Id1.3.6.1.4.1.12559.11.10.1.3.1.3.4Effective Date2019‑04‑08 12:46:30
Statusretired RetiredVersion Label
NameMedicationItemDisplay NameMedication Item
Description

This entry content module makes use of the medicine and instruction entry content modules. Medi- cations and their prescriptions are perhaps the most difficult data elements to model due to varia- tions in the ways that medications are prescribed.

This profile identifies the following relevant fields of a medication as being important to be able to generate in a medical summary. The table below identifies and describes these fields, and indicates the constraints on whether or not they are required to be sent. The fields are listed in the order that they appear in the CDA XML content.

FieldCDA TagDescription
Start and Stop Date<effectiveTime>The date (and time if available) when the medication regimen began and is expected to finish. The first component of the <effectiveTime> encodes the lower and upper bounds over which the <substanceAdministration> occurs, and the start time is determined from the lower bound. If the medication has been known to be stopped, the high value must be present, but expressed as a flavor of null (e.g., Unknown).
Frequency<effectiveTime>The frequency indicates how often the medication is to be administered. It is often expressed as the number of times per day, but which may also include information such as 1 hour before/after meals, or in the morning, or evening.The second <effectiveTime> element encodes the frequency. In cases where split or tapered doses are used, these may be found in subordinate <substanceAdministration> elements.
Route<routeCode>The route is a coded value, and indicates how the medication is received by the patient (by mouth, intravenously, topically, et cetera).
Dose<doseQuantity>The amount of the medication given. This should be in some known and measurable unit, such as grams, milligrams, et cetera. It may be measured in "administration" units (such as tablets or each), for medications where the strength is relevant. In this case, only the unit count is specified , no units are specified. It may be a range.
Product<consumable>
  <manufacturedProduct>
    <manufacturedMaterial>
      <name>
    </manufacturedMaterial>
  </manufacturedProduct>
</consumable>		The name of the substance or product. This should be sufficient for a provider to identify the kind of medication. It may be a trade name or a generic name. This information is required in all medication entries. If the name of the medication is unknown, the type, purpose or other description may be supplied. The name should not include packaging, strength or dosing information. Note: Due to restrictions of the CDA schema, there is no way to explicitly link the name to the narrative text.
Strength<manufacturedMaterial>
  <ingredient>
    <quantity> </quantity>
  </ingredient>
</manufacturedMaterial>		The strength of the medication is expressed as a the ratio of each active ingredient to a unit of medication. For example, the medication Percocet comes in a variety of strengths, which indicate specific amounts of two different medications being received in single tablet. Another example is eye-drops, where the medication is in a solution of a particular strength, and the dose quantity is some number of drops. Note: Due to restrictions of the CDA schema, there is no way to separately record the strength. The epSOS extension is used to provide this information.
In order to be compliant with the IHE PCC template strength information should be also conveyed through the consumable/code/originalText element as reference to the narrative block.
Ingredient Code<manufacturedMaterial>
  <ingredient>
    <ingredient>
      <code/>
     </ingredient>
  <ingredient>
</manufacturedMaterial>		A code describing the active ingredient(s) of the product from a controlled vocabulary, such as ATC, for example.
Instructions<entryRelationship>A place to put free text comments to support additional relevant information, or to deal with specialized dosing instructions. For example, "take with food", or tapered dosing.
Indication<entryRelationship>A link to supporting clinical information about the reason for providing the medication (e.g., a link to the relevant diagnosis).
ContextParent nodes of template element with id 1.3.6.1.4.1.12559.11.10.1.3.1.3.4
ClassificationCDA Entry Level Template
Open/ClosedOpen (other than defined elements are allowed)
Associated with
Associated with 19 concepts
IdNameData Set
ehdsi-dataelement-234draft HP Identifier draft eHDSI Data Set
ehdsi-dataelement-232draft Given Name draft eHDSI Data Set
ehdsi-dataelement-231draft Family Name/Surname draft eHDSI Data Set
ehdsi-dataelement-227draft Medical Specialty draft eHDSI Data Set
ehdsi-dataelement-229draft Profession draft eHDSI Data Set
ehdsi-dataelement-224draft Street Address draft eHDSI Data Set
ehdsi-dataelement-223draft City draft eHDSI Data Set
ehdsi-dataelement-222draft Zip or Postal Code draft eHDSI Data Set
ehdsi-dataelement-221draft State or Province draft eHDSI Data Set
ehdsi-dataelement-220draft Country draft eHDSI Data Set
