Description:

The source is an excerpt from the target.

Definition:

Description: A directed association between a source Act and a target Act.

Usage Note: This code should never be transmitted in an instance as the value of ActRelationship.typeCode (attribute)

Concept Relationships:
  Generalizes (derived): COMP OUTC PERT SEQL _ActRelationshipConditional

Definition:

A collection of sub-services as steps or subtasks performed for the source service. Services may be performed sequentially or concurrently.

Concept Relationships:
  Specializes: ART
  Generalizes (derived): ARR CTRLV DEP

Concept Properties:   conductible: false   isDocumentCharacteristic: false   Name:Act:outboundRelationship:ActRelationship: component   Sort:Act:outboundRelationship:ActRelationship: E________   Name:Act:inboundRelationship:ActRelationship: componentOf   Sort:Act:inboundRelationship:ActRelationship: E________

Definition:

The relationship that links to a Transportation Act (target) from another Act (source) indicating that the subject of the source Act entered into the source Act by means of the target Transportation act.

Concept Relationships:
  Specializes: COMP

Concept Properties:   isDocumentCharacteristic: false   Name:Act:outboundRelationship:ActRelationship: arrivedBy   Sort:Act:outboundRelationship:ActRelationship: EB_______   Name:Act:inboundRelationship:ActRelationship: arrivalFor   Sort:Act:inboundRelationship:ActRelationship: EB_______

Definition:

A relationship from an Act to a Control Variable. For example, if a Device makes an Observation, this relates the Observation to its Control Variables documenting the device's settings that influenced the observation.

Concept Relationships:
  Specializes: COMP

Concept Properties:   isDocumentCharacteristic: false   Name:Act:outboundRelationship:ActRelationship: controlVariable   Sort:Act:outboundRelationship:ActRelationship: EA_______   Name:Act:inboundRelationship:ActRelationship: controlVariableFor   Sort:Act:inboundRelationship:ActRelationship: EA_______

Definition:

The relationship that links to a Transportation Act (target) from another Act (source) indicating that the subject of the source Act departed from the source Act by means of the target Transportation act.

Concept Relationships:
  Specializes: COMP

Concept Properties:   isDocumentCharacteristic: false   Name:Act:outboundRelationship:ActRelationship: departedBy   Sort:Act:outboundRelationship:ActRelationship: EC_______   Name:Act:inboundRelationship:ActRelationship: departureFor   Sort:Act:inboundRelationship:ActRelationship: EC_______

Definition:

An observation that should follow or does actually follow as a result or consequence of a condition or action (sometimes called "post-conditional".) Target must be an observation as a goal, risk or any criterion. For complex outcomes a conjunction attribute (AND, OR, XOR) can be used. An outcome link is often inverted to describe an outcome assessment.

Concept Relationships:
  Specializes: ART
  Generalizes (derived): GOAL RISK _ActRelationsipObjective

Concept Properties:   appliesTo: condition or action   conductible: false   howApplies: outcome   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: outcome   Sort:Act:outboundRelationship:ActRelationship: A________   Name:Act:inboundRelationship:ActRelationship: outcomeOf   Sort:Act:inboundRelationship:ActRelationship: A________

Definition:

A goal that one defines given a patient's health condition. Subsequently planned actions aim to meet that goal. Source is an observation or condition node, target must be an observation in goal mood.

Concept Relationships:
  Specializes: OUTC

Concept Properties:   appliesTo: observation, condition   howApplies: goal   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: goal   Sort:Act:outboundRelationship:ActRelationship: AB_______   Name:Act:inboundRelationship:ActRelationship: goalOf   Sort:Act:inboundRelationship:ActRelationship: AB_______

Definition:

A noteworthy undesired outcome of a patient's condition that is either likely enough to become an issue or is less likely but dangerous enough to be addressed.

Concept Relationships:
  Specializes: OUTC

Concept Properties:   appliesTo: observation, condition   howApplies: risk   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: risk   Sort:Act:outboundRelationship:ActRelationship: AA_______   Name:Act:inboundRelationship:ActRelationship: riskOf   Sort:Act:inboundRelationship:ActRelationship: AA_______

Definition:

The target act is a desired outcome of the source act. Source is any act (typically an intervention). Target must be an observation in criterion mood.

Concept Relationships:
  Specializes: OUTC
  Generalizes (derived): OBJC OBJF

Concept Properties:   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: goal   Sort:Act:outboundRelationship:ActRelationship: AC_______   Name:Act:inboundRelationship:ActRelationship: goalOf   Sort:Act:inboundRelationship:ActRelationship: AC_______

Definition:

A desired state that a service action aims to maintain. E.g., keep systolic blood pressure between 90 and 110 mm Hg. Source is an intervention service. Target must be an observation in criterion mood.

Concept Relationships:
  Specializes: _ActRelationsipObjective

Concept Properties:   appliesTo: service   howApplies: criterion   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: maintenanceGoal   Sort:Act:outboundRelationship:ActRelationship: ACA______   Name:Act:inboundRelationship:ActRelationship: maintenanceGoalOf   Sort:Act:inboundRelationship:ActRelationship: ACA______

Definition:

A desired outcome that a service action aims to meet finally. Source is any service (typically an intervention). Target must be an observation in criterion mood.

