001package org.hl7.fhir.r4.model.codesystems; 002 003/* 004 Copyright (c) 2011+, HL7, Inc. 005 All rights reserved. 006 007 Redistribution and use in source and binary forms, with or without modification, 008 are permitted provided that the following conditions are met: 009 010 * Redistributions of source code must retain the above copyright notice, this 011 list of conditions and the following disclaimer. 012 * Redistributions in binary form must reproduce the above copyright notice, 013 this list of conditions and the following disclaimer in the documentation 014 and/or other materials provided with the distribution. 015 * Neither the name of HL7 nor the names of its contributors may be used to 016 endorse or promote products derived from this software without specific 017 prior written permission. 018 019 THIS SOFTWARE IS PROVIDED BY THE COPYRIGHT HOLDERS AND CONTRIBUTORS "AS IS" AND 020 ANY EXPRESS OR IMPLIED WARRANTIES, INCLUDING, BUT NOT LIMITED TO, THE IMPLIED 021 WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE ARE DISCLAIMED. 022 IN NO EVENT SHALL THE COPYRIGHT HOLDER OR CONTRIBUTORS BE LIABLE FOR ANY DIRECT, 023 INDIRECT, INCIDENTAL, SPECIAL, EXEMPLARY, OR CONSEQUENTIAL DAMAGES (INCLUDING, BUT 024 NOT LIMITED TO, PROCUREMENT OF SUBSTITUTE GOODS OR SERVICES; LOSS OF USE, DATA, OR 025 PROFITS; OR BUSINESS INTERRUPTION) HOWEVER CAUSED AND ON ANY THEORY OF LIABILITY, 026 WHETHER IN CONTRACT, STRICT LIABILITY, OR TORT (INCLUDING NEGLIGENCE OR OTHERWISE) 027 ARISING IN ANY WAY OUT OF THE USE OF THIS SOFTWARE, EVEN IF ADVISED OF THE 028 POSSIBILITY OF SUCH DAMAGE. 029 030*/ 031 032// Generated on Wed, Jan 30, 2019 16:19-0500 for FHIR v4.0.0 033 034import org.hl7.fhir.exceptions.FHIRException; 035 036public enum V3ActClass { 037 038 /** 039 * A record of something that is being done, has been done, can be done, or is 040 * intended or requested to be done. 041 * 042 * 043 * Examples:The kinds of acts that are common in health care are (1) a clinical 044 * observation, (2) an assessment of health condition (such as problems and 045 * diagnoses), (3) healthcare goals, (4) treatment services (such as medication, 046 * surgery, physical and psychological therapy), (5) assisting, monitoring or 047 * attending, (6) training and education services to patients and their next of 048 * kin, (7) and notary services (such as advanced directives or living will), 049 * (8) editing and maintaining documents, and many others. 050 * 051 * 052 * Discussion and Rationale: Acts are the pivot of the RIM; all domain 053 * information and processes are represented primarily in Acts. Any profession 054 * or business, including healthcare, is primarily constituted of intentional 055 * and occasionally non-intentional actions, performed and recorded by 056 * responsible actors. An Act-instance is a record of such an action. 057 * 058 * Acts connect to Entities in their Roles through Participations and connect to 059 * other Acts through ActRelationships. Participations are the authors, 060 * performers and other responsible parties as well as subjects and 061 * beneficiaries (which includes tools and material used in the performance of 062 * the act, which are also subjects). The moodCode distinguishes between Acts 063 * that are meant as factual records, vs. records of intended or ordered 064 * services, and the other modalities in which act can appear. 065 * 066 * One of the Participations that all acts have (at least implicitly) is a 067 * primary author, who is responsible of the Act and who "owns" the act. 068 * Responsibility for the act means responsibility for what is being stated in 069 * the Act and as what it is stated. Ownership of the act is assumed in the 070 * sense of who may operationally modify the same act. Ownership and 071 * responsibility of the Act is not the same as ownership or responsibility of 072 * what the Act-object refers to in the real world. The same real world activity 073 * can be described by two people, each being the author of their Act, 074 * describing the same real world activity. Yet one can be a witness while the 075 * other can be a principal performer. The performer has responsibilities for 076 * the physical actions; the witness only has responsibility for making a true 077 * statement to the best of his or her ability. The two Act-instances may even 078 * disagree, but because each is properly attributed to its author, such 079 * disagreements can exist side by side and left to arbitration by a recipient 080 * of these Act-instances. 081 * 082 * In this sense, an Act-instance represents a "statement" according to Rector 083 * and Nowlan (1991) [Foundations for an electronic medical record. Methods Inf 084 * Med. 30.] Rector and Nowlan have emphasized the importance of understanding 085 * the medical record not as a collection of facts, but "a faithful record of 086 * what clinicians have heard, seen, thought, and done." Rector and Nowlan go on 087 * saying that "the other requirements for a medical record, e.g., that it be 088 * attributable and permanent, follow naturally from this view." Indeed the Act 089 * class is this attributable statement, and the rules of updating acts 090 * (discussed in the state-transition model, see Act.statusCode) versus 091 * generating new Act-instances are designed according to this principle of 092 * permanent attributable statements. 093 * 094 * Rector and Nolan focus on the electronic medical record as a collection of 095 * statements, while attributed statements, these are still mostly factual 096 * statements. However, the Act class goes beyond this limitation to attributed 097 * factual statements, representing what is known as "speech-acts" in 098 * linguistics and philosophy. The notion of speech-act includes that there is 099 * pragmatic meaning in language utterances, aside from just factual statements; 100 * and that these utterances interact with the real world to change the state of 101 * affairs, even directly cause physical activities to happen. For example, an 102 * order is a speech act that (provided it is issued adequately) will cause the 103 * ordered action to be physically performed. The speech act theory has 104 * culminated in the seminal work by Austin (1962) [How to do things with words. 105 * Oxford University Press]. 106 * 107 * An activity in the real world may progress from defined, through planned and 108 * ordered to executed, which is represented as the mood of the Act. Even though 109 * one might think of a single activity as progressing from planned to executed, 110 * this progression is reflected by multiple Act-instances, each having one and 111 * only one mood that will not change along the Act-instance life cycle. This is 112 * because the attribution and content of speech acts along this progression of 113 * an activity may be different, and it is often critical that a permanent and 114 * faithful record be maintained of this progression. The specification of 115 * orders or promises or plans must not be overwritten by the specification of 116 * what was actually done, so as to allow comparing actions with their earlier 117 * specifications. Act-instances that describe this progression of the same real 118 * world activity are linked through the ActRelationships (of the relationship 119 * category "sequel"). 120 * 121 * Act as statements or speech-acts are the only representation of real world 122 * facts or processes in the HL7 RIM. The truth about the real world is 123 * constructed through a combination (and arbitration) of such attributed 124 * statements only, and there is no class in the RIM whose objects represent 125 * "objective state of affairs" or "real processes" independent from attributed 126 * statements. As such, there is no distinction between an activity and its 127 * documentation. Every Act includes both to varying degrees. For example, a 128 * factual statement made about recent (but past) activities, authored (and 129 * signed) by the performer of such activities, is commonly known as a procedure 130 * report or original documentation (e.g., surgical procedure report, clinic 131 * note etc.). Conversely, a status update on an activity that is presently in 132 * progress, authored by the performer (or a close observer) is considered to 133 * capture that activity (and is later superceded by a full procedure report). 134 * However, both status update and procedure report are acts of the same kind, 135 * only distinguished by mood and state (see statusCode) and completeness of the 136 * information. 