Patient Administration
 HL7 PA, R2-2010 HL7 Version 3 Standard: Patient Administration, DSTU Release 2 Update February 2010 Update to DSTU Release 2 |
| Responsible Group | Patient Administration Work Group HL7 |
| Patient Administration Facilitator | Norman Daoust Daoust Associates |
| International Liason | Irma Jongeneel - de Haas HL7 Netherlands |
| Patient Administration Co-Chair | Gregg Seppala U S Dept of Veterans Affairs |
| Patient Administration Interim Co-Chair | Jay Zimmerman Canada Health Infoway |
HTML Generated: 2012-08-31T12:10:00
Content Last Edited: 2011-06-17T13:44:56
HL7® Version 3 Standard, © 2010 Health Level Seven® International All Rights Reserved.
HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. Pat & TM Off.
Use of these materials is governed by HL7 International's IP Compliance Policy.
Table of Contents
Preface
i Notes to Readers
ii Changes from Previous Release
iii Known Issues & Planned Changes
iv Message Design Element Navigation
1 Overview
1.1 Introduction & Scope
1.2 Domain Information Models
2 Person Topic
2.1 Introduction
2.2 Storyboards
2.3 Application Roles
2.4 Trigger Events
2.5 Refined Message Information Models
2.6 Hierarchical Message Descriptions
2.7 Interactions
3 Identity Document Topic
3.1 Introduction
3.2 Storyboards
3.3 Application Roles
3.4 Trigger Events
3.5 Refined Message Information Models
3.6 Hierarchical Message Descriptions
3.7 Interactions
4 Patient Topic
4.1 Introduction
4.2 Storyboards
4.3 Application Roles
4.4 Trigger Events
4.5 Refined Message Information Models
4.6 Hierarchical Message Descriptions
4.7 Interactions
5 Service Delivery Location Topic
5.1 Introduction
5.2 Storyboards
5.3 Application Roles
5.4 Trigger Events
5.5 Refined Message Information Models
5.6 Hierarchical Message Descriptions
5.7 Interactions
6 Ambulatory Encounter Topic
6.1 Introduction
6.2 Storyboards
6.3 Application Roles
6.4 Trigger Events
6.5 Refined Message Information Models
6.6 Hierarchical Message Descriptions
6.7 Interactions
7 Short Stay Encounter Topic
7.1 Introduction
7.2 Storyboards
7.3 Application Roles
7.4 Trigger Events
7.5 Refined Message Information Models
7.6 Hierarchical Message Descriptions
7.7 Interactions
8 Inpatient Encounter Topic
8.1 Introduction
8.2 Storyboards
8.3 Application Roles
8.4 Trigger Events
8.5 Refined Message Information Models
8.6 Hierarchical Message Descriptions
8.7 Interactions
9 Emergency Encounter Topic
9.1 Introduction
9.2 Storyboards
9.3 Application Roles
9.4 Trigger Events
9.5 Refined Message Information Models
9.6 Hierarchical Message Descriptions
9.7 Interactions
10 Home Health Encounter Topic
10.1 Introduction
10.2 Storyboards
10.3 Application Roles
10.4 Trigger Events
10.5 Refined Message Information Models
10.6 Hierarchical Message Descriptions
10.7 Interactions
11 Attending Practitioner Topic
11.1 Introduction
11.2 Storyboards
11.3 Application Roles
11.4 Trigger Events
11.5 Refined Message Information Models
11.6 Hierarchical Message Descriptions
11.7 Interactions
12 Encounter Location Topic
12.1 Introduction
12.2 Storyboards
12.3 Application Roles
12.4 Trigger Events
12.5 Refined Message Information Models
12.6 Hierarchical Message Descriptions
12.7 Interactions
13 Encounter Organization Topic
13.1 Introduction
13.2 Storyboards
13.3 Application Roles
13.4 Trigger Events
13.5 Refined Message Information Models
13.6 Hierarchical Message Descriptions
13.7 Interactions
14 Encounter Queries Topic
14.1 Introduction
14.2 Storyboards
14.3 Application Roles
14.4 Trigger Events
14.5 Refined Message Information Models
14.6 Hierarchical Message Descriptions
14.7 Interactions
15 Quality Analysis Report Topic
16 CMETs Defined by this Domain
17 CMETs Used by this Domain
18 Interactions Annex
18.1 By Application Role
18.2 By Trigger Event
18.3 By Message Type
19 Glossary
Welcome to the Patient Administration DSTU for NE2011. This content reflects the Patient Administration DSTU that passed ballot in Spetember 2009 with an additional update to the Person topic that passed ballot in May 2010.
Changes include adding attribute-level documentation to all information models, revising constraints in encounter messages based on a detailed review conducted by the Patient Administration work group, correcting context control modeling in act relationships, removing negation indicator from ValuablesLocation class, creating separate R-MIMs where more than one message type was previously derived from a single R-MIM.
The following topics are published with only technical corrections:
- Patient Registry
- Service Delivery Location Registry
- Identity Document
The following topics are published with content changes:
- Person
- Ambulatory Encounter
- Inpatient Encounter
- Emergency Encounter
- Home Health Encounter
- Attending Practitioner
- Patient Location
- Responsible Organization
- Encounter Queries
One new topic is added to the domain:
- Short Stay Ambulatory Encounter
- The note attached to A_Observation CMET in the Encounter RMIMs indicating that the diagnosis is an Admitting Dx or a Discharge Dx should be ignored. There is no intended constraint on the types of diagnoses that can be sent with any message type. This will be made clearer in the next release.