ehdsi-dataelement-219draft Telephone draft eHDSI Data Set
ehdsi-dataelement-218draft E-mail draft eHDSI Data Set
ehdsi-dataelement-216draft Organization Name draft eHDSI Data Set
ehdsi-dataelement-215draft Organization Identifier draft eHDSI Data Set
epsos-dataelement-110draft Date of onset of treatment draft epSOS Data Set
epsos-dataelement-107draft Number of units per intake draft epSOS Data Set
epsos-dataelement-140draft Route of administration draft epSOS Data Set
epsos-dataelement-109draft Duration of treatment draft epSOS Data Set
epsos-dataelement-108draft Frequency of intakes draft epSOS Data Set
Used by / Uses
Used by 0 transactions and 0 templates, Uses 3 templates
Uses as NameVersion
1.3.6.1.4.1.12559.11.10.1.3.1.3.1Containmentretired eHDSI Manufactured ProductDYNAMIC
1.3.6.1.4.1.19376.1.5.3.1.4.3.1Containmentretired eHDSI Medication FulFillment InstructionsDYNAMIC
2.16.840.1.113883.3.1937.777.11.10.103Includeactive eHDSI Author PrescriberDYNAMIC
RelationshipVersion: template 1.3.6.1.4.1.12559.11.10.1.3.1.3.4 Medication Item (2013‑12‑20)
Example
Example
<substanceAdministration classCode="SBADM" moodCode="INT|EVN">
  <templateId root="2.16.840.1.113883.10.20.1.24"/>  <templateId root="1.3.6.1.4.1.12559.11.10.1.3.1.3.4"/>  <id root="" extension=""/>  <!-- Optional NOT TO BE USED for medication being administered or prescribed -->
  <code code="" codeSystem="" displayName="" codeSystemName=""/>  <text>
    <reference value="#med-1"/>  </text>  <statusCode code="completed"/>  <effectiveTime xsi:type="IVL_TS">
    <low value=""/>    <high value=""/>  </effectiveTime>  <effectiveTime operator="A" xsi:type="TS|PIVL_TS|EIVL_TS|SXPR_TS">
    <!-- ... -->
  </effectiveTime>  <routeCode code="" codeSystem="" displayName="" codeSystemName=""/>  <doseQuantity value="" unit=""/>  <approachSiteCode code="" codeSystem="" displayName="" codeSystemName=""/>  <rateQuantity value="" unit=""/>  <consumable>
    <!-- ... -->
  </consumable>  <author>
    <time/>    <assignedAuthor>
      <id/>      <assignedPerson>
        <name/>      </assignedPerson>    </assignedAuthor>  </author>  <!-- 0..* entries describing the components -->
  <entryRelationship typeCode="COMP">
    <sequenceNumber value=""/>  </entryRelationship>  <!-- An optional entry relationship that indicates the reason for use -->
  <entryRelationship typeCode="RSON">
    <act classCode="ACT" moodCode="EVN">
      <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.4.1"/>      <id root="" extension=""/>    </act>  </entryRelationship>  <!-- Optional instrctions for Phramacist -->
  <entryRelationship typeCode="SUBJ">
    <!-- ... -->
  </entryRelationship></substanceAdministration>
Example
No information available
<substanceAdministration classCode="SBADM" moodCode="INT">
  <templateId root="2.16.840.1.113883.10.20.1.24"/>  <templateId root="1.3.6.1.4.1.12559.11.10.1.3.1.3.4"/>  <id root="1.2.3.999" extension="--example only--"/>  <code code="no-medication-info" codeSystem="2.16.840.1.113883.5.1150.1" displayName="No information about medications"/>  <statusCode code="completed"/>  <effectiveTime nullFlavor="NA" xsi:type="IVL_TS"/>  <consumable>
    <manufacturedProduct classCode="MANU">
      <templateId root="1.3.6.1.4.1.12559.11.10.1.3.1.3.1"/>      <manufacturedMaterial nullFlavor="NA"/>    </manufacturedProduct>  </consumable></substanceAdministration>
Example
Known absence
<substanceAdministration classCode="SBADM" moodCode="INT">
  <templateId root="2.16.840.1.113883.10.20.1.24"/>  <templateId root="1.3.6.1.4.1.12559.11.10.1.3.1.3.4"/>  <id root="1.2.3.999" extension="--example only--"/>  <code code="no-known-medications" codeSystem="2.16.840.1.113883.5.1150.1" displayName="No known medications"/>  <statusCode code="completed"/>  <effectiveTime nullFlavor="NA" xsi:type="IVL_TS"/>  <consumable>
    <manufacturedProduct classCode="MANU">
      <templateId root="1.3.6.1.4.1.12559.11.10.1.3.1.3.1"/>      <manufacturedMaterial nullFlavor="NA"/>    </manufacturedProduct>  </consumable></substanceAdministration>
ItemDTCardConfDescriptionLabel
hl7:substanceAdministration
RThe general model is to record each prescribed medication in a <substanceAdministration> intent (moodCode='INT'). To record medications which were taken in the past, the moodCode shall be set to 'EVN'. The <substanceAdministration> element may contain subordinate <substanceAdministration> elements in a related component entry to deal with special cases (see the following sections below on Special Cases).
These cases include split, tapered, or conditional dosing, or combination medications. The use of subordinate <substanceAdministration> elements to deal with these cases is optional. The comment field should always be used in these cases to provide the same information as free text in the top level <substanceAdministration> element. There are a variety of special cases for dosing that need to be accounted for. These are described below. Most of these special cases involve changing the dosage or frequency over time, or based on some measurement. When the dosage changes, then additional entries are required for each differing dosage. The last case deals with combination medications.