137 */ 138 ACT, 139 /** 140 * Used to group a set of acts sharing a common context. Organizer structures 141 * can nest within other context structures - such as where a document is 142 * contained within a folder, or a folder is contained within an EHR extract. 143 */ 144 _ACTCLASSRECORDORGANIZER, 145 /** 146 * A context representing a grouped commitment of information to the EHR. It is 147 * considered the unit of modification of the record, the unit of transmission 148 * in record extracts, and the unit of attestation by authorizing clinicians. 149 * 150 * A composition represents part of a patient record originating from a single 151 * interaction between an authenticator and the record. 152 * 153 * Unless otherwise stated all statements within a composition have the same 154 * authenticator, apply to the same patient and were recorded in a single 155 * session of use of a single application. 156 * 157 * A composition contains organizers and entries. 158 */ 159 COMPOSITION, 160 /** 161 * The notion of a document comes particularly from the paper world, where it 162 * corresponds to the contents recorded on discrete pieces of paper. In the 163 * electronic world, a document is a kind of composition that bears resemblance 164 * to their paper world counter-parts. Documents typically are meant to be 165 * human-readable. 166 * 167 * HL7's notion of document differs from that described in the W3C XML 168 * Recommendation, in which a document refers specifically to the contents that 169 * fall between the root element's start-tag and end-tag. Not all XML documents 170 * are HL7 documents. 171 */ 172 DOC, 173 /** 174 * A clinical document is a documentation of clinical observations and services, 175 * with the following characteristics: 176 * 177 * 178 * 179 * Persistence - A clinical document continues to exist in an unaltered state, 180 * for a time period defined by local and regulatory requirements; 181 * 182 * 183 * 184 * Stewardship - A clinical document is maintained by a person or organization 185 * entrusted with its care; 186 * 187 * 188 * 189 * Potential for authentication - A clinical document is an assemblage of 190 * information that is intended to be legally authenticated; 191 * 192 * 193 * 194 * Wholeness - Authentication of a clinical document applies to the whole and 195 * does not apply to portions of the document without the full context of the 196 * document; 197 * 198 * 199 * 200 * Human readability - A clinical document is human readable. 201 */ 202 DOCCLIN, 203 /** 204 * A clinical document that conforms to Level One of the HL7 Clinical Document 205 * Architecture (CDA) 206 */ 207 CDALVLONE, 208 /** 209 * Description: Container of clinical statements. Navigational. No semantic 210 * content. Knowledge of the section code is not required to interpret contained 211 * observations. Represents a heading in a heading structure, or "container 212 * tree". 213 * 214 * The record entries relating to a single clinical session are usually grouped 215 * under headings that represent phases of the encounter, or assist with layout 216 * and navigation. Clinical headings usually reflect the clinical workflow 217 * during a care session, and might also reflect the main author's reasoning 218 * processes. Much research has demonstrated that headings are used differently 219 * by different professional groups and specialties, and that headings are not 220 * used consistently enough to support safe automatic processing of the E H R. 221 */ 222 CONTAINER, 223 /** 224 * A group of entries within a composition or topic that have a common 225 * characteristic - for example, Examination, Diagnosis, Management OR 226 * Subjective, Objective, Analysis, Plan. 227 * 228 * The distinction from Topic relates to value sets. For Category there is a 229 * bounded list of things like "Examination", "Diagnosis" or SOAP categories. 230 * For Topic the list is wide open to any clinical condition or reason for a 231 * part of an encounter. 232 * 233 * A CATEGORY MAY CONTAIN ENTRIES. 234 */ 235 CATEGORY, 236 /** 237 * A context that distinguishes the body of a document from the document header. 238 * This is seen, for instance, in HTML documents, which have discrete <head> and 239 * <body> elements. 240 */ 241 DOCBODY, 242 /** 243 * A context that subdivides the body of a document. Document sections are 244 * typically used for human navigation, to give a reader a clue as to the 245 * expected content. Document sections are used to organize and provide 246 * consistency to the contents of a document body. Document sections can contain 247 * document sections and can contain entries. 248 */ 249 DOCSECT, 250 /** 251 * A group of entries within a composition that are related to a common clinical 252 * theme - such as a specific disorder or problem, prevention, screening and 253 * provision of contraceptive services. 254 * 255 * A topic may contain categories and entries. 256 */ 257 TOPIC, 258 /** 259 * This context represents the part of a patient record conveyed in a single 260 * communication. It is drawn from a providing system for the purposes of 261 * communication to a requesting process (which might be another repository, a 262 * client application or a middleware service such as an electronic guideline 263 * engine), and supporting the faithful inclusion of the communicated data in 264 * the receiving system. 265 * 266 * An extract may be the entirety of the patient record as held by the sender or 267 * it may be a part of that record (e.g. changes since a specified date). 268 * 269 * An extract contains folders or compositions. 270 * 271 * An extract cannot contain another extract. 272 */ 273 EXTRACT, 274 /** 275 * A context that comprises all compositions. The EHR is an extract that 276 * includes the entire chart. 277 * 278 * 279 * NOTE: In an exchange scenario, an EHR is a specialization of an extract. 280 */ 281 EHR, 282 /** 283 * A context representing the high-level organization of an extract e.g. to 284 * group parts of the record by episode, care team, clinical specialty, clinical 285 * condition, or source application. Internationally, this kind of organizing 286 * structure is used variably: in some centers and systems the folder is treated 287 * as an informal compartmentalization of the overall health record; in others 288 * it might represent a significant legal portion of the EHR relating to the 289 * originating enterprise or team. 290 * 291 * A folder contains compositions. 292 * 293 * Folders may be nested within folders. 294 */ 295 FOLDER, 296 /** 297 * Definition: An ACT that organizes a set of component acts into a semantic 298 * grouping that share a particular context such as timeframe, patient, etc. 299 * 300 * 301 * UsageNotes: The focus in a GROUPER act is the grouping of the contained acts. 302 * For example "a request to group" (RQO), "a type of grouping that is allowed 303 * to occur" (DEF), etc. 304 * 305 * Unlike WorkingList, which represents a dynamic, shared, continuously updated 306 * collection to provide a "view" of a set of objects, GROUPER collections tend 307 * to be static and simply indicate a shared set of semantics. Note that sharing 308 * of semantics can be achieved using ACT as well. However, with GROUPER, the 309 * sole semantic is of grouping. 310 */ 311 GROUPER, 312 /** 313 * Description:An ACT that organizes a set of component acts into a semantic 314 * grouping that have a shared subject. The subject may be either a subject 315 * participation (SBJ), subject act relationship (SUBJ), or child 316 * participation/act relationship types. 317 * 318 * 319 * Discussion: The focus in a CLUSTER act is the grouping of the contained acts. 320 * For example "a request to cluster" (RQO), "a type of cluster that is allowed 321 * to occur" (DEF), etc. 322 * 323 * 324 * Examples: 325 * 326 * 327 * 328 * 329 * Radiologic investigations that might include administration of a dye, 330 * followed by radiographic observations; 331 * 332 * 333 * 334 * "Isolate cluster" which includes all testing and specimen processing 335 * performed on a specific isolate; 336 * 337 * 338 * 339 * a set of actions to perform at a particular stage in a clinical trial. 340 */ 341 CLUSTER, 342 /** 343 * An accommodation is a service provided for a Person or other LivingSubject in 344 * which a place is provided for the subject to reside for a period of time. 345 * Commonly used to track the provision of ward, private and semi-private 346 * accommodations for a patient. 