- The March 2007 Harmonization meeting approved a proposal to deprecate Person.livingArrangementCode and instead convey such information as an Observation. That change is not included in this release.
- The Patient Encounter topics are undergoing a significant restructuring based on implementer feedback. The first ballot of that content was published in the 2011May ballot.
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Patient Administration Domain
The Patient Administration domain defines person and patient demographics and visit information about patients. Generally, information is entered into a Patient or Person Registry or into a Patient Administration system and passed to other systems (e.g., other registries, clinical, ancillary and financial systems).
Diagram
The Patient Administration D-MIM is a refined subset of the HL7 Reference Information Model (RIM) that includes the set of classes, attributes and relationships used to create messages for new or updated demographic and visit information about patients. The D-MIM encompasses several subject areas:
Encounter - An interaction between a patient and care provider(s) for the purpose of providing healthcare-related service(s). This can be a request, appointment, or event.
- moodCode - Conveys whether the encounter should be interpreted as an event that is being done or has been done (event) or an event that is intended to be done (appointment).
- id - Identifiers for this encounter (for example, an "internal" id used only by computer systems and an "external" id for display to users)
- code - A value further specifying the type of patient encounter drawn from the ActEncounterType domain. Examples include inpatient, ambulatory, emergency, home heath, field and virtual.
- statusCode - A value specifying the state of this patient encounter (based on the RIM Act class state machine), for example, active, aborted, completed
- effectiveTime - The time interval starting with the administrative onset of the encounter (e.g. admission, registration, patient arrival) and ending with the patient's departure (e.g. discharge). Note_1: for active encounters the end of the effectiveTime range is the anticipated end date-time. Note_2: all messages, except the "nullify" message, require at least a starting time.
- activityTime - The total time interval for this encounter including preparation before the patient arrives and clean-up actions after the patient departs
- priorityCode - A value representing the urgency for the encounter
- confidentialityCode - A set of values that control the disclosure of information about this patient encounter
- reasonCode - A set of values specifying the administrative reasons for this encounter. Examples are "Medical Necessity", "Patient's Request" and "Dependency". Note: medical reason(s) for the encounter are specified as associated diagnoses.
- admissionReferralSourceCode - A value categorizing the type of place or organization responsible for the patient immediately prior to this encounter. Note: in the US realm this references the UB92 FL 20 - Source of Admission value set.
- lengthOfStayQuantity - The expected or actual quantity of time for the patient encounter. While the encounter is still "active" (the encounter does not have an end date yet) this field should be interpreted as the expected length. When the encounter is "completed" this field contains the actual length of stay. The actual quantity cannot be simply calculated from the start and end dates because of possible leaves of absence.
- dischargeDispositionCode - A code depicting the disposition of the patient at the end of the encounter (e.g., discharged to home, expired, against medical advice, etc.). While the encounter is still "active" (the encounter does not have an end date yet) this attribute should be interpreted as the expected discharge disposition. When the encounter is "completed" this attribute contains the actual discharge disposition. Note: in the US realm this references the UB92 FL 22 - Patient Status value set.
- preAdmitTestInd - Indicates whether tests were done or will need to be done in a preadmission encounter prior to this encounter. The encounters for the pre-admit tests are related to the encounter via the reasonOf act relationship
- specialCourtesiesCode - A set of values identifying special courtesies extended or to be extended to the patient for this encounter (e.g., no courtesies, extended courtesies, professional courtesy, VIP courtesies).
- specialArrangementCode - A set of values representing the types of special arrangements provided or to be provided for this patient encounter (e.g., wheelchair, stretcher, interpreter, attendant, seeing eye dog)
componentOf - An optional association from the focal encounter (target) to an overall care event (source) of which it is a component. The care event represents someone (generally a health care practitioner) taking responsibility for some aspect of a patient's health; examples include primary/preferred care provider, case manager. Both the encompassing care event and the focal encounter have the same subject (patient) so the blockedContextParticipationType attribute is set to block all participations except subject (patient) from conducting.
reasonOf - An optional association from the focal encounter (target) one or more pre-admission patient encounters (source) for tests. The focal encounter is the reason for the pre-admission encounter(s). Both the pre-admission encounter and the focal encounter have the same subject (patient) so the blockedContextParticipationType attribute is set to to block all participations except subject (patient) from conducting. Note, the Encounter.preAdmitTestInd should also be set to "true."
inFulfillmentOf - An optional association from the focal encounter (source) to the appointment that scheduled the encounter (target). Both the appointment and the focal encounter have the same subject (Patient) so the blockedContextParticipationType attribute is set to block all participations except subject (patient) from conducting.
pertinentInformation - An optional association for care and billing purposes from the focal encounter (source) to another encounter (target) for a different patient. Examples include encounters for a mother and her newborn baby or encounters for an organ recipient and organ donor. The contextConductionInd is set to "false" because the two encounters have different subjects (patients). The two linked encounters always have different subjects (patients) so the blockedContextParticipationType attribute is set to block all participations from conducting.