For the purposes of WP3.5 only the normal, the split dosing and the combination medications are addressed.
  • Normal Dosing 1.3.6.1.4.1.19376.1.5.3.1.4.7.1
    This template identifier is used to identify medication administration events that do not require any special processing. The parent template is 1.3.6.1.4.1.19376.1.5.3.1.4.7. Medications that use this template identifier shall not use subordinate <substanceAdministation> acts.
  • Combination Medications 1.3.6.1.4.1.19376.1.5.3.1.4.11

    This template identifier is used to identify medication administration events that require special processing to handle combination medications. The parent template is 1.3.6.1.4.1.19376.1.5.3.1.4.7. A combination medication is made up of two or more other medications. These may be prepackaged, such as Percocet, which is a combination of Acetaminophen and oxycodone in predefined ratios, or prepared by a pharmacist, such as a GI cocktail.

    In the case of the prepackaged combination, it is sufficient to supply the name of the combination drug product, and its strength designation in a single <substanceAdministation> entry. The dosing information should then be recorded as simply a count of administration units.

    In the latter case of a prepared mixture, the description of the mixture should be provided as the product name (e.g., "GI Cocktail"), in the <substanceAdministration> entry. That entry may, but is not required, to have subordinate <substanceAdministration> entries included beneath it to record the components of the mixture.

  • Split Dosing 1.3.6.1.4.1.19376.1.5.3.1.4.9
    This template identifier is used to identify medication administration events that require special processing to handle split dosing. The parent template is 1.3.6.1.4.1.19376.1.5.3.1.4.7. A split dose is often used when different dosages are given at different times (e.g., at different times of day, or on different days). This may be to account for different metabolism rates at different times of day, or to simply address drug packaging deficiencies (e.g., and order for Coumadin 2mg on even days, 2.5mg on odd days is used because Coumadin does not come in a 2.25mg dose form).
    In this case a subordinate <substanceAdministration> entry is required for each separate dosage.

Other template IDs exist for the tapered doses, split dosing, conditional dosing, and combination medications. The reader is pointed to the PCC-TF:2 section 6.1.4.16.5. For the epSOS purposes, only the normal, the combination and the split dosing are described.