Concept Relationships:
  Specializes: _ActRelationsipObjective

Concept Properties:   appliesTo: service   howApplies: criterion   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: finalGoal   Sort:Act:outboundRelationship:ActRelationship: ACB______   Name:Act:inboundRelationship:ActRelationship: finalGoalOf   Sort:Act:inboundRelationship:ActRelationship: ACB______

Definition:

This is a very unspecific relationship from one item of clinical information to another. It does not judge about the role the pertinent information plays.

Concept Relationships:
  Specializes: ART
  Generalizes (derived): AUTH CAUS COVBY DRIV ELNK EVID EXACBY EXPL ITEMSLOC LIMIT META MFST NAME PREV REFR REFV RELVBY SPRT SUBJ SUMM _ActClassTemporallyPertains _ActRelationshipAccounting

Concept Properties:   appliesTo: any service   conductible: true   howApplies: any service   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: pertinentInformation   Sort:Act:outboundRelationship:ActRelationship: D________   Name:Act:inboundRelationship:ActRelationship: pertainsTo   Sort:Act:inboundRelationship:ActRelationship: D________

Definition:

A relationship in which the target act authorizes or certifies the source act.

Concept Relationships:
  Specializes: PERT

Concept Properties:   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: authorization   Sort:Act:outboundRelationship:ActRelationship: DH_______   Name:Act:inboundRelationship:ActRelationship: authorizationOf   Sort:Act:inboundRelationship:ActRelationship: DH_______

Definition:

Description: An assertion that an act was the cause of another act.This is stronger and more specific than the support link. The source (cause) is typically an observation, but may be any act, while the target may be any act.

Examples:

• a growth of Staphylococcus aureus may be considered the cause of an abscess
• contamination of the infusion bag was deemed to be the cause of the infection that the patient experienced
• lack of staff on the shift was deemed to be a supporting factor (proximal factor) causing the patient safety incident where the patient fell out of bed because the bed-sides had not been put up which caused the night patient to fall out of bed

Concept Relationships:
  Specializes: PERT

Concept Properties:   appliesTo: cause   howApplies: effect   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: causeOf   Sort:Act:outboundRelationship:ActRelationship: DD_______   Name:Act:inboundRelationship:ActRelationship: cause   Sort:Act:inboundRelationship:ActRelationship: DD_______

Definition:

A relationship in which the source act is covered by or is under the authority of a target act. A financial instrument such as an Invoice Element is covered by one or more specific instances of an Insurance Policy.

Concept Relationships:
  Specializes: PERT

Concept Properties:   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: coverage   Sort:Act:outboundRelationship:ActRelationship: DP_______   Name:Act:inboundRelationship:ActRelationship: coverageOf   Sort:Act:inboundRelationship:ActRelationship: DP_______

Definition:

Associates a derived Act with its input parameters. E.G., an anion-gap observation can be associated as being derived from given sodium-, (potassium-,), chloride-, and bicarbonate-observations. The narrative content (Act.text) of a source act is wholly machine-derived from the collection of target acts.

Concept Relationships:
  Specializes: PERT

Concept Properties:   appliesTo: output parameter   howApplies: input parameter   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: derivedFrom   Sort:Act:outboundRelationship:ActRelationship: DF_______   Name:Act:inboundRelationship:ActRelationship: derivation   Sort:Act:inboundRelationship:ActRelationship: DF_______

Definition:

Expresses an association that links two instances of the same act over time, indicating that the instance are part of the same episode, e.g. linking two condition nodes for episode of illness; linking two encounters for episode of encounter.

Concept Relationships:
  Specializes: PERT

Concept Properties:   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: links   Sort:Act:outboundRelationship:ActRelationship: BG_______   Name:Act:inboundRelationship:ActRelationship: linkedBy   Sort:Act:inboundRelationship:ActRelationship: BG_______

Definition:

Indicates that the target Act provides evidence in support of the action represented by the source Act. The target is not a 'reason' for the source act, but rather gives supporting information on why the source act is an appropriate course of action. Possible targets might be clinical trial results, journal articles, similar successful therapies, etc.

Rationale: Provides a mechanism for conveying clinical justification for non-approved or otherwise non-traditional therapies.

Concept Relationships:
  Specializes: PERT

Concept Properties:   isDocumentCharacteristic: true

Definition:

Description:The source act is aggravated by the target act. (Example "chest pain" EXACBY "exercise")

Concept Relationships:
  Specializes: PERT

Definition:

This is the inversion of support. Used to indicate that a given observation is explained by another observation or condition.

Concept Relationships:
  Specializes: PERT

Concept Properties:   howApplies: explaining observation or condition   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: explanation   Sort:Act:outboundRelationship:ActRelationship: DI_______   Name:Act:inboundRelationship:ActRelationship: explanationFor   Sort:Act:inboundRelationship:ActRelationship: DI_______

Definition:

Items located

Concept Relationships:
  Specializes: PERT

Concept Properties:   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: itemStorage   Sort:Act:outboundRelationship:ActRelationship: DR_______   Name:Act:inboundRelationship:ActRelationship: itemStorageFor   Sort:Act:inboundRelationship:ActRelationship: DR_______

Definition:

A relationship that limits or restricts the source act by the elements of the target act. For example, an authorization may be limited by a financial amount (up to $500). Target Act must be in EVN.CRIT mood.