sequelTo - An optional association from the focal encounter (source) to a previous encounter (target) for the same patient. Examples include: (1) a patient in an ambulatory encounter is admitted as an inpatient after an evaluation of the seriousness of the patient's condition, (2) an inpatient is discharged from an inpatient encounter directly to an ambulatory encounter as part of the same episode of care, (3) a patient is re-admitted to a healthcare facility. Both encounters have the same subject (Patient) so the blockedContextParticipationType attribute is set to block all participations except subject (patient) from conducting.
component (Transportation)- An optional association to information about the patient's arrival at or departure from the site of the patient encounter or possibly transportation of the patient within the encounter. The transportation can represent either actual (event) or planned (appointment) events. The Transportation is described later.
- For admissions (1) use a transportedBy act relationship of typeCode "ARR" (arrival), (2) use a location participation of typeCode "ORG" (origin) to link to the admitted-from location, (3) do not include a location participation of typeCode "DST" (destination) because the destination is assumed to be the site of the patient encounter, (4) the mode of arrival (e.g., ambulance, car, on foot, helicopter, public transport) is sent as TransportationProcess.code.
- For discharges (1) use a transportedBy act relationship of typeCode "DEP" (departure), (2) use a location participation of typeCode "DST" (destination) to link to the discharged-to location, (3) do not include a location participation of typeCode "ORG" (origin) because the origin is assumed to be the site of the patient encounter, (4) the mode of departure (e.g., ambulance, car, on foot, helicopter, public transport) is sent as TransportationProcess.code.
pertinentInformation (ProcedureEvent) - an optional association to a procedure performed as part of a patient encounter. The Procedure and Encounter have the same subject (Patient) so the blockedContextParticipationType attribute is set to block all participations except subject (patient) from conducting.
reference (AccountGuarantor) - an optional association from the focal encounter (source) to one or more patient accounts (target). Encounter and A_AccountGuarantor have no participations in common so the blockedContextParticipationType attribute is set to block all participations from conducting.
reason (ObservationDx) - an optional association from the focal encounter (source) to one or more diagnoses (target). The contextConductionInd is set to "true" because the encounter and the observation have the same subject (the patient). Encounter and A_ObservationDX have no participations in common so the blockedContextParticipationType attribute is set to block all participations from conducting.. Each diagnosis is sent in a separate A_ObservationDx CMET. The type of diagnosis is determined by the Observation.code within the A_ObservationDx CMET; "ADMX" for an admission diagnosis, "INTDX" for an interim diagnosis, and "DISDX" for a discharge diagnosis. Multiple diagnoses of the same type can be rank ordered using the reason.priorityNumber.
authorization (Consent) - an optional association from the focal encounter (source) to one or more consents granted by the patient or patient's representative (target). Encounter and A_Consent have no participations in common (the patient is the "author" of the consent, not its "subject") so the blockedContextParticipationType attribute is set to block all participations from conducting. Each consent is sent in a separate A_Consent CMET. Note, this is currently a placeholder CMET until the Medical Records TC completes work on medico-legal document modeling.
itemStorage (ValuablesLocation) - An optional association from the focal encounter (source) to one or more reports of patient valuables stored during the patient encounter (target). Each report is sent as a free text observation of the valuables and where they were stored during the encounter. The patient is not the subject of the valuables location observation so the blockedContextParticipationType attribute is set to block all participations from conducting.
admitter - Optional association to the healthcare practitioner who required/authorized this patient encounter
- time - An interval of time specifying the period this healthcare practitioner was actively involved in authorizing this patient encounter
- modeCode - A code specifying the modality by which the healthcare practitioner authorized this patient encounter. Examples include physically present, over the telephone, written communication.
responsibleParty - Optional association to one or more healthcare provider organizations that hold clinical responsibility for the patient encounter. Note: only one responsibleParty participation should be in the active state at a time.
- time - An interval of time specifying the period this assigned organization holds clinical responsibility for the patient encounter. Note, this is only needed if the organization does not hold clinical responsibility for the duration of the entire patient encounter.
- id - Identifier(s) for this responsible organization participation
- statusCode - A value representing the state of the responsible organization participation (based on the RIM Managed Participation class state-machine), for example pending, active, completed
discharger - Optional association to the practitioner who required or authorized the ending of the patient encounter
- time - An interval of time specifying the period this practitioner was actively involved in ending this patient encounter
- modeCode - A code specifying the modality by which the practitioner authorized the end of this patient encounter. Examples include physically present, over the telephone, written communication.
location - Optional association to the patient's assigned locations during an encounter. Each location is a ServiceDeliveryLocation that can optionally lead to an AccommodationProcess describing the provision of room and board to the patient during a hospital stay. Note: only one location participation should be in the active state at a time.
- time - An interval of time specifying the period the patient is assigned to this location
- performInd - Indicates whether this location assignment must be reserved before use (i.e. it is controlled by a schedule). Note: this is included only in appointment messages.
- substitutionConditionCode - Indicates the conditions under which this location may be substituted with a different one. Note: this is included only in appointment messages.