MedidotsItem
@classCode
cs1 … 1FSBADM
@moodCode
cs1 … 1R
 CONF
@moodCode shall be "INT"
or
@moodCode shall be "EVN"
hl7:templateId
II.EPSOS0 … 1R(CCD)MedidotsItem
@root
uid1 … 1F2.16.840.1.113883.10.20.1.24
hl7:templateId
II.EPSOS0 … 1RIHE PCC templateId Note: The usage of statusCode values different from “completed” makes this specification not formally compliant with the current IHE PCC specification of the Medication Item Entry Content Module. All the requirements of conformance assertion with these IHE PCC templates cannot therefore be applied until the revision – if any - of the referenced IHE PCC templates.MedidotsItem
@root
uid1 … 1F1.3.6.1.4.1.19376.1.5.3.1.4.7
hl7:templateId
II.EPSOS1 … 1R(epSOS)MedidotsItem
@root
uid1 … 1F1.3.6.1.4.1.12559.11.10.1.3.1.3.4
hl7:templateId
II.EPSOS0 … 1RA "normal" act that may not contain any subordinate actsMedidotsItem
@root
uid1 … 1F1.3.6.1.4.1.19376.1.5.3.1.4.7.1
hl7:templateId
II.EPSOS0 … 1RA act that records combination medication component information in subordinate acts.MedidotsItem
@root
uid1 … 1F1.3.6.1.4.1.19376.1.5.3.1.4.11
hl7:templateId
II.EPSOS0 … 1RA act that records split dose information in subordinate acts.MedidotsItem
@root
uid1 … 1F1.3.6.1.4.1.19376.1.5.3.1.4.9
hl7:id
II.EPSOS1 … 1MA top level element must be uniquely identified. This can be the prescription item ID if appropriate. Although HL7 allows for multiple identifiers, one and only one shall be used. MedidotsItem
hl7:code
CD.EPSOS0 … 1RThe <code> element is used to supply a code that describes the <substanceAdminstration> act, not the medication being administered or prescribed. This may be a procedure code, such as those found in ICD-10, or may describe the method of medication administration, such as by intravenous injection. The type of medication is coded in the consumable; do not supply the code for the medication in this element. This element is optional.

Note: One of the concepts from the Value Set eHDSI-AbsentOrUnknownMedication shall be used in the <code> element to record that a patient is either not on medications, or that medications are not known.		MedidotsItem
 CONF
The value of @code shall be drawn from value set 1.3.6.1.4.1.12559.11.10.1.3.1.42.49 eHDSIAbsentOrUnknownMedication (DYNAMIC)
or
@code shall be "DRUG"
hl7:text
ED0 … 1RMedidotsItem
 Example<text>...</text>
hl7:reference
0 … 1R The URI given in the value attribute of the element points to an element in the narrative content that contains the complete text describing the medication. In a CDA document, the URI given in the value attribute of the element points to an element in the narrative content that contains the complete text describing the medication. MedidotsItem
 Example<reference value="#eP_as_text"/>
hl7:statusCode
CS1 … 1M The status of all elements must be either "active" or "completed". Status of "active" indicates a currently valid prescription, status of completed indicates a previously taken medication. MedidotsItem
 CONF
@code shall be "active"
or
@code shall be "completed"
 Example<statusCode code="active"/>
hl7:effectiveTime
IVL_TS1 … 1R The first <effectiveTime> element encodes the start and stop time of the medication regimen. This an interval of time (xsi:type='IVL_TS'), and must be specified as shown. This is an additional constraint placed upon CDA Release 2.0 by this profile, and simplifies the exchange of start/stop and frequency information between EMR systems.
The <low> and <high> values of the first <effectiveTime> element represent the start and stop times for the medication. The <low> value represents the start time, and the <high> value represents the stop time. If either the <low> or the <high> value is unknown, this shall be recorded by setting the nullFlavor attribute to UNK.

