Non-Coded CDA Document
Domain Message Specification

Version: 1.1; Status: Final

Attachment Tabular View

COCD_TP146224GB02
ObservationMedia

A template to allow attachments to be carried in a CDA document

This class is a derivative of the RIM Observation class that represents multimedia that is logically part of the current document. This class is only for multimedia that is logically part of the attested content of the document. Rendering ObservationMedia requires a software tool that recognizes the particular media (MIME) type.
Used by:
[1..1] [M] classCode (CS { CNE: ActClass } )
{ Fixed="OBS" }

Model Attribute Description

The HL7 attribute classCode uses a code to describe this class as an observation.

Implementation in XML Instance

The XML attribute classCode is fixed to " OBS".
[1..1] [M] moodCode (CS { CNE: ActMood } )
{ Fixed="EVN" }

Model Attribute Description

The HL7 attribute moodCode uses a code to describe this class as an observation event.

Implementation in XML Instance

The XML attribute moodCode is fixed to " EVN".
[1..1] [M] id (II)

Model Attribute Description

The HL7 attribute id uses an identifier to identify this instance of an attachment.

Implementation in XML Instance

The Identifier Global data type flavour is used to carry this information in the XML element id as follows:

  • The XML attribute root shall contain a DCE UUID.
[1..1] [M] templateId (II)
{ Fixed="COCD_TP146224GB02#ObservationMedia" }
Model Attribute Description

The HL7 attribute templateId provides a unique identifier for the template and the classname 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_TP146224GB02#ObservationMedia"
[1..1] [M] value (ED)

Model Attribute Description

The HL7 attribute value is used to allow attachments to be carried in a CDA document.

Implementation in XML Instance

The ED (encapsulated data) data type is used to carry this encapsulated data in the XML element value. The XML element value should be populated as follows:
  • The XML attribute mediaType of the XML element value identifies the MIME type of the encapsulated data.
  • The XML attribute representation of the XML element value identifies the representation of the encapsulated data.
    • The representation is either "B64" for Base 64 Encoding or "TXT" for all other representations.
[0..1] author

This class is a participation of authorship.

This is the person or device who/which authored the information in the attachment.

This will normally be the person or device who/which added the attachment to the CDA document and should be present if different to inherited author or if no author is inherited.
[1..1] [M] typeCode (CS { CNE: ParticipationType } )
{ Fixed="AUT" }

Model Attribute Description

The HL7 attribute typeCode describes this class as an author participation.

Implementation in XML Instance

The XML attribute classCode is fixed to " AUT".
[1..1] [M] contextControlCode (CS { CNE: ContextControl } )
{ Fixed="OP" }

Model Attribute Description

The HL7 attribute contextConductionCode uses a set of codes from the HL7 vocabulary ContextControl to determine whether participations associated with the parent section is conducted across to the child section (also associated with the child section). This set of codes also determine how these participations conduct.

The conduction can only take place if the contextConductionInd is set to "true".

The value of this attribute is fixed in the HL7 model to "OP":

  • "O" (Overriding)- the author replaces any author that has been conducted from any previous acts.
  • "P" (Propagating)- the author is conducted to all child acts where the contextConductionInd is set to "true".

Implementation in XML Instance

The XML attribute contextControlCode shall contain the value " OP"
[1..1] [M] contentId (II) { "NPFIT-000081#Role" }

Model Attribute Description

The HL7 (NHS localisation) attribute contentId, when valued in an instance, provides a unique forward pointing identifier for the template which constrains the classes and attributes which follow, for NHS use.

The attribute is intended simply as a structural navigational aid and should not be relied upon as an indicator of semantic meaning. The contentId is populated at runtime with a value from the allowed list contained in the model.


Implementation in XML Instance

The Identifier External data type flavour is used to carry this information in the XML element contentId as follows:
  • The XML attribute root is fixed to the OID "2.16.840.1.113883.2.1.3.2.4.18.16"
  • The XML attribute extension shall contain one of the allowed template artefact identifiers.
[1..1] [M] functionCode (CV { CNE:AuthorFunctionType } )
{ Fixed="OA" }

Model Attribute Description

The HL7 attribute functionCode uses a code from the vocabulary AuthorFunctionType to describe the function of the attachment author

Implementation in XML Instance

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

  • The XML attribute code is fixed to "OA"
  • The XML attribute codeSystem is fixed to the OID "2.16.840.1.113883.2.1.3.2.4.17.178"
  • The XML attribute displayName is fixed to the author's function name "Originating Author"
[1..1] [M] templateId (II)
{ Fixed="COCD_TP146224GB02#author" }
Model Attribute Description

The HL7 attribute templateId provides a unique identifier for the template and the classname 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_TP146224GB02#author"
[1..1] [R] time (TS)

Model Attribute Description

The HL7 attribute time specifies the time at which the author authored the attachment.

Implementation in XML Instance

The XML attribute value of the XML element time shall be populated a time stamp in the format yyyymmddhhmmss[+|-ZZzz] where:

  • yyyy is the year
  • mm is the month
  • dd is the day
  • hh is the hour
  • mm is the minute
  • [+|-ZZzz] is the time zone offset in hours and minutes

At least the year must be present.

Sections from the right of this representation may be left off when the sending system does not record to this level of accuracy. When hours are present, the time zone offset must also be present.

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

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

nullFlavor Description
UNK Unknown - A proper value is applicable, but not known
ASKU Asked but unknown - Information was sought but not found (e.g. patient 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., patient 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] participant (AuthorChoice)
A link to the choice of author templates.
[0..1] informant

This class is a participation of informant.

An informant is someone who informed about the information in the attachment.
[1..1] [M] typeCode (CS { CNE: ParticipationType } )
{ Fixed="INF" }

Model Attribute Description

The HL7 attribute typeCode describes this class as an informant participation. The informant is the person who provided information about attachment to the author.

