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CCD Export: Problem code system is SNOMED CT instead of ICD-9 #10

Closed ejancic closed 11 years ago

ejancic commented 11 years ago

The CCD Export identifies the code system for problems to be SNOMED CT. The code system should be ICD-9

Problem excerpt from XML is attached, full XML is below:

Screen Shot 2013-04-01 at 1 33 09 PM

Full XML:

<?xml version="1.0" ?>
<ClinicalDocument xmlns="urn:hl7-org:v3" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="urn:hl7-org:v3 http://xreg2.nist.gov:8080/hitspValidation/schema/cdar2c32/infrastructure/cda/C32_CDA.xsd">
    <realmCode code="US" />
    <typeId root="2.16.840.1.113883.1.3" extension="POCD_HD000040" />
    <templateId root="2.16.840.1.113883.3.27.1776" assigningAuthorityName="CDA/R2" />
    <templateId root="2.16.840.1.113883.10.20.3" assigningAuthorityName="HL7/CDT Header" />
    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.1.1" assigningAuthorityName="IHE/PCC" />
    <templateId root="2.16.840.1.113883.3.88.11.32.1" assigningAuthorityName="HITSP/C32" />
    <id root="2.16.840.1.113883.3.72" extension="MU_Rev2_HITSP_C32C83" assigningAuthorityName="NIST Healthcare Project" /><code code="34133-9" displayName="Summarization of episode note" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" />
    <title/>
    <effectiveTime value="20130401125826" />
    <confidentialityCode/>
    <languageCode code="en-US" />
    <recordTarget>
        <patientRole>
            <id root="2.16.840.1.113883.4.1" extension="345-34-3456" />
            <addr use="HP">
                <streetAddressLine>355 Maple Street</streetAddressLine>
                <streetAddressLine></streetAddressLine>
                <city>williamsport</city>
                <state>PA</state>
                <postalCode>17701</postalCode>
                <country>US</country>
            </addr>
            <telecom use="WP" value="tel:(570)837-8364" />
            <patient>
                <name>
                    <given>John</given>
                    <family>Smith</family>
                </name>
                <administrativeGenderCode code="M" displayName="Male" codeSystem="2.16.840.1.113883.5.1" codeSystemName="HL7 AdministrativeGender" />
                <birthTime value="19600704" />
                <languageCommunication>
                    <templateId root="2.16.840.1.113883.3.88.11.83.2" assigningAuthorityName="HITSP/C83" />
                    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.2.1" assigningAuthorityName="IHE/PCC" />
                    <languageCode code="en-US" />
                </languageCommunication>
            </patient>
        </patientRole>
    </recordTarget>
    <author>
        <time value="20130401125826" />
        <assignedAuthor>
            <id/>
            <addr/>
            <telecom/>
            <assignedPerson>
                <name>Staff</name>
            </assignedPerson>
            <representedOrganization>
                <name>NIST Healthcare Testing Laboratory</name>
                <telecom></telecom>
                <addr></addr>
            </representedOrganization>
        </assignedAuthor>
    </author>
    <custodian>
        <assignedCustodian>
            <representedCustodianOrganization>
                <id></id>
                <name></name>
                <telecom></telecom>
                <addr></addr>
            </representedCustodianOrganization>
        </assignedCustodian>
    </custodian>
    <component>
        <structuredBody>
            <component>
                <section>
                    <templateId root="2.16.840.1.113883.3.88.11.83.102" assigningAuthorityName="HITSP/C83" />
                    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.3.13" assigningAuthorityName="IHE PCC" />
                    <templateId root="2.16.840.1.113883.10.20.1.2" assigningAuthorityName="HL7 CCD" /><code code="48765-2" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Allergies" />
                    <title>Allergies and Adverse Reactions</title>
                    <text>
                        <table border="1" width="100%">
                            <thead>
                                <tr>
                                    <th>Type</th>
                                    <th>Substance</th>
                                    <th>Reaction</th>
                                    <th>Status</th>
                                </tr>
                            </thead>
                            <tbody>
                                <tr ID="ALGSUMMARY_1">
                                    <td ID="ALGTYPE_1">Drug Allergy</td>
                                    <td ID="ALGSUB_1">Codeine allergy</td>
                                    <td ID="ALGREACT_1">Rash</td>
                                    <td ID="ALGSTATUS_1">active</td>
                                </tr>
                            </tbody>
                        </table>
                    </text>
                    <entry typeCode="DRIV">
                        <act classCode="ACT" moodCode="EVN">
                            <templateId root="2.16.840.1.113883.3.88.11.83.6" assigningAuthorityName="HITSP/C83" />
                            <templateId root="2.16.840.1.113883.10.20.1.27" assigningAuthorityName="CCD" />
                            <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.5.1" assigningAuthorityName="IHE PCC" />
                            <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.5.3" assigningAuthorityName="IHE PCC" />
                            <id root="36e3e930-7b14-11db-9fe1-0800200c9a66" /><code nullFlavor="NA" />
                            <statusCode code="completed" />
                            <effectiveTime>
                                <low nullFlavor="UNK" />
                                <high nullFlavor="UNK" />
                            </effectiveTime>
                            <entryRelationship typeCode="SUBJ" inversionInd="false">
                                <observation classCode="OBS" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.10.20.1.18" assigningAuthorityName="CCD" />
                                    <templateId root="2.16.840.1.113883.10.20.1.28" assigningAuthorityName="CCD" />
                                    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.5" assigningAuthorityName="IHE PCC" />
                                    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.6" assigningAuthorityName="IHE PCC" />
                                    <templateId root="2.16.840.1.113883.10.20.1.18" />
                                    <id root="4adc1020-7b14-11db-9fe1-0800200c9a66" /><code code="416098002" codeSystem="2.16.840.1.113883.6.96" displayName="drug allergy" codeSystemName="SNOMED CT" />
                                    <text>
                                        <reference value="#ALGSUMMARY_1" />
                                    </text>
                                    <statusCode code="completed" />
                                    <effectiveTime>
                                        <low nullFlavor="UNK" />
                                    </effectiveTime>
                                    <value code="293597001" codeSystem="2.16.840.1.113883.6.88" displayName="Codeine allergy" codeSystemName="RxNorm" xsi:type="CD">
                                        <originalText>
                                            <reference value="#ALGSUB_1" />
                                        </originalText>
                                    </value>
                                    <participant typeCode="CSM">
                                        <participantRole classCode="MANU">
                                            <addr/>
                                            <telecom/>
                                            <playingEntity classCode="MMAT"><code code="293597001" codeSystem="2.16.840.1.113883.6.88" displayName="Codeine allergy" codeSystemName="RxNorm"><originalText><reference value="#ALGSUB_1"/></originalText></code>
                                                <name>Codeine allergy</name>
                                            </playingEntity>
                                        </participantRole>
                                    </participant>
                                </observation>
                            </entryRelationship>
                        </act>
                    </entry>
                </section>
            </component>
            <component>
                <section>
                    <templateId root="2.16.840.1.113883.3.88.11.83.103" assigningAuthorityName="HITSP/C83" />
                    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.3.6" assigningAuthorityName="IHE PCC" />
                    <templateId root="2.16.840.1.113883.10.20.1.11" assigningAuthorityName="HL7 CCD" /><code code="11450-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Problem list" />