- id - Identifier(s) for this patient location assignment
- statusCode - A value representing the state of this patient location assignment (based on the RIM Managed Participation class state-machine), for example pending, active, completed. Note: this is included only in event messages.
performer - Optional association to one or more practitioners who will carry out actions in a scheduled patient encounter. Need not be the principal responsible actor, e.g. a surgery resident operating under supervision of attending surgeon. Note: this participation is used only in appointment messages.
- functionCode - A value specifying additional detail about the function this performer will play in the scheduled patient encounter
- time - An interval of time specifying the time during which this practitioner is expected to be a physical performer in the scheduled patient encounter
- modeCode - A code specifying the modality by which the practitioner will perform in the scheduled patient encounter. The default value is "physical".
- performInd - Indicates whether the practitioner's participation in the patient encounter must be scheduled
- substitutionConditionCode - Indicates the conditions under which this practitioner may be substituted with a different one
reusableDevice - Optional association to one or more devices required for a scheduled patient encounter. Note: this participation is used only in appointment messages.
- time - An interval of time specifying the time during which this equipment is expected to be needed in the scheduled patient encounter
- performInd - Indicates whether the equipment's participation in the patient encounter must be scheduled
- substitutionConditionCode - Indicates the conditions under which this piece of equipment may be substituted with a different one
subject -A required association to the patient in this patient encounter.
referrer - Optional association to the healthcare practitioner who requested this patient encounter take place
- modeCode - A code specifying the modality by which this practitioner participated in this patient encounter as referrer. Examples include physically present, over the telephone, written communication.
consultant - Optional association to advisor(s) participating in this patient encounter by performing evaluations and making recommendations
- functionCode - A code further specifying the consultant participation, for example, cardiologist, anesthetist, dietician.
- time - An interval of time specifying the period this practitioner was actively participating in this patient encounter by performing evaluations and making recommendations
- modeCode - A code specifying the modality by which the practitioner participated in this patient encounter as a consultant. Examples include physically present, over the telephone, written communication.
attender - Optional association to the healthcare practitioners who have responsibility for overseeing a patient's care during a patient encounter.
- priorityNumber - An integer specifying the relative priority of attending practitioners in a patient encounter if more than one attender participation is active at a given time
- time - An interval of time specifying the period this practitioner has responsibility for overseeing a patient's care during a patient encounter
- modeCode - A code specifying the modality by which the practitioner participated in this patient encounter as attender. Examples include physically present, over the telephone, written communication.
- performInd - Indicates whether the practitioner's participation in the patient encounter must be scheduled
- substitutionConditionCode - Indicates the conditions under which this practitioner may be substituted with a different one
- id - Identifier(s) for this attender participation
- statusCode - A value representing the state of this attender participation (based on the RIM Managed Participation class state-machine), for example pending, active, completed
notificationContact - Optional association to the patient's designated emergency contact(s) for this encounter
- time - An interval of time specifying the period this notification party is the patient's emergency contact. Note: this only needed if a notification party is not the patient's emergency contact for duration of the patient encounter.
ServiceDeliveryLocation - A role played by a place at which services may be provided by, or on behalf of, an organization. Note that a single physical place can play multiple service delivery location roles each with its own attributes. For example, a Podiatry clinic and Research clinic may meet on alternate days in the same physical location; each clinic uses its own mailing address and telephone number.
- id - Identifier(s) for this service delivery location
- code - A value further specifying what type of service delivery location this is, drawn from the ServiceDeliveryLocationRoleType domain. A service delivery location may be either an incidental service delivery location (a place at which services may be provided without prior designation or authorization) or a dedicated service delivery location (a place that is intended to house the provision of services). Dedicated service delivery locations can be further characterized as either clinical (DedicatedClinicalLocationRoleType) or non-clinical (DedicatedNonClinicalLocationRoleType).
- name - A textual name for this service delivery location
- addr - Address(es) for a place playing this service delivery location role
- telecom - Telecommunication address(es) for a place playing this service delivery location role
- statusCode - A value specifying the state of this service delivery location (based on the RIM Role class state-machine), for example, pending, active, suspended, terminated.
- effectiveTime - An interval of time specifying the period during which this service delivery location role is in effect, if such time limit is applicable and known
- partOf / part - A service delivery location may exist in a hierarchy of service delivery locations. For example an Emergency Ward may be part of an encompassing Hospital.
A_SpatialCoordinate - The position of a Service Delivery Location can be specified by a spatial coordinate observation. The ServiceDeliveryLocation is the subjectOf the A_SpatialCoordinate observation. A sequenceNumber attribute in the participation can sequence a series of spatial coordinate observations (track its location over time) for a mobile service delivery location such as an ambulance.
Place - The physical place playing the role of ServiceDeliveryLocation. Place is a subtype of Entity representing a bounded physical place or site with its contained structures, if any.
- id - Identifier(s) for this physical place
- code - A value further specifying the type of place drawn from the PlaceEntityType domain. Examples include bed location, room location, floor location, wing location, and building location.
- name - A non-unique textual identifier or moniker for this place
- desc - A textual or multimedia depiction of this place. Note: descriptions are meant to be shown to interested human individuals.