347 */ 348 ACCM, 349 /** 350 * A financial account established to track the net result of financial acts. 351 */ 352 ACCT, 353 /** 354 * A unit of work, a grouper of work items as defined by the system performing 355 * that work. Typically some laboratory order fulfillers communicate references 356 * to accessions in their communications regarding laboratory orders. Often one 357 * or more specimens are related to an accession such that in some environments 358 * the accession number is taken as an identifier for a specimen (group). 359 */ 360 ACSN, 361 /** 362 * A transformation process where a requested invoice is transformed into an 363 * agreed invoice. Represents the adjudication processing of an invoice (claim). 364 * Adjudication results can be adjudicated as submitted, with adjustments or 365 * refused. 366 * 367 * Adjudication results comprise 2 components: the adjudication processing 368 * results and a restated (or adjudicated) invoice or claim 369 */ 370 ADJUD, 371 /** 372 * An act representing a system action such as the change of state of another 373 * act or the initiation of a query. All control acts represent trigger events 374 * in the HL7 context. ControlActs may occur in different moods. 375 */ 376 CACT, 377 /** 378 * Sender asks addressee to do something depending on the focal Act of the 379 * payload. An example is "fulfill this order". Addressee has responsibilities 380 * to either reject the message or to act on it in an appropriate way (specified 381 * by the specific receiver responsibilities for the interaction). 382 */ 383 ACTN, 384 /** 385 * Sender sends payload to addressee as information. Addressee does not have 386 * responsibilities beyond serving addressee's own interest (i.e., read and 387 * memorize if you see fit). This is equivalent to an FYI on a memo. 388 */ 389 INFO, 390 /** 391 * Description: Sender transmits a status change pertaining to the focal act of 392 * the payload. This status of the focal act is the final state of the state 393 * transition. This can be either a request or an event, according to the mood 394 * of the control act. 395 */ 396 STC, 397 /** 398 * An agreement of obligation between two or more parties that is subject to 399 * contractual law and enforcement. 400 */ 401 CNTRCT, 402 /** 403 * A contract whose value is measured in monetary terms. 404 */ 405 FCNTRCT, 406 /** 407 * When used in the EVN mood, this concept means with respect to a covered 408 * party: 409 * 410 * 411 * 412 * A health care insurance policy or plan that is contractually binding between 413 * two or more parties; or 414 * 415 * 416 * 417 * A health care program, usually administered by government entities, that 418 * provides coverage to persons determined eligible under the terms of the 419 * program. 420 * 421 * 422 * 423 * 424 * 425 * When used in the definition (DEF) mood, COV means potential coverage for a 426 * patient who may or may not be a covered party. 427 * 428 * 429 * 430 * The concept's meaning is fully specified by the choice of ActCoverageTypeCode 431 * (abstract) ActProgramCode or ActInsurancePolicyCode. 432 */ 433 COV, 434 /** 435 * Definition: A worry that tends to persist over time and has as its subject a 436 * state or process. The subject of the worry has the potential to require 437 * intervention or management. 438 * 439 * 440 * Examples: an observation result, procedure, substance administration, 441 * equipment repair status, device recall status, a health risk, a financial 442 * risk, public health risk, pregnancy, health maintenance, allergy, and acute 443 * or chronic illness. 444 */ 445 CONC, 446 /** 447 * A public health case is a Concern about an observation or event that has a 448 * specific significance for public health. The creation of a PublicHealthCase 449 * initiates the tracking of the object of concern. The decision to track is 450 * related to but somewhat independent of the underlying event or observation. 451 * 452 * 453 * UsageNotes: Typically a Public Health Case involves an instance or instances 454 * of a reportable infectious disease or other condition. The public health case 455 * can include a health-related event concerning a single individual or it may 456 * refer to multiple health-related events that are occurrences of the same 457 * disease or condition of interest to public health. 458 * 459 * A public health case definition (Act.moodCode = "definition") includes the 460 * description of the clinical, laboratory, and epidemiologic indicators 461 * associated with a disease or condition of interest to public health. There 462 * are case definitions for conditions that are reportable, as well as for those 463 * that are not. A public health case definition is a construct used by public 464 * health for the purpose of counting cases, and should not be used as clinical 465 * indications for treatment. Examples include AIDS, toxic-shock syndrome, and 466 * salmonellosis and their associated indicators that are used to define a case. 467 */ 468 HCASE, 469 /** 470 * An Outbreak is a concern resulting from a series of public health cases. 471 * 472 * 473 * UsageNotes: The date on which an outbreak starts is the earliest date of 474 * onset among the cases assigned to the outbreak and its ending date is the 475 * last date of onset among the cases assigned to the outbreak. The 476 * effectiveTime attribute is used to convey the relevant dates for the case. An 477 * outbreak definition (Act.moodCode = "definition" includes the criteria for 478 * the number, types and occurrence pattern of cases necessary to declare an 479 * outbreak and to judge the severity of an outbreak. 480 */ 481 OUTBR, 482 /** 483 * The Consent class represents informed consents and all similar medico-legal 484 * transactions between the patient (or his legal guardian) and the provider. 485 * Examples are informed consent for surgical procedures, informed consent for 486 * clinical trials, advanced beneficiary notice, against medical advice decline 487 * from service, release of information agreement, etc. 488 * 489 * The details of consents vary. Often an institution has a number of different 490 * consent forms for various purposes, including reminding the physician about 491 * the topics to mention. Such forms also include patient education material. In 492 * electronic medical record communication, consents thus are 493 * information-generating acts on their own and need to be managed similar to 494 * medical activities. Thus, Consent is modeled as a special class of Act. 495 * 496 * The "signatures" to the consent document are represented electronically 497 * through Participation instances to the consent object. Typically an informed 498 * consent has Participation.typeCode of "performer", the healthcare provider 499 * informing the patient, and "consenter", the patient or legal guardian. Some 500 * consent may associate a witness or a notary public (e.g., living wills, 501 * advanced directives). In consents where a healthcare provider is not required 502 * (e.g. living will), the performer may be the patient himself or a notary 503 * public. 504 * 505 * Some consent has a minimum required delay between the consent and the 506 * service, so as to allow the patient to rethink his decisions. This minimum 507 * delay can be expressed in the act definition by the 508 * ActRelationship.pauseQuantity attribute that delays the service until the 509 * pause time has elapsed after the consent has been completed. 510 */ 511 CONS, 512 /** 513 * An Act where a container is registered either via an automated sensor, such 514 * as a barcode reader, or by manual receipt 515 */ 516 CONTREG, 517 /** 518 * An identified point during a clinical trial at which one or more actions are 519 * scheduled to be performed (definition mood), or are actually performed (event 520 * mood). The actions may or may not involve an encounter between the subject 521 * and a healthcare professional. 522 */ 523 CTTEVENT, 524 /** 525 * An action taken with respect to a subject Entity by a regulatory or 526 * authoritative body with supervisory capacity over that entity. The action is 527 * taken in response to behavior by the subject Entity that body finds to be 528 * undesirable. 529 * 530 * Suspension, license restrictions, monetary fine, letter of reprimand, 531 * mandated training, mandated supervision, etc.Examples: 532 */ 533 DISPACT, 534 /** 535 * An interaction between entities that provides opportunity for transmission of 536 * a physical, chemical, or biological agent from an exposure source entity to 537 * an exposure target entity. 