Implementation in XML Instance

The XML attribute classCode is fixed to " INF".
[1..1] [M] contextControlCode (CS { CNE: ContextControl } )
{ Fixed="OP" }

Model Attribute Description

The HL7 attribute contextConductionCode uses a set of codes from the HL7 vocabulary ContextControl to determine whether participations associated with the parent section is conducted across to the child section (also associated with the child section). This set of codes also determine how these participations conduct.

The conduction can only take place if the contextConductionInd is set to "true"

The value of this attribute is fixed in the HL7 model to "OP":

  • "O" (Overriding)- the author replaces any author that has been conducted from any previous acts.
  • "P" (Propagating)- the author is conducted to all child acts where the contextConductionInd is set to "true".

Implementation in XML Instance

The XML attribute contextControlCode shall contain the value " OP".
[1..1] [M] contentId (II) { "NPFIT-000085#Role" }
Model Attribute Description

The HL7 (NHS localisation) attribute contentId, when valued in an instance, provides a unique forward pointing identifier for the template which constrains the classes and attributes which follow, for NHS use.

The attribute is intended simply as a structural navigational aid and should not be relied upon as an indicator of semantic meaning. The contentId is populated at runtime with a value from the allowed list contained in the model.


Implementation in XML Instance

The Identifier External data type flavour is used to carry this information in the XML element content Id as follows:
  • The XML attribute root is fixed to the OID "2.16.840.1.113883.2.1.3.2.4.18.16"
  • The XML attribute extension shall contain one of the allowed template artefact identifiers.
[1..1] [M] templateId (II)
{ Fixed="COCD_TP146224GB02#informant" }
Model Attribute Description

The HL7 attribute templateId provides a unique identifier for the template and the classname 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_TP146224GB02#informant"
[1..1] participant (InformantChoice)
A link to the choice of informants.
[0..*] subject

This class is the participation of the subject of the attachment.

It is used when the subject is not the patient.
[1..1] [M] typeCode (CS { CNE: ParticipationType } )
{ Fixed="SBJ" }

Model Attribute Description

The HL7 attribute typeCode describes this participation class as a subject of the attachment.

Implementation in XML Instance

The XML attribute classCode is fixed to " SUBJ".
[1..1] [M] contextControlCode (CS { CNE: ContextControl } )
{ Fixed="OP" }

Model Attribute Description

The HL7 attribute contextConductionCode uses a set of codes from the HL7 vocabulary ContextControl to determine whether participations associated with the parent section is conducted across to the child section (also associated with the child section). This set of codes also determine how these participations conduct.

The conduction can only take place if the contextConductionInd is set to "true"

The value of this attribute is fixed in the HL7 model to "OP":

  • "O" (Overriding)- the author replaces any author that has been conducted from any previous acts.
  • "P" (Propagating)- the author is conducted to all child acts where the contextConductionInd is set to "true".

Implementation in XML Instance

The XML attribute contextControlCode shall contain the value " OP".
[0..1] awarenessCode (CE { CWE:TargetAwareness } )

Model Attribute Description

The HL7 attribute awarenessCode uses a code from the HL7 vocabulary TargetAwareness or any alternative vocabulary to describe the extent to which the subject of the attachment is aware of the attachment content.

Implementation in XML Instance

When using the TargetAwareness vocabulary then:

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

  • The XML attribute code shall contain a value from the TargetAwareness vocabulary
  • The XML attribute codeSystem shall contain the OID "2.16.840.1.113883.5.137"
  • The XML attribute displayName shall contain the text associated with the code in the TargetAwareness vocabulary

When using the HL7 vocabulary TargetAwareness only the values listed below are recommended to be used:

Code
Description
D The target person has been informed about the issue but currently denies it.
F
 The target person is fully aware of the issue.
I The target person is not capable of comprehending the issue.
M
 The target person is marginally aware of the issue.
P The target person is partially aware of the issue.
U The target person has not yet been informed of the issue.

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

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

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

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

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

  • The XML attribute code shall contain a value from the alternative vocabulary
  • The XML attribute codeSystem shall contain the OID "2.16.840.1.113883.2.1.3.2.4.17.411"
  • The XML attribute displayName shall contain the text associated with the code in the alternative vocabulary.
[1..1] [M] contentId (II) { "NPFIT-000070#Role" }

Model Attribute Description

The HL7 (NHS localisation) attribute contentId, when valued in an instance, provides a unique forward pointing identifier for the template which constrains the classes and attributes which follow, for NHS use.

The attribute is intended simply as a structural navigational aid and should not be relied upon as an indicator of semantic meaning. The contentId is populated at runtime with a value from the allowed list contained in the model.


Implementation in XML Instance

The Identifier External data type flavour is used to carry this information in the XML element contentId as follows:
  • The XML attribute root is fixed to the OID "2.16.840.1.113883.2.1.3.2.4.18.16"
  • The XML attribute extension shall contain one of the allowed template artefact identifiers.
[1..1] [M] templateId (II)
{ Fixed="COCD_TP146224GB02#subject" }
Model Attribute Description

The HL7 attribute templateId provides a unique identifier for the template and the classname 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_TP146224GB02#subject"
[1..1] participant (SubjectChoice)
A link to the choice of subjects.
SubjectChoice
The choice of subject templates.
Used by: ObservationMedia
[1..1] : Template3
A link to the subject templates.
InformantChoice
The choice of informant templates.
Used by: ObservationMedia
[1..1] : Template2
A link to the informant templates.
AuthorChoice
The choice of author templates.
Used by: ObservationMedia
[1..1] : Template1
A link to the author templates.