                    <title>Problems</title>
                    <text>
                        <table border="1" width="100%">
                            <thead>
                                <tr>
                                    <th>Problem</th>
                                    <th>Effective Dates</th>
                                    <th>Problem Status</th>
                                </tr>
                            </thead>
                            <tbody>
                                <tr ID="PROBSUMMARY_1">
                                    <td ID="PROBKIND_1">Other and unspecified hyperlipidemia</td>
                                    <td ID="PROBDATE_1">20020505</td>
                                    <td ID="PROBSTATUS_1">active</td>
                                </tr>
                                <tr ID="PROBSUMMARY_2">
                                    <td ID="PROBKIND_2">Diabetes mellitus without mention of complication, type II or unspecified type, uncontrolled</td>
                                    <td ID="PROBDATE_2">20090916</td>
                                    <td ID="PROBSTATUS_2">active</td>
                                </tr>
                                <tr ID="PROBSUMMARY_3">
                                    <td ID="PROBKIND_3">Unspecified essential hypertension</td>
                                    <td ID="PROBDATE_3">20020505</td>
                                    <td ID="PROBSTATUS_3">active</td>
                                </tr>
                                <tr ID="PROBSUMMARY_4">
                                    <td ID="PROBKIND_4">Coronary atherosclerosis of native coronary artery</td>
                                    <td ID="PROBDATE_4">20020505</td>
                                    <td ID="PROBSTATUS_4">active</td>
                                </tr>
                            </tbody>
                        </table>
                    </text>
                    <entry typeCode="DRIV">
                        <act classCode="ACT" moodCode="EVN">
                            <templateId root="2.16.840.1.113883.3.88.11.83.7" assigningAuthorityName="HITSP/C83" />
                            <templateId root="2.16.840.1.113883.10.20.1.27" assigningAuthorityName="CCD" />
                            <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.5.1" assigningAuthorityName="IHE PCC" />
                            <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.5.2" assigningAuthorityName="IHE PCC" />
                            <id root="6a2fa88d-4174-4909-aece-db44b60a3abb" /><code nullFlavor="NA" />
                            <statusCode code="completed" />
                            <effectiveTime>
                                <low value="20020505" />
                                <high nullFlavor="UNK" />
                            </effectiveTime>
                            <entryRelationship typeCode="SUBJ" inversionInd="false">
                                <observation classCode="OBS" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.10.20.1.28" assigningAuthorityName="CCD" />
                                    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.5" assigningAuthorityName="IHE PCC" />
                                    <id root="d11275e7-67ae-11db-bd13-0800200c9a66" /><code code="64572001" codeSystem="2.16.840.1.113883.6.96" displayName="Condition" codeSystemName="SNOMED CT" />
                                    <text>
                                        <reference value="#PROBSUMMARY_1" />
                                    </text>
                                    <statusCode code="completed" />
                                    <effectiveTime>
                                        <low value="20020505" />
                                    </effectiveTime>
                                    <value xsi:type="CD" code="272.4" codeSystem="2.16.840.1.113883.6.96" displayName="Other and unspecified hyperlipidemia" codeSystemName="SNOMED CT" />
                                </observation>
                            </entryRelationship>
                        </act>
                    </entry>
                    <entry typeCode="DRIV">
                        <act classCode="ACT" moodCode="EVN">
                            <templateId root="2.16.840.1.113883.3.88.11.83.7" assigningAuthorityName="HITSP/C83" />
                            <templateId root="2.16.840.1.113883.10.20.1.27" assigningAuthorityName="CCD" />
                            <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.5.1" assigningAuthorityName="IHE PCC" />
                            <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.5.2" assigningAuthorityName="IHE PCC" />
                            <id root="6a2fa88d-4174-4909-aece-db44b60a3abb" /><code nullFlavor="NA" />
                            <statusCode code="completed" />
                            <effectiveTime>
                                <low value="20090916" />
                                <high nullFlavor="UNK" />
                            </effectiveTime>
                            <entryRelationship typeCode="SUBJ" inversionInd="false">
                                <observation classCode="OBS" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.10.20.1.28" assigningAuthorityName="CCD" />
                                    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.5" assigningAuthorityName="IHE PCC" />
                                    <id root="d11275e7-67ae-11db-bd13-0800200c9a66" /><code code="64572001" codeSystem="2.16.840.1.113883.6.96" displayName="Condition" codeSystemName="SNOMED CT" />
                                    <text>
                                        <reference value="#PROBSUMMARY_2" />
                                    </text>
                                    <statusCode code="completed" />
                                    <effectiveTime>
                                        <low value="20090916" />
                                    </effectiveTime>
                                    <value xsi:type="CD" code="250.02" codeSystem="2.16.840.1.113883.6.96" displayName="Diabetes mellitus without mention of complication, type II or unspecified type, uncontrolled" codeSystemName="SNOMED CT" />
                                </observation>
                            </entryRelationship>
                        </act>
                    </entry>
                    <entry typeCode="DRIV">
                        <act classCode="ACT" moodCode="EVN">
                            <templateId root="2.16.840.1.113883.3.88.11.83.7" assigningAuthorityName="HITSP/C83" />
                            <templateId root="2.16.840.1.113883.10.20.1.27" assigningAuthorityName="CCD" />
                            <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.5.1" assigningAuthorityName="IHE PCC" />
                            <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.5.2" assigningAuthorityName="IHE PCC" />
                            <id root="6a2fa88d-4174-4909-aece-db44b60a3abb" /><code nullFlavor="NA" />
                            <statusCode code="completed" />
                            <effectiveTime>
                                <low value="20020505" />
                                <high nullFlavor="UNK" />
                            </effectiveTime>
                            <entryRelationship typeCode="SUBJ" inversionInd="false">
                                <observation classCode="OBS" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.10.20.1.28" assigningAuthorityName="CCD" />
                                    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.5" assigningAuthorityName="IHE PCC" />
                                    <id root="d11275e7-67ae-11db-bd13-0800200c9a66" /><code code="64572001" codeSystem="2.16.840.1.113883.6.96" displayName="Condition" codeSystemName="SNOMED CT" />
                                    <text>
                                        <reference value="#PROBSUMMARY_3" />
                                    </text>
                                    <statusCode code="completed" />
                                    <effectiveTime>
                                        <low value="20020505" />
                                    </effectiveTime>
                                    <value xsi:type="CD" code="401.9" codeSystem="2.16.840.1.113883.6.96" displayName="Unspecified essential hypertension" codeSystemName="SNOMED CT" />
                                </observation>
                            </entryRelationship>
                        </act>
                    </entry>
                    <entry typeCode="DRIV">
                        <act classCode="ACT" moodCode="EVN">
