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retired Template  eHDSI Substance Administration

Id 1.3.6.1.4.1.12559.11.10.1.3.1.3.2 Effective Date 2022‑07‑06 13:39:09
Other versions this id:
Status retired Retired Version Label
Name eHDSISubstanceAdministration Display Name eHDSI Substance Administration
Description
The general model is to record each prescribed medication in a <substanceAdministration> intent (moodCode='INT'). 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
Context Parent nodes of template element with id 1.3.6.1.4.1.12559.11.10.1.3.1.3.2
Classification CDA Entry Level Template
Open/Closed Open (other than defined elements are allowed)
Associated with
Associated with 9 concepts
Id Name Data Set
ehdsi-dataelement-191 draft Frequency of intakes draft eHDSI Data Set
ehdsi-dataelement-200 draft Number of packages draft eHDSI Data Set
ehdsi-dataelement-189 draft Duration of treatment draft eHDSI Data Set
ehdsi-dataelement-193 draft Posology instructions draft eHDSI Data Set
ehdsi-dataelement-195 draft Route of Administration draft eHDSI Data Set
ehdsi-dataelement-212 draft Prescription Identifier draft eHDSI Data Set
ehdsi-dataelement-192 draft Number of units per intake draft eHDSI Data Set
ehdsi-dataelement-190 draft Timing of intakes draft eHDSI Data Set
ehdsi-dataelement-187 draft Substitution draft eHDSI Data Set
Used by / Uses
Used by 0 transactions and 0 templates, Uses 5 templates
Uses as Name Version
1.3.6.1.4.1.12559.11.10.1.3.1.3.29 Containment active eHDSI eP/eD Medication Information DYNAMIC
2.16.840.1.113883.3.1937.777.11.10.103 Include active eHDSI Author Prescriber DYNAMIC
2.16.840.1.113883.3.1937.777.11.10.134 Include active eHDSI Participant (Body) DYNAMIC
1.3.6.1.4.1.12559.11.10.1.3.1.3.13 Containment active eHDSI Medication FulFillment Instructions DYNAMIC
1.3.6.1.4.1.12559.11.10.1.3.1.3.12 Containment active eHDSI Patient Medication Instructions DYNAMIC
Relationship Version: template 1.3.6.1.4.1.12559.11.10.1.3.1.3.2 eHDSI Substance Administration (2021‑12‑23 14:25:03)
Adaptation: template 1.3.6.1.4.1.19376.1.5.3.1.4.7 (DYNAMIC)
ref
?
Example
Example
<substanceAdministration classCode="SBADM" moodCode="INT">
  <templateId root="2.16.840.1.113883.10.20.1.24"/>  <templateId root="1.3.6.1.4.1.12559.11.10.1.3.1.3.2"/>  <templateId root=""/>  <!-- Prescription Item ID -->
  <id root="" extension=""/>  <code code="" codeSystem="" displayName="" codeSystemName=""/>  <!-- Reference to narrative text of prescription, e.g.
Pyrimon, Chloramphenicol/ Dexamethasone 1% w/v/ 0.1% w/v 5 ml Eye Drops – three drops -->
  <text>
    <reference value="#med-1"/>  </text>
  <statusCode code="active"/>  <effectiveTime type="IVL_TS">
    <low value=""/>    <high value=""/>  </effectiveTime>
  <effectiveTime operator="A" type="TS|PIVL_TS|EIVL_TS|SXPR_TS">
    <!-- ... -->
  </effectiveTime>
  <routeCode code="20051000" codeSystem="1.3.6.1.4.1.12559.11.10.1.3.1.44.1" displayName="Ocular use" codeSystemName="EDQM"/>  <doseQuantity value="3"/>  <!-- Optional -->
  <approachSiteCode code="" codeSystem="" displayName="" codeSystemName=""/>  <rateQuantity value="" unit=""/>  <consumable>
    <!-- ... -->
  </consumable>
  <participant typeCode="AUT">
    <participantRole classCode="LIC">
      <id root=" " extension=" "/>      <scopingEntity classCode="ORG">
        <id root=" " extension=" "/>        <desc>...</desc>      </scopingEntity>
    </participantRole>
  </participant>
  <author>
    <time/>    <assignedAuthor>
      <id/>      <assignedPerson>
        <name/>      </assignedPerson>
    </assignedAuthor>
  </author>
  <!-- 0..* entries describing the components -->
  <entryRelationship typeCode="COMP">
    <sequenceNumber value=""/>  </entryRelationship>
  <!-- Optional instructions for Pharmacist -->
  <entryRelationship typeCode="SUBJ">
    <!-- ... -->
  </entryRelationship>
  <!--Optional Substitution information -->
  <entryRelationship typeCode="SUBJ">
    <!-- ... -->
  </entryRelationship>
</substanceAdministration>
Item DT Card Conf Description Label
hl7:substanceAdministration
R (eHDdotsion)
@classCode
cs 1 … 1 F SBADM
@moodCode
cs 1 … 1 F INT
hl7:templateId
II.EPSOS 1 … 1 M eHDSI Substance Administration (eHDdotsion)
@root
uid 1 … 1 F 1.3.6.1.4.1.12559.11.10.1.3.1.3.2
hl7:templateId
II.EPSOS 0 … 1 R IHE Medications Entry (IHE PCC) 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. (eHDdotsion)
@root
uid 1 … 1 F 1.3.6.1.4.1.19376.1.5.3.1.4.7
hl7:templateId
II.EPSOS 1 … 1 M Medication activity (CCD) (eHDdotsion)
@root
uid 1 … 1 F 2.16.840.1.113883.10.20.1.24
hl7:templateId
II.EPSOS 0 … 1 R A "normal" act that may not contain any subordinate acts (eHDdotsion)
@root
uid 1 … 1 F 1.3.6.1.4.1.19376.1.5.3.1.4.7.1
hl7:templateId
II.EPSOS 0 … 1 R A act that records combination medication component information in subordinate acts. (eHDdotsion)
@root
uid 1 … 1 F 1.3.6.1.4.1.19376.1.5.3.1.4.11
hl7:templateId
II.EPSOS 0 … 1 R A act that records split dose information in subordinate acts. (eHDdotsion)
@root
uid 1 … 1 F 1.3.6.1.4.1.19376.1.5.3.1.4.9
hl7:id
II.EPSOS 1 … 1 M
Prescription ID. The following must be true: 
  • The prescription ID must be globally unique.
  • The prescription ID can be used by the prescribing system or provider to identify the prescription to which it belongs. This provides the link from the dispensed medicine to the prescription.
(eHDdotsion)
 