- mobileInd - An indication of whether a place has the capability to move from one location to another. Example: air and ground ambulances, mobile clinics
- addr - The physical address of this place
- directionsText - A free text note that carries information related to a site that is useful for entities accessing that site. For example, it could include information useful to people visiting the location such as "Last house on the right" or "If owner not present, check whereabouts with neighbor down the road".
- positionText - A text reference that locates the site within a mapping scheme, for example, map coordinates for US Geological Survey maps
- LocatedEntityHasParts / LocatedEntityPartOf-
A Place may exist in a hierachy of places, for example a building wing contains rooms that contain bed locations.
- id - Identifier(s) for this hierarchical relationship of a place containing another place
ServiceDefinition - A type of service that can be performed at a service delivery location. The ServiceDeliveryLocation is the target of a locationOf participation act relationship from the ServiceDefinition act.
- code - A value specifying the type of service
- statusCode - A value specifying the availability of this service (based on the RIM Act class state-machine), for example, active, suspended, completed
- activityTime - The time(s) that this service is generally available. E.g. 8am to 7pm, Monday through Friday.
ContactParty - A party that provides or receives information regarding a service delivery location. A ServiceDeliveryLocation may have multiple type of contact parties. The ContactParty is the target of a directAuthorityOver role link from the ServiceDeliveryLocation role.
- code - A value further specifying the general purpose for which this contact information is appropriate such as admitting, billing, after-hours, etc.
- addr - Address(es) for corresponding with the contact party
- telecom - Telecommunication address(es) for communicating with this contact party
TerritorialAuthority - The identifier for a geographic region over which an organization has certain authority (jurisdiction). For example, the Calgary Regional Health Authority has authority over the territory 'Region 4 of Alberta' in matters of health. The ServiceDeliveryLocation is the target of an indirectAuthority role link from the TerritorialAuthority that holds jurisdiction for its location.
IdentifiedLocation - An identifier used for the Service Delivery Location by an organization other than the organization that provides the services at the location. The ServiceDeliveryLocation is the target of an indirectAuthority role link from the IdentifiedLocation role.
- id - The identifier used for the Service Delivery Location by the IdentifierOrganization
- code - A value that further characterizes the type of identifier
IdentifierOrganization -The name of the organization that uses a particular identifier for the Service Delivery Location.
locationOf - Optional association of the patient's assigned location during a patient encounter to an accommodation act (provision of food and lodging). The most common example is admission of a patient to a hospital stay.
Accommodation - The provision of room and board to a patient during a patient encounter. Commonly used to track the provision of ward, private and semi-private accommodations for a patient. This can be an accommodation request, appointment, or event.
- code - A value further specifying the type of accommodation requested, scheduled, or provided for the patient. Examples include isolation, suite, private, semi-private, ward.
- effectiveTime - The time interval the accommodation is to be or was provided
- reasonCode - A set of values specifying the reason a particular type of accommodation was requested, scheduled or provided. Examples include medical necessity and patient request.
Transportation - Transportation of a payload (people or material) from a location of origin to a destination location. This can be a transportation request, appointment or event.
- id - Identifier(s) for this transportation act
- code - A value specifying the mode of transportation. Examples include ambulance, private transport, public transport, on foot.
- text - A textual description of this transportation act
- statusCode - A value specifying the state of this transportation act (based on the RIM act class state-machine). Examples include pending, active, aborted, completed.
- effectiveTime - The time the transported payload is en route
- priorityCode - A code or set of codes (e.g., for routine, emergency), specifying the urgency under which the transportation act happened, can happen, is happening, or is intended to happen
- confidentialityCode - Value(s) that control the disclosure of information about this transportation act
performer - Optional association to the person(s) who transported or will transport a payload (people or material) from a location of origin to a destination location
- time - An interval of time specifying the period this person transported a payload. Note, this is only needed if this person did not participate for the full duration of the transport.
escort - Optional association to the person(s) who escorted or will escort the patient during a transportation act
- time - An interval of time specifying the period this person escorted the patient. Note, this is only needed if the escort did not participate for the full duration of the patient transport.
assignedPerson - A person assigned to participate in a transportation act as performer or escort. The role is played by a Person and scoped by the Organization that assigned the person to the role of performer or escort.
- id - An identifier for a person assigned to participate in a transportation act as performer or escort
- telecom - A telecommunication address for a person assigned to participate in a transportation act as performer or escort
subject - Required association to the entity being transported (person or material) by the transportation act
aRole - Links the subject participation to the entity being transported
anEntity - The thing (person or material) being transported
- id - Identifier(s) for this entity
- name - Name(s) of this entity
location - Optional association to locations transited in this transportation act. A location can be specialized as origin, via or destination location.
- sequenceNumber - An integer specifying the relative order of locations transited in a multi-segment transportation act
LocatedEntity - Relates an entity (player) to a location (scoper) at which it is present in some way. This presence may be limited in time. In a patient transport message this might be a nursing home, hospital or an ambulance.
- id - Identifier(s) for this located entity
- addr - Address(es) for the focal entity at this location
- telecom - Telecommunication address(es) for the focal entity at this location
- statusCode - A value specifying the state of this located entity role (based on the RIM Role class state-machine), for example active, suspended, terminated
- effectiveTime - An interval of time specifying the period during which the focal entity is at the specified location, if such time is applicable and known
A_SpatialCoordinate - The position of the LocatedEntity can be specified by a spatial coordinate observation. The LocatedEntity is the subjectOf the A_SpatialCoordinate observation. A sequenceNumber attribute in the participation can sequence a series of spatial coordinate observations (track its location over time) for a mobile located entity such as an ambulance.