                            <templateId root="2.16.840.1.113883.3.88.11.83.7" assigningAuthorityName="HITSP/C83" />
                            <templateId root="2.16.840.1.113883.10.20.1.27" assigningAuthorityName="CCD" />
                            <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.5.1" assigningAuthorityName="IHE PCC" />
                            <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.5.2" assigningAuthorityName="IHE PCC" />
                            <id root="6a2fa88d-4174-4909-aece-db44b60a3abb" /><code nullFlavor="NA" />
                            <statusCode code="completed" />
                            <effectiveTime>
                                <low value="20020505" />
                                <high nullFlavor="UNK" />
                            </effectiveTime>
                            <entryRelationship typeCode="SUBJ" inversionInd="false">
                                <observation classCode="OBS" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.10.20.1.28" assigningAuthorityName="CCD" />
                                    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.5" assigningAuthorityName="IHE PCC" />
                                    <id root="d11275e7-67ae-11db-bd13-0800200c9a66" /><code code="64572001" codeSystem="2.16.840.1.113883.6.96" displayName="Condition" codeSystemName="SNOMED CT" />
                                    <text>
                                        <reference value="#PROBSUMMARY_4" />
                                    </text>
                                    <statusCode code="completed" />
                                    <effectiveTime>
                                        <low value="20020505" />
                                    </effectiveTime>
                                    <value xsi:type="CD" code="414.01" codeSystem="2.16.840.1.113883.6.96" displayName="Coronary atherosclerosis of native coronary artery" codeSystemName="SNOMED CT" />
                                </observation>
                            </entryRelationship>
                        </act>
                    </entry>
                </section>
            </component>
            <component>
                <section>
                    <templateId root="2.16.840.1.113883.3.88.11.83.112" assigningAuthorityName="HITSP/C83" />
                    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.3.19" assigningAuthorityName="IHE PCC" />
                    <templateId root="2.16.840.1.113883.10.20.1.8" assigningAuthorityName="HL7 CCD" /><code code="10160-0" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="History of medication use" />
                    <title>Medications</title>
                    <text>
                        <table border="1" width="100%">
                            <thead>
                                <tr>
                                    <th>Medication</th>
                                    <th>Dose</th>
                                    <th>Form</th>
                                    <th>Route</th>
                                    <th>Sig Text</th>
                                    <th>Dates</th>
                                    <th>Status</th>
                                </tr>
                            </thead>
                            <tbody>
                                <tr ID="MEDSUMMARY_1">
                                    <td ID="MEDNAME_1">Diabeta</td>
                                    <td ID="MEDDOSE_1">3 tablets</td>
                                    <td ID="MEDFORM_1">by mouth</td>
                                    <td ID="MEDROUTE_1">by mouth</td>
                                    <td ID="SIGTXT_1">once a day</td>
                                    <td ID="MEDDATES_1">19691231</td>
                                    <td ID="MEDSTATUS_1">active</td>
                                </tr>
                                <tr ID="MEDSUMMARY_2">
                                    <td ID="MEDNAME_2">Lipitor</td>
                                    <td ID="MEDDOSE_2">12 tablets</td>
                                    <td ID="MEDFORM_2">by mouth</td>
                                    <td ID="MEDROUTE_2">by mouth</td>
                                    <td ID="SIGTXT_2">four times a day</td>
                                    <td ID="MEDDATES_2">19691231</td>
                                    <td ID="MEDSTATUS_2">active</td>
                                </tr>
                                <tr ID="MEDSUMMARY_3">
                                    <td ID="MEDNAME_3">Lasix</td>
                                    <td ID="MEDDOSE_3">4 tablets</td>
                                    <td ID="MEDFORM_3">by mouth</td>
                                    <td ID="MEDROUTE_3">by mouth</td>
                                    <td ID="SIGTXT_3">once a day</td>
                                    <td ID="MEDDATES_3">19691231</td>
                                    <td ID="MEDSTATUS_3">active</td>
                                </tr>
                                <tr ID="MEDSUMMARY_4">
                                    <td ID="MEDNAME_4">Klor-Con 10</td>
                                    <td ID="MEDDOSE_4">4 tablets</td>
                                    <td ID="MEDFORM_4">by mouth</td>
                                    <td ID="MEDROUTE_4">by mouth</td>
                                    <td ID="SIGTXT_4">twice a day</td>
                                    <td ID="MEDDATES_4">19691231</td>
                                    <td ID="MEDSTATUS_4">active</td>
                                </tr>
                            </tbody>
                        </table>
                    </text>
                    <entry typeCode="DRIV">
                        <substanceAdministration classCode="SBADM" moodCode="EVN">
                            <templateId root="2.16.840.1.113883.3.88.11.83.8" assigningAuthorityName="HITSP/C83" />
                            <templateId root="2.16.840.1.113883.10.20.1.24" assigningAuthorityName="CCD" />
                            <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.7" assigningAuthorityName="IHE PCC" />
                            <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.7.1" assigningAuthorityName="IHE PCC" />
                            <id root="cdbd33f0-6cde-11db-9fe1-0800200c9a66" />
                            <text>
                                <reference value="#SIGTEXT_1" />
                            </text>
                            <statusCode code="completed" />
                            <effectiveTime xsi:type="IVL_TS">
                                <low value="19691231" />
                                <high nullFlavor="UNK" />
                            </effectiveTime>
                            <effectiveTime xsi:type="PIVL_TS">
                                <period value="6" unit="h" />
                            </effectiveTime>
                            <routeCode>
                                <originalText>by mouth</originalText>
                            </routeCode>
                            <doseQuantity value="1" unit="tablet" />
                            <administrationUnitCode>
                                <originalText>by mouth</originalText>
                            </administrationUnitCode>
                            <consumable>
                                <manufacturedProduct>
                                    <templateId root="2.16.840.1.113883.3.88.11.83.8.2" assigningAuthorityName="HITSP/C83" />
                                    <templateId root="2.16.840.1.113883.10.20.1.53" assigningAuthorityName="CCD" />
                                    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.7.2" assigningAuthorityName="IHE PCC" />
                                    <manufacturedMaterial><code code="00039005110" codeSystem="2.16.840.1.113883.6.88" displayName="Diabeta" codeSystemName="RxNorm"><originalText>Diabeta<reference/></originalText></code>
                                    </manufacturedMaterial>
                                </manufacturedProduct>
                            </consumable>
                        </substanceAdministration>
                    </entry>
                    <entry typeCode="DRIV">
                        <substanceAdministration classCode="SBADM" moodCode="EVN">
                            <templateId root="2.16.840.1.113883.3.88.11.83.8" assigningAuthorityName="HITSP/C83" />
                            <templateId root="2.16.840.1.113883.10.20.1.24" assigningAuthorityName="CCD" />
                            <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.7" assigningAuthorityName="IHE PCC" />
                            <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.7.1" assigningAuthorityName="IHE PCC" />
                            <id root="cdbd33f0-6cde-11db-9fe1-0800200c9a66" />
                            <text>