target
ehdsi-dataelement-212 draft Prescription Identifier draft eHDSI Data Set
  Example <id extension="23" root="1.2.246.556.12001.4.93.1.1"/>
hl7:code
CD.EPSOS 0 … 1 R The <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.
(eHDdotsion)
  CONF
The value of @code shall be drawn from value set 2.16.840.1.113883.1.11.19708 ActSubstanceAdministrationCode (DYNAMIC)
hl7:text
ED 0 … 1 R (eHDdotsion)
 
target
ehdsi-dataelement-193 draft Posology instructions draft eHDSI Data Set
  Example <text>...</text>
hl7:reference
0 … 1 R 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. (eHDdotsion)
  Example <reference value="#eP_as_text"/>
hl7:statusCode
CS 1 … 1 M The status of all <substanceAdministration> elements must be either "active" or "completed" and track the progress of the Act in its specified mood.
For example, statusCode="completed" when moodCode is "RQO" doesn't mean that the substance has been administrated, but that the request (e.g. the prescription) has been completed.
(eHDdotsion)
  CONF
@code shall be "active"
or
@code shall be "completed"
  Example <statusCode code="active"/>
hl7:effectiveTime
IVL_TS 1 … * R The first <effectiveTime> element encodes the start and stop time of the medication regimen or the length 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/length and frequency information between EMR systems. If no information is available for the dosage period, a nullFlavor attribute has to be provided with the value 'UNK'.