RoleChoice - The Patient Administration D-MIM defines content for living subjects and two types of registries for living subjects -- patient registry and identified entity registry.
ObservationEvent - An administrative observation about the focal living subject; examples include Preferred Contact Method, Preferred Contact Times, Preferred Written Communication Format. In query responses this might convey degree of match.
- id - Identifier(s) for this observation instance
- code - A value further characterizing the type of observation performed.
- statusCode - A value specifying the state of this observation (based on the RIM act state-machine), for example, completed, aborted, active
- effectiveTime - The time for which the observation holds (is effective) for the subject
- value - The result determined by this observation. For example, the confidence value that a record matches the living subject whose demographics were sent in a "find candidates" query.
One step in verifying the identity of an IdentifiedPerson or Patient is verifying the validity of an identification document presented by the person. Note that the focus is on verifying the validity of a document such as a passport or driver's license and not on authenticating the identity of the person presenting the document.
IdentityDocument: An identification document
- id: identifier for the identification document
- code: code identifying the type of identification document (e.g. passport, drivers license)
- subject Participation: The person whose details are shown on the identification document
subject Act Relationship: This relationship associates a verification act with the identification document to be verified.
ValidityVerification: The verification of the validity of an identification document. This can be in request mood or event mood.
- id: identifier for the verification event
- code: code identifying the type of verification. Codes are taken from the ActVerificationTypeCode domain
- effectiveTime: time of the verification event
- value: the actual outcome of the verification process e.g. 'verified', 'not verified'
- PrimaryPerformer Participation: The person, organization or device that actually performed the verification, and the organization they represent, are identified via this participation
- author Participation: The person, organization or device that requested the verification
PatientRole - The primary record for the focal living subject in a patient registry
- id - Identifiers designated by this patient registry for the focal living subject
- addr - Address(es) for corresponding with the focal living subject in the context of this patient registry
- telecom - Telecommunication address(es) for communicating with the focal living subject in the context of this patient registry
- statusCode - A value specifying the state of this record in a patient registry (based on the RIM role class state-machine). Examples include pending, active, suspended, terminated, nullified).
- effectiveTime - An interval of time specifying the period during which this record in a patient registry is in effect, if such time limit is applicable and known
- confidentialityCode - Value(s) that control the disclosure of information about this living subject as a patient
- veryImportantPersonCode - A code specifying the patient's special status granted by the scoper organization, often resulting in preferred treatment and special considerations. Examples include board member, diplomat.
CoveredPartyOf - An optional association from a patient to one or more insurance policies that provide coverage for the patient
- sequenceNumber - A number that conveys coordination of benefits sequence for insurance claims if the patient has more than one insurance policy (coverage)
- time - An interval of time specifying the time the patient is covered by an insurance policy. This may be different than the life time of the policy.
IdentifiedEntity - The primary record for the focal living subject in an identified living subject registry
- id - One or more identifiers designated for the focal living subject by this living subject registry. Note, this is a mandatory attribute; it makes no sense to have a record in an identified living subject registry that does not have an identifier.
- addr - Address(es) for corresponding with the focal living subject in the context of this living subject registry
- telecom - Telecommunication address(es) for communicating with the focal living subject in the context of this living subject registry
- statusCode - A value specifying the state of this record in a living subject registry (based on the RIM role class state-machine). Examples include pending, active, suspended, terminated, nullified).
- effectiveTime - An interval of time specifying the period during which record in a living subject registry is in effect, if such time limit is applicable and known
- confidentialityCode - Value(s) that control the disclosure of information about this living subject as an identified entity
EntityChoiceSubject - Either a person or a non-person living subject can be registered in a patient registry or a living subject (person) registry
Person - A subtype of LivingSubject representing a human being. This may be either a specific person or a general description of a kind of person depending on the determinerCode value.
- id - Identifier(s) for this person. Note that these identifiers can only be used for matching purposes since no scoping organization or status information is included.
- quantity - The number or quantity of this type of person
- name - Name(s) for this person
- desc - A textual or multimedia depiction of this person. Descriptions are meant to be shown to interested human individuals.
- telecom - Telecommunication address(es) for communicating with this person
- administrativeGenderCode - A value representing the gender (sex) of this person. Note: this attribute does not include terms related to clinical gender which is a complex physiological, genetic and sociological concept that requires multiple observations in order to be comprehensively described.
- birthTime - The date and time this person was born. This could be an exact moment such as January 1, 1960 @ 03:00:00 EST or an approximate date such as January 1960.
- deceasedInd - An indication that this person is dead
- deceasedTime - The date and time this person died. This could be an exact moment such as January 1, 1960 @ 03:00:00 EST or an approximate date such as January 1960.
- multipleBirthInd - An indication that this person was part of a multiple birth
- multipleBirthOrderNumber - The order in which this person was born if part of a multiple birth
- organDonorInd - An indication that this person is a candidate to serve as an organ donor. Note: specifics of an organ donor agreement would be conveyed in a medico-legal document.