538 * 539 * 540 * Examples: The following examples are provided to indicate what interactions 541 * are considered exposures rather than other types of Acts: 542 * 543 * 544 * 545 * A patient accidentally receives three times the recommended dose of their 546 * medication due to a dosing error. 547 * 548 * 549 * 550 * This is a substance administration. Public health and/or safety authorities 551 * may also be interested in documenting this with an associated exposure. 552 * 553 * 554 * 555 * 556 * 557 * A patient accidentally is dispensed an incorrect medicine (e.g., clomiphene 558 * instead of clomipramine). They have taken several doses before the mistake is 559 * detected. They are therefore "exposed" to a medicine that there was no 560 * therapeutic indication for them to receive. 561 * 562 * 563 * 564 * There are several substance administrations in this example. Public health 565 * and/or safety authorities may also be interested in documenting this with 566 * associated exposures. 567 * 568 * 569 * 570 * 571 * 572 * In a busy medical ward, a patient is receiving chemotherapy for a lymphoma. 573 * Unfortunately, the IV infusion bag containing the medicine splits, spraying 574 * cytotoxic medication over the patient being treated and the patient in the 575 * adjacent bed. 576 * 577 * 578 * 579 * There are three substance administrations in this example. The first is the 580 * intended one (IV infusion) with its associated (implicit) exposure. There is 581 * an incident with an associated substance administration to the same patient 582 * involving the medication sprayed over the patient as well as an associated 583 * exposure. Additionally, the incident includes a substance administration 584 * involving the spraying of medication on the adjacent patient, also with an 585 * associated exposure. 586 * 587 * 588 * 589 * 590 * 591 * A patient who is a refugee from a war-torn African nation arrives in a busy 592 * inner city A&E department suffering from a cough with bloody sputum. Not 593 * understanding the registration and triage process, they sit in the waiting 594 * room for several hours before it is noticed that they have not booked in. As 595 * soon as they are being processed, it is suspected that they are suffering 596 * from TB. Vulnerable (immunosuppressed) patients who were sharing the waiting 597 * room with this patient may have been exposed to the tubercule bacillus, and 598 * must be traced for investigation. 599 * 600 * 601 * 602 * This is an exposure (or possibly multiple exposures) in the waiting room 603 * involving the refugee and everyone else in the waiting room during the 604 * period. There might also be a number of known or presumed substance 605 * administrations (coughing) via several possible routes. The substance 606 * administrations are only hypotheses until confirmed by further testing. 607 * 608 * 609 * 610 * 611 * 612 * A patient who has received an elective total hip replacement procedure 613 * suffers a prolonged stay in hospital, due to contracting an MRSA infection in 614 * the surgical wound site after the surgery. 615 * 616 * 617 * 618 * This is an exposure to MRSA. Although there was some sort of substance 619 * administration, it's possible the exact mechanism for introduction of the 620 * MRSA into the wound will not be identified. 621 * 622 * 623 * 624 * 625 * 626 * Routine maintenance of the X-ray machines at a local hospital reveals a 627 * serious breach of the shielding on one of the machines. Patients who have 628 * undergone investigations using that machine in the last month are likely to 629 * have been exposed to significantly higher doses of X-rays than was intended, 630 * and must be tracked for possible adverse effects. 631 * 632 * 633 * 634 * There has been an exposure of each patient who used the machine in the past 635 * 30 days. Some patients may have had substance administrations. 636 * 637 * 638 * 639 * 640 * 641 * A new member of staff is employed in the laundry processing room of a small 642 * cottage hospital, and a misreading of the instructions for adding detergents 643 * results in fifty times the usual concentration of cleaning materials being 644 * added to a batch of hospital bedding. As a result, several patients have been 645 * exposed to very high levels of detergents still present in the "clean" 646 * bedding, and have experienced dermatological reactions to this. 647 * 648 * 649 * 650 * There has been an incident with multiple exposures to several patients. 651 * Although there are substance administrations involving the application of the 652 * detergent to the skin of the patients, it is expected that the substance 653 * administrations would not be directly documented. 654 * 655 * 656 * 657 * 658 * 659 * Seven patients who are residents in a health care facility for the elderly 660 * mentally ill have developed respiratory problems. After several months of 661 * various tests having been performed and various medications prescribed to 662 * these patients, the problem is traced to their being "sensitive" to a new 663 * fungicide used in the wall plaster of the ward where these patients reside. 664 * 665 * 666 * 667 * The patients have been continuously exposed to the fungicide. Although there 668 * have been continuous substance administrations (via breathing) this would not 669 * normally be documented as a substance administration. 670 * 671 * 672 * 673 * 674 * 675 * A patient with osteoarthritis of the knees is treated symptomatically using 676 * analgesia, paracetamol (acetaminophen) 1g up to four times a day for pain 677 * relief. His GP does not realize that the patient has, 20 years previously 678 * (while at college) had severe alcohol addiction problems, and now, although 679 * this is completely under control, his liver has suffered significantly, 680 * leaving him more sensitive to hepatic toxicity from paracetamol use. Later 681 * that year, the patient returns with a noticeable level of jaundice. 682 * Paracetamol is immediately withdrawn and alternative solutions for the knee 683 * pain are sought. The jaundice gradually subsides with conservative 684 * management, but referral to the gastroenterologist is required for advice and 685 * monitoring. 686 * 687 * 688 * 689 * There is a substance administration with an associated exposure. The exposure 690 * component is based on the relative toxic level of the substance to a patient 691 * with a compromised liver function. 692 * 693 * 694 * 695 * 696 * 697 * A patient goes to their GP complaining of abdominal pain, having been 698 * discharged from the local hospital ten days' previously after an emergency 699 * appendectomy. The GP can find nothing particularly amiss, and presumes it is 700 * post operative surgical pain that will resolve. The patient returns a 701 * fortnight later, when the GP prescribes further analgesia, but does decide to 702 * request an outpatient surgical follow-up appointment. At this post-surgical 703 * outpatient review, the registrar decides to order an ultrasound, which, when 704 * performed three weeks later, shows a small faint inexplicable mass. A 705 * laparoscopy is then performed, as a day case procedure, and a piece of a 706 * surgical swab is removed from the patient's abdominal cavity. Thankfully, a 707 * full recovery then takes place. 708 * 709 * 710 * 711 * This is a procedural sequelae. There may be an Incident recorded for this 712 * also. 713 * 714 * 715 * 716 * 717 * 718 * A patient is slightly late for a regular pacemaker battery check in the 719 * Cardiology department of the local hospital. They are hurrying down the 720 * second floor corridor. A sudden summer squall has recently passed over the 721 * area, and rain has come in through an open corridor window leaving a small 722 * puddle on the corridor floor. In their haste, the patient slips in the puddle 723 * and falls so badly that they have to be taken to the A&E department, where it 724 * is discovered on investigation they have slightly torn the cruciate ligament 725 * in their left knee. 726 * 727 * 728 * 729 * This is not an exposure. There has been an incident. 730 * 731 * 732 * 733 * 734 * 735 * 736 * Usage Notes: This class deals only with opportunity and not the outcome of 737 * the exposure; i.e. not all exposed parties will necessarily experience actual 738 * harm or benefit. 739 * 740 * Exposure differs from Substance Administration by the absence of the 741 * participation of a performer in the act. 742 * 743 * The following participations SHOULD be used with the following participations 744 * to distinguish the specific entities: 745 * 746 * 747 * 748 * The exposed entity participates via the "exposure target" (EXPTRGT) 749 * participation. 