Ambulance
Domain Message Specification

Version: 2.1; Status: Final

RelatedSubject Tabular View

COCD_TP145213GB01
RelatedSubject

A template to identify the subject of the information when it is not the patient.

The subject is someone who has a relationship to the patient.

This class carries details of the type of subject of the information.
Used by:
[1..1] [M] classCode (CS { CNE:x_DocumentSubject } )

Model Attribute Description

The HL7 attribute classCode describes the type of role using a value from the x_DocumentSubject domain of the HL7 vocabulary RoleClass.

Implementation in XML Instance

The XML attribute classCode shall contain the value " PRS".
[0..*] addr (SET<AD>)

Model Attribute Description

The HL7 attribute addr uses an address of the subject.

The HL7 attribute addr allows structured and unstructured addresses to be carried. Only structured addresses are recommended to be used.

Implementation in XML Instance

There are a number of forms of structured address. The three shown here are the recommended formats for patient addresses, they are listed in no particular order.

The XML element addr is populated as follows:

When using the structured address in the style of PDS the XML element addr shall contain five XML elements streetAddressLine.

  • The first XML element streetAddressLine shall contain the premises name
  • The second XML element streetAddressLine shall contain the number and thoroughfare
  • The third XML element streetAddressLine shall contain the locality
  • The fourth XML element streetAddressLine shall contain the post town
  • The fifth XML element streetAddressLine shall contain the county

The first XML element streetAddressLine or the second XML element streetAddressLine and the fourth XML element streetAddressLine are mandatory to be populated.

  • The XML element postalCode can be used to carry a postcode
  • The XML element addressKey can be used to carry a PAF key

When using the fully structured address format then the XML element addr shall be populated as follows:

  • The XML element houseNumber shall contain the house/building number or name
  • The XML element streetName shall contain the street name
  • The XML element city shall contain the city name
  • The XML element county shall contain the county
  • The XML element country shall contain the country name
  • The XML element postalCode shall contain the postcode
  • The XML element addressKey shall contain the address key

Note that unpopulated XML elements should not be present.

Alternatively the structured address may contain just a series of XML elements streetAddressLine populated in the correct order to render as a postal address with as much information as available included.

  • The first XML element streetAddressLine shall contain the first address line
  • The second XML element streetAddressLine shall contain the second address line
  • The third XML element streetAddressLine shall contain the third address line
  • and so on ....

Note that unpopulated XML elements should not be present.

The XML element addr also allows an XML attribute use and this should be used to further define the subject's address type when required. Only the use values listed below are recommended to be used for subject's addresses.

Code
Definition
WP Work place - An office address. First choice for business related contacts during business hours.
TMP Temporary address - A temporary address; may be good for visit or mailing.
PHYS Physical visit address - Used primarily to visit an address.
PST
 Postal address - Used to send mail.
H
 Home address - The person's home address; attempted contacts for business purposes might intrude privacy and chances are one will contact family or other household members instead of the person one wishes to call. Typically used with urgent cases, or if no other contacts are available.
HP
 The primary home address - The primary address to reach a person after business hours.
HV
 A vacation home - An address to reach a person while on vacation.

When the XML attribute use of the XML element addr contains the value "PHYS" then the following two XML elements of the XML element addr may be populated.

  • The XML element desc of the XML element addr may contain a description of the address; this may be used for things like directions for the address
  • The XML element additionalLocator of the XML element addr may contain additional location information such as longitude and latitude coordinates

The XML element useablePeriod of XML element addr can be used to indicate some of the following types of valid times for an address:

  • A point in time when the contact address details are valid
  • A start and end time
    • Just including hours and minutes to indicate opening hours of an office for a work address
    • Using dates for indicating a contact address is only for a certain period of time
  • A start time only to indicate when the contact address is valid from
  • An end time only to indicate that the contact address is only valid until a certain date
[0..1] code (CE { CWE:PersonalRelationshipRoleType } )

Model Attribute Description

The HL7 attribute code uses a code from the PersonalRelationshipRoleType or an alternative vocabulary to describe the relationship between the patient and the named subject person.

Implementation in XML Instance

When using the PersonalRelationshipRoleType vocabulary then:

The Coded Plain flavour of the Coded Value (CV) data type shall be used to carry this information in the XML element code as follows:

  • The XML attribute code shall contain a code from the PersonalRelationshipRoleType vocabulary
  • The XML attribute codeSystem shall contain the OID "2.16.840.1.113883.1.11.19563"
  • The XML attribute displayName shall carry the name associated with the code.

When using an alternative vocabulary and an OID is available then:

The Coded Plain flavour of the Coded Value (CV) data type shall be used to carry this information in the XML element code as follows:

  • The XML attribute code shall contain a code from the alternative vocabulary
  • The XML attribute codeSystem shall contain the OID for the alternative vocabulary
  • The XML attribute displayName shall carry the name associated with the code.

When using an alternative vocabulary and an OID is not available then:

The Coded Plain flavour of the Coded Value (CV) data type shall be used to carry this information in the XML element code as follows:

  • The XML attribute code shall contain a code from the alternative vocabulary
  • The XML attribute codeSystem shall contain OID "2.16.840.1.113883.2.1.3.2.4.17.407"
  • The XML attribute displayName shall carry the name associated with the code.
[0..*] telecom (SET<TEL>)

Model Attribute Description

The HL7 Attribute telecom specifies contact details for the subject in the form of telephone numbers, fax numbers and email addresses.

Implementation in XML Instance

The XML value attribute of the XML element telecom should contain the telephone / fax number or an email address prefixed by the type of contact and a colon.

  • For a telephone number the actual telephone number would be prefixed with tel:
  • For a fax number the actual fax number would be prefixed with fax:
  • For an email address the actual email address would be prefixed with mailto:

The XML attribute use of the XML element telecom may be used to give further information about the type of contact details contained in the XML attribute value. Only the use values listed below are recommended to be used for the subject contact details:

Code Definition
AS Answering service - An automated answering machine used for less urgent cases and if the main purpose of contact is to leave a message or access an automated announcement.
EC
Emergency contact - A contact specifically designated to be used for emergencies. This is the first choice in emergencies, independent of any other use codes.
H
Home - A communication address at a home, attempted contacts for business purposes might intrude privacy and chances are one will contact family or other household members instead of the person one wishes to call. Typically used with urgent cases, or if no other contacts are available.
HP
Home primary - The primary contact to reach a person after business hours.
HV
 Home vacation - A vacation home, to reach a person while on vacation.
WP
 Work place - An office address. First choice for business related contacts during business hours
PG
Pager - A paging device suitable to solicit a callback or to leave a very short message.
MC
Mobile contact - A telecommunication device that moves and stays with its owner. May have characteristics of all other use codes, suitable for urgent matters, not the first choice for routine business.

The XML element useablePeriod of the XML element telecom may be used to indicate when the contact details given are valid, for example to indicate that a telephone number is only for office hours (9am to 5 pm). It can be used to indicate some of the following types of valid times:

  • A point in time when the contact details are valid
  • A start and end time
    • Just including hours and minutes to indicate opening hours of an office for work contacts
    • Using dates for indicating a contact is only for a certain period of time
  • A start time only to indicate when the contact details are valid from
  • An end time only to indicate that the contact details are only valid until a certain date
[1..1] [M] templateId (II)
{ Fixed="COCD_TP145213GB01#RelatedSubject" }
Model Attribute Description

The HL7 attribute templateId provides a unique identifier for the template and the class name within that template. This is used to identify how the CDA standard has been constrained for NHS use.

Implementation in XML Instance

The Identifier External data type flavour is used to carry this information in the XML element templateId as follows:
  • The XML attribute root is fixed to the OID "2.16.840.1.113883.2.1.3.2.4.18.2"
  • The XML attribute extension is fixed to "COCD_TP145213GB01#RelatedSubject"
[0..1] subject (SubjectPerson)
A link to the subject person
SubjectPerson

This class carries details to allow identification of the person who is the subject.
Used by: RelatedSubject
[1..1] [M] classCode (CS { CNE: EntityClass } )
{ Fixed="PSN" }

Model Attribute Description

The HL7 attribute classCode describes this class as a person.

Implementation in XML Instance

The XML attribute classCode is fixed to " PSN".
[1..1] [M] determinerCode (CS { CNE: EntityDeterminer } )
{ Fixed="INSTANCE" }

Model Attribute Description

The HL7 attribute determinerCode describes this class as an instance of a person.

Implementation in XML Instance

The XML attribute determinerCode is fixed to " INSTANCE".
[0..1] administrativeGenderCode (CE { CWE:Sex } )

Model Attribute Description

The HL7 attribute administrativeGenderCode uses a code from the Sex vocabulary or an alternative vocabualry to indicate the gender of the person.

This code is for administrative purposes only and does not imply a particular genetic or physical sex.

Implementation in XML Instance

When using the sex vocabulary then:

The Coded Plain data type flavour of Coded Value (CV) shall be used to carry this information in the XML element administrativeGenderCode as follows:

  • The XML attribute code shall contain a code from the Sex vocabulary
  • The XML attribute codeSystem shall contain the fixed OID "2.16.840.1.113883.2.1.3.2.4.16.25"
  • The XML attribute displayName shall carry the description associated with the code in the Sex vocabulary.

When using an alternative vocabulary and an OID is available then:

The Coded Plain data type flavour of Coded Value (CV) shall be used to carry this information in the XML element administrativeGenderCode as follows:

  • The XML attribute code shall contain a code from the alternative vocabulary
  • The XML attribute codeSystem shall contain the OID for the alternative vocabulary
  • The XML attribute displayName shall carry the description associated with the code in the alternative vocabulary.

When using an alternative vocabulary and an OID is not available then:

The Coded Plain data type flavour of Coded Value (CV) shall be used to carry this information in the XML element administrativeGenderCode as follows:

  • The XML attribute code shall contain a code from the alternative vocabulary
  • The XML attribute codeSystem shall contain the OID "2.16.840.1.113883.2.1.3.2.4.17.408"
  • The XML attribute displayName shall carry the description associated with the code in the alternative vocabulary.

When the person's gender cannot be sent because there is no information to populate the XML element admininistrativeGenderCode available on the sending system, then an appropriate XML attribute nullFlavor of the XML element admininistrativeGenderCode may used.

The recommended values for the XML attribute nullFlavor are listed below:

nullFlavor Definition
UNK Unknown - A proper value is applicable, but not known
ASKU Asked but unknown - Information was sought but not found (e.g., person was asked but didn't know)
NAV Temporarily unavailable - Information is not available at this time but it is expected that it will be available later.
NASK Not asked - This information has not been sought (e.g., person was not asked)
MSK Masked - There is information on this item available but it has not been provided by the sender due to security, privacy or other reasons.

There may be an alternate mechanism for gaining access to this information.
[0..1] birthTime (TS)

Model Attribute Description

The HL7 attribute birthTime specifies the person's date of birth.

Implementation in XML Instance

The XML attribute value of the XML element birthTime shall be populated a time stamp in the format yyyymmddhhmm where:

  • yyyy is the year
  • mm is the month
  • dd is the day
  • hh is the hour
  • mm is the minute

At least the year must be present

The XML attribute value of the XML element birthTime should be populated to the level of detail that is available on the sending system.

When the person's date of birth cannot be sent because there is no information to populate the XML element birthTime available on the sending system, then an XML attribute nullFlavor of the XML element birthTime can be used. The recommended values for the XML attribute nullFlavor are listed below:

nullFlavor Definition
UNK Unknown - A proper value is applicable, but not known
ASKU Asked but unknown - Information was sought but not found (e.g. person was asked but didn't know)
NAV Temporarily unavailable - Information is not available at this time but it is expected that it will be available later.
NASK Not asked - This information has not been sought (e.g., person was not asked)
MSK Masked - There is information on this item available but it has not been provided by the sender due to security, privacy or other reasons.

There may be an alternate mechanism for gaining access to this information.
[0..*] name (SET<PN>)

Model Attribute Description

The HL7 attribute name provides names associated with the person who is the subject.

Implementation in XML Instance

The Person Name Structured with optional Use and optional Valid Time flavour of the PN data type is the recommended format for the patient's name. This information is carried in the XML element name as follows:

  • The XML element prefix should contain the person's title
  • The XML element given should contain the patient's forenames; there can be as many occurrences of the XML element as required
  • The XML element family should contain the person's surname
  • The XML element suffix may contain any suffix for the person

Additionally the XML attribute use of the XML element name should be used to indicate the type of name; the recommended codes to be used are listed below:

Note some of the codes listed are NHS extensions, these are marked with an *

Code Definition
L
 Legal
A
 Artist / stage
I
 Indigenous/Tribal
R
 Religious
PREVIOUS-BIRTH *
 Birth name
PREVIOUS-MAIDEN *
 Maiden name
PREVIOUS-BACHELOR *
 Bachelor name
PREVIOUS *
 Other previous name
PREFERRED *
 Preferred name

Additionally the XML element validTime of the XML element name may be used to indicate the time when the name is valid/was valid for the person, some uses are shown below:

  • A point in time when the name details are known to be valid
  • A start and end time
    • To represent the period of time the person is/was known by this name
  • A start time only to indicate when the name is/was valid from for the person
  • An end time only to indicate that the name is/was only valid for the person until a certain date

When no person name is available to the sending system to then an appropriate XML attribute nullFlavor may be used to populate the XML element name. The recommended values for the XML attribute nullFlavor are listed below:

nullFlavor Definition
UNK Unknown - A proper value is applicable, but not known
ASKU Asked but unknown - Information was sought but not found (e.g., person was asked but didn't know)
NAV Temporarily unavailable - Information is not available at this time but it is expected that it will be available later.
NASK Not asked - This information has not been sought (e.g. person was not asked)
MSK Masked - There is information on this item available but it has not been provided by the sender due to security, privacy or other reasons.

There may be an alternate mechanism for gaining access to this information.
[1..1] [M] templateId (II)
{ Fixed="COCD_TP145213GB01#subject" }
Model Attribute Description

The HL7 attribute templateId provides a unique identifier for the template and the class name within that template. This is used to identify how the CDA standard has been constrained for NHS use.

Implementation in XML Instance

The Identifier External data type flavour is used to carry this information in the XML element templateId as follows:
  • The XML attribute root is fixed to the OID "2.16.840.1.113883.2.1.3.2.4.18.2"
  • The XML attribute extension is fixed to "COCD_TP145213GB01#subject"