Case 1: specified interval
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.

In case of unbounded period (continuous therapy) the <high> element will be valued with the nullFlavor attribute to NA.

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 than 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.

Case 2: 'floating' period
If the start and/or stop time is unknown, but the length of the medication regimen is known, it shall be indicated in the <width> value.
(eHDdotsion)
where [@xsi:type='IVL_TS']
 
target
ehdsi-dataelement-189 draft Duration of treatment draft eHDSI Data Set
@nullFlavor
cs 0 … 1 F UNK
  Example
Known Interval
<effectiveTime type="IVL_TS">
  <low value="20200415"/>  <high value="20210415"/></effectiveTime>
  Example
Information not available about the period
<effectiveTime type="IVL_TS" nullFlavor="UNK"/>
  Example
Unknown end date
<effectiveTime type="IVL_TS">
  <low value="20200415"/>  <high nullFlavor="UNK"/></effectiveTime>
  Example
Continuous therapy
<effectiveTime type="IVL_TS">
  <low value="20200415"/>  <high nullFlavor="NA"/></effectiveTime>
  Example
2 week period
<effectiveTime type="IVL_TS">
  <width value="2" unit="wk"/></effectiveTime>
  Example
7 day period starting 15/04/2020
<effectiveTime type="IVL_TS">
  <low value="20200415"/>  <width value="7" unit="d"/></effectiveTime>
  Example
7 day period ending 15/04/2020
<effectiveTime type="IVL_TS">
  <width value="7" unit="d"/>  <high value="20200415"/></effectiveTime>
hl7:low
IVXB_TS 0 … 1 Start of the medication regimen. If specified, must be complemented by the <high> or the <width> value.
(eHDdotsion)
hl7:width
PQ 0 … 1 Length of the medication regimen.
(eHDdotsion)
hl7:high
IVXB_TS 0 … 1 Stop of the medication regimen. If specified, must be complemented by the <low> or the <width> value.
(eHDdotsion)
Choice 1 … * Elements to choose from:
  • hl7:effectiveTime[(@value or @nullFlavor) and not(@xsi:type='IVL_TS' or @xsi:type='PIVL_TS' or @xsi:type='EIVL_TS' or @xsi:type='SXPR_TS')]
  • hl7:effectiveTime[@xsi:type='PIVL_TS']
  • hl7:effectiveTime[@xsi:type='EIVL_TS']
  • hl7:effectiveTime[@xsi:type='SXPR_TS']
hl7:effectiveTime
TS 0 … * C This required element describes the frequency of intakes. If not known it shall be valued with the nullflavor "UNK".

An 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)
(eHDdotsion)
where [(@value or @nullFlavor) and not(@xsi:type='IVL_TS' or @xsi:type='PIVL_TS' or @xsi:type='EIVL_TS' or @xsi:type='SXPR_TS')]
 
target
ehdsi-dataelement-191 draft Frequency of intakes draft eHDSI Data Set
  Example
Once (known date)
<effectiveTime value="20191203"/>
  Example
Unknown
<effectiveTime nullFlavor="UNK"/>
hl7:effectiveTime
PIVL_TS 0 … * C An 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.
(eHDdotsion)
where [@xsi:type='PIVL_TS']
 
target
ehdsi-dataelement-191 draft Frequency of intakes draft eHDSI Data Set
@institutionSpecified
bl 0 … 1  

Indicates whether the exact timing is up to the party executing the 

schedule (e.g., to distinguish "every 8 hours" from "3 times a day".)