750 * 751 * 752 * 753 * An entity that has carried the agent transmitted in the exposure participates 754 * via the "exposure source" (EXSRC) participation. For example: 755 * 756 * 757 * 758 * a person or animal who carried an infectious disease and interacts (EXSRC) 759 * with another person or animal (EXPTRGT) transmitting the disease agent; 760 * 761 * 762 * 763 * a place or other environment (EXSRC) and a person or animal (EXPTRGT) who is 764 * exposed in the presence of this environment. 765 * 766 * 767 * 768 * 769 * 770 * When it is unknown whether a participating entity is the source of the agent 771 * (EXSRC) or the target of the transmission (EXPTRGT), the "exposure 772 * participant" (EXPART) is used. 773 * 774 * 775 * 776 * The physical (including energy), chemical or biological substance which is 777 * participating in the exposure uses the "exposure agent" (EXPAGNT) 778 * participation. There are at least three scenarios: 779 * 780 * 781 * 782 * the player of the Role that participates as EXPAGNT is the chemical or 783 * biological substance mixed or carried by the scoper-entity of the Role (e.g., 784 * ingredient role); or 785 * 786 * 787 * 788 * the player of the Role that participates as EXPAGNT is a mixture known to 789 * contain the chemical, radiological or biological substance of interest; or 790 * 791 * 792 * 793 * the player of the Role that participates as a EXPAGNT is known to carry the 794 * agent (i.e., the player is a fomite, vector, etc.). 795 * 796 * 797 * 798 * 799 * 800 * The Exposure.statusCode attribute should be interpreted as the state of the 801 * Exposure business object (e.g., active, aborted, completed) and not the 802 * clinical status of the exposure (e.g., probable, confirmed). The clinical 803 * status of the exposure should be associated with the exposure via a subject 804 * observation. 805 * 806 * 807 * Design Comment: The usage notes require a clear criterion for determining 808 * whether an act is an exposure or substance administration-deleterious 809 * potential, uncertainty of actual transmission, or otherwise. SBADM states 810 * that the criterion is the presence of a performer-but there are examples 811 * above that call this criterion into question (e.g., the first one, concerning 812 * a dosing error). 813 */ 814 EXPOS, 815 /** 816 * Description: 817 * 818 * 819 * An acquisition exposure act describes the proximity (location and time) 820 * through which the participating entity was potentially exposed to a physical 821 * (including energy), chemical or biological agent from another entity. The 822 * acquisition exposure act is used in conjunction with transmission exposure 823 * acts as part of an analysis technique for contact tracing. Although an 824 * exposure can be decomposed into transmission and acquisition exposures, there 825 * is no requirement that all exposures be treated in this fashion. 826 * 827 * 828 * Constraints: The Acquisition Exposure inherits the participation constraints 829 * that apply to Exposure with the following exception. The EXPSRC (exposure 830 * source) participation must never be associated with the Transmission Exposure 831 * either directly or via context conduction. 832 */ 833 AEXPOS, 834 /** 835 * Description: 836 * 837 * 838 * A transmission exposure act describes the proximity (time and location) over 839 * which the participating source entity was capable of transmitting a physical 840 * (including energy), chemical or biological substance agent to another entity. 841 * The transmission exposure act is used in conjunction with acquisition 842 * exposure acts as part of an analysis technique for contact tracing. Although 843 * an exposure can be decomposed into transmission and acquisition exposures, 844 * there is no requirement that all exposures be treated in this fashion. 845 * 846 * 847 * Constraints: The Transmission Exposure inherits the participation constraints 848 * that apply to Exposure with the following exception. The EXPTRGT (exposure 849 * target) participation must never be associated with the Transmission Exposure 850 * either directly or via context conduction. 851 */ 852 TEXPOS, 853 /** 854 * An event that occurred outside of the control of one or more of the parties 855 * involved. Includes the concept of an accident. 856 */ 857 INC, 858 /** 859 * The act of transmitting information and understanding about a topic to a 860 * subject where the participation association must be SBJ. 861 * 862 * 863 * Discussion: This act may be used to request that a patient or provider be 864 * informed about an Act, or to indicate that a person was informed about a 865 * particular act. 866 */ 867 INFRM, 868 /** 869 * Represents concepts related to invoice processing in health care 870 */ 871 INVE, 872 /** 873 * Working list collects a dynamic list of individual instances of Act via 874 * ActRelationship which reflects the need of an individual worker, team of 875 * workers, or an organization to manage lists of acts for many different 876 * clinical and administrative reasons. Examples of working lists include 877 * problem lists, goal lists, allergy lists, and to-do lists. 878 */ 879 LIST, 880 /** 881 * An officially or unofficially instituted program to track acts of a 882 * particular type or categorization. 883 */ 884 MPROT, 885 /** 886 * Description:An act that is intended to result in new information about a 887 * subject. The main difference between Observations and other Acts is that 888 * Observations have a value attribute. The code attribute of Observation and 889 * the value attribute of Observation must be considered in combination to 890 * determine the semantics of the observation. 891 * 892 * 893 * Discussion: 894 * 895 * 896 * Structurally, many observations are name-value-pairs, where the 897 * Observation.code (inherited from Act) is the name and the Observation.value 898 * is the value of the property. Such a construct is also known as a variable (a 899 * named feature that can assume a value) hence, the Observation class is always 900 * used to hold generic name-value-pairs or variables, even though the variable 901 * valuation may not be the result of an elaborate observation method. It may be 902 * a simple answer to a question or it may be an assertion or setting of a 903 * parameter. 904 * 905 * As with all Act statements, Observation statements describe what was done, 906 * and in the case of Observations, this includes a description of what was 907 * actually observed (results or answers); and those results or answers are part 908 * of the observation and not split off into other objects. 909 * 910 * The method of action is asserted by the Observation classCode or its 911 * subclasses at the least granular level, by the Observation.code attribute 912 * value at the medium level of granularity, and by the attribute value of 913 * observation.methodCode when a finer level of granularity is required. The 914 * method in whole or in part may also appear in the attribute value of 915 * Observation.value when using coded data types to express the value of the 916 * attribute. Relevant aspects of methodology may also be restated in value when 917 * the results themselves imply or state a methodology. 918 * 919 * An observation may consist of component observations each having their own 920 * Observation.code and Observation.value. In this case, the composite 921 * observation may not have an Observation.value for itself. For instance, a 922 * white blood cell count consists of the sub-observations for the counts of the 923 * various granulocytes, lymphocytes and other normal or abnormal blood cells 924 * (e.g., blasts). The overall white blood cell count Observation itself may 925 * therefore not have a value by itself (even though it could have one, e.g., 926 * the sum total of white blood cells). Thus, as long as an Act is essentially 927 * an Act of recognizing and noting information about a subject, it is an 928 * Observation, regardless of whether it has a simple value by itself or whether 929 * it has sub-observations. 930 * 931 * Even though observations are professional acts (see Act) and as such are 932 * intentional actions, this does not require that every possible outcome of an 933 * observation be pondered in advance of it being actually made. For instance, 934 * differential white blood cell counts (WBC) rarely show blasts, but if they 935 * do, this is part of the WBC observation even though blasts might not be 936 * predefined in the structure of a normal WBC. 937 * 938 * Clinical documents commonly have Subjective and Objective findings, both of 939 * which are kinds of Observations. In addition, clinical documents commonly 940 * contain Assessments, which are also kinds of Observations. Thus, the 941 * establishment of a diagnosis is an Observation. 