Concept Relationships:
  Specializes: PERT

Concept Properties:   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: limitation   Sort:Act:outboundRelationship:ActRelationship: DQ_______   Name:Act:inboundRelationship:ActRelationship: limitationOf   Sort:Act:inboundRelationship:ActRelationship: DQ_______

Definition:

Definition: Indicates that the attributes and associations of the target act provide metadata (for example, identifiers, authorship, etc.) for the source act.

Constraint: Source act must have the Act.isCriterion attribute set to true. Target act must be an Act with a moodCode of EVN.

Concept Relationships:
  Specializes: PERT

Concept Properties:   conductible: false   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: metadataFor   Name:Act:outboundRelationship:ActRelationship: metadata   Sort:Act:inboundRelationship:ActRelationship: DZ_______   Sort:Act:outboundRelationship:ActRelationship: AA_______

Definition:

An assertion that a new observation may be the manifestation of another existing observation or action. This assumption is attributed to the same actor who asserts the manifestation. This is stronger and more specific than an inverted support link. For example, an agitated appearance can be asserted to be the manifestation (effect) of a known hyperthyroxia. This expresses that one might not have realized a symptom if it would not be a common manifestation of a known condition. The target (cause) may be any service, while the source (manifestation) must be an observation.

Concept Relationships:
  Specializes: PERT

Concept Properties:   appliesTo: manifestation   howApplies: cause   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: manifestationOf   Sort:Act:outboundRelationship:ActRelationship: DE_______   Name:Act:inboundRelationship:ActRelationship: manifestation   Sort:Act:inboundRelationship:ActRelationship: DE_______

Definition:

Used to assign a "name" to a condition thread. Source is a condition node, target can be any service.

Concept Relationships:
  Specializes: PERT

Concept Properties:   appliesTo: condition thread   howApplies: name   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: conditionNamed   Sort:Act:outboundRelationship:ActRelationship: DJ_______   Name:Act:inboundRelationship:ActRelationship: assignedConditionName   Sort:Act:inboundRelationship:ActRelationship: DJ_______

Definition:

A relationship in which the target act is a predecessor instance to the source act. Generally each of these instances is similar, but no identical. In healthcare coverage it is used to link a claim item to a previous claim item that might have claimed for the same set of services.

Concept Relationships:
  Specializes: PERT

Concept Properties:   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: predecessor   Sort:Act:outboundRelationship:ActRelationship: DC_______   Name:Act:inboundRelationship:ActRelationship: successor   Sort:Act:inboundRelationship:ActRelationship: DC_______

Definition:

A relationship in which the target act is referred to by the source act. This permits a simple reference relationship that distinguishes between the referent and the referee.

Concept Relationships:
  Specializes: PERT
  Generalizes (derived): USE

Concept Properties:   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: reference   Sort:Act:outboundRelationship:ActRelationship: DK_______   Name:Act:inboundRelationship:ActRelationship: referencedBy   Sort:Act:inboundRelationship:ActRelationship: DK_______

Definition:

Indicates that the source act makes use of (or will make use of) the information content of the target act.

UsageNotes: A usage relationship only makes sense if the target act is authored and occurs independently of the source act. Otherwise a simpler relationship such as COMP would be appropriate.

Rationale: There is a need when defining a clinical trial protocol to indicate that the protocol makes use of other protocol or treatment specifications. This is stronger than the assertion of "references". References may exist without usage, and in a clinical trial protocol is common to assert both: what other specifications does this trial use and what other specifications does it merely reference.

Concept Relationships:
  Specializes: REFR

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: usedBy   Name:Act:outboundRelationship:ActRelationship: uses   Sort:Act:inboundRelationship:ActRelationship: DKA______   Sort:Act:outboundRelationship:ActRelationship: DKA______

Definition:

Reference ranges are essentially descriptors of a class of result values assumed to be "normal", "abnormal", or "critical." Those can vary by sex, age, or any other criterion. Source and target are observations, the target is in criterion mood. This link type can act as a trigger in case of alarms being triggered by critical results.

Concept Relationships:
  Specializes: PERT

Concept Properties:   howApplies: range   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: referenceRange   Sort:Act:outboundRelationship:ActRelationship: DL_______   Name:Act:inboundRelationship:ActRelationship: referenceRangeFor   Sort:Act:inboundRelationship:ActRelationship: DL_______

Definition:

Description:The source act is wholly or partially alleviated by the target act. (Example "chest pain" RELVBY "sublingual nitroglycerin administration")

Concept Relationships:
  Specializes: PERT

Definition:

Used to indicate that an existing service is suggesting evidence for a new observation. The assumption of support is attributed to the same actor who asserts the observation. Source must be an observation, target may be any service (e.g., to indicate a status post).

Concept Relationships:
  Specializes: PERT
  Generalizes (derived): SPRTBND

Concept Properties:   howApplies: supporting evidence   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: support   Sort:Act:outboundRelationship:ActRelationship: DA_______   Name:Act:inboundRelationship:ActRelationship: supportOf   Sort:Act:inboundRelationship:ActRelationship: DA_______

Definition:

A specialization of "has support" (SPRT), used to relate a secondary observation to a Region of Interest on a multidimensional observation, if the ROI specifies the true boundaries of the secondary observation as opposed to only marking the approximate area. For example, if the start and end of an ST elevation episode is visible in an EKG, this relation would indicate the ROI bounds the "ST elevation" observation -- the ROI defines the true beginning and ending of the episode. Conversely, if a ROI simply contains ST elevation, but it does not define the bounds (start and end) of the episode, the more general "has support" relation is used. Likewise, if a ROI on an image defines the true bounds of a "1st degree burn", the relation "has bounded support" is used; but if the ROI only points to the approximate area of the burn, the general "has support" relation is used.