The <high> value records the end of the medication regime according to the information provided in the prescription or order. For example, if the prescription is for enough medication to last 30 days, then the high value should contain a date that is 30 days later then the <low> value. The rationale is that a provider, seeing an un-refilled prescription would normally assume that the medication is no longer being taken, even if the intent of the treatment plan is to continue the medication indefinitely.
MedidotsItem
where [1]
 
target
epsos-dataelement-110draft Date of onset of treatment draft epSOS Data Set
epsos-dataelement-109draft Duration of treatment draft epSOS Data Set
 Example<effectiveTime xsi:type="IVL_TS">
  <low value="20130321"/>  <high value="20140321"/></effectiveTime>
hl7:effectiveTime
1 … *R

The second <effectiveTime> element records the frequency of administration.
This <effectiveTime> element must be intersected with the previous time specification (operator='A'), producing the bounded set containing only those time specifications that fall within the start and stop time of the medication regimen. Several common frequency expressions appear in the table below, along with their XML representations.
This effectiveTime has a xsi:type of either TS, PIVL_TS, EIVL_TS, or SXPR_TS.

FrequencyDescriptionXML Representation
b.i.d.Twice a day<effectiveTime xsi:type='PIVL_TS' institutionSpecified='true' operator='A'> <period value='12' unit='h' /></effectiveTime>
q12hEvery 12 hours<effectiveTime xsi:type='PIVL_TS' institutionSpecified='false' operator='A'> <period value='12' unit='h' /></effectiveTime>
OnceOnce, on 2005-09-01 at 1:18am.<effectiveTime xsi:type='TS' value='200509010118'/>
t.i.d.Three times a day, at times determined by the person administering the medication .<effectiveTime xsi:type='PIVL_TS' institutionSpecified='true' operator='A'> <period value='8' unit='h' /></effectiveTime>
q8hEvery 8 hours<effectiveTime xsi:type='PIVL_TS' institutionSpecified='false' operator='A'> <period value='8' unit='h' /></effectiveTime>
qamIn the morning<effectiveTime xsi:type='EIVL' operator='A'> <event code='ACM'/></effectiveTime>
 Every day at 8 in the morning for 10 minutes<effectiveTime xsi:type='PIVL_TS' operator='A'> <phase> <low value="198701010800" inclusive="true"/> <width value="10" unit="min"/> </phase> <period value='1' unit='d'/></effectiveTime>
q4-6hEvery 4 to 6 hours.<effectiveTime xsi:type="PIVL_TS" institutionSpecified="false" operator="A"> <period xsi:type="PPD_PQ" value="5" unit="h"> <standardDeviation value="1" unit="h"/> </period></effectiveTime>

The mean (average) of the low and high values is specified for the period. The mean of 4 and 6 is 5. The standard deviation is recorded as one half the differences between the high and low values, with an unspecified distribution. The type attribute of the <effectiveTime> element describes the kind of frequency specification it contains. More detail is given for each type in the table below.
xsi:typeDescription
TSAn xsi:type of TS represents a single point in time, and is the simplest of all to represent. The value attribute of the <effectiveTime> element specifies the point in time in HL7 date-time format (CCYYMMDDHHMMSS)
PIVL_TSAn xsi:type of PIVL_TS is the most commonly used, representing a periodic interval of time. The <low> element of <phase> may be present. If so it specifies the starting point, and only the lower order components of this value are relevant with respect to the <period>. The <width> element represents the duration of the dose administration (e.g., for IV administration). The <period> indicates how often the dose is given. Legal values for the unit attribute of <period> are s, min, h, d, wk and mo representing seconds, minutes, hours, days, weeks, and months respectively.
EIVL_TSAn xsi:type of EIVL_TS represents an event based time interval, where the event is not a precise time, but is often used for timing purposes (e.g. with meals, between meals, before breakfast, before sleep). Refer to the HL7 TimingEvent vocabulary for the codes to use for the <event> element. This interval may specify an <offset> which provides information about the time offset from the specified event (e.g., <offset><low value='-1' unit='h'/><width value='10' unit='min'/></offset> means 1 hour before the event. In that same example, the <width> element indicates the duration for the dose to be given.
SXPR_TSAn xsi:type of SXPR_TS represents a parenthetical set of time expressions. This type is used when the frequency varies over time (e.g., for some cases of tapered dosing, or to handle split dosing). The <comp> elements of this <effectiveTime> element are themselves time expressions (using any of the types listed above). Each <comp> element may specify an operator (e.g. to intersect or form the union of two sets).
MedidotsItem
where [position()>1]
 
