Ambulance
Domain Message Specification

MedicationDiscontinuation Tabular View

COCD_TP146336GB01
MedicationDiscontinuation

Refers to the actual act of discontinuating the medication supply.

Used by:
[1..1] [M] classCode (CS { CNE: ActClass } )
{ Fixed="OBS" }

Indicates this is an observation.

[1..1] [M] moodCode (CS { CNE: ActMood } )
{ Fixed="EVN" }

Indicates this is an event.

[1..1] [M] code (CD { CWE:CodedEntryCode } )

A code to identify the act as a type of discontinuation of the supply of medication.

The Concept Descriptor (CD) with CDA URL datatype/flavour shall be used to carry this information as follows:
  • The code attribute shall contain a code from the relevant vocabulary.
  • The codeSystem attribute shall contain the OID for vocabulary.
  • The displayName attribute shall carry a description associated with the code in the vocabulary.
  • The originalText element can be used to carry a reference element. This can link the coded item to the relevant text in the CDA section.
  • qualifier (s) may be used if required.
[1..1] [M] effectiveTime (TS)

When the medication supply was discontinued.

[1..1] [M] id (II)

This is a unique identifier for this instance of a medication discontinuation act.

The Identifier Global data type flavour is used to carry the identifiers follows:

  • The root attribute shall contain a DCE UUID.
[1..1] [M] statusCode (CS { CNE:ActStatus } )
{ Fixed="completed" }

The status of the discontinuation of the supply of medication.

The Coded Only data type flavour is used to carry this information as follows:

  • The code attribute will contain a fixed code from the Act Status vocabulary
[1..1] [M] templateId (II)
{ Fixed="COCD_TP146336GB01#MedicationDiscontinuation" }

The fixed value of this attribute provides a unique identifier for the template and the classname within that template.

The IdentifierExternal datatype flavour is used to carry this information as follows:

  • The root attribute shall contain the OID "2.16.840.1.113883.2.1.3.2.4.18.2"
  • The extension attribute shall contain the fixed value.
[0..1] author

The person who authored the discontinuation of medication.

Only required if different to inherited author or no author is inherited

[1..1] [M] typeCode (CS { CNE: ParticipationType } )
{ Fixed="AUT" }
Indicates this is an author.
[1..1] [M] contextControlCode (CS { CNE: ContextControl } )
{ Fixed="OP" }

Specifies how this author contributes to the context of the discontinuation of medication act and whether it may be propagated to descendent acts whose association allows such propagation.

"O" (Overriding)- the association replaces any context of the same or more specific type that has been conducted from the parent act.

"P" (Propagating)- the association is conducted to all child acts where the ActRelationship.contextConductionInd is set to "true".
[1..1] [M] contentId (II) { "NPFIT-000001#Role" }

This attribute, when valued in an instance, provides a unique forward pointing identifier for a template which constrains the classes and attributes which follow.

The attribute is intended simply as a structural navigational aid and should not be relied upon as an indicator of semantic meaning.

The IdentifierExternal datatype flavour is used to carry this information as follows:

  • The root attribute shall contain the OID "2.16.840.1.113883.2.1.3.2.4.18.16"
  • The extension attribute shall contain the template artifact Id.
[1..1] [M] functionCode (CV { CNE:AuthorFunctionType } )
{ Fixed="OA" }

A code from the vocabulary shown indicating the function of the document author

The Coded Plain flavour of Coded Value (CV) datatype shall be used to carry this information as follows:

  • The code attribute shall contain the value
  • The codeSystem attribute shall contain the OID for the vocabulary concerned
  • The displayName attribute shall contain the text associated with the code
[1..1] [M] templateId (II)
{ Fixed="COCD_TP146336GB01#author" }

The fixed value of this attribute provides a unique identifier for the template and the classname within that template.

The IdentifierExternal datatype flavour is used to carry this information as follows:

  • The root attribute shall contain the OID "2.16.840.1.113883.2.1.3.2.4.18.2"
  • The extension attribute shall contain the fixed value.
[1..1] [R] time (TS)

When the author authored the medication discontinuation.

[1..1] participant (AuthorChoice)

A link to the choice of author templates.

[0..1] entryRelationship

Refers to the patient inform act which is a component of the medication discontinuation.

[1..1] [M] typeCode (CS { CNE: ActRelationshipType } )
{ Fixed="COMP" }

Indicates this is a component.