                                <reference value="#SIGTEXT_2" />
                            </text>
                            <statusCode code="completed" />
                            <effectiveTime xsi:type="IVL_TS">
                                <low value="19691231" />
                                <high nullFlavor="UNK" />
                            </effectiveTime>
                            <effectiveTime xsi:type="PIVL_TS">
                                <period value="6" unit="h" />
                            </effectiveTime>
                            <routeCode>
                                <originalText>by mouth</originalText>
                            </routeCode>
                            <doseQuantity value="1" unit="tablet" />
                            <administrationUnitCode>
                                <originalText>by mouth</originalText>
                            </administrationUnitCode>
                            <consumable>
                                <manufacturedProduct>
                                    <templateId root="2.16.840.1.113883.3.88.11.83.8.2" assigningAuthorityName="HITSP/C83" />
                                    <templateId root="2.16.840.1.113883.10.20.1.53" assigningAuthorityName="CCD" />
                                    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.7.2" assigningAuthorityName="IHE PCC" />
                                    <manufacturedMaterial><code code="00071015540" codeSystem="2.16.840.1.113883.6.88" displayName="Lipitor" codeSystemName="RxNorm"><originalText>Lipitor<reference/></originalText></code>
                                    </manufacturedMaterial>
                                </manufacturedProduct>
                            </consumable>
                        </substanceAdministration>
                    </entry>
                    <entry typeCode="DRIV">
                        <substanceAdministration classCode="SBADM" moodCode="EVN">
                            <templateId root="2.16.840.1.113883.3.88.11.83.8" assigningAuthorityName="HITSP/C83" />
                            <templateId root="2.16.840.1.113883.10.20.1.24" assigningAuthorityName="CCD" />
                            <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.7" assigningAuthorityName="IHE PCC" />
                            <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.7.1" assigningAuthorityName="IHE PCC" />
                            <id root="cdbd33f0-6cde-11db-9fe1-0800200c9a66" />
                            <text>
                                <reference value="#SIGTEXT_3" />
                            </text>
                            <statusCode code="completed" />
                            <effectiveTime xsi:type="IVL_TS">
                                <low value="19691231" />
                                <high nullFlavor="UNK" />
                            </effectiveTime>
                            <effectiveTime xsi:type="PIVL_TS">
                                <period value="6" unit="h" />
                            </effectiveTime>
                            <routeCode>
                                <originalText>by mouth</originalText>
                            </routeCode>
                            <doseQuantity value="1" unit="tablet" />
                            <administrationUnitCode>
                                <originalText>by mouth</originalText>
                            </administrationUnitCode>
                            <consumable>
                                <manufacturedProduct>
                                    <templateId root="2.16.840.1.113883.3.88.11.83.8.2" assigningAuthorityName="HITSP/C83" />
                                    <templateId root="2.16.840.1.113883.10.20.1.53" assigningAuthorityName="CCD" />
                                    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.7.2" assigningAuthorityName="IHE PCC" />
                                    <manufacturedMaterial><code code="00039006710" codeSystem="2.16.840.1.113883.6.88" displayName="Lasix" codeSystemName="RxNorm"><originalText>Lasix<reference/></originalText></code>
                                    </manufacturedMaterial>
                                </manufacturedProduct>
                            </consumable>
                        </substanceAdministration>
                    </entry>
                    <entry typeCode="DRIV">
                        <substanceAdministration classCode="SBADM" moodCode="EVN">
                            <templateId root="2.16.840.1.113883.3.88.11.83.8" assigningAuthorityName="HITSP/C83" />
                            <templateId root="2.16.840.1.113883.10.20.1.24" assigningAuthorityName="CCD" />
                            <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.7" assigningAuthorityName="IHE PCC" />
                            <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.7.1" assigningAuthorityName="IHE PCC" />
                            <id root="cdbd33f0-6cde-11db-9fe1-0800200c9a66" />
                            <text>
                                <reference value="#SIGTEXT_4" />
                            </text>
                            <statusCode code="completed" />
                            <effectiveTime xsi:type="IVL_TS">
                                <low value="19691231" />
                                <high nullFlavor="UNK" />
                            </effectiveTime>
                            <effectiveTime xsi:type="PIVL_TS">
                                <period value="6" unit="h" />
                            </effectiveTime>
                            <routeCode>
                                <originalText>by mouth</originalText>
                            </routeCode>
                            <doseQuantity value="1" unit="tablet" />
                            <administrationUnitCode>
                                <originalText>by mouth</originalText>
                            </administrationUnitCode>
                            <consumable>
                                <manufacturedProduct>
                                    <templateId root="2.16.840.1.113883.3.88.11.83.8.2" assigningAuthorityName="HITSP/C83" />
                                    <templateId root="2.16.840.1.113883.10.20.1.53" assigningAuthorityName="CCD" />
                                    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.7.2" assigningAuthorityName="IHE PCC" />
                                    <manufacturedMaterial><code code="00245004115" codeSystem="2.16.840.1.113883.6.88" displayName="Klor-Con 10" codeSystemName="RxNorm"><originalText>Klor-Con 10<reference/></originalText></code>
                                    </manufacturedMaterial>
                                </manufacturedProduct>
                            </consumable>
                        </substanceAdministration>
                    </entry>
                </section>
            </component>
            <component>
                <section>
                    <templateId root="2.16.840.1.113883.3.88.11.83.122" assigningAuthorityName="HITSP/C83" />
                    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.3.28" assigningAuthorityName="IHE PCC" /><code code="30954-2" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Results" />
                    <title>Diagnostic Results</title>
                    <text>
                        <table border="1" width="100%">
                            <thead>
                                <tr>
                                    <th>&#xA0;</th>
                                    <th>2011-09-05</th>
                                    <th>2011-09-15</th>
                                    <th>2013-01-01</th>
                                    <th>2013-01-05</th>
                                </tr>
                            </thead>
                            <tbody>
                                <tr>
                                    <td colspan="5">
                                        <content styleCode="BoldItalics"></content>
                                    </td>
                                </tr>
                                <tr>
                                    <td>Fasting Blood Glucose ()</td>
                                    <td/>
                                    <td/>
                                    <td>178 mg/dl</td>
                                    <td/>
                                </tr>
                                <tr>
                                    <td>BUN ()</td>
                                    <td/>
                                    <td/>
                                    <td/>
                                    <td>18 mg/dl</td>
                                </tr>
                                <tr>
                                    <td>Creatinine ()</td>