target
epsos-dataelement-108draft Frequency of intakes draft epSOS Data Set
@operator
cs1 … 1FA
hl7:routeCode
CE.EPSOS0 … 1R The element specifies the route of administration using the EDQM route of administration vocabulary. A code must be specified if the route is known, and the displayName attribute should be specified. If the route is unknown, this element shall not be sent. MedidotsItem
 
target
epsos-dataelement-140draft Route of administration draft epSOS Data Set
 CONF
The value of @code shall be drawn from value set 1.3.6.1.4.1.12559.11.10.1.3.1.42.12 eHDSIRouteofAdministration (DYNAMIC)
hl7:doseQuantity
IVL_PQ0 … 1R

The dose is specified in the <doseQuantity> element.

If a dose range is given (e.g., 1-2 tablets, or 325-750mg), then the <low> and <high> bounds are specified in their respective elements...

If the dose is in countable items (tablets, caplets, "eaches"), then the unit should be valorized  = ‘1’. In this case it is allowed to used the UCUM annotations for describing the type of countable items (e.g. .{tablet}, {puff},..).

The unit attribute – when expresses unit of measures- shall be derived from the Value Sets epSOSUnits, 1.3.6.1.4.1.12559.11.10.1.3.1.42.16 based on the UCUM code system.  The countable units attribute is derived from the value set epSOSDoseForm, OID 1.3.6.1.4.1.12559.11.10.1.3.1.42.2

MedidotsItem
 
target
epsos-dataelement-107draft Number of units per intake draft epSOS Data Set
 Example<doseQuantity nullFlavor="UNK">...</doseQuantity>
 Example<doseQuantity value="2" unit="{tablet}"/>
hl7:rateQuantity
IVL_PQ0 … 1R The rate is specified in the <rateQuantity> element. The rate is given in units that have measure over time. In this case, the units should be specified as a string made up of a unit of measure (see doseQuantity above), followed by a slash (/), followed by a time unit (s, min, h or d).
Again, if a range is given, then the <low> and <high> elements contain the lower and upper bound of the range, otherwise, they contain the same value.
Any <low> and <high> elements used for <doseQuantity> or <rateQuantity> should contain a <translation> element that provides a <reference> to the <originalText> found in the narrative body of the document.

In a CDA document, any <low> and <high> elements used for <doseQuantity> or <rateQuantity> SHOULD contain a <translation> element that provides a <reference> to the <originalText> found in the narrative body of the document.
MedidotsItem
hl7:consumable
1 … 1RThe element shall be present, and shall contain a element, conforming to the Medicine Entry Content module template.
Contains 1.3.6.1.4.1.12559.11.10.1.3.1.3.1 eHDSI Manufactured Product (DYNAMIC)		MedidotsItem
@typeCode
cs0 … 1FCSM
Included0 … *R from 2.16.840.1.113883.3.1937.777.11.10.103 eHDSI Author Prescriber (DYNAMIC)
In the case where there is a prescriber of a medication, the prescriber is represented by the element of the entry. See the Prescriber description for the structure of the element.
hl7:author
0 … *ReHDSdotsiber
@typeCode
cs0 … 1FAUT
@contextControlCode
cs0 … 1FOP
hl7:functionCode
CE.EPSOS1 … 1MR1.10.6
 
target
ehdsi-dataelement-229draft Profession draft eHDSI Data Set
 CONF
The value of @code shall be drawn from value set 1.3.6.1.4.1.12559.11.10.1.3.1.42.1 eHDSIHealthcareProfessionalRole (DYNAMIC)
hl7:time
TS.EPSOS.TZ1 … 1RThe author/time element represents the start time of the author’s participation in the creation of the clinical document. The author/time element SHALL be present.eHDSdotsiber
hl7:assignedAuthor
1 … 1ReHDSdotsiber
@classCode
cs0 … 1FASSIGNED
 Schematron assertrolered error 
 test@nullFlavor or hl7:assignedPerson or hl7:assignedAuthoringDevice 
 MessageAt least an assignedPerson or an assignedAuthoringDevice has to be provided, otherwise a nullFlavor shall be present. 
hl7:id
II.EPSOS1 … *RIdentification of the Healthcare Practitioner that is the author of this document.
R1.10.5
 