942 * 943 * 944 * Examples: 945 * 946 * 947 * 948 * 949 * Recording the results of a Family History Assessment 950 * 951 * 952 * 953 * Laboratory test and associated result 954 * 955 * 956 * 957 * Physical exam test and associated result 958 * 959 * 960 * 961 * Device temperature 962 * 963 * 964 * 965 * Soil lead level 966 */ 967 OBS, 968 /** 969 * Regions of Interest (ROI) within a subject Act. Primarily used for making 970 * secondary observations on a subset of a subject observation. The relationship 971 * between a ROI and its referenced Act is specified through an ActRelationship 972 * of type "subject" (SUBJ), which must always be present. 973 */ 974 _ACTCLASSROI, 975 /** 976 * A Region of Interest (ROI) specified for a multidimensional observation, such 977 * as an Observation Series (OBSSER). The ROI is specified using a set of 978 * observation criteria, each delineating the boundary of the region in one of 979 * the dimensions in the multidimensional observation. The relationship between 980 * a ROI and its referenced Act is specified through an ActRelationship of type 981 * subject (SUBJ), which must always be present. Each of the boundary criteria 982 * observations is connected with the ROI using ActRelationships of type "has 983 * component" (COMP). In each boundary criterion, the Act.code names the 984 * dimension and the Observation.value specifies the range of values inside the 985 * region. Typically the bounded dimension is continuous, and so the 986 * Observation.value will be an interval (IVL) data type. The Observation.value 987 * need not be specified if the respective dimension is only named but not 988 * constrained. For example, an ROI for the QT interval of a certain beat in ECG 989 * Lead II would contain 2 boundary criteria, one naming the interval in time 990 * (constrained), and the other naming the interval in ECG Lead II (only named, 991 * but not constrained). 992 */ 993 ROIBND, 994 /** 995 * A Region of Interest (ROI) specified for an image using an overlay shape. 996 * Typically used to make reference to specific regions in images, e.g., to 997 * specify the location of a radiologic finding in an image or to specify the 998 * site of a physical finding by "circling" a region in a schematic picture of a 999 * human body. The units of the coordinate values are in pixels. The origin is 1000 * in the upper left hand corner, with positive X values going to the right and 1001 * positive Y values going down. The relationship between a ROI and its 1002 * referenced Act is specified through an ActRelationship of type "subject" 1003 * (SUBJ), which must always be present. 1004 */ 1005 ROIOVL, 1006 /** 1007 * The spatial relationship of a subject whether human, other animal, or plant, 1008 * to a frame of reference such as gravity or a collection device. 1009 */ 1010 _SUBJECTPHYSICALPOSITION, 1011 /** 1012 * Contains codes for defining the observed, physical position of a subject, 1013 * such as during an observation, assessment, collection of a specimen, etc. ECG 1014 * waveforms and vital signs, such as blood pressure, are two examples where a 1015 * general, observed position typically needs to be noted. 1016 * 1017 * 1018 * 1019 * Deprecation Comment: This concept has been deprecated because it does not 1020 * describe a type of Act (as it should in the ActClass code system), but rather 1021 * encodes the result or value of an observation. The same code has been added 1022 * to the ObservationValue code system. 1023 */ 1024 _SUBJECTBODYPOSITION, 1025 /** 1026 * Lying on the left side. 1027 * 1028 * 1029 * 1030 * Deprecation Comment: This concept has been deprecated because it does not 1031 * describe a type of Act (as it should in the ActClass code system), but rather 1032 * encodes the result or value of an observation. The same code has been added 1033 * to the ObservationValue code system. 1034 */ 1035 LLD, 1036 /** 1037 * Lying with the front or ventral surface downward; lying face down. 1038 * 1039 * 1040 * 1041 * Deprecation Comment: This concept has been deprecated because it does not 1042 * describe a type of Act (as it should in the ActClass code system), but rather 1043 * encodes the result or value of an observation. The same code has been added 1044 * to the ObservationValue code system. 1045 */ 1046 PRN, 1047 /** 1048 * Lying on the right side. 1049 * 1050 * 1051 * 1052 * Deprecation Comment: This concept has been deprecated because it does not 1053 * describe a type of Act (as it should in the ActClass code system), but rather 1054 * encodes the result or value of an observation. The same code has been added 1055 * to the ObservationValue code system. 1056 */ 1057 RLD, 1058 /** 1059 * A semi-sitting position in bed with the head of the bed elevated 1060 * approximately 45 degrees. 1061 * 1062 * 1063 * 1064 * Deprecation Comment: This concept has been deprecated because it does not 1065 * describe a type of Act (as it should in the ActClass code system), but rather 1066 * encodes the result or value of an observation. The same code has been added 1067 * to the ObservationValue code system. 1068 */ 1069 SFWL, 1070 /** 1071 * Resting the body on the buttocks, typically with upper torso erect or semi 1072 * erect. 1073 * 1074 * 1075 * 1076 * Deprecation Comment: This concept has been deprecated because it does not 1077 * describe a type of Act (as it should in the ActClass code system), but rather 1078 * encodes the result or value of an observation. The same code has been added 1079 * to the ObservationValue code system. 1080 */ 1081 SIT, 1082 /** 1083 * To be stationary, upright, vertical, on one's legs. 1084 * 1085 * 1086 * 1087 * Deprecation Comment: This concept has been deprecated because it does not 1088 * describe a type of Act (as it should in the ActClass code system), but rather 1089 * encodes the result or value of an observation. The same code has been added 1090 * to the ObservationValue code system. 1091 */ 1092 STN, 1093 /** 1094 * Deprecation Comment: This concept has been deprecated because it does not 1095 * describe a type of Act (as it should in the ActClass code system), but rather 1096 * encodes the result or value of an observation. The same code has been added 1097 * to the ObservationValue code system. 1098 */ 1099 SUP, 1100 /** 1101 * Lying on the back, on an inclined plane, typically about 30-45 degrees with 1102 * head raised and feet lowered. 1103 * 1104 * 1105 * 1106 * Deprecation Comment: This concept has been deprecated because it does not 1107 * describe a type of Act (as it should in the ActClass code system), but rather 1108 * encodes the result or value of an observation. The same code has been added 1109 * to the ObservationValue code system. 1110 */ 1111 RTRD, 1112 /** 1113 * Lying on the back, on an inclined plane, typically about 30-45 degrees, with 1114 * head lowered and feet raised. 1115 * 1116 * 1117 * 1118 * Deprecation Comment: This concept has been deprecated because it does not 1119 * describe a type of Act (as it should in the ActClass code system), but rather 1120 * encodes the result or value of an observation. The same code has been added 1121 * to the ObservationValue code system. 1122 */ 1123 TRD, 1124 /** 1125 * An observation identifying a potential adverse outcome as a result of an Act 1126 * or combination of Acts. 1127 * 1128 * 1129 * Examples: Detection of a drug-drug interaction; Identification of a 1130 * late-submission for an invoice; Requesting discharge for a patient who does 1131 * not meet hospital-defined discharge criteria. 1132 * 1133 * 1134 * Discussion: This class is commonly used for identifying 'business rule' or 1135 * 'process' problems that may result in a refusal to carry out a particular 1136 * request. In some circumstances it may be possible to 'bypass' a problem by 1137 * modifying the request to acknowledge the issue and/or by providing some form 1138 * of mitigation. 1139 * 1140 * 1141 * Constraints: the Act or Acts that may cause the the adverse outcome are the 1142 * target of a subject ActRelationship. The subbtypes of this concept indicate 1143 * the type of problem being detected (e.g. drug-drug interaction) while the 1144 * Observation.value is used to repesent a specific problem code (e.g. specific 1145 * drug-drug interaction id). 