Concept Relationships:
  Specializes: SPRT

Concept Properties:   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: boundedSupport   Sort:Act:outboundRelationship:ActRelationship: DAA______   Name:Act:inboundRelationship:ActRelationship: boundedSupportOf   Sort:Act:inboundRelationship:ActRelationship: DAA______

Definition:

Relates an Act to its subject Act that the first Act is primarily concerned with.

Examples

1. The first Act may be a ControlAct manipulating the subject Act

2. The first act is a region of interest (ROI) that defines a region within the subject Act.

3. The first act is a reporting or notification Act, that echos the subject Act for a specific new purpose.

Constraints

An Act may have multiple subject acts.

Rationale

The ActRelationshipType "has subject" is similar to the ParticipationType "subject", Acts that primarily operate on physical subjects use the Participation, those Acts that primarily operate on other Acts (other information) use the ActRelationship.

Concept Relationships:
  Specializes: PERT

Concept Properties:   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: subject   Sort:Act:outboundRelationship:ActRelationship: DB_______   Name:Act:inboundRelationship:ActRelationship: subjectOf   Sort:Act:inboundRelationship:ActRelationship: DB_______

Definition:

An act that contains summary values for a list or set of subordinate acts. For example, a summary of transactions for a particular accounting period.

Concept Relationships:
  Specializes: PERT

Concept Properties:   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: summary   Sort:Act:outboundRelationship:ActRelationship: DM_______   Name:Act:inboundRelationship:ActRelationship: summaryOf   Sort:Act:inboundRelationship:ActRelationship: DM_______

Concept Relationships:
  Specializes: PERT
  Generalizes (derived): DURING OVERLAP _ActRelationshipTemporallyPertainsEnd _ActRelationshipTemporallyPertainsStart

Concept Properties:   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: temporallyRelatedInformation   Sort:Act:outboundRelationship:ActRelationship: DN_______   Name:Act:inboundRelationship:ActRelationship: temporallyRelatesTo   Sort:Act:inboundRelationship:ActRelationship: DN_______

Definition:

A relationship in which the source act's effective time is wholly within the target act's effective time.

Concept Relationships:
  Specializes: TemporallyPertains _ActClassTemporallyPertains

Definition:

A relationship in which the source act's effective time overlaps the target act's effective time in any way.

Concept Relationships:
  Specializes: TemporallyPertains _ActClassTemporallyPertains

Definition:

Concept Relationships:
  Specializes: TemporallyPertains _ActClassTemporallyPertains
  Generalizes (derived): EAE EAS EBS ECW

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: endTemporallyRelatedTo   Name:Act:outboundRelationship:ActRelationship: temporallyRelatedEndInformation

Definition:

Concept Relationships:
  Specializes: _ActRelationshipTemporallyPertainsEnd

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: endsBeforeEndOf   Name:Act:outboundRelationship:ActRelationship: endsAfterEndOf

Definition:

Concept Relationships:
  Specializes: _ActRelationshipTemporallyPertainsEnd
  Generalizes (derived): EDU

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: startsBeforeEndOf   Name:Act:outboundRelationship:ActRelationship: endsAfterStartOf

Definition:

Concept Relationships:
  Specializes: EAS

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: encompassesEndOf   Name:Act:outboundRelationship:ActRelationship: endsDuring

Definition:

Concept Relationships:
  Specializes: _ActRelationshipTemporallyPertainsEnd

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: startsAfterEndOf   Name:Act:outboundRelationship:ActRelationship: endsBeforeStartOf

Definition:

A relationship in which the source act's effective time ends with the end of the target act's effective time.

Concept Relationships:
  Specializes: _ActRelationshipTemporallyPertainsEnd
  Generalizes (derived): CONCURRENT

Definition:

A relationship in which the source act's effective time is the same as the target act's effective time.

Concept Relationships:
  Specializes: ECW SCW

Definition:

Concept Relationships:
  Specializes: TemporallyPertains _ActClassTemporallyPertains
  Generalizes (derived): SAE SAS SBS SCW

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: startTemporallyRelatedTo   Name:Act:outboundRelationship:ActRelationship: temporallyRelatedStartInformation

Definition:

Concept Relationships:
  Specializes: _ActRelationshipTemporallyPertainsStart

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: endsBeforeStartof   Name:Act:outboundRelationship:ActRelationship: startsAfterEndOf

Definition:

The source Act starts after the start of the target Act (i.e. if we say "ActOne SAS ActTwo", it means that ActOne starts after the start of ActTwo, therefore ActOne is the source and ActTwo is the target).

