Logical Record Architecture for Health and Social Care

Discharge Summary Release 0.02

The content of this release is not comprehensive and is not fully validated and must not be used in live system implementations.

ENTRY Domain Model: ProductOrSubstanceRelatedActivity

An ENTRY containing a collection of data items required to represent a product or substance related activity which is carried out (or intended to be carried out) on the subject of care. Comprises a single coded Product Or Substance Related Activity and optionally may contain:

  • a textual description of the activity
  • a coded representation of any relevant findings, observations, investigations, diagnoses or treatments that indicate this activity
  • a coded representation of the type of product or substance
  • a coded representation of the quantity and flow rate
  • a coded representation of the type of device used
  • a non-SNOMED CT bound representation of future timing events relevant to this activity
Incorporates requirements from the following sources:
  • NPfIT MIM 7.2.02 Treatment template (COCD_TP146027UK04)
  • Section 3.12.3 of 2: NPFIT-NCR-DES-0135.07 NHS Care Record Elements
  • LRA Discharge Summary Requirements Specification

Attributes

Name Data type Occurs Description Value Constraints
name SC 1..1 The name, expressed as a coded value or as plain text, specifies the clinical or administrative concept to which this EHR node corresponds, as labelled in the EHR system in which it was first committed.

value
Literal value(s): ENTRY
rc_id II 1..1 The globally-unique identifier by which this node in the EHR hierarchy is referenced in the EHR system to which the data were first committed. This identifier shall be retained by the EHR Recipient and re-used whenever this RECORD_COMPONENT is subsequently included in another EHR_EXTRACT.
synthesised BL 1..1 This attribute value shall be TRUE if this RECORD_COMPONENT has been created in order to comply with this standard , but this point in the EHR hierarchy has no corresponding node in the EHR from which it was extracted.

value
Default value: false
uncertainty_expressed BL 1..1 This attribute is set to TRUE to advise the EHR Recipient that this ENTRY contains data that indicates some degree of uncertainty, and that care should be taken when using these data within automated processes and systems.

nullFlavor
Literal value(s): NA


Contained ELEMENTs

Graphical Representation

Name ELEMENT Class Occurs Description
items GenericInvestigation 0..*
items RecommendationActivity 0..*
items GenericFindingObservation 0..*
items MedicationTag 0..*
items MaterialFlowRate 0..*
items ProductOrSubstanceRelatedActivity 1..*
items GenericProcedure 0..*
items ValidityPeriod 0..*
items MaterialQuantity 0..*
items FutureEventTime 0..*
items TreatmentDevice 0..*
items GenericTreatment 0..*
other_participations OtherParticipationsChoice 0..*
items GenericProblemAndIssue 0..*
items UnboundData 0..*
items DiagnosisName 0..*
items AllergyOrAdverseReactionEvent 0..*
items MedicationReviewPlan 0..*
items ProductOrSubstance 0..*
items CourseTiming 0..*
items GenericPropertyObservation 0..*
items Text 0..*


Reference Model Type

ENTRY