                                    <td/>
                                    <td/>
                                    <td>1.0 mg/dl</td>
                                    <td/>
                                </tr>
                                <tr>
                                    <td>Sodium ()</td>
                                    <td>141 mEq/L</td>
                                    <td/>
                                    <td/>
                                    <td/>
                                </tr>
                                <tr>
                                    <td>HDL cholesterol ()</td>
                                    <td/>
                                    <td>43 mg/dl</td>
                                    <td/>
                                    <td/>
                                </tr>
                                <tr>
                                    <td>LDL cholesterol ()</td>
                                    <td/>
                                    <td>84 mg/dl</td>
                                    <td/>
                                    <td/>
                                </tr>
                                <tr>
                                    <td>Potassium ()</td>
                                    <td/>
                                    <td>4.3 mEq/L</td>
                                    <td/>
                                    <td/>
                                </tr>
                                <tr>
                                    <td>Triglycerides ()</td>
                                    <td/>
                                    <td>177 mg/dl</td>
                                    <td/>
                                    <td/>
                                </tr>
                                <tr>
                                    <td>Total cholesterol ()</td>
                                    <td/>
                                    <td>162 mg/dl</td>
                                    <td/>
                                    <td/>
                                </tr>
                            </tbody>
                        </table>
                    </text>
                    <entry typeCode="DRIV">
                        <organizer classCode="BATTERY" moodCode="EVN">
                            <id root="7d5a02b0-67a4-11db-bd13-0800200c9a66" /><code code="14771-0" codeSystem="2.16.840.1.113883.6.96" displayName="" />
                            <statusCode code="completed" />
                            <effectiveTime value="20130101" />
                            <component>
                                <procedure classCode="PROC" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.3.88.11.83.17" assigningAuthorityName="HITSP/C83" />
                                    <templateId root="2.16.840.1.113883.10.20.1.29" assigningAuthorityName="CCD" />
                                    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.19" assigningAuthorityName="IHE PCC" />
                                    <id/><code code="14771-0" codeSystem="2.16.840.1.113883.6.96" displayName=""><originalText>Obtain sample for <reference value="Ptr to text in parent Section"/></originalText></code>
                                    <text>Obtain sample for
                                        <reference value="PtrToParentInsectionText" />
                                    </text>
                                    <statusCode code="completed" />
                                    <effectiveTime value="20130101" />
                                </procedure>
                            </component>
                            <component>
                                <observation classCode="OBS" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.3.88.11.83.15.1" assigningAuthorityName="HITSP/C83" />
                                    <templateId root="2.16.840.1.113883.10.20.1.31" assigningAuthorityName="CCD" />
                                    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.13" assigningAuthorityName="IHE PCC" />
                                    <id root="107c2dc0-67a5-11db-bd13-0800200c9a66" /><code code="000" codeSystem="2.16.840.1.113883.6.1" displayName="Fasting Blood Glucose" />
                                    <text>
                                        <reference value="PtrToValueInsectionText" />
                                    </text>
                                    <statusCode code="completed" />
                                    <effectiveTime value="20130101" />
                                    <value xsi:type="PQ" value="178" unit="mg/dl" />
                                    <interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83" />
                                </observation>
                            </component>
                        </organizer>
                    </entry>
                    <entry typeCode="DRIV">
                        <organizer classCode="BATTERY" moodCode="EVN">
                            <id root="7d5a02b0-67a4-11db-bd13-0800200c9a66" /><code code="14937-7" codeSystem="2.16.840.1.113883.6.96" displayName="" />
                            <statusCode code="completed" />
                            <effectiveTime value="20130105" />
                            <component>
                                <procedure classCode="PROC" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.3.88.11.83.17" assigningAuthorityName="HITSP/C83" />
                                    <templateId root="2.16.840.1.113883.10.20.1.29" assigningAuthorityName="CCD" />
                                    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.19" assigningAuthorityName="IHE PCC" />
                                    <id/><code code="14937-7" codeSystem="2.16.840.1.113883.6.96" displayName=""><originalText>Obtain sample for <reference value="Ptr to text in parent Section"/></originalText></code>
                                    <text>Obtain sample for
                                        <reference value="PtrToParentInsectionText" />
                                    </text>
                                    <statusCode code="completed" />
                                    <effectiveTime value="20130105" />
                                </procedure>
                            </component>
                            <component>
                                <observation classCode="OBS" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.3.88.11.83.15.1" assigningAuthorityName="HITSP/C83" />
                                    <templateId root="2.16.840.1.113883.10.20.1.31" assigningAuthorityName="CCD" />
                                    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.13" assigningAuthorityName="IHE PCC" />
                                    <id root="107c2dc0-67a5-11db-bd13-0800200c9a66" /><code code="000" codeSystem="2.16.840.1.113883.6.1" displayName="BUN" />
                                    <text>
                                        <reference value="PtrToValueInsectionText" />
                                    </text>
                                    <statusCode code="completed" />
                                    <effectiveTime value="20130105" />
                                    <value xsi:type="PQ" value="18" unit="mg/dl" />
                                    <interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83" />
                                </observation>
                            </component>
                        </organizer>
                    </entry>
                    <entry typeCode="DRIV">
                        <organizer classCode="BATTERY" moodCode="EVN">
                            <id root="7d5a02b0-67a4-11db-bd13-0800200c9a66" /><code code="14682-9" codeSystem="2.16.840.1.113883.6.96" displayName="" />
                            <statusCode code="completed" />
                            <effectiveTime value="20130101" />
                            <component>
                                <procedure classCode="PROC" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.3.88.11.83.17" assigningAuthorityName="HITSP/C83" />
                                    <templateId root="2.16.840.1.113883.10.20.1.29" assigningAuthorityName="CCD" />
                                    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.19" assigningAuthorityName="IHE PCC" />
                                    <id/><code code="14682-9" codeSystem="2.16.840.1.113883.6.96" displayName=""><originalText>Obtain sample for <reference value="Ptr to text in parent Section"/></originalText></code>
                                    <text>Obtain sample for
                                        <reference value="PtrToParentInsectionText" />
                                    </text>
                                    <statusCode code="completed" />