Concept Relationships:
  Specializes: _ActRelationshipTemporallyPertainsStart
  Generalizes (derived): SDU

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: startsBeforeStartOf   Name:Act:outboundRelationship:ActRelationship: startsAfterStartOf   Sort:Act:outboundRelationship:ActRelationship: DNA______   Sort:Act:inboundRelationship:ActRelationship: DNA______

Definition:

Concept Relationships:
  Specializes: SAS

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: encompassesStartOf   Name:Act:outboundRelationship:ActRelationship: startsDuring

Definition:

Concept Relationships:
  Specializes: _ActRelationshipTemporallyPertainsStart

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: startsAfterStartOf   Name:Act:outboundRelationship:ActRelationship: startsBeforeStartOf

Definition:

A relationship in which the source act's effective time starts with the start of the target act's effective time.

Concept Relationships:
  Specializes: _ActRelationshipTemporallyPertainsStart
  Generalizes (derived): CONCURRENT

Definition:

A relationship in which the source act's effective time is the same as the target act's effective time.

Concept Relationships:
  Specializes: ECW SCW

Definition:

Codes that describe the relationship between an Act and a financial instrument such as a financial transaction, account or invoice element.

Concept Relationships:
  Specializes: PERT
  Generalizes (derived): _ActRelationshipCostTracking _ActRelationshipPosting

Concept Properties:   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: accounting   Sort:Act:outboundRelationship:ActRelationship: DO_______   Name:Act:inboundRelationship:ActRelationship: accountingFor   Sort:Act:inboundRelationship:ActRelationship: DO_______

Definition:

Expresses values for describing the relationship relationship between an InvoiceElement or InvoiceElementGroup and a billable act.

Concept Relationships:
  Specializes: _ActRelationshipAccounting _ActRelationshipPosts
  Generalizes (derived): CHRG COST

Concept Properties:   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: costTracking   Sort:Act:outboundRelationship:ActRelationship: DOB______   Name:Act:inboundRelationship:ActRelationship: costTrackingOf   Sort:Act:inboundRelationship:ActRelationship: DOB______

Definition:

A relationship that provides an ability to associate a financial transaction (target) as a charge to a clinical act (source). A clinical act may have a charge associated with the execution or delivery of the service.

The financial transaction will define the charge (bill) for delivery or performance of the service.

Charges and costs are distinct terms. A charge defines what is charged or billed to another organization or entity within an organization. The cost defines what it costs an organization to perform or deliver a service or product.

Concept Relationships:
  Specializes: _ActRelationshipCostTracking

Concept Properties:   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: charge   Sort:Act:outboundRelationship:ActRelationship: DOBA_____   Name:Act:inboundRelationship:ActRelationship: chargeFor   Sort:Act:inboundRelationship:ActRelationship: DOBA_____

Definition:

A relationship that provides an ability to associate a financial transaction (target) as a cost to a clinical act (source). A clinical act may have an inherit cost associated with the execution or delivery of the service.

The financial transaction will define the cost of delivery or performance of the service.

Charges and costs are distinct terms. A charge defines what is charged or billed to another organization or entity within an organization. The cost defines what it costs an organization to perform or deliver a service or product.

Concept Relationships:
  Specializes: _ActRelationshipCostTracking

Concept Properties:   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: cost   Sort:Act:outboundRelationship:ActRelationship: DOBB_____   Name:Act:inboundRelationship:ActRelationship: costOf   Sort:Act:inboundRelationship:ActRelationship: DOBB_____

Definition:

Expresses values for describing the relationship between a FinancialTransaction and an Account.

Concept Relationships:
  Specializes: _ActRelationshipAccounting _ActRelationshipPosts
  Generalizes (derived): CREDIT DEBIT

Concept Properties:   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: posting   Sort:Act:outboundRelationship:ActRelationship: DOA______   Name:Act:inboundRelationship:ActRelationship: postingTo   Sort:Act:inboundRelationship:ActRelationship: DOA______

Definition:

A credit relationship ties a financial transaction (target) to an account (source). A credit, once applied (posted), may have either a positive or negative effect on the account balance, depending on the type of account. An asset account credit will decrease the account balance. A non-asset account credit will decrease the account balance.

Concept Relationships:
  Specializes: _ActRelationshipPosting

Concept Properties:   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: credit   Sort:Act:outboundRelationship:ActRelationship: DOAA_____   Name:Act:inboundRelationship:ActRelationship: creditTo   Sort:Act:inboundRelationship:ActRelationship: DOAA_____

Definition:

A debit relationship ties a financial transaction (target) to an account (source). A debit, once applied (posted), may have either a positive or negative effect on the account balance, depending on the type of account. An asset account debit will increase the account balance. A non-asset account debit will decrease the account balance.

Concept Relationships:
  Specializes: _ActRelationshipPosting

Concept Properties:   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: debit   Sort:Act:outboundRelationship:ActRelationship: DOAB_____   Name:Act:inboundRelationship:ActRelationship: debitTo   Sort:Act:inboundRelationship:ActRelationship: DOAB_____

Definition:

An act relationship indicating that the source act follows the target act. The source act should in principle represent the same kind of act as the target. Source and target need not have the same mood code (mood will often differ). The target of a sequel is called antecedent. Examples for sequel relationships are: revision, transformation, derivation from a prototype (as a specialization is a derivation of a generalization), followup, realization, instantiation.