  • true = 3 times a day

  • false (default) = every 8 hours

  Example
Every 4 hours
<effectiveTime type="PIVL_TS" institutionSpecified="false">
  <period value="4" unit="h"/></effectiveTime>
  Example
Twice a day
<effectiveTime type="PIVL_TS" institutionSpecified="true">
  <period value="12" unit="h"/></effectiveTime>
  Example
Every day at 8 in the morning for 10 minutes
<effectiveTime type="PIVL_TS">
  <phase>
    <low value="202001010800" inclusive="true"/>    <width value="10" unit="min"/>  </phase>
  <period value="1" unit="d"/></effectiveTime>
  Example
Every 4 to 6 hours
<effectiveTime type="PIVL_TS" institutionSpecified="false">
  <period type="PPD_PQ" value="5" unit="h">
    <standardDeviation value="1" unit="h"/>  </period>
</effectiveTime>
hl7:effectiveTime
EIVL_TS 0 … * C An 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 eHDSITimingEvent value set 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.
(eHDdotsion)
where [@xsi:type='EIVL_TS']
 
target
ehdsi-dataelement-191 draft Frequency of intakes draft eHDSI Data Set
  Example
After meal
<effectiveTime type="EIVL_TS">
  <event code="PC" codeSystem="2.16.840.1.113883.5.139"/></effectiveTime>
  Example
One hour before breakfast
<effectiveTime type="EIVL_TS">
  <event code="ACM" codeSystem="2.16.840.1.113883.5.139"/>  <offset>
    <low value="-1" unit="h"/>  </offset>
</effectiveTime>
hl7:event
EIVL.event 0 … 1 C (eHDdotsion)
 
target
ehdsi-dataelement-190 draft Timing of intakes draft eHDSI Data Set
@code
cs 0 … 1  
  CONF
The value of @code shall be drawn from value set 1.3.6.1.4.1.12559.11.10.1.3.1.42.41 eHDSITimingEvent (DYNAMIC)
hl7:effectiveTime
SXPR_TS 0 … * C An 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).
(eHDdotsion)
where [@xsi:type='SXPR_TS']
 
target
ehdsi-dataelement-191 draft Frequency of intakes draft eHDSI Data Set
hl7:routeCode
CE.EPSOS 0 … 1 R 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. (eHDdotsion)
 
target
ehdsi-dataelement-195 draft Route of Administration draft eHDSI Data Set
  CONF
The value of @code shall be drawn from value set 1.3.6.1.4.1.12559.11.10.1.3.1.42.12 eHDSIRouteofAdministration (DYNAMIC)
hl7:doseQuantity
IVL_PQ 0 … 1 R The doseQuantity element specifies the amount of medication (i.e. dose) for each intake. The dose could be for example "2 tablets".
If the dose quantity is unknown, it must be nullFlavored (nullFlavor="UNK").
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, otherwise both <low> and <high> have the same value.
(eHDdotsion)
 