target
ehdsi-dataelement-234draft HP Identifier draft eHDSI Data Set
@nullFlavor
cs0 … 1FNA
hl7:code
CE.EPSOS0 … 1RHP SpecialtyR1.10.7
 
target
ehdsi-dataelement-227draft Medical Specialty draft eHDSI Data Set
hl7:addr
AD.EPSOS1 … *RIHE PCC
 
target
ehdsi-dataelement-224draft Street Address draft eHDSI Data Set
ehdsi-dataelement-223draft City draft eHDSI Data Set
ehdsi-dataelement-222draft Zip or Postal Code draft eHDSI Data Set
ehdsi-dataelement-221draft State or Province draft eHDSI Data Set
ehdsi-dataelement-220draft Country draft eHDSI Data Set
hl7:telecom
TEL.EPSOS1 … *RThis telephone or e-mail <telecom> element is required.

If there is no information, the nullFlavor attribute shall have a value of 'NI' and the "value" and "use" attributes shall be omitted, otherwise the nullFlavor attribute shall not be present, and the "value" and "use" attributes shall be present.

Attribute @value SHALL contain a URI if element telecom is used. The URI scheme SHALL be one of URLScheme.		IHE PCC / R1.10.8 / R1.10.8.1 / R1.10.8.2
 
target
ehdsi-dataelement-219draft Telephone draft eHDSI Data Set
ehdsi-dataelement-218draft E-mail draft eHDSI Data Set
@use
set_cs0 … 1 
 CONF
The value of @use shall be drawn from value set 1.3.6.1.4.1.12559.11.10.1.3.1.42.40 eHDSITelecomAddress (DYNAMIC)
hl7:assignedPerson
1 … 1MeHDSdotsiber
@classCode
cs0 … 1FPSN
@determinerCode
cs0 … 1FINSTANCE
hl7:name
PN1 … 1RHP NameIHE PCC
 Example<name>
  <given>John</given>  <family>Español Smith</family></name>
hl7:family
1 … *RHP Family Name/SurnameR1.10.1
 
target
ehdsi-dataelement-231draft Family Name/Surname draft eHDSI Data Set
hl7:given
1 … *RHP Given NameR1.10.2
 
target
ehdsi-dataelement-232draft Given Name draft eHDSI Data Set
hl7:prefix
0 … *RHP PrefixR1.10.3
hl7:suffix
0 … *RHP SuffixR1.10.4
hl7:representedOrganization
1 … 1RContains 2.16.840.1.113883.3.1937.777.11.10.111 eHDSI Organization (DYNAMIC)R1.10.9
 
target
ehdsi-dataelement-216draft Organization Name draft eHDSI Data Set
ehdsi-dataelement-215draft Organization Identifier draft eHDSI Data Set
hl7:entryRelationship
0 … *RAn entry relationship may be present to provide the fulfillment instructions. When present, this entry relationship shall contain a Medication Fulfillment Instructions entry content module.

Again, a related statement is made about the medication or immunization. In CDA, this observation is recorded inside an <entryRelationship> element occurring at the end of the substance administra- tion or supply entry. The containing <act> is the subject (typeCode='SUBJ') of this new observation, which is the inverse of the normal containment structure, thus inversionInd='true'.


Contains 1.3.6.1.4.1.19376.1.5.3.1.4.3.1 eHDSI Medication FulFillment Instructions (DYNAMIC)		MedidotsItem
@typeCode
cs1 … 1FSUBJ
@inversionInd
bl1 … 1R
hl7:entryRelationship
0 … *RA top level <substanceAdministration> element may contain one or more related components, either to handle split dosing, or to support combination medications.
In the first case, the subordinate components shall specify only the changed <effectiveTime> and/or <doseQuantity> elements. The value of the <sequenceNumber> shall be an ordinal number, starting at 1 for the first component, and increasing by 1 for each subsequent component. Components shall be sent in <sequenceNumber> order.

This information is given for informative purposes as only normal or combination medications are administered in epSOS.

MedidotsItem
@typeCode
cs1 … 1FCOMP
hl7:sequenceNumber
INT1 … 1MMedidotsItem