Concept Relationships:
  Specializes: ART
  Generalizes (derived): APND BSLN COMPLY DOC FLFS GEN GEVL INST MOD MTCH OPTN RCHAL REV RPLC SUCC UPDT XCRPT XFRM

Concept Properties:   conductible: false   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: sequelTo   Sort:Act:outboundRelationship:ActRelationship: B________   Name:Act:inboundRelationship:ActRelationship: sequel   Sort:Act:inboundRelationship:ActRelationship: B________

Definition:

An addendum (source) to an existing service object (target), containing supplemental information. The addendum is itself an original service object linked to the supplemented service object. The supplemented service object remains in place and its content and status are unaltered.

Concept Relationships:
  Specializes: SEQL

Concept Properties:   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: appendage   Sort:Act:outboundRelationship:ActRelationship: BJ_______   Name:Act:inboundRelationship:ActRelationship: appendageOf   Sort:Act:inboundRelationship:ActRelationship: BJ_______

Definition:

Indicates that the target observation(s) provide an initial reference for the source observation or observation group.

UsageConstraints: Both source and target must be Observations or specializations thereof.

Concept Relationships:
  Specializes: SEQL

Concept Properties:   Name:Act:inboundRelationship:ActRelationship: baselineFor   Name:Act:outboundRelationship:ActRelationship: baseline   Sort:Act:inboundRelationship:ActRelationship: BG_______   Sort:Act:outboundRelationship:ActRelationship: BG_______

Definition:

Description:The source act complies with, adheres to, conforms to, or is permissible under (in whole or in part) the policy, contract, agreement, law, conformance criteria, certification guidelines or requirement conveyed by the target act.

Examples for compliance relationships are: audits of adherence with a security policy, certificate of conformance to system certification requirements, or consent directive in compliance with or permissible under a privacy policy.

Concept Relationships:
  Specializes: SEQL

Concept Properties:   isDocumentCharacteristic: true   Name:Act:inboundRelationship:ActRelationship: compliesWith   Name:Act:outboundRelationship:ActRelationship: compliance   Sort:Act:inboundRelationship:ActRelationship: BO_______   Sort:Act:outboundRelationship:ActRelationship: BO_______

Definition:

The source act documents the target act.

Concept Relationships:
  Specializes: SEQL

Concept Properties:   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: documentationOf   Sort:Act:outboundRelationship:ActRelationship: BH_______   Name:Act:inboundRelationship:ActRelationship: documentation   Sort:Act:inboundRelationship:ActRelationship: BH_______

Definition:

The source act fulfills (in whole or in part) the target act. Source act must be in a mood equal or more actual than the target act.

Concept Relationships:
  Specializes: SEQL
  Generalizes (derived): OCCR OREF SCH

Concept Properties:   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: inFulfillmentOf   Sort:Act:outboundRelationship:ActRelationship: BA_______   Name:Act:inboundRelationship:ActRelationship: fulfillment   Sort:Act:inboundRelationship:ActRelationship: BA_______

Definition:

The source act is a single occurrence of a repeatable target act. The source and target act can be in any mood on the "completion track" but the source act must be as far as or further along the track than the target act (i.e., the occurrence of an intent can be an event but not vice versa).

Concept Relationships:
  Specializes: FLFS

Concept Properties:   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: occurrenceOf   Sort:Act:outboundRelationship:ActRelationship: BAA______   Name:Act:inboundRelationship:ActRelationship: occurrence   Sort:Act:inboundRelationship:ActRelationship: BAA______

Definition:

Relates either an appointment request or an appointment to the order for the service being scheduled.

Concept Relationships:
  Specializes: FLFS

Concept Properties:   appliesTo: ActMood = ARQ or APT and ActMood = ORD   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: referencedOrder   Sort:Act:outboundRelationship:ActRelationship: BAB______   Name:Act:inboundRelationship:ActRelationship: referencedBy   Sort:Act:inboundRelationship:ActRelationship: BAB______

Definition:

Associates a specific time (and associated resources) with a scheduling request or other intent.

Concept Relationships:
  Specializes: FLFS

Concept Properties:   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: scheduleRequest   Sort:Act:outboundRelationship:ActRelationship: BAC______   Name:Act:inboundRelationship:ActRelationship: requestedBy   Sort:Act:inboundRelationship:ActRelationship: BAC______

Definition:

The generalization relationship can be used to express categorical knowledge about services (e.g., amilorid, triamterene, and spironolactone have the common generalization potassium sparing diuretic).

Concept Relationships:
  Specializes: SEQL

Concept Properties:   appliesTo: specialization   howApplies: generalization   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: generalization   Sort:Act:outboundRelationship:ActRelationship: BC_______   Name:Act:inboundRelationship:ActRelationship: specialization   Sort:Act:inboundRelationship:ActRelationship: BC_______

Definition:

A goal-evaluation links an observation (intent or actual) to a goal to indicate that the observation evaluates the goal. Given the goal and the observation, a "goal distance" (e.g., goal to observation) can be "calculated" and need not be sent explicitly.

Concept Relationships:
  Specializes: SEQL

Concept Properties:   appliesTo: evaluation   howApplies: goal   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: evaluationOf   Sort:Act:outboundRelationship:ActRelationship: BD_______   Name:Act:inboundRelationship:ActRelationship: evaluation   Sort:Act:inboundRelationship:ActRelationship: BD_______

Definition:

Used to capture the link between a potential service ("master" or plan) and an actual service, where the actual service instantiates the potential service. The instantiation may override the master's defaults.