1146 */ 1147 ALRT, 1148 /** 1149 * Definition: An observation that is composed of a set of observations. These 1150 * observations typically have a logical or practical grouping for generally 1151 * accepted clinical or functional purposes, such as observations that are run 1152 * together because of automation. A battery can define required and optional 1153 * component observations and, in some cases, will define complex rules that 1154 * determine whether or not a particular observation is made. BATTERY is a 1155 * constraint on the Observation class in that it is understood to always be 1156 * composed of component observations. 1157 * 1158 * 1159 * UsageNotes: The focus in a BATTERY is that it is composed of individual 1160 * observations. In request (RQO) mood, a battery is a request to perform the 1161 * component observations. In event (EVN) mood a battery is a reporting of 1162 * associated set of observation events. In definition mood a battery is the 1163 * definition of the associated set of observations. 1164 * 1165 * 1166 * Examples: Vital signs, Full blood count, Chemistry panel. 1167 */ 1168 BATTERY, 1169 /** 1170 * The set of actions that define an experiment to assess the effectiveness 1171 * and/or safety of a biopharmaceutical product (food, drug, device, etc.). In 1172 * definition mood, this set of actions is often embodied in a clinical trial 1173 * protocol; in event mood, this designates the aggregate act of applying the 1174 * actions to one or more subjects. 1175 */ 1176 CLNTRL, 1177 /** 1178 * An instance of Observation of a Condition at a point in time that includes 1179 * any Observations or Procedures associated with that Condition as well as 1180 * links to previous instances of Condition Node for the same Condition 1181 * 1182 * 1183 * 1184 * Deprecation Comment: This concept has been deprecated because an alternative 1185 * structure for tracking the evolution of a problem has been presented and 1186 * adopted by the Care Provision Work Group. 1187 */ 1188 CNOD, 1189 /** 1190 * An observable finding or state that persists over time and tends to require 1191 * intervention or management, and, therefore, distinguished from an Observation 1192 * made at a point in time; may exist before an Observation of the Condition is 1193 * made or after interventions to manage the Condition are undertaken. Examples: 1194 * equipment repair status, device recall status, a health risk, a financial 1195 * risk, public health risk, pregnancy, health maintenance, chronic illness 1196 */ 1197 COND, 1198 /** 1199 * A public health case is an Observation representing a condition or event that 1200 * has a specific significance for public health. Typically it involves an 1201 * instance or instances of a reportable infectious disease or other condition. 1202 * The public health case can include a health-related event concerning a single 1203 * individual or it may refer to multiple health-related events that are 1204 * occurrences of the same disease or condition of interest to public health. An 1205 * outbreak involving multiple individuals may be considered as a type of public 1206 * health case. A public health case definition (Act.moodCode = "definition") 1207 * includes the description of the clinical, laboratory, and epidemiologic 1208 * indicators associated with a disease or condition of interest to public 1209 * health. There are case definitions for conditions that are reportable, as 1210 * well as for those that are not. There are also case definitions for 1211 * outbreaks. A public health case definition is a construct used by public 1212 * health for the purpose of counting cases, and should not be used as clinical 1213 * indications for treatment. Examples include AIDS, toxic-shock syndrome, and 1214 * salmonellosis and their associated indicators that are used to define a case. 1215 */ 1216 CASE, 1217 /** 1218 * An outbreak represents a series of public health cases. The date on which an 1219 * outbreak starts is the earliest date of onset among the cases assigned to the 1220 * outbreak, and its ending date is the last date of onset among the cases 1221 * assigned to the outbreak. 1222 */ 1223 OUTB, 1224 /** 1225 * Class for holding attributes unique to diagnostic images. 1226 */ 1227 DGIMG, 1228 /** 1229 * Description:An observation of genomic phenomena. 1230 */ 1231 GEN, 1232 /** 1233 * Description:A determinant peptide in a polypeptide as described by 1234 * polypeptide. 1235 */ 1236 DETPOL, 1237 /** 1238 * Description:An expression level of genes/proteins or other expressed genomic 1239 * entities. 1240 */ 1241 EXP, 1242 /** 1243 * Description:The position of a gene (or other significant sequence) on the 1244 * genome. 1245 */ 1246 LOC, 1247 /** 1248 * Description:A genomic phenomenon that is expressed externally in the 1249 * organism. 1250 */ 1251 PHN, 1252 /** 1253 * Description:A polypeptide resulting from the translation of a gene. 1254 */ 1255 POL, 1256 /** 1257 * Description:A sequence of biomolecule like the DNA, RNA, protein and the 1258 * like. 1259 */ 1260 SEQ, 1261 /** 1262 * Description:A variation in a sequence as described by BioSequence. 1263 */ 1264 SEQVAR, 1265 /** 1266 * An formalized inquiry into the circumstances surrounding a particular 1267 * unplanned event or potential event for the purposes of identifying possible 1268 * causes and contributing factors for the event. This investigation could be 1269 * conducted at a local institutional level or at the level of a local or 1270 * national government. 1271 */ 1272 INVSTG, 1273 /** 1274 * Container for Correlated Observation Sequences sharing a common frame of 1275 * reference. All Observations of the same cd must be comparable and relative to 1276 * the common frame of reference. For example, a 3-channel ECG device records a 1277 * 12-lead ECG in 4 steps (3 leads at a time). Each of the separate 3-channel 1278 * recordings would be in their own "OBSCOR". And, all 4 OBSCOR would be 1279 * contained in one OBSSER because all the times are relative to the same origin 1280 * (beginning of the recording) and all the ECG signals were from a fixed set of 1281 * electrodes. 1282 */ 1283 OBSSER, 1284 /** 1285 * Container for Observation Sequences (Observations whose values are contained 1286 * in LIST<>'s) having values correlated with each other. Each contained 1287 * Observation Sequence LIST<> must be the same length. Values in the LIST<>'s 1288 * are correlated based on index. E.g. the values in position 2 in all the 1289 * LIST<>'s are correlated. This is analogous to a table where each column is an 1290 * Observation Sequence with a LIST<> of values, and each row in the table is a 1291 * correlation between the columns. For example, a 12-lead ECG would contain 13 1292 * sequences: one sequence for time, and a sequence for each of the 12 leads. 1293 */ 1294 OBSCOR, 1295 /** 1296 * An observation denoting the physical location of a person or thing based on a 1297 * reference coordinate system. 1298 */ 1299 POS, 1300 /** 1301 * Description:An observation representing the degree to which the assignment of 1302 * the spatial coordinates, based on a matching algorithm by a geocoding engine 1303 * against a reference spatial database, matches true or accepted values. 1304 */ 1305 POSACC, 1306 /** 1307 * Description:An observation representing one of a set of numerical values used 1308 * to determine the position of a place. The name of the coordinate value is 1309 * determined by the reference coordinate system. 1310 */ 1311 POSCOORD, 1312 /** 1313 * An observation on a specimen in a laboratory environment that may affect 1314 * processing, analysis or result interpretation 1315 */ 1316 SPCOBS, 1317 /** 1318 * An act which describes the process whereby a 'verifying party' validates 1319 * either the existence of the Role attested to by some Credential or the actual 1320 * Vetting act and its details. 1321 */ 1322 VERIF, 1323 /** 1324 * An Act that of taking on whole or partial responsibility for, or attention 1325 * to, safety and well-being of a subject of care. 1326 * 1327 * 1328 * Discussion: A care provision event may exist without any other care actions 1329 * taking place. For example, when a patient is assigned to the care of a 1330 * particular health professional. 