target
ehdsi-dataelement-192 draft Number of units per intake draft eHDSI Data Set
  Example
Dose quantity is unknown
<doseQuantity nullFlavor="UNK"/>
  Example
Non pre-coordinated consumable - Dose Range
<doseQuantity>
  <low value="25" unit="mg"/>  <high value="50" unit="mg"/></doseQuantity>
  Example
Pre-coordinated consumable using UCUM annotations - Dose Range
<doseQuantity>
  <low value="1" unit="{tablet}"/>  <high value="2" unit="{tablet}"/></doseQuantity>
  Example
Pre-coordinated consumable - Dose Range
<doseQuantity>
  <low value="2" unit="1">
    <translation>
      <originalText>tablet</originalText>    </translation>
  </low>
  <high value="2" unit="1">
    <translation>
      <originalText>tablet</originalText>    </translation>
  </high>
</doseQuantity>
hl7:low
IVXB_TS 1 … 1 R indicates the minimum amount of intake for every dose. If the value of low is 0, this means that the medication should be taken if needed. (eHDdotsion)
@unit
cs 1 … 1 R must specify the unit of the dose. Units must be taken from UCUM code system. If the dose is in countable units (tablets, drops, pieces), then the unit must equal "1". The exact type of the countable unit may be specified as text in the underlying translation element with a concept from the eHDSIQuantityUnit Value Set. For the sake of understandability the text needs to be presented in English.
@value
1 … 1 R must be a positive integer or decimal representing the number of units in the dose.
hl7:high
IVXB_TS 1 … 1 R indicates the maximum amount of intake for every dose. (eHDdotsion)
@unit
cs 1 … 1 R must specify the unit of the dose. Units must be taken from UCUM code system. If the dose is in countable units (tablets, drops, pieces), then the unit must equal "1". The exact type of the countable unit may be specified as text in the underlying translation element with a concept from the eHDSIQuantityUnit Value Set. For the sake of understandability the text needs to be presented in English.
@value
1 … 1 R must be a positive integer or decimal representing the number of units in the dose.
hl7:rateQuantity
IVL_PQ 0 … 1 R 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 <rateQuantity> should contain a <translation> element that provides a <reference> to the <originalText> found in the narrative body of the document.
(eHDdotsion)
hl7:consumable
1 … 1 R Contains 1.3.6.1.4.1.12559.11.10.1.3.1.3.29 eHDSI eP/eD Medication Information (DYNAMIC) (eHDdotsion)
@typeCode
cs 1 … 1 F CSM
Included 0 … * R from 2.16.840.1.113883.3.1937.777.11.10.103 eHDSI Author Prescriber (DYNAMIC)
In the unlikely case where the prescriber of a prescription item is different from the author of the prescription, the prescription item prescriber shall be represented by the element of the entry. When the Prescription Item Entry is part of a Dispensed Medicine Entry as a Related Prescription Item (see subsection 12.1.3.4.8), the author element shall be present, and shall contain the prescription item author (or author of the prescription if the prescription item has no separate author). See the 2.4.3.3 Prescriber description for the structure of the element.
hl7:author
0 … * R (eHDdotsion)
@typeCode
cs 0 … 1 F AUT
@contextControlCode
cs 0 … 1 F OP
hl7:functionCode
CE.EPSOS 1 … 1 M R1.10.6
 
target
ehdsi-dataelement-227 draft Medical Specialty draft eHDSI Data Set
ehdsi-dataelement-229 draft 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.TZ 1 … 1 R The 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. (eHDdotsion)
hl7:assignedAuthor
1 … 1 R (eHDdotsion)
@classCode
cs 0 … 1 F ASSIGNED
  Schematron assert role red error  
  test @nullFlavor or hl7:assignedPerson or hl7:assignedAuthoringDevice  
  Message At least an assignedPerson or an assignedAuthoringDevice has to be provided, otherwise a nullFlavor shall be present.  
hl7:id
II.EPSOS 1 … * R Identification of the Healthcare Practitioner that is the author of this document.
R1.10.5
 
target
ehdsi-dataelement-234 draft HP Identifier draft eHDSI Data Set
@nullFlavor
cs 0 … 1 F NA
hl7:code
CE.EPSOS 0 … 1 R HP Specialty R1.10.7
hl7:addr
AD.EPSOS 1 … * R IHE PCC
 
target
ehdsi-dataelement-223 draft City draft eHDSI Data Set
ehdsi-dataelement-224 draft Street Address draft eHDSI Data Set
ehdsi-dataelement-220 draft Country draft eHDSI Data Set
ehdsi-dataelement-222 draft Zip or Postal Code draft eHDSI Data Set
ehdsi-dataelement-221 draft State or Province draft eHDSI Data Set
hl7:telecom
TEL.EPSOS 1 … * R This 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-219 draft Telephone draft eHDSI Data Set
ehdsi-dataelement-218 draft E-mail draft eHDSI Data Set
@use
set_cs 0 … 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 … 1 M (eHDdotsion)
@classCode
cs 0 … 1 F PSN
@determinerCode
cs 0 … 1 F INSTANCE
hl7:name
PN 1 … 1 R HP Name IHE PCC
  Example <name>
  <given>John</given>  <family>Español Smith</family></name>
hl7:family
1 … * R HP Family Name/Surname R1.10.1
 