Concept Relationships:
  Specializes: SEQL

Concept Properties:   appliesTo: instance   howApplies: master   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: definition   Sort:Act:outboundRelationship:ActRelationship: BB_______   Name:Act:inboundRelationship:ActRelationship: instantiation   Sort:Act:inboundRelationship:ActRelationship: BB_______

Definition:

Definition: Used to link a newer version or 'snapshot' of a business object (source) to an older version or 'snapshot' of the same business object (target).

Usage:The identifier of the Act should be the same for both source and target. If the identifiers are distinct, RPLC should be used instead.

Name from source to target = "modifiesPrior"

Name from target to source = "modifiesByNew"

Concept Relationships:
  Specializes: SEQL

Concept Properties:   isDocumentCharacteristic: true

Definition:

A trigger-match links an actual service (e.g., an observation or procedure that took place) with a service in criterion mood. For example if the trigger is "observation of pain" and pain is actually observed, and if that pain-observation caused the trigger to fire, that pain-observation can be linked with the trigger.

Concept Relationships:
  Specializes: SEQL

Concept Properties:   appliesTo: matching service   howApplies: trigger   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: matchOf   Sort:Act:outboundRelationship:ActRelationship: BF_______   Name:Act:inboundRelationship:ActRelationship: match   Sort:Act:inboundRelationship:ActRelationship: BF_______

Definition:

A relationship between a source Act that provides more detailed properties to the target Act.

The source act thus is a specialization of the target act, but instead of mentioning all the inherited properties it only mentions new property bindings or refinements.

The typical use case is to specify certain alternative variants of one kind of Act. The priorityNumber attribute is used to weigh refinements as preferred over other alternative refinements.

Example: several routing options for a drug are specified as one SubstanceAdministration for the general treatment with attached refinements for the various routing options.

Concept Relationships:
  Specializes: SEQL

Concept Properties:   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: option   Sort:Act:outboundRelationship:ActRelationship: BN_______   Name:Act:inboundRelationship:ActRelationship: optionFor   Sort:Act:inboundRelationship:ActRelationship: BN_______

Definition:

Description:A relationship in which the target act is carried out to determine whether an effect attributed to the source act can be recreated.

Concept Relationships:
  Specializes: SEQL

Concept Properties:   isDocumentCharacteristic: true

Definition:

A relationship between a source Act that seeks to reverse or undo the action of the prior target Act.

Example: A posted financial transaction (e.g., a debit transaction) was applied in error and must be reversed (e.g., by a credit transaction) the credit transaction is identified as an undo (or reversal) of the prior target transaction.

Constraints: the "completion track" mood of the target Act must be equally or more "actual" than the source act. I.e., when the target act is EVN the source act can be EVN, or any INT. If the target act is INT, the source act can be INT.

Concept Relationships:
  Specializes: SEQL

Concept Properties:   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: reversalOf   Sort:Act:outboundRelationship:ActRelationship: BK_______   Name:Act:inboundRelationship:ActRelationship: reversal   Sort:Act:inboundRelationship:ActRelationship: BK_______

Definition:

A replacement source act replaces an existing target act. The state of the target act being replaced becomes obselete, but the act is typically still retained in the system for historical reference. The source and target must be of the same type.

Concept Relationships:
  Specializes: SEQL

Concept Properties:   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: replacementOf   Sort:Act:outboundRelationship:ActRelationship: BI_______   Name:Act:inboundRelationship:ActRelationship: replacement   Sort:Act:inboundRelationship:ActRelationship: BI_______

Definition:

Definition: A new act that carries forward the intention of the original act, but does not completely replace it. The status of the predecessor act must be 'completed'. The original act is the target act and the successor is the source act.

OpenIssue:

Concept Relationships:
  Specializes: SEQL

Concept Properties:   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: predecessor   Sort:Act:outboundRelationship:ActRelationship: BIA______   Name:Act:inboundRelationship:ActRelationship: successor   Sort:Act:inboundRelationship:ActRelationship: BIA______

Definition:

A condition thread relationship specifically links condition nodes together to form a condition thread. The source is the new condition node and the target links to the most recent node of the existing condition thread.

Concept Relationships:
  Specializes: SEQL

Concept Properties:   appliesTo: new head of thread   howApplies: old head of thread   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: updateOf   Sort:Act:outboundRelationship:ActRelationship: BE_______   Name:Act:inboundRelationship:ActRelationship: update   Sort:Act:inboundRelationship:ActRelationship: BE_______

Definition:

The source is an excerpt from the target.

Concept Relationships:
  Specializes: SEQL
  Generalizes (derived): VRXCRPT

Concept Properties:   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: excerptFrom   Sort:Act:outboundRelationship:ActRelationship: BM_______   Name:Act:inboundRelationship:ActRelationship: excerpt   Sort:Act:inboundRelationship:ActRelationship: BM_______

Definition:

The source is a direct quote from the target.

Concept Relationships:
  Specializes: XCRPT

Concept Properties:   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: verbatimExcerptFrom   Sort:Act:outboundRelationship:ActRelationship: BMA______   Name:Act:inboundRelationship:ActRelationship: verbatimExcerpt   Sort:Act:inboundRelationship:ActRelationship: BMA______

Definition:

Used when the target Act is a transformation of the source Act. (For instance, used to show that a CDA document is a transformation of a DICOM SR document.)