                                    <effectiveTime value="20130101" />
                                </procedure>
                            </component>
                            <component>
                                <observation classCode="OBS" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.3.88.11.83.15.1" assigningAuthorityName="HITSP/C83" />
                                    <templateId root="2.16.840.1.113883.10.20.1.31" assigningAuthorityName="CCD" />
                                    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.13" assigningAuthorityName="IHE PCC" />
                                    <id root="107c2dc0-67a5-11db-bd13-0800200c9a66" /><code code="000" codeSystem="2.16.840.1.113883.6.1" displayName="Creatinine" />
                                    <text>
                                        <reference value="PtrToValueInsectionText" />
                                    </text>
                                    <statusCode code="completed" />
                                    <effectiveTime value="20130101" />
                                    <value xsi:type="PQ" value="1.0" unit="mg/dl" />
                                    <interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83" />
                                </observation>
                            </component>
                        </organizer>
                    </entry>
                    <entry typeCode="DRIV">
                        <organizer classCode="BATTERY" moodCode="EVN">
                            <id root="7d5a02b0-67a4-11db-bd13-0800200c9a66" /><code code="2951-2" codeSystem="2.16.840.1.113883.6.96" displayName="" />
                            <statusCode code="completed" />
                            <effectiveTime value="20110905" />
                            <component>
                                <procedure classCode="PROC" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.3.88.11.83.17" assigningAuthorityName="HITSP/C83" />
                                    <templateId root="2.16.840.1.113883.10.20.1.29" assigningAuthorityName="CCD" />
                                    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.19" assigningAuthorityName="IHE PCC" />
                                    <id/><code code="2951-2" codeSystem="2.16.840.1.113883.6.96" displayName=""><originalText>Obtain sample for <reference value="Ptr to text in parent Section"/></originalText></code>
                                    <text>Obtain sample for
                                        <reference value="PtrToParentInsectionText" />
                                    </text>
                                    <statusCode code="completed" />
                                    <effectiveTime value="20110905" />
                                </procedure>
                            </component>
                            <component>
                                <observation classCode="OBS" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.3.88.11.83.15.1" assigningAuthorityName="HITSP/C83" />
                                    <templateId root="2.16.840.1.113883.10.20.1.31" assigningAuthorityName="CCD" />
                                    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.13" assigningAuthorityName="IHE PCC" />
                                    <id root="107c2dc0-67a5-11db-bd13-0800200c9a66" /><code code="000" codeSystem="2.16.840.1.113883.6.1" displayName="Sodium" />
                                    <text>
                                        <reference value="PtrToValueInsectionText" />
                                    </text>
                                    <statusCode code="completed" />
                                    <effectiveTime value="20110905" />
                                    <value xsi:type="PQ" value="141" unit="mEq/L" />
                                    <interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83" />
                                </observation>
                            </component>
                        </organizer>
                    </entry>
                    <entry typeCode="DRIV">
                        <organizer classCode="BATTERY" moodCode="EVN">
                            <id root="7d5a02b0-67a4-11db-bd13-0800200c9a66" /><code code="14646-4" codeSystem="2.16.840.1.113883.6.96" displayName="" />
                            <statusCode code="completed" />
                            <effectiveTime value="20110915" />
                            <component>
                                <procedure classCode="PROC" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.3.88.11.83.17" assigningAuthorityName="HITSP/C83" />
                                    <templateId root="2.16.840.1.113883.10.20.1.29" assigningAuthorityName="CCD" />
                                    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.19" assigningAuthorityName="IHE PCC" />
                                    <id/><code code="14646-4" codeSystem="2.16.840.1.113883.6.96" displayName=""><originalText>Obtain sample for <reference value="Ptr to text in parent Section"/></originalText></code>
                                    <text>Obtain sample for
                                        <reference value="PtrToParentInsectionText" />
                                    </text>
                                    <statusCode code="completed" />
                                    <effectiveTime value="20110915" />
                                </procedure>
                            </component>
                            <component>
                                <observation classCode="OBS" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.3.88.11.83.15.1" assigningAuthorityName="HITSP/C83" />
                                    <templateId root="2.16.840.1.113883.10.20.1.31" assigningAuthorityName="CCD" />
                                    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.13" assigningAuthorityName="IHE PCC" />
                                    <id root="107c2dc0-67a5-11db-bd13-0800200c9a66" /><code code="000" codeSystem="2.16.840.1.113883.6.1" displayName="HDL cholesterol" />
                                    <text>
                                        <reference value="PtrToValueInsectionText" />
                                    </text>
                                    <statusCode code="completed" />
                                    <effectiveTime value="20110915" />
                                    <value xsi:type="PQ" value="43" unit="mg/dl" />
                                    <interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83" />
                                </observation>
                            </component>
                        </organizer>
                    </entry>
                    <entry typeCode="DRIV">
                        <organizer classCode="BATTERY" moodCode="EVN">
                            <id root="7d5a02b0-67a4-11db-bd13-0800200c9a66" /><code code="2089-1" codeSystem="2.16.840.1.113883.6.96" displayName="" />
                            <statusCode code="completed" />
                            <effectiveTime value="20110915" />
                            <component>
                                <procedure classCode="PROC" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.3.88.11.83.17" assigningAuthorityName="HITSP/C83" />
                                    <templateId root="2.16.840.1.113883.10.20.1.29" assigningAuthorityName="CCD" />
                                    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.19" assigningAuthorityName="IHE PCC" />
                                    <id/><code code="2089-1" codeSystem="2.16.840.1.113883.6.96" displayName=""><originalText>Obtain sample for <reference value="Ptr to text in parent Section"/></originalText></code>
                                    <text>Obtain sample for
                                        <reference value="PtrToParentInsectionText" />
                                    </text>
                                    <statusCode code="completed" />
                                    <effectiveTime value="20110915" />
                                </procedure>
                            </component>
                            <component>
                                <observation classCode="OBS" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.3.88.11.83.15.1" assigningAuthorityName="HITSP/C83" />
                                    <templateId root="2.16.840.1.113883.10.20.1.31" assigningAuthorityName="CCD" />
                                    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.13" assigningAuthorityName="IHE PCC" />
                                    <id root="107c2dc0-67a5-11db-bd13-0800200c9a66" /><code code="000" codeSystem="2.16.840.1.113883.6.1" displayName="LDL cholesterol" />