1331 * 1332 * In request (RQO) mood care provision communicates a referral, which is a 1333 * request: 1334 * 1335 * 1336 * 1337 * from one party (linked as a participant of type author (AUT)), 1338 * 1339 * 1340 * 1341 * to another party (linked as a participant of type performer (PRF), 1342 * 1343 * 1344 * 1345 * to take responsibility for a scope specified by the code attribute, 1346 * 1347 * 1348 * 1349 * for an entity (linked as a participant of type subject (SBJ)). 1350 * 1351 * 1352 * 1353 * The scope of the care for which responsibility is taken is identified by code 1354 * attribute. 1355 * 1356 * In event (EVN) mood care provision indicates the effective time interval of a 1357 * specified scope of responsibility by a performer (PRF) or set of performers 1358 * (PRF) for a subject (SBJ). 1359 * 1360 * 1361 * Examples: 1362 * 1363 * 1364 * 1365 * 1366 * Referral from GP to a specialist. 1367 * 1368 * 1369 * 1370 * Assignment of a patient or group of patients to the case list of a health 1371 * professional. 1372 * 1373 * 1374 * 1375 * Assignment of inpatients to the care of particular nurses for a working 1376 * shift. 1377 */ 1378 PCPR, 1379 /** 1380 * An interaction between a patient and healthcare participant(s) for the 1381 * purpose of providing patient service(s) or assessing the health status of a 1382 * patient. For example, outpatient visit to multiple departments, home health 1383 * support (including physical therapy), inpatient hospital stay, emergency room 1384 * visit, field visit (e.g., traffic accident), office visit, occupational 1385 * therapy, telephone call. 1386 */ 1387 ENC, 1388 /** 1389 * Description:A mandate, regulation, obligation, requirement, rule, or 1390 * expectation unilaterally imposed by one party on: 1391 * 1392 * 1393 * 1394 * The activity of another party 1395 * 1396 * 1397 * 1398 * The behavior of another party 1399 * 1400 * 1401 * 1402 * The manner in which an act is executed 1403 */ 1404 POLICY, 1405 /** 1406 * Description:A mandate, regulation, obligation, requirement, rule, or 1407 * expectation unilaterally imposed by a jurisdiction on: 1408 * 1409 * 1410 * 1411 * The activity of another party 1412 * 1413 * 1414 * 1415 * The behavior of another party 1416 * 1417 * 1418 * 1419 * The manner in which an act is executed 1420 * 1421 * 1422 * 1423 * 1424 * Examples:A jurisdictional mandate regarding the prescribing and dispensing of 1425 * a particular medication. A jurisdictional privacy or security regulation 1426 * dictating the manner in which personal health information is disclosed. A 1427 * jurisdictional requirement that certain services or health conditions are 1428 * reported to a monitoring program, e.g., immunizations, methadone treatment, 1429 * or cancer registries. 1430 */ 1431 JURISPOL, 1432 /** 1433 * Description:A mandate, obligation, requirement, rule, or expectation 1434 * unilaterally imposed by an organization on: 1435 * 1436 * 1437 * 1438 * The activity of another party 1439 * 1440 * 1441 * 1442 * The behavior of another party 1443 * 1444 * 1445 * 1446 * The manner in which an act is executed 1447 * 1448 * 1449 * 1450 * 1451 * Examples:A clinical or research protocols imposed by a payer, a malpractice 1452 * insurer, or an institution to which a provider must adhere. A mandate imposed 1453 * by a denominational institution for a provider to provide or withhold certain 1454 * information from the patient about treatment options. 1455 */ 1456 ORGPOL, 1457 /** 1458 * Description:An ethical or clinical obligation, requirement, rule, or 1459 * expectation imposed or strongly encouraged by organizations that oversee 1460 * particular clinical domains or provider certification which define the 1461 * boundaries within which a provider may practice and which may have legal 1462 * basis or ramifications on: 1463 * 1464 * 1465 * 1466 * The activity of another party 1467 * 1468 * 1469 * 1470 * The behavior of another party 1471 * 1472 * 1473 * 1474 * The manner in which an act is executed 1475 * 1476 * 1477 * 1478 * 1479 * Examples:An ethical obligation for a provider to fully inform a patient about 1480 * all treatment options. An ethical obligation for a provider not to disclose 1481 * personal health information that meets certain criteria, e.g., where 1482 * disclosure might result in harm to the patient or another person. The set of 1483 * health care services which a provider is credentialed or privileged to 1484 * provide. 1485 */ 1486 SCOPOL, 1487 /** 1488 * Description:A requirement, rule, or expectation typically documented as 1489 * guidelines, protocols, or formularies imposed or strongly encouraged by an 1490 * organization that oversees or has authority over the practices within a 1491 * domain, and which may have legal basis or ramifications on: 1492 * 1493 * 1494 * 1495 * The activity of another party 1496 * 1497 * 1498 * 1499 * The behavior of another party 1500 * 1501 * 1502 * 1503 * The manner in which an act is executed 1504 * 1505 * 1506 * 1507 * 1508 * Examples:A payer may require a prescribing provider to adhere to formulary 1509 * guidelines. An institution may adopt clinical guidelines and protocols and 1510 * implement these within its electronic health record and decision support 1511 * systems. 1512 */ 1513 STDPOL, 1514 /** 1515 * An Act whose immediate and primary outcome (post-condition) is the alteration 1516 * of the physical condition of the subject. 1517 * 1518 * 1519 * Examples: : Procedures may involve the disruption of some body surface (e.g. 1520 * an incision in a surgical procedure), but they also include conservative 1521 * procedures such as reduction of a luxated join, chiropractic treatment, 1522 * massage, balneotherapy, acupuncture, shiatsu, etc. Outside of clinical 1523 * medicine, procedures may be such things as alteration of environments (e.g. 1524 * straightening rivers, draining swamps, building dams) or the repair or change 1525 * of machinery etc. 1526 */ 1527 PROC, 1528 /** 1529 * The act of introducing or otherwise applying a substance to the subject. 1530 * 1531 * 1532 * Discussion: The effect of the substance is typically established on a 1533 * biochemical basis, however, that is not a requirement. For example, 1534 * radiotherapy can largely be described in the same way, especially if it is a 1535 * systemic therapy such as radio-iodine. This class also includes the 1536 * application of chemical treatments to an area. 1537 * 1538 * 1539 * Examples: Chemotherapy protocol; Drug prescription; Vaccination record 1540 */ 1541 SBADM, 1542 /** 1543 * Description: The act of removing a substance from the subject. 1544 */ 1545 SBEXT, 1546 /** 1547 * A procedure for obtaining a specimen from a source entity. 1548 */ 1549 SPECCOLLECT, 1550 /** 1551 * Represents the act of maintaining information about the registration of its 1552 * associated registered subject. The subject can be either an Act or a Role, 1553 * and includes subjects such as lab exam definitions, drug protocol 1554 * definitions, prescriptions, persons, patients, practitioners, and equipment. 1555 * 1556 * The registration may have a unique identifier - separate from the unique 1557 * identification of the subject - as well as a core set of related 1558 * participations and act relationships that characterize the registration event 1559 * and aid in the disposition of the subject information by a receiving system. 1560 */ 1561 REG, 1562 /** 1563 * The act of examining and evaluating the subject, usually another act. For 1564 * example, "This prescription needs to be reviewed in 2 months." 1565 */ 1566 REV, 1567 /** 1568 * A procedure or treatment performed on a specimen to prepare it for analysis 1569 */ 1570 SPCTRT, 1571 /** 1572 * Supply orders and deliveries are simple Acts that focus on the delivered 1573 * product. The product is associated with the Supply Act via 1574 * Participation.typeCode="product". With general Supply Acts, the precise 1575 * identification of the Material (manufacturer, serial numbers, etc.) is 1576 * important. Most of the detailed information about the Supply should be 1577 * represented using the Material class. If delivery needs to be scheduled, 1578 * tracked, and billed separately, one can associate a Transportation Act with 1579 * the Supply Act. Pharmacy dispense services are represented as Supply Acts, 1580 * associated with a SubstanceAdministration Act. The SubstanceAdministration 1581 * class represents the administration of medication, while dispensing is 1582 * supply. 1583 */ 1584 SPLY, 1585 /** 1586 * Diet services are supply services, with some aspects resembling Medication 1587 * services: the detail of the diet is given as a description of the Material 1588 * associated via Participation.typeCode="product". Medically relevant diet