target
ehdsi-dataelement-231 draft Family Name/Surname draft eHDSI Data Set
hl7:given
1 … * R HP Given Name R1.10.2
 
target
ehdsi-dataelement-232 draft Given Name draft eHDSI Data Set
hl7:prefix
0 … * R HP Prefix R1.10.3
hl7:suffix
0 … * R HP Suffix R1.10.4
hl7:representedOrganization
1 … 1 R Contains 2.16.840.1.113883.3.1937.777.11.10.111 eHDSI Organization (DYNAMIC) R1.10.9
 
target
ehdsi-dataelement-216 draft Organization Name draft eHDSI Data Set
ehdsi-dataelement-215 draft Organization Identifier draft eHDSI Data Set
Included 0 … * R from 2.16.840.1.113883.3.1937.777.11.10.134 eHDSI Participant (Body) (DYNAMIC)
The organization which provided the credentialing for the prescriber needs to be expressed via a <participant> structure, which is in addition to the <author> element specified earlier. The type code of the <participant> element shall be "AUT", and the class code of the <participantRole> element shall be "LIC".

The ID of the participation role is optional, and when present it shall be the prescriber ID as specified in the <author> structure at the section or entry level.

The credentialing organization (College) is represented by the <scopingEntity> element with a class code of "ORG". The name is represented by the <desc> element, and the credentialing organization (College) ID is represented by the <id> element of the scoping entity
hl7:participant
0 … * R (eHDdotsion)
@typeCode
cs 1 … 1 R
  CONF
The value of @typeCode shall be drawn from value set 2.16.840.1.113883.1.11.10901 ParticipationType (DYNAMIC)
@contextControlCode
cs 1 … 1 F OP
hl7:time
IVL_TS 0 … 1 R (eHDdotsion)
hl7:awarenessCode
CE.EPSOS 0 … 1 R (eHDdotsion)
  CONF
The value of @code shall be drawn from value set 2.16.840.1.113883.1.11.10310 TargetAwareness (DYNAMIC)
hl7:participantRole
1 … 1 R (eHDdotsion)
@classCode
cs 0 … 1  
  CONF
The value of @classCode shall be drawn from value set 2.16.840.1.113883.1.11.13940 RoleClassRoot (DYNAMIC)
hl7:id
II.EPSOS 0 … * R (eHDdotsion)
hl7:code
CE.EPSOS 0 … 1 R (eHDdotsion)
@codeSystem
CONF 0 … 1 F 2.16.840.1.113883.5.111 (RoleCode)
hl7:addr
AD 0 … * R (eHDdotsion)
hl7:telecom
TEL 0 … * R (eHDdotsion)
Choice 0 … 1 Elements to choose from:
hl7:playingDevice
R Contains 2.16.840.1.113883.3.1937.777.11.10.129 eHDSI Device (DYNAMIC) (eHDdotsion)
hl7:playingEntity
R Contains 2.16.840.1.113883.3.1937.777.11.10.128 eHDSI Playing Entity (DYNAMIC) (eHDdotsion)
hl7:scopingEntity
0 … 1 R (eHDdotsion)
@classCode
cs 0 … 1  
  CONF
The value of @classCode shall be drawn from value set 2.16.840.1.113883.1.11.13922 EntityClassRoot (DYNAMIC)
@determinerCode
cs 0 … 1 F INSTANCE
hl7:id
II.EPSOS 0 … * R (eHDdotsion)
hl7:code
CE.EPSOS 0 … 1 R (eHDdotsion)
  CONF
The value of @code shall be drawn from value set 2.16.840.1.113883.1.11.16040 EntityCode (DYNAMIC)
hl7:desc
ED 0 … 1 R (eHDdotsion)
hl7:entryRelationship
1 … 1 R An entry relationship is used to represent the number of packages in an ePrescription/eDispensation document. (eHDdotsion)
@typeCode
cs 1 … 1 F COMP
  Example <entryRelationship typeCode="COMP">
  <supply classCode="SPLY" moodCode="RQO">
    <independentInd value="false"/>    <quantity unit="1" value="4"/>  </supply>
</entryRelationship>
hl7:supply
(eHDdotsion)
@classCode
cs 1 … 1 F SPLY
@moodCode
cs 1 … 1 F RQO
hl7:independentInd
BL 1 … 1 M (eHDdotsion)
@value
bl 1 … 1 F false
hl7:quantity
PQ 1 … 1 M
The supply entry shall indicate the number of packages available for dispensation on the prescription.