                                    <text>
                                        <reference value="PtrToValueInsectionText" />
                                    </text>
                                    <statusCode code="completed" />
                                    <effectiveTime value="20110915" />
                                    <value xsi:type="PQ" value="84" unit="mg/dl" />
                                    <interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83" />
                                </observation>
                            </component>
                        </organizer>
                    </entry>
                    <entry typeCode="DRIV">
                        <organizer classCode="BATTERY" moodCode="EVN">
                            <id root="7d5a02b0-67a4-11db-bd13-0800200c9a66" /><code code="2823-3" codeSystem="2.16.840.1.113883.6.96" displayName="" />
                            <statusCode code="completed" />
                            <effectiveTime value="20110915" />
                            <component>
                                <procedure classCode="PROC" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.3.88.11.83.17" assigningAuthorityName="HITSP/C83" />
                                    <templateId root="2.16.840.1.113883.10.20.1.29" assigningAuthorityName="CCD" />
                                    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.19" assigningAuthorityName="IHE PCC" />
                                    <id/><code code="2823-3" codeSystem="2.16.840.1.113883.6.96" displayName=""><originalText>Obtain sample for <reference value="Ptr to text in parent Section"/></originalText></code>
                                    <text>Obtain sample for
                                        <reference value="PtrToParentInsectionText" />
                                    </text>
                                    <statusCode code="completed" />
                                    <effectiveTime value="20110915" />
                                </procedure>
                            </component>
                            <component>
                                <observation classCode="OBS" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.3.88.11.83.15.1" assigningAuthorityName="HITSP/C83" />
                                    <templateId root="2.16.840.1.113883.10.20.1.31" assigningAuthorityName="CCD" />
                                    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.13" assigningAuthorityName="IHE PCC" />
                                    <id root="107c2dc0-67a5-11db-bd13-0800200c9a66" /><code code="000" codeSystem="2.16.840.1.113883.6.1" displayName="Potassium" />
                                    <text>
                                        <reference value="PtrToValueInsectionText" />
                                    </text>
                                    <statusCode code="completed" />
                                    <effectiveTime value="20110915" />
                                    <value xsi:type="PQ" value="4.3" unit="mEq/L" />
                                    <interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83" />
                                </observation>
                            </component>
                        </organizer>
                    </entry>
                    <entry typeCode="DRIV">
                        <organizer classCode="BATTERY" moodCode="EVN">
                            <id root="7d5a02b0-67a4-11db-bd13-0800200c9a66" /><code code="14927-8" codeSystem="2.16.840.1.113883.6.96" displayName="" />
                            <statusCode code="completed" />
                            <effectiveTime value="20110915" />
                            <component>
                                <procedure classCode="PROC" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.3.88.11.83.17" assigningAuthorityName="HITSP/C83" />
                                    <templateId root="2.16.840.1.113883.10.20.1.29" assigningAuthorityName="CCD" />
                                    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.19" assigningAuthorityName="IHE PCC" />
                                    <id/><code code="14927-8" codeSystem="2.16.840.1.113883.6.96" displayName=""><originalText>Obtain sample for <reference value="Ptr to text in parent Section"/></originalText></code>
                                    <text>Obtain sample for
                                        <reference value="PtrToParentInsectionText" />
                                    </text>
                                    <statusCode code="completed" />
                                    <effectiveTime value="20110915" />
                                </procedure>
                            </component>
                            <component>
                                <observation classCode="OBS" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.3.88.11.83.15.1" assigningAuthorityName="HITSP/C83" />
                                    <templateId root="2.16.840.1.113883.10.20.1.31" assigningAuthorityName="CCD" />
                                    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.13" assigningAuthorityName="IHE PCC" />
                                    <id root="107c2dc0-67a5-11db-bd13-0800200c9a66" /><code code="000" codeSystem="2.16.840.1.113883.6.1" displayName="Triglycerides" />
                                    <text>
                                        <reference value="PtrToValueInsectionText" />
                                    </text>
                                    <statusCode code="completed" />
                                    <effectiveTime value="20110915" />
                                    <value xsi:type="PQ" value="177" unit="mg/dl" />
                                    <interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83" />
                                </observation>
                            </component>
                        </organizer>
                    </entry>
                    <entry typeCode="DRIV">
                        <organizer classCode="BATTERY" moodCode="EVN">
                            <id root="7d5a02b0-67a4-11db-bd13-0800200c9a66" /><code code="14647-2" codeSystem="2.16.840.1.113883.6.96" displayName="" />
                            <statusCode code="completed" />
                            <effectiveTime value="20110915" />
                            <component>
                                <procedure classCode="PROC" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.3.88.11.83.17" assigningAuthorityName="HITSP/C83" />
                                    <templateId root="2.16.840.1.113883.10.20.1.29" assigningAuthorityName="CCD" />
                                    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.19" assigningAuthorityName="IHE PCC" />
                                    <id/><code code="14647-2" codeSystem="2.16.840.1.113883.6.96" displayName=""><originalText>Obtain sample for <reference value="Ptr to text in parent Section"/></originalText></code>
                                    <text>Obtain sample for
                                        <reference value="PtrToParentInsectionText" />
                                    </text>
                                    <statusCode code="completed" />
                                    <effectiveTime value="20110915" />
                                </procedure>
                            </component>
                            <component>
                                <observation classCode="OBS" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.3.88.11.83.15.1" assigningAuthorityName="HITSP/C83" />
                                    <templateId root="2.16.840.1.113883.10.20.1.31" assigningAuthorityName="CCD" />
                                    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.13" assigningAuthorityName="IHE PCC" />
                                    <id root="107c2dc0-67a5-11db-bd13-0800200c9a66" /><code code="000" codeSystem="2.16.840.1.113883.6.1" displayName="Total cholesterol" />
                                    <text>
                                        <reference value="PtrToValueInsectionText" />
                                    </text>
                                    <statusCode code="completed" />
                                    <effectiveTime value="20110915" />
                                    <value xsi:type="PQ" value="162" unit="mg/dl" />
                                    <interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83" />
                                </observation>
                            </component>
                        </organizer>
                    </entry>
                </section>
            </component>
        </structuredBody>
    </component>
</ClinicalDocument>
Skwerl commented 11 years ago