- addr - Address(es) for corresponding with this person
- maritalStatusCode - A value representing the domestic partnership status of this person
- educationLevelCode - A value representing the highest level of education this person achieved
- disabilityCode - A set of values identifying this person's disabilities
- livingArrangementCode - A value specifying the housing situation of this person
- religiousAffiliationCode - A value representing the primary religious preference of this person
- raceCode - A set of values representing the races of this person
- ethnicGroupCode - A set of values representing the ethnic groups of this person
NonPersonLivingSubject -A subtype of LivingSubject representing a non-person living subject (e.g., animal, microorganism, plant). This may be either a specific non-person living subject or a general description of a kind of non-person living subject depending on the determinerCode value.
- id - Identifier(s) for this non-person living subject. Note that these identifiers can only be used for matching purposes since no scoping organization or status information is included.
- code - A value representing the specific kind of non-person living subject the instance represents, for example animal or plant taxonomy.
- quantity - The number or quantity of this type of non-person living subject
- name - The name(s) of this non-person living subject
- desc - A textual or multimedia depiction of this non-person living subject. Descriptions are meant to be shown to interested human individuals.
- existenceTime - An interval of time specifying the period in which this non-person living subject physically existed
- telecom - Telecommunication address(es) for communicating with the focal non-person living subject
- riskCode - A value representing the type of hazard or threat associated with this non-person living subject. Animals of irascible temperament may prove to be a risk to healthcare personnel.
- handlingCode - A value representing special handling requirements for this non-person living subject to avoid damage to it or other entities
- administrativeGenderCode - A value representing the gender (sex) of this non-person living subject. This attribute does not include terms related to clinical gender which is a complex physiological, genetic and sociological concept that requires multiple observations in order to be comprehensively described.
- birthTime - The date and time this non-person living subject was born. This could be an exact moment such as January 1, 1960 @ 03:00:00 EST or an approximate date such as January 1960.
- deceasedInd - An indication that this non-person living subject is dead.
- multipleBirthInd - An indication that this non-person living subject was part of a multiple birth
- multipleBirthOrderNumber - The order in which this non-person living subject was born if part of a multiple birth
- organDonorInd - An indication that this non-person living subject is a candidate to serve as an organ donor
- strainText - A text string representing the specific genotypic or phenotypic variant of this non-person living subject
- genderStatusCode - A value representing whether the primary reproductive organs of this non-person living subject are present
- deceasedTime - The date and time this non-person living subject died. This could be an exact moment such as January 1, 1960 @ 03:00:00 EST or an approximate date such as January 1960.
OtherIDs - An identifying relationship between the focal living subject and a scoping organization. This can be any specialization of "role" except for Citizen, Employee, Student, or Member.Note: this could be an identifier used by the primary scoping organization in a different context.
- id - One or more identifiers issued to the focal living subject by the associated assigningOrganization
- statusCode - A value specifying the state of this identifying relationship (based on the RIM Role class state-machine), for example, active, terminated, nullified
- effectiveTime - An interval of time specifying the period during which this identifying relationship is in effect, if such time limit is applicable and known
CareProvision - An association of the focal living subject to a care provision act. The care provision performer takes whole or partial responsibility for, or attention to, the safety and well-being of the subject. Examples include Primary Care Provider who takes responsiblity for a Patient, After School program that takes responsiblity for a school-age child, Day Care program that takes responsiblity for an elderly person.
BirthPlace - The birthplace of the focal living subject represented as BirthPlace.addr (a physical address), Place.name or A_SpatialCoordinate observation
- addr - A living subject's birth place represented as an address. This could be a full address or only known address components such as city or country. Note: Either BirthPlace.addr or an associated Place.name must be valued.
R-Guarantor - An association of the focal living subject to potential guarantors who will take financial responsibility over an account for the.
Citizen - A formal relationship between the focal person (player) who owes loyalty to and is entitled by birth or naturalization to the protection of a nation (scoper)
- id - Identifier(s) for the focal person as a citizen of a nation
- code - A value qualifying the focal person's citizenship status especially in cases where the person has less than full citizenship status such as "asylum seeker","noncitizen with residence permit".
- effectiveTime - An interval of time specifying the period during which this citizenship is in effect, if such time limit is applicable and known
Nation - A politically organized body of people bonded by territory and known as a nation
- code - A value that identifies a nation state
- name - A non-unique textual identifier or moniker for this nation
Employee - A relationship of the focal person with an organization to receive wages or salary. The purpose of this class is to identify the type of relationship the employee has to the employer rather than the nature of the work actually performed.
- id - Employee identifier(s) for the focal person in this employment relationship
- code - A value that qualifies the employment relationship such as "paid employee", "consultant", "volunteer".
- negationInd - Role (BL) Employee with negationInd "true" and no EmployerOrganization conveys that the focal person is not employed
- addr - The focal person's work address(es) for this employment relationship (addr.use = WP)
- telecom - The focal person's work telecommunications address(es) for this employment relationship (telecom.use = WP)
- statusCode - A value specifying the state of this employment relationship (based on the RIM Role class state-machine), for example, active, suspended, terminated
- effectiveTime - An interval of time specifying the period during which this employment relationship is in effect, if such time limit is applicable and known
- jobTitleName - The title of the job held, for example, Vice President, Senior Technical Analyst. This is a local name for the employee's occupation that does not necessarily correspond to any scheme for categorizing occupation. Trading partners that need a coded standard should be using Employee "occupation" attribute.