The value attribute shall be present and indicate the number of packages. In prescriptions for overall amount (such as 400 tablets), the value attribute must equal 1, and the overall amount shall be placed in epsos:containerPackageMedicine/epsos:capacityQuantity element. See its description for more information.

The unit attribute shall be present and equal UCUM unit 1.
(eHDdotsion)
 
target
ehdsi-dataelement-200 draft Number of packages draft eHDSI Data Set
@unit
cs 1 … 1 F 1
hl7:entryRelationship
0 … * R An 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 administration 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 1.3.6.1.4.1.12559.11.10.1.3.1.3.13 eHDSI Medication FulFillment Instructions (DYNAMIC)
(eHDdotsion)
where [hl7:act/hl7:templateId/@root='1.3.6.1.4.1.12559.11.10.1.3.1.3.13']
@typeCode
cs 1 … 1 F SUBJ
@inversionInd
bl 1 … 1 F true
hl7:entryRelationship
0 … 1 R An entry relationship may be present to provide the substitution instructions. When present, this entry relationship SHALL contain one and only one observation.

This observation SHALL have :

  • the code element valorized with @code=‟SUBST' and @codeSystem='2.16.840.1.113883.5.6'
  • the value element valorized with one of the value of the eHDSISubstitutionCode Value Set (Value Set OID 1.3.6.1.4.1.12559.11.10.1.3.1.42.7). Nullflavor is not allowed.

NOTE:
Within the epSOS-I scope the “N” code shall be interpreted as No substitution allowed excepting for the Package Size.

The presence of any other code that is not “N”, or the absence of the substitution instructions, means that also the brand name (as well as the Package Size) can be changed.

(eHDdotsion)
where [hl7:observation/hl7:code/@code='SUBST']
 
target
ehdsi-dataelement-187 draft Substitution draft eHDSI Data Set
@typeCode
cs 1 … 1 F SUBJ
hl7:observation
(eHDdotsion)
@classCode
cs 0 … 1 F OBS
@moodCode
cs 0 … 1 F EVN
hl7:code
1 … 1 M (eHDdotsion)
@code
CONF 1 … 1 F SUBST
@codeSystem
1 … 1 F 2.16.840.1.113883.5.6 (ActClass)
hl7:value
1 … 1 M (eHDdotsion)
  CONF
The value of @code shall be drawn from value set 1.3.6.1.4.1.12559.11.10.1.3.1.42.7 eHDSISubstitutionCode (DYNAMIC)
hl7:entryRelationship
0 … * R An entry relationship may be present to provide the patient medication instructions. When present, this entry relationship shall contain a Patient Medications 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 administration 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 1.3.6.1.4.1.12559.11.10.1.3.1.3.12 eHDSI Patient Medication Instructions (DYNAMIC)
(eHDdotsion)
where [hl7:act/hl7:templateId/@root='1.3.6.1.4.1.12559.11.10.1.3.1.3.12']
@typeCode
cs 1 … 1 F SUBJ
@inversionInd
bl 1 … 1 F true