I'm really hoping I didn't just step on a land mine. I changed this on dev, but the test export does not validate. The validation tool specifically checks for SNOMED codes for problems. There's never been any talk of needing SNOMED codes for problems.

Here's the only possible parachute... If I specify no code (just the description), the CCD validates.

Thoughts?

ejancic commented 11 years ago

What did you change on dev?

We should be using ICD-9 codes and not SNOMED codes for problems. There's no requirement to use SNOMED for problems. The export looks wrong because we seem to be claiming that an ICD-9 code is a SNOMED code. The CCR file that we're using identifies ICD-9 as the coding system for problems so it seems like CCD should do the same.

On Apr 2, 2013, at 10:51 AM, Skwerl notifications@github.com wrote:

I'm really hoping I didn't just step on a land mine. I changed this on dev, but the test export does not validate. The validation tool specifically checks for SNOMED codes for problems. There's never been any talk of needing SNOMED codes for problems.

Here's the only possible parachute... If I specify no code (just the description), the CCD validates.

Thoughts?

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Skwerl commented 11 years ago

Well, yes, the export specifies code system 2.16.840.1.113883.6.96, which is SNOMED, but the code in there is an ICD-9 code. To that extent you're correct.

But if I modify the XML to specify code system 2.16.840.1.113883.6.103, which is ICD-9, the validation fails. The validation tool actually explicitly makes sure that we're using code system 2.16.840.1.113883.6.96 (SNOMED).

CCR validates fine with ICD-9, imports fine, no problem there. But CCD validation seems to require either SNOMED or no code at all.

Skwerl commented 11 years ago

Well, for now, the CCD export properly specifies that the code system is ICD9. That commit is pretty easy to read.

Here is the error that the validator is throwing though:

Message: Error: HITSP/C83 Condition Problem Code SHALL be coded as specified in HITSP/C80 Section 2.2.3.1.1 Problem. See HITSP/C83 Section 2.2.2.7.5, rule C154-[DE-7.04-1]. Context: /ClinicalDocument[1]/component[1]/structuredBody[1]/component[2]/section[1]/entry[3]/act[1]/entryRelationship[1]/observation[1] Test: not(cda:value[@code and @codeSystem]) or cda:value[@codeSystem="2.16.840.1.113883.6.96" and @code]

To translate the NIST validation tool's syntax, it's failing the following check: "Either code and codeSystem are not present, or code is present along with a codeSystem value of 2.16.840.1.113883.6.96"

Thus it's specifically looking for SNOMED or nothing. So not sure how we should proceed.

ejancic commented 11 years ago

Given the option of SNOMED and no code system at all, I vote for no code system at all.

On Apr 2, 2013, at 11:15 AM, Skwerl notifications@github.com wrote:

Well, for now, the CCD export properly specifies that the code system is ICD9. That commit is pretty easy to read.

Here is the error that the validator is throwing though:

Message: Error: HITSP/C83 Condition Problem Code SHALL be coded as specified in HITSP/C80 Section 2.2.3.1.1 Problem. See HITSP/C83 Section 2.2.2.7.5, rule C154-[DE-7.04-1]. Context: /ClinicalDocument[1]/component[1]/structuredBody[1]/component[2]/section[1]/entry[3]/act[1]/entryRelationship[1]/observation[1] Test: not(cda:value[@code and @codeSystem]) or cda:value[@codeSystem="2.16.840.1.113883.6.96" and @code]

To translate the NIST validation tool's syntax, it's failing the following check: "Either code and codeSystem are not present, or code is present along with a codeSystem value of 2.16.840.1.113883.6.96"

Thus it's specifically looking for SNOMED or nothing. So not sure how we should proceed.

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Skwerl commented 11 years ago

Would that screw up CCD import?

ejancic commented 11 years ago

I would have to test it to be sure but I don't think we're using the code set field for anything, just the code itself.

On Apr 2, 2013, at 11:59 AM, Skwerl notifications@github.com wrote:

Would that screw up CCD import?

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Skwerl commented 11 years ago

Well, they come together. If any code is specified, SNOMED codesystem must also be. It's both or neither.

ejancic commented 11 years ago

Well yes we do need the problem code there unless you are pulling it from somewhere else. Since neither one of us know lets leave this alone for now and move on.

On Apr 2, 2013, at 12:08 PM, Skwerl notifications@github.com wrote:

Well, they come together. If any code is specified, SNOMED codesystem must also be. It's both or neither.

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Skwerl commented 11 years ago

Closing this until we know we need to reopen.