Concept Relationships:
  Specializes: SEQL

Concept Properties:   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: transformationOf   Sort:Act:outboundRelationship:ActRelationship: BL_______   Name:Act:inboundRelationship:ActRelationship: transformation   Sort:Act:inboundRelationship:ActRelationship: BL_______

Definition:

Specifies under what circumstances (target Act) the source-Act may, must, must not or has occurred

Concept Relationships:
  Specializes: ART
  Generalizes (derived): CIND PRCN RSON TRIG

Concept Properties:   conductible: true   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: conditions   Sort:Act:outboundRelationship:ActRelationship: C________   Name:Act:inboundRelationship:ActRelationship: conditionedBy   Sort:Act:inboundRelationship:ActRelationship: C________

Definition:

A contraindication is just a negation of a reason, i.e. it gives a condition under which the action is not to be done. Both, source and target can be any kind of service; target service is in criterion mood. How the strength of a contraindication is expressed (e.g., relative, absolute) is left as an open issue. The priorityNumber attribute could be used.

Concept Relationships:
  Specializes: _ActRelationshipConditional

Concept Properties:   appliesTo: action   howApplies: contra-indication   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: contraindication   Sort:Act:outboundRelationship:ActRelationship: CC_______   Name:Act:inboundRelationship:ActRelationship: contraindicationFor   Sort:Act:inboundRelationship:ActRelationship: CC_______

Definition:

A requirement to be true before a service is performed. The target can be any service in criterion mood. For multiple pre-conditions a conjunction attribute (AND, OR, XOR) is applicable.

Concept Relationships:
  Specializes: _ActRelationshipConditional

Concept Properties:   appliesTo: action   howApplies: pre-condition   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: precondition   Sort:Act:outboundRelationship:ActRelationship: CD_______   Name:Act:inboundRelationship:ActRelationship: preconditionFor   Sort:Act:inboundRelationship:ActRelationship: CD_______

Definition:

The reason or rationale for a service. A reason link is weaker than a trigger, it only suggests that some service may be or might have been a reason for some action, but not that this reason requires/required the action to be taken. Also, as opposed to the trigger, there is no strong timely relation between the reason and the action.

Discussion: In prior releases, the code "SUGG" (suggests) was expressed as "an inversion of the reason link." That code has been retired in favor of the inversion indicator that is an attribute of ActRelationship.

Concept Relationships:
  Specializes: _ActRelationshipConditional
  Generalizes (derived): BLOCK CURE CURE.ADJ DIAG MITGT MTGT.ADJ SYMP

Concept Properties:   appliesTo: action   howApplies: reason   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: reason   Sort:Act:outboundRelationship:ActRelationship: CA_______   Name:Act:inboundRelationship:ActRelationship: reasonOf   Sort:Act:inboundRelationship:ActRelationship: CA_______

Definition:

Definition: The source act is performed to block the effects of the target act. This act relationship should be used when describing near miss type incidents where potential harm could have occurred, but the action described in the source act blocked the potential harmful effects of the incident actually occurring.

Concept Relationships:
  Specializes: RSON

Concept Properties:   isDocumentCharacteristic: true

Concept Relationships:
  Specializes: RSON

Concept Properties:   isDocumentCharacteristic: true

Concept Relationships:
  Specializes: RSON

Concept Properties:   isDocumentCharacteristic: true

Concept Relationships:
  Specializes: RSON

Concept Properties:   isDocumentCharacteristic: true

Definition:

The source act removes or lessens the occurrence or effect of the target act.

Concept Relationships:
  Specializes: RSON
  Generalizes (derived): RCVY

Concept Properties:   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: mitigates   Sort:Act:outboundRelationship:ActRelationship: CAA______   Name:Act:inboundRelationship:ActRelationship: mitigatedBy   Sort:Act:inboundRelationship:ActRelationship: CAA______

Definition:

Definition: The source act is performed to recover from the effects of the target act.

Concept Relationships:
  Specializes: MITGT

Concept Properties:   isDocumentCharacteristic: true

Concept Relationships:
  Specializes: RSON

Concept Properties:   isDocumentCharacteristic: true

Definition:

Used in the diagnosis of the indicated disease.

Concept Relationships:
  Specializes: RSON

Concept Properties:   isDocumentCharacteristic: true

Definition:

A pre-condition that if true should result in the source Act being executed. The target is in typically in criterion mood. When reported after the fact (i.e. the criterion has been met) it may be in Event mood. A delay between the trigger and the triggered action can be specified.

Discussion: This includes the concept of a required act for a service or financial instrument such as an insurance plan or policy. In such cases, the trigger is the occurrence of a specific condition such as coverage limits being exceeded.

Concept Relationships:
  Specializes: _ActRelationshipConditional

Concept Properties:   appliesTo: action   howApplies: trigger   isDocumentCharacteristic: true   Name:Act:outboundRelationship:ActRelationship: trigger   Sort:Act:outboundRelationship:ActRelationship: CB_______   Name:Act:inboundRelationship:ActRelationship: triggerFor   Sort:Act:inboundRelationship:ActRelationship: CB_______