- jobClassCode - A code qualifying the employment regarding frequency or periodicity, such as, full-time vs. part-time
- occupationCode - A code qualifying the classification of kind-of-work based upon a recognized industry or jurisdictional standard. OccupationCode is used to convey the person's occupation as opposed to jobCode which characterizes this particular job.
Student - An enrollment of the focal person as a student of a school
- id - Student identifier(s) for the focal person in this school enrollment relationship
- addr - Address(es) for corresponding with the focal person in the context of this school enrollment
- telecom - Telecommunication address(es) for communicating with the focal person in the context of this school enrollment
- statusCode - A value specifying the state of this school enrollment (based on the RIM Role class state-machine), for example, active, suspended, terminated
- effectiveTime - An interval of time specifying the period during which this school enrollment is in effect, if such time limit is applicable and known
PersonalRelationship - A personal relationship between the focal living subject and another living subject
- id - Identifier(s) for this personal relationship
- code - A required value specifying the type of personal relationship between the relationshipHolder and the scoping living subject drawn from the PersonalRelationshipRoleType domain, for example, spouse, parent, unrelated friend
- negationInd - A PersonalRelationship with negationInd "true" and no relationshipHolder conveys that the scoping living subject has no recorded personal relationships
- statusCode - A value specifying the state of this personal relationship (based on the RIM Role class state-machine), for example, following divorce a spouse relationship would be "terminated"
- effectiveTime - An interval of time specifying the period during which this personal relationship is in effect, if such time is applicable and known
CareGiver -A living subject providing primary care for the focal living subject at home
- id - Identifier(s) for this care giver relationship
- code - A value further specifying the type of care giver
- addr - Address(es) for corresponding with the care giver
- telecom - Telecommunication address(es) for contacting the care giver
- statusCode - A value specifying the state of this care giver relationship (based on the RIM Role class state-machine), for example, active, suspended, terminated
- effectiveTime - An interval of time specifying the period during which this care giver relationship is in effect, if such time limit is applicable and known
Member - A membership of the playing living subject in a group such as family, tribe, household or religious organization
- id - Identifier(s) for this membership
- code - A value further specifying the type of membership the playing living subject has in the scoping entity, drawn from the MemberRoleType domain
- statusCode - A value specifying the state of this membership (based on the RIM Role class state-machine), for example, active, suspended, terminated
- effectiveTime - The timing specification that describes the period during which this membership is in effect, if such time limit is applicable and known
ObservationEvent2 - An observation about a membership (subject of the observation) in a group such as membership in a household
- code -A value that qualifies the type of observation. For example, HHOBS would indicate that this the observation of a person's living situation in a household.
- effectiveTime -The time for which the observation holds.
- confidentialityCode -A value representing constraints around appropriate disclosure of this observation information.
- languageCode -A value representing the primary language in which the observation is recorded.
- value -The result of the observation, for example a narrative report.
- methodCode -The means or technique used to ascertain the observation, for example, in person interview, telephone interview, survey form.
Group- The group of which the living subject is a member
- determinerCode - Structural attribute; this is a specific entity
- id - Identifier(s) for this group
- code - A value further specifying the type of group drawn from the OrganizationEntityType domain, for example "religious institution" or "household"
- name - A non-unique textual identifier or moniker for this group
- desc - A textual or multimedia depiction of this group
- statusCode - A value representing whether the information associated with this group is currently active or inactive
- existenceTime - An interval of time specifying the period in which this group physically existed if such time interval is applicable and known
- telecom - Telecommunication address(es) for communicating with this group
- addr - An address for corresponding with this group
Agent - A person or an organization that is authorized to act on behalf of the scoping living subject; examples include Guardian and Contact
- id - Identifier(s) for this agent relationship
- code - A value further specifying the agent role.
- negationInd - An Agent with negationInd "true" and no playing entity conveys that the scoping living subject does not have this type of agent
- addr - Address(es) for corresponding with this person or organization as an agent for the scoping living subject
- telecom - One or more telecommunication addresses for communicating with this person or organization as an agent for the scoping living subject
- statusCode - A value specifying the state of this agent relationship (based on the RIM Role class state-machine), for example, active, suspended, terminated
- effectiveTime - An interval of time specifying the period during which this agent relationship is in effect, if such time limit is applicable and known
- certificateText - In the case of a Guardian type agent this could contain a facsimile of the legal document establishing guardianship
LanguageCommunication - A language communication capability of the focal person
- languageCode - A value representing a language for which the focal person has some level of proficiency for written or spoken communication. Examples: Spanish, Italian, German, English, American Sign
- modeCode - A value representing the person's method of expression of this language Examples: expressed spoken, expressed written, expressed signed, received spoken, received written, received signed
- proficiencyLevelCode - A value representing the person's level of proficiency in this language. Examples: excellent, good, fair, poor
- preferenceInd - An indicator specifying whether or not this language is preferred by the focal person for the associated mode
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