[1..1] [M] inversionInd (BL)
{ Fixed="false" }

An indicator specifying that the ActRelationship.typeCode should be interpreted as if the roles of the source and target Acts were reversed

[1..1] [M] contextConductionInd (BL)
{ Fixed="true" }

If true, associations in the parent act are conducted across the Act Relationship to the child act.

[1..1] [M] seperatableInd (BL)
{ Fixed="false" }

This attribute indicates whether or not the source Act is intended to be interpreted independently of the target Act.

[1..1] [M] templateId (II)
{ Fixed="COCD_TP146336GB01#entryRelationship" }

The fixed value of this attribute provides a unique identifier for the template and the classname within that template.

The IdentifierExternal datatype flavour is used to carry this information as follows:

  • The root attribute shall contain the OID "2.16.840.1.113883.2.1.3.2.4.18.2"
  • The extension attribute shall contain the fixed value.
[1..1] informPatient (InformPatient)

A link to the inform patient act.

[0..*] entryRelationship1

Refers to any unsucessful attempt to contact the patient.

[1..1] [M] typeCode (CS { CNE: ActRelationshipType } )
{ Fixed="COMP" }

Indicates this is a component.

[1..1] [M] inversionInd (BL)
{ Fixed="false" }

An indicator specifying that the ActRelationship.typeCode should be interpreted as if the roles of the source and target Acts were reversed

[1..1] [M] contextConductionInd (BL)
{ Fixed="true" }

If true, associations in the parent act are conducted across the Act Relationship to the child act.

[1..1] [M] seperatableInd (BL)
{ Fixed="false" }

This attribute indicates whether or not the source Act is intended to be interpreted independently of the target Act.

[1..1] [M] templateId (II)
{ Fixed="COCD_TP146336GB01#entryRelationship1" }

The fixed value of this attribute provides a unique identifier for the template and the classname within that template.

The IdentifierExternal datatype flavour is used to carry this information as follows:

  • The root attribute shall contain the OID "2.16.840.1.113883.2.1.3.2.4.18.2"
  • The extension attribute shall contain the fixed value.
[1..1] patientContactAttempt (PatientContactAttempt)

A link to the patient contact attempt act.

[0..*] entryRelationship2

Refers to a reference to a reason to discontinue medication.

[1..1] [M] typeCode (CS { CNE: ActRelationshipType } )
{ Fixed="RSON" }

Indicates this is a reason.

[1..1] [M] contextConductionInd (BL)
{ Fixed="false" }

If true, associations in the parent act are conducted across the Act Relationship to the child act.

[1..1] [M] contentId (II) { "NPFIT-000317#ActRef" }

This attribute, when valued in an instance, provides a unique forward pointing identifier for a template which constrains the classes and attributes which follow.

The attribute is intended simply as a structural navigational aid and should not be relied upon as an indicator of semantic meaning.

The IdentifierExternal datatype flavour is used to carry this information as follows:

  • The root attribute shall contain the OID "2.16.840.1.113883.2.1.3.2.4.18.16"
  • The extension attribute shall contain the template artifact Id.
[1..1] [M] seperatableInd (BL)
{ Fixed="false" }

This attribute indicates whether or not the source Act is intended to be interpreted independently of the target Act.

[1..1] [M] templateId (II)
{ Fixed="COCD_TP146336GB01#entryRelationship2" }

The fixed value of this attribute provides a unique identifier for the template and the classname within that template.

The IdentifierExternal datatype flavour is used to carry this information as follows:

  • The root attribute shall contain the OID "2.16.840.1.113883.2.1.3.2.4.18.2"
  • The extension attribute shall contain the fixed value.
[1..1] justifyingReasonForDiscontinuation (ReasonForDiscontinuation)

A link to the choice of reason for medcation discontinuation reference templates.

AuthorChoice

An abstract placeholder for the templates of an author.

Used by: MedicationDiscontinuation
[1..1] : Template1

A link to the author templates.

InformPatient

The act of informing the patient about the discontinuation of the medication.

Only used when the patient has been informed.

Used by: MedicationDiscontinuation
[1..1] [M] classCode (CS { CNE: ActClass } )
{ Fixed="INFRM" }

Indicates this is an inform act.

[1..1] [M] moodCode (CS { CNE: ActMood } )
{ Fixed="EVN" }

Indicates this is an event.

[1..1] [M] code (CD { CWE:CodedEntryCode } )

A code to identify the act as a type of patient inform.

The Concept Descriptor (CD) with CDA URL datatype/flavour shall be used to carry this information as follows:
  • The code attribute shall contain a code from the relevant vocabulary.
  • The codeSystem attribute shall contain the OID for vocabulary.
  • The displayName attribute shall carry a description associated with the code in the vocabulary.
  • The originalText element can be used to carry a reference element. This can link the coded item to the relevant text in the CDA section.
  • qualifier (s) may be used if required.
[1..1] [R] effectiveTime (TS)

The time the patient was informed about the discontinuation of medication.

[1..1] [M] id (II)

A unique identifier for this instance of a inform patient act.

The Identifier Global datatype flavour is used to carry the identifier as follows:

  • The root attribute shall contain a DCE UUID
[1..1] [M] templateId (II)
{ Fixed="COCD_TP146336GB01#informPatient" }

The fixed value of this attribute provides a unique identifier for the template and the classname within that template.

The IdentifierExternal datatype flavour is used to carry this information as follows:

  • The root attribute shall contain the OID "2.16.840.1.113883.2.1.3.2.4.18.2"
  • The extension attribute shall contain the fixed value.
[1..1] [M] performer

Refers to who informed the patient.

[1..1] [M] typeCode (CS { CNE: ParticipationType } )
{ Fixed="PRF" }

Indicates this is a performer.

[1..1] [M] contentId (II) { "NPFIT-000022#Role" }

This attribute, when valued in an instance, provides a unique forward pointing identifier for a template which constrains the classes and attributes which follow.

The attribute is intended simply as a structural navigational aid and should not be relied upon as an indicator of semantic meaning.

The IdentifierExternal datatype flavour is used to carry this information as follows:

  • The root attribute shall contain the OID "2.16.840.1.113883.2.1.3.2.4.18.16"
  • The extension attribute shall contain the template artifact Id.
[1..1] [M] modeCode (CS { CNE:ParticipationMode } )

The mode in which the performer informed the patient.

The Coded Only datatype flavour is used to carry this information as follows:

  • The code attribute will contain a value from the list of codes in the ParticipationMode vocabulary
[1..1] [M] templateId (II)
{ Fixed="COCD_TP146336GB01#performer" }

The fixed value of this attribute provides a unique identifier for the template and the classname within that template.

The IdentifierExternal datatype flavour is used to carry this information as follows:

  • The root attribute shall contain the OID "2.16.840.1.113883.2.1.3.2.4.18.2"
  • The extension attribute shall contain the fixed value.
[1..1] [M] participant (PerformerChoice)

A link to the choice of performer.

[1..1] [M] primaryInformationRecipient

Refers to the person who is the primary information recipient of the inform of medication discontinuation.

[1..1] [M] typeCode (CS { CNE: ParticipationType } )
{ Fixed="PRCP" }

Indicates the role of primary information recipient.

[1..1] [M] contextControlCode (CS { CNE: ContextControl } )
{ Fixed="OP" }

Specifies how the primary information recipient contributes to the context of the inform act and whether they may be propagated to descendent acts whose association allows such propagation.

"O" (Overriding)- the association replaces any context of the same or more specific type that has been conducted from the parent act.

"P" (Propagating)- the association is conducted to all child acts where the ActRelationship.contextConductionInd is set to "true."
[1..1] [M] templateId (II)
{ Fixed="COCD_TP146336GB01#primaryInformationRecipient" }

The fixed value of this attribute provides a unique identifier for the template and the classname within that template.

The IdentifierExternal datatype flavour is used to carry this information as follows:

  • The root attribute shall contain the OID "2.16.840.1.113883.2.1.3.2.4.18.2"
  • The extension attribute shall contain the fixed value.
[1..1] [M] patientRole (PatientRole)

A link to the patient role.

PatientRole

The role of patient.

Used by: InformPatient
[1..1] [M] classCode (CS { CNE: RoleClass } )
{ Fixed="PAT" }

Indicates this is a patient role.

[1..1] [M] id (II)
To provide the nationally recognised identifier for the patient, the NHS number.

The Identifier External datatype flavour is used to carry this information as follows:

An NHS number is carried in the following way:
  • The root attribute will contain an OID with the value "2.16.840.1.113883.2.1.4.1"
  • The extension attribute will contain the NHS number.
Only new permanent NHS numbers can be used to identify patients.
[1..1] [M] templateId (II)
{ Fixed="COCD_TP146336GB01#patientRole" }

The fixed value of this attribute provides a unique identifier for the template and the classname within that template.

The IdentifierExternal datatype flavour is used to carry this information as follows:

  • The root attribute shall contain the OID "2.16.840.1.113883.2.1.3.2.4.18.2"
  • The extension attribute shall contain the fixed value.
PerformerChoice

An abstract placeholder for the templates of a performer of the medication discontinuation.

Used by: InformPatient
[1..1] : Template2

A link to the performer templates.

PatientContactAttempt

An attempt to inform the patient about the discontinuation of medication.

Only used when the patient could not be contacted.

Used by: MedicationDiscontinuation
[1..1] [M] classCode (CS { CNE: ActClass } )
{ Fixed="ENC" }

Indicates this is an encounter.

[1..1] [M] moodCode (CS { CNE: ActMood } )
{ Fixed="EVN" }

Indicates this is an event.

[1..1] [M] code (CD { CWE:CodedEntryCode } )

A code to identify the act as a type of encounter where the attempt to contact patient took place.

The Concept Descriptor (CD) with CDA URL datatype/flavour shall be used to carry this information as follows:
  • The code attribute shall contain a code from the relevant vocabulary.
  • The codeSystem attribute shall contain the OID for vocabulary.
  • The displayName attribute shall carry a description associated with the code in the vocabulary.
  • The originalText element can be used to carry a reference element. This can link the coded item to the relevant text in the CDA section.
  • qualifier (s) may be used if required.
[1..1] [M] effectiveTime (TS)

The time the attempt to contact the patient was made.

[1..1] [M] id (II)

This is a unique identifier for this instance of a patient contact attempt.

The Identifier Global data type flavour is used to carry the identifiers follows:

  • The root attribute shall contain a DCE UUID.
[1..1] [M] statusCode (CS { CNE:ActStatus } )
{ Fixed="aborted" }

The status of the contact attempt.

The Coded Only data type flavour is used to carry this information as follows:

  • The code attribute will contain a fixed code from the Act Status vocabulary
[1..1] [M] templateId (II)
{ Fixed="COCD_TP146336GB01#patientContactAttempt" }

The fixed value of this attribute provides a unique identifier for the template and the classname within that template.

The IdentifierExternal datatype flavour is used to carry this information as follows:

  • The root attribute shall contain the OID "2.16.840.1.113883.2.1.3.2.4.18.2"
  • The extension attribute shall contain the fixed value.
[1..1] [M] performer

Refers to a performer of the contact attempt.

[1..1] [M] typeCode (CS { CNE: ParticipationType } )
{ Fixed="PRF" }

Indicates that this is a performer.

[1..1] [M] contentId (II) { "NPFIT-000022#Role" }

This attribute, when valued in an instance, provides a unique forward pointing identifier for a template which constrains the classes and attributes which follow.

The attribute is intended simply as a structural navigational aid and should not be relied upon as an indicator of semantic meaning.

The IdentifierExternal datatype flavour is used to carry this information as follows:

  • The root attribute shall contain the OID "2.16.840.1.113883.2.1.3.2.4.18.16"
  • The extension attribute shall contain the template artifact Id.
[0..1] modeCode (CE { CNE:ParticipationMode } )

The mode in which the performer performed in the contact attempt.

The Coded Only datatype flavour is used to carry this information as follows:

  • The code attribute will contain a value from the list of codes in the ParticipationMode vocabulary
[1..1] [M] templateId (II)
{ Fixed="COCD_TP146336GB01#performer" }

The fixed value of this attribute provides a unique identifier for the template and the classname within that template.

The IdentifierExternal datatype flavour is used to carry this information as follows:

  • The root attribute shall contain the OID "2.16.840.1.113883.2.1.3.2.4.18.2"
  • The extension attribute shall contain the fixed value.
[1..1] [R] time (IVL<TS>)

The time that the perfomer performer during the contact attempt.

The date range shall be carried as follows:

If a single point in time is to be carried the Date or Time Point data type shall be used:

  • The center attribute shall contain the date.
This datatype is used if date of the contact attempt is not fully known / available


If both a start date and an end date are present the Date or Time Interval Complete data type shall be used:

  • The low attribute shall contain the start date.
  • The high attribute shall contain the end date.

If only a start date is present the Date or Time Interval After data type shall be used

[1..1] [M] participant (PerformerChoice1)

A link to the choice of performer templates.

PerformerChoice1

An abstract placeholder for the templates of a performer of the attempt to contact the patient.

Used by: PatientContactAttempt
[1..1] : Template3

A link to the performer templates.

ReasonForDiscontinuation

The reason for the discontinuation of medication.

Used by: MedicationDiscontinuation
[1..1] : Template

A choice of reason for discontinuation reference templates.