means that ActOne starts before the end of ActTwo, therefore ActOne is the source and ActTwo is the target).

Concept Relationships:
  Specializes: _ActRelationshipTemporallyPertainsStart

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: endsAfterStartOf   Name:Act:outboundRelationship:ActRelationship: startsBeforeEndOf

4-L . . . . SBS
. . . .   v:ActRelationshipStartsBeforeStartOf
starts before start of

Definition:

Concept Relationships:
  Specializes: _ActRelationshipTemporallyPertainsStart

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: startsAfterStartOf   Name:Act:outboundRelationship:ActRelationship: startsBeforeStartOf

4-S . . . . SCW
. . . .   v:ActRelationshipStartsConcurrentWith
starts concurrent with

Definition:

A relationship in which the source act's effective time starts with the start of the target act's effective time.

Concept Relationships:
  Specializes: _ActRelationshipTemporallyPertainsStart
  Generalizes (derived): CONCURRENT

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: startsConcurrentlyWith   Name:Act:outboundRelationship:ActRelationship: startsConcurrentlyWith

5-L . . . . . CONCURRENT
. . . . .   v:ActRelationshipConcurrentWith
concurrent with

Definition:

A relationship in which the source act's effective time is the same as the target act's effective time.

Concept Relationships:
  Specializes: ECW SCW

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: isConcurrentWith   Name:Act:outboundRelationship:ActRelationship: isConcurrentWith

4-L . . . . SCWE
. . . .   v:ActRelationshipStartsConcurrentWithEnd
starts concurrent with end

Definition:

The source Act starts when the target act ends (i.e. if we say "ActOne SCWE ActTwo", it means that ActOne starts when ActTwo ends, therefore ActOne is the source and ActTwo is the target).

Concept Relationships:
  Specializes: _ActRelationshipTemporallyPertainsStart

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: endsConcurrentWithStartOf   Name:Act:outboundRelationship:ActRelationship: startsConcurrentWithEndOf

2-A . . _ActRelationshipAccounting
. .   v:ActRelationshipAccounting
ActRelationshipAccounting

Definition:

Codes that describe the relationship between an Act and a financial instrument such as a financial transaction, account or invoice element.

Concept Relationships:
  Specializes: PERT
  Generalizes (derived): _ActRelationshipCostTracking _ActRelationshipPosting

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: accountingFor   Name:Act:outboundRelationship:ActRelationship: accounting   Sort:Act:inboundRelationship:ActRelationship: DO_______   Sort:Act:outboundRelationship:ActRelationship: DO_______

3-A . . . _ActRelationshipCostTracking
. . .   v:ActRelationshipCostTracking
ActRelationshipCostTracking

Definition:

Expresses values for describing the relationship relationship between an InvoiceElement or InvoiceElementGroup and a billable act.

Concept Relationships:
  Specializes: _ActRelationshipAccounting _ActRelationshipPosts
  Generalizes (derived): CHRG COST

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: costTrackingOf   Name:Act:outboundRelationship:ActRelationship: costTracking   Sort:Act:inboundRelationship:ActRelationship: DOB______   Sort:Act:outboundRelationship:ActRelationship: DOB______

4-L . . . . CHRG
. . . .   v:ActRelationshipHasCharge
has charge

Definition:

A relationship that provides an ability to associate a financial transaction (target) as a charge to a clinical act (source). A clinical act may have a charge associated with the execution or delivery of the service.

The financial transaction will define the charge (bill) for delivery or performance of the service.

Charges and costs are distinct terms. A charge defines what is charged or billed to another organization or entity within an organization. The cost defines what it costs an organization to perform or deliver a service or product.

Concept Relationships:
  Specializes: _ActRelationshipCostTracking

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: chargeFor   Name:Act:outboundRelationship:ActRelationship: charge   Sort:Act:inboundRelationship:ActRelationship: DOBA_____   Sort:Act:outboundRelationship:ActRelationship: DOBA_____

4-L . . . . COST
. . . .   v:ActRelationshipHasCost
has cost

Definition:

A relationship that provides an ability to associate a financial transaction (target) as a cost to a clinical act (source). A clinical act may have an inherit cost associated with the execution or delivery of the service.

The financial transaction will define the cost of delivery or performance of the service.

Charges and costs are distinct terms. A charge defines what is charged or billed to another organization or entity within an organization. The cost defines what it costs an organization to perform or deliver a service or product.

Concept Relationships:
  Specializes: _ActRelationshipCostTracking

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: costOf   Name:Act:outboundRelationship:ActRelationship: cost   Sort:Act:inboundRelationship:ActRelationship: DOBB_____   Sort:Act:outboundRelationship:ActRelationship: DOBB_____

3-A . . . _ActRelationshipPosting
. . .   v:ActRelationshipPosting
ActRelationshipPosting

Definition:

Expresses values for describing the relationship between a FinancialTransaction and an Account.

Concept Relationships:
  Specializes: _ActRelationshipAccounting _ActRelationshipPosts
  Generalizes (derived): CREDIT DEBIT

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: postingTo   Name:Act:outboundRelationship:ActRelationship: posting   Sort:Act:inboundRelationship:ActRelationship: DOA______   Sort:Act:outboundRelationship:ActRelationship: DOA______

4-L . . . . CREDIT
. . . .   v:ActRelationshipHasCredit
has credit

Definition:

A credit relationship ties a financial transaction (target) to an account (source). A credit, once applied (posted), may have either a positive or negative effect on the account balance, depending on the type of account. An asset account credit will decrease the account balance. A non-asset account credit will decrease the account balance.

Concept Relationships:
  Specializes: _ActRelationshipPosting

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: creditTo   Name:Act:outboundRelationship:ActRelationship: credit   Sort:Act:inboundRelationship:ActRelationship: DOAA_____   Sort:Act:outboundRelationship:ActRelationship: DOAA_____

4-L . . . . DEBIT
. . . .   v:ActRelationshipHasDebit
has debit

Definition:

A debit relationship ties a financial transaction (target) to an account (source). A debit, once applied (posted), may have either a positive or negative effect on the account balance, depending on the type of account. An asset account debit will increase the account balance. A non-asset account debit will decrease the account balance.

Concept Relationships:
  Specializes: _ActRelationshipPosting

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: debitTo   Name:Act:outboundRelationship:ActRelationship: debit   Sort:Act:inboundRelationship:ActRelationship: DOAB_____   Sort:Act:outboundRelationship:ActRelationship: DOAB_____

1-S SEQL
 v:ActRelationshipSequel
is sequel

Definition:

An act relationship indicating that the source act follows the target act. The source act should in principle represent the same kind of act as the target. Source and target need not have the same mood code (mood will often differ). The target of a sequel is called antecedent. Examples for sequel relationships are: revision, transformation, derivation from a prototype (as a specialization is a derivation of a generalization), followup, realization, instantiation.

Concept Relationships:
  Specializes: ART
  Generalizes (derived): APND BSLN COMPLY DOC FLFS GEN GEVL INST MOD MTCH OPTN RCHAL REV RPLC SUCC UPDT XCRPT XFRM

Concept Properties:   conductible: false   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: sequel   Name:Act:outboundRelationship:ActRelationship: sequelTo   Sort:Act:inboundRelationship:ActRelationship: B________   Sort:Act:outboundRelationship:ActRelationship: B________

2-L . . APND
. .   v:ActRelationshipIsAppendage
is appendage

Definition:

An addendum (source) to an existing service object (target), containing supplemental information. The addendum is itself an original service object linked to the supplemented service object. The supplemented service object remains in place and its content and status are unaltered.

Concept Relationships:
  Specializes: SEQL

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: appendageOf   Name:Act:outboundRelationship:ActRelationship: appendage   Sort:Act:inboundRelationship:ActRelationship: BJ_______   Sort:Act:outboundRelationship:ActRelationship: BJ_______

2-L . . BSLN
. .   v:ActRelationshipHasBaseline
has baseline

Definition:

Indicates that the target observation(s) provide an initial reference for the source observation or observation group.

UsageConstraints: Both source and target must be Observations or specializations thereof.

Concept Relationships:
  Specializes: SEQL

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: baselineFor   Name:Act:outboundRelationship:ActRelationship: baseline   Sort:Act:inboundRelationship:ActRelationship: BG_______   Sort:Act:outboundRelationship:ActRelationship: BG_______

2-L . . COMPLY
. .   v:ActRelationshipCompliesWith
complies with

Definition:

Description:The source act complies with, adheres to, conforms to, or is permissible under (in whole or in part) the policy, contract, agreement, law, conformance criteria, certification guidelines or requirement conveyed by the target act.

Examples for compliance relationships are: audits of adherence with a security policy, certificate of conformance to system certification requirements, or consent directive in compliance with or permissible under a privacy policy.

Concept Relationships:
  Specializes: SEQL

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: compliesWith   Name:Act:outboundRelationship:ActRelationship: compliance   Sort:Act:inboundRelationship:ActRelationship: BO_______   Sort:Act:outboundRelationship:ActRelationship: BO_______

2-L . . DOC
. .   v:ActRelationshipDocuments
documents

Definition:

The source act documents the target act.

Concept Relationships:
  Specializes: SEQL

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: documentation   Name:Act:outboundRelationship:ActRelationship: documentationOf   Sort:Act:inboundRelationship:ActRelationship: BH_______   Sort:Act:outboundRelationship:ActRelationship: BH_______

2-S . . FLFS
. .   v:ActRelationshipFulfills
fulfills

Definition:

The source act fulfills (in whole or in part) the target act. Source act must be in a mood equal or more actual than the target act.

Concept Relationships:
  Specializes: SEQL
  Generalizes (derived): OCCR OREF SCH

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: fulfillment   Name:Act:outboundRelationship:ActRelationship: inFulfillmentOf   Sort:Act:inboundRelationship:ActRelationship: BA_______   Sort:Act:outboundRelationship:ActRelationship: BA_______

3-L . . . OCCR
. . .   v:ActRelationshipOccurrence
occurrence
is occurrence of

Definition:

The source act is a single occurrence of a repeatable target act. The source and target act can be in any mood on the "completion track" but the source act must be as far as or further along the track than the target act (i.e., the occurrence of an intent can be an event but not vice versa).

Concept Relationships:
  Specializes: FLFS

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: occurrence   Name:Act:outboundRelationship:ActRelationship: occurrenceOf   Sort:Act:inboundRelationship:ActRelationship: BAA______   Sort:Act:outboundRelationship:ActRelationship: BAA______

3-L . . . OREF
. . .   v:ActRelationshipReferencesOrder
references order

Definition:

Relates either an appointment request or an appointment to the order for the service being scheduled.

Concept Relationships:
  Specializes: FLFS

Concept Properties:   appliesTo: ActMood = ARQ or APT and ActMood = ORD   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: referencedBy   Name:Act:outboundRelationship:ActRelationship: referencedOrder   Sort:Act:inboundRelationship:ActRelationship: BAB______   Sort:Act:outboundRelationship:ActRelationship: BAB______

3-L . . . SCH
. . .   v:ActRelationshipSchedulesRequest
schedules request
schedules

Definition:

Associates a specific time (and associated resources) with a scheduling request or other intent.

Concept Relationships:
  Specializes: FLFS

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: requestedBy   Name:Act:outboundRelationship:ActRelationship: scheduleRequest   Sort:Act:inboundRelationship:ActRelationship: BAC______   Sort:Act:outboundRelationship:ActRelationship: BAC______

2-L . . GEN
. .   v:ActRelationshipHasGeneralization
has generalization

Definition:

The generalization relationship can be used to express categorical knowledge about services (e.g., amilorid, triamterene, and spironolactone have the common generalization potassium sparing diuretic).

Concept Relationships:
  Specializes: SEQL

Concept Properties:   appliesTo: specialization   howApplies: generalization   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: specialization   Name:Act:outboundRelationship:ActRelationship: generalization   Sort:Act:inboundRelationship:ActRelationship: BC_______   Sort:Act:outboundRelationship:ActRelationship: BC_______

2-L . . GEVL
. .   v:ActRelationshipEvaluatesGoal
evaluates (goal)

Definition:

A goal-evaluation links an observation (intent or actual) to a goal to indicate that the observation evaluates the goal. Given the goal and the observation, a "goal distance" (e.g., goal to observation) can be "calculated" and need not be sent explicitly.

Concept Relationships:
  Specializes: SEQL

Concept Properties:   appliesTo: evaluation   howApplies: goal   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: evaluation   Name:Act:outboundRelationship:ActRelationship: evaluationOf   Sort:Act:inboundRelationship:ActRelationship: BD_______   Sort:Act:outboundRelationship:ActRelationship: BD_______

2-L . . INST
. .   v:ActRelationshipInstantiatesMaster
instantiates (master)

Definition:

Used to capture the link between a potential service ("master" or plan) and an actual service, where the actual service instantiates the potential service. The instantiation may override the master's defaults.

Concept Relationships:
  Specializes: SEQL

Concept Properties:   appliesTo: instance   howApplies: master   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: instantiation   Name:Act:outboundRelationship:ActRelationship: definition   Sort:Act:inboundRelationship:ActRelationship: BB_______   Sort:Act:outboundRelationship:ActRelationship: BB_______

2-L . . MOD
. .   v:ActRelationshipModifies
modifies

Definition:

Definition: Used to link a newer version or 'snapshot' of a business object (source) to an older version or 'snapshot' of the same business object (target).

Usage:The identifier of the Act should be the same for both source and target. If the identifiers are distinct, RPLC should be used instead.

Name from source to target = "modifiesPrior"

Name from target to source = "modifiesByNew"

Concept Relationships:
  Specializes: SEQL

Concept Properties:   isDocumentCharacteristic: true

2-L . . MTCH
. .   v:ActRelationshipMatchesTrigger
matches (trigger)

Definition:

A trigger-match links an actual service (e.g., an observation or procedure that took place) with a service in criterion mood. For example if the trigger is "observation of pain" and pain is actually observed, and if that pain-observation caused the trigger to fire, that pain-observation can be linked with the trigger.

Concept Relationships:
  Specializes: SEQL

Concept Properties:   appliesTo: matching service   howApplies: trigger   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: match   Name:Act:outboundRelationship:ActRelationship: matchOf   Sort:Act:inboundRelationship:ActRelationship: BF_______   Sort:Act:outboundRelationship:ActRelationship: BF_______

2-L . . OPTN
. .   v:ActRelationshipHasOption
has option

Definition:

A relationship between a source Act that provides more detailed properties to the target Act.

The source act thus is a specialization of the target act, but instead of mentioning all the inherited properties it only mentions new property bindings or refinements.

The typical use case is to specify certain alternative variants of one kind of Act. The priorityNumber attribute is used to weigh refinements as preferred over other alternative refinements.

Example: several routing options for a drug are specified as one SubstanceAdministration for the general treatment with attached refinements for the various routing options.

Concept Relationships:
  Specializes: SEQL

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: optionFor   Name:Act:outboundRelationship:ActRelationship: option   Sort:Act:inboundRelationship:ActRelationship: BN_______   Sort:Act:outboundRelationship:ActRelationship: BN_______

2-L . . RCHAL
. .   v:ActRelationshipRe-challenge
re-challenge

Definition:

Description:A relationship in which the target act is carried out to determine whether an effect attributed to the source act can be recreated.

Concept Relationships:
  Specializes: SEQL

Concept Properties:   isDocumentCharacteristic: true

2-L . . REV
. .   v:ActRelationshipReverses
reverses

Definition:

A relationship between a source Act that seeks to reverse or undo the action of the prior target Act.

Example: A posted financial transaction (e.g., a debit transaction) was applied in error and must be reversed (e.g., by a credit transaction) the credit transaction is identified as an undo (or reversal) of the prior target transaction.

Constraints: the "completion track" mood of the target Act must be equally or more "actual" than the source act. I.e., when the target act is EVN the source act can be EVN, or any INT. If the target act is INT, the source act can be INT.

Concept Relationships:
  Specializes: SEQL

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: reversal   Name:Act:outboundRelationship:ActRelationship: reversalOf   Sort:Act:inboundRelationship:ActRelationship: BK_______   Sort:Act:outboundRelationship:ActRelationship: BK_______

2-L . . RPLC
. .   v:ActRelationshipReplaces
replaces

Definition:

A replacement source act replaces an existing target act. The state of the target act being replaced becomes obselete, but the act is typically still retained in the system for historical reference. The source and target must be of the same type.

Concept Relationships:
  Specializes: SEQL

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: replacement   Name:Act:outboundRelationship:ActRelationship: replacementOf   Sort:Act:inboundRelationship:ActRelationship: BI_______   Sort:Act:outboundRelationship:ActRelationship: BI_______

2-L . . SUCC
. .   v:ActRelationshipSucceeds
succeeds

Definition:

Definition: A new act that carries forward the intention of the original act, but does not completely replace it. The status of the predecessor act must be 'completed'. The original act is the target act and the successor is the source act.

OpenIssue:

Concept Relationships:
  Specializes: SEQL

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: successor   Name:Act:outboundRelationship:ActRelationship: predecessor   Sort:Act:inboundRelationship:ActRelationship: BIA______   Sort:Act:outboundRelationship:ActRelationship: BIA______

2-L . . UPDT
. .   v:ActRelationshipUpdatesCondition
updates (condition)

Definition:

A condition thread relationship specifically links condition nodes together to form a condition thread. The source is the new condition node and the target links to the most recent node of the existing condition thread.

Concept Relationships:
  Specializes: SEQL

Concept Properties:   appliesTo: new head of thread   howApplies: old head of thread   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: update   Name:Act:outboundRelationship:ActRelationship: updateOf   Sort:Act:inboundRelationship:ActRelationship: BE_______   Sort:Act:outboundRelationship:ActRelationship: BE_______

2-S . . XCRPT
. .   v:ActRelationshipExcerpt
Excerpts

Definition:

The source is an excerpt from the target.

Concept Relationships:
  Specializes: SEQL
  Generalizes (derived): VRXCRPT

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: excerpt   Name:Act:outboundRelationship:ActRelationship: excerptFrom   Sort:Act:inboundRelationship:ActRelationship: BM_______   Sort:Act:outboundRelationship:ActRelationship: BM_______

3-L . . . VRXCRPT
. . .   v:ActRelationshipExcerptVerbatim
Excerpt verbatim

Definition:

The source is a direct quote from the target.

Concept Relationships:
  Specializes: XCRPT

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: verbatimExcerpt   Name:Act:outboundRelationship:ActRelationship: verbatimExcerptFrom   Sort:Act:inboundRelationship:ActRelationship: BMA______   Sort:Act:outboundRelationship:ActRelationship: BMA______

2-L . . XFRM
. .   v:ActRelationshipTransformation
transformation

Definition:

Used when the target Act is a transformation of the source Act. (For instance, used to show that a CDA document is a transformation of a DICOM SR document.)

Concept Relationships:
  Specializes: SEQL

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: transformation   Name:Act:outboundRelationship:ActRelationship: transformationOf   Sort:Act:inboundRelationship:ActRelationship: BL_______   Sort:Act:outboundRelationship:ActRelationship: BL_______

1-L VALUE
 v:ActRelationshipHasValue
has value

Definition:

Description:Indicates that the target Act represents the result of the source observation Act.

FormalConstraint: Source Act must be an Observation or specialization there-of. Source Act must not have the value attribute specified

UsageNote: This relationship allows the result of an observation to be fully expressed as RIM acts as opposed to being embedded in the value attribute. For example, sending a Document act as the result of an imaging observation, sending a list of Procedures and/or other acts as the result of a medical history observation.

The valueNegationInd attribute on the source Act has the same semantics of "negated finding" when it applies to the target of a VALUE ActRelationship as it does to the value attribute. On the other hand, if the ActRelationship.negationInd is true for a VALUE ActRelationship, that means the specified observation does not have the indicated value but does not imply a negated finding. Because the semantics are extremely close, it is recommended that Observation.valueNegationInd be used, not ActRelationship.negationInd.

OpenIssue: The implications of negationInd on ActRelationship and the valueNegationind on Observation.

Concept Relationships:
  Specializes: ART

1-A _ActRelationshipConditional
 v:ActRelationshipConditional
ActRelationshipConditional

Definition:

Specifies under what circumstances (target Act) the source-Act may, must, must not or has occurred

Concept Relationships:
  Specializes: ART
  Generalizes (derived): CIND PRCN RSON TRIG

Concept Properties:   conductible: true   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: conditionedBy   Name:Act:outboundRelationship:ActRelationship: conditions   Sort:Act:inboundRelationship:ActRelationship: C________   Sort:Act:outboundRelationship:ActRelationship: C________

2-L . . CIND
. .   v:ActRelationshipHasContra-indication
has contra-indication

Definition:

A contraindication is just a negation of a reason, i.e. it gives a condition under which the action is not to be done. Both, source and target can be any kind of service; target service is in criterion mood. How the strength of a contraindication is expressed (e.g., relative, absolute) is left as an open issue. The priorityNumber attribute could be used.

Concept Relationships:
  Specializes: _ActRelationshipConditional

Concept Properties:   appliesTo: action   howApplies: contra-indication   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: contraindicationFor   Name:Act:outboundRelationship:ActRelationship: contraindication   Sort:Act:inboundRelationship:ActRelationship: CC_______   Sort:Act:outboundRelationship:ActRelationship: CC_______

2-L . . PRCN
. .   v:ActRelationshipHasPre-condition
has pre-condition

Definition:

A requirement to be true before a service is performed. The target can be any service in criterion mood. For multiple pre-conditions a conjunction attribute (AND, OR, XOR) is applicable.

Concept Relationships:
  Specializes: _ActRelationshipConditional

Concept Properties:   appliesTo: action   howApplies: pre-condition   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: preconditionFor   Name:Act:outboundRelationship:ActRelationship: precondition   Sort:Act:inboundRelationship:ActRelationship: CD_______   Sort:Act:outboundRelationship:ActRelationship: CD_______

2-S . . RSON
. .   v:ActRelationshipReason
has reason

Definition:

Description: The reason or rationale for a service. A reason link is weaker than a trigger, it only suggests that some service may be or might have been a reason for some action, but not that this reason requires/required the action to be taken. Also, as opposed to the trigger, there is no strong timely relation between the reason and the action. As well as providing various types of information about the rationale for a service, the RSON act relationship is routinely used between a SBADM act and an OBS act to describe the indication for use of a medication. Child concepts may be used to describe types of indication.

Discussion: In prior releases, the code "SUGG" (suggests) was expressed as "an inversion of the reason link." That code has been retired in favor of the inversion indicator that is an attribute of ActRelationship.

Concept Relationships:
  Specializes: _ActRelationshipConditional
  Generalizes (derived): BLOCK DIAG IMM MITGT PRYLX TREAT

Concept Properties:   appliesTo: action   howApplies: reason   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: reasonOf   Name:Act:outboundRelationship:ActRelationship: reason   Sort:Act:inboundRelationship:ActRelationship: CA_______   Sort:Act:outboundRelationship:ActRelationship: CA_______

3-L . . . BLOCK
. . .   v:ActRelationshipBlocks
blocks

Definition:

Definition: The source act is performed to block the effects of the target act. This act relationship should be used when describing near miss type incidents where potential harm could have occurred, but the action described in the source act blocked the potential harmful effects of the incident actually occurring.

Concept Relationships:
  Specializes: RSON

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: blockedBy   Name:Act:outboundRelationship:ActRelationship: blocks

3-L . . . DIAG
. . .   v:ActRelationshipDiagnosis
diagnoses

Definition:

Description: The source act is intended to help establish the presence of a (an adverse) situation described by the target act. This is not limited to diseases but can apply to any adverse situation or condition of medical or technical nature.

Concept Relationships:
  Specializes: RSON

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: diagnosedBy

3-S . . . IMM
. . .   v:ActRelationshipImmunizationAgainst
immunization against

Definition:

Description: The source act is intented to provide immunity against the effects of the target act (the target act describes an infectious disease)

Concept Relationships:
  Specializes: RSON
  Generalizes (derived): ACTIMM PASSIMM

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: immunizedAgainst

4-L . . . . ACTIMM
. . . .   v:ActRelationshipActiveImmunizationAgainst
active immunization against

Definition:

Description: The source act is intended to provide active immunity against the effects of the target act (the target act describes an infectious disease)

Concept Relationships:
  Specializes: IMM

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: activelyImmunizedAgainst

4-L . . . . PASSIMM
. . . .   v:ActRelationshipPassiveImmunizationAgainst
passive immunization against

Definition:

Description: The source act is intended to provide passive immunity against the effects of the target act (the target act describes an infectious disease).

Concept Relationships:
  Specializes: IMM

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: passivelyImmunizedAgainst

3-S . . . MITGT
. . .   v:ActRelationshipMitigates
mitigates

Definition:

The source act removes or lessens the occurrence or effect of the target act.

Concept Relationships:
  Specializes: RSON
  Generalizes (derived): RCVY

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: mitigatedBy   Name:Act:outboundRelationship:ActRelationship: mitigates   Sort:Act:inboundRelationship:ActRelationship: CAA______   Sort:Act:outboundRelationship:ActRelationship: CAA______

4-L . . . . RCVY
. . . .   v:ActRelationshipRecovery
recovers

Definition:

Definition: The source act is performed to recover from the effects of the target act.

Concept Relationships:
  Specializes: MITGT

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: recoveredFrom   Name:Act:outboundRelationship:ActRelationship: recovers

3-L . . . PRYLX
. . .   v:ActRelationshipProphylaxisOf
prophylaxis of

Definition:

Description: The source act is intended to reduce the risk of of an adverse situation to emerge as described by the target act. This is not limited to diseases but can apply to any adverse situation or condition of medical or technical nature.

Concept Relationships:
  Specializes: RSON

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: prophylaxisOf

3-S . . . TREAT
. . .   v:ActRelationshipTreats
treats

Definition:

Description: The source act is intended to improve a pre-existing adverse situation described by the target act. This is not limited to diseases but can apply to any adverse situation or condition of medical or technical nature.

Concept Relationships:
  Specializes: RSON
  Generalizes (derived): ADJUNCT MTREAT PALLTREAT SYMP

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: treatmentFor

4-L . . . . ADJUNCT
. . . .   v:ActRelationshipAdjunctiveTreatment
adjunctive treatment

Definition:

Description: The source act is intended to offer an additional treatment for the management or cure of a pre-existing adverse situation described by the target act. This is not limited to diseases but can apply to any adverse situation or condition of medical or technical nature. It is not a requirement that the non-adjunctive treatment is explicitly specified.

Concept Relationships:
  Specializes: TREAT

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: adjunctiveTreatmentFor

4-L . . . . MTREAT
. . . .   v:ActRelationshipMaintenanceTreatment
maintenance treatment

Definition:

Description: The source act is intended to provide long term maintenance improvement or management of a pre-existing adverse situation described by the target act. This is not limited to diseases but can apply to any adverse situation or condition of medical or technical nature.

Concept Relationships:
  Specializes: TREAT

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: maintenanceTreatmentFor

4-L . . . . PALLTREAT
. . . .   v:ActRelationshipPalliates
palliates

Definition:

Description: The source act is intended to provide palliation for the effects of the target act.

Concept Relationships:
  Specializes: TREAT

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: palliativeTreatmentFor

4-L . . . . SYMP
. . . .   v:ActRelationshipSymptomaticRelief
symptomatic relief

Definition:

Description: The source act is intented to provide symptomatic relief for the effects of the target act.

Concept Relationships:
  Specializes: TREAT

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: symptomaticTreatmentFor

2-L . . TRIG
. .   v:ActRelationshipHasTrigger
has trigger

Definition:

A pre-condition that if true should result in the source Act being executed. The target is in typically in criterion mood. When reported after the fact (i.e. the criterion has been met) it may be in Event mood. A delay between the trigger and the triggered action can be specified.

Discussion: This includes the concept of a required act for a service or financial instrument such as an insurance plan or policy. In such cases, the trigger is the occurrence of a specific condition such as coverage limits being exceeded.

Concept Relationships:
  Specializes: _ActRelationshipConditional

Concept Properties:   appliesTo: action   howApplies: trigger   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: triggerFor   Name:Act:outboundRelationship:ActRelationship: trigger   Sort:Act:inboundRelationship:ActRelationship: CB_______   Sort:Act:outboundRelationship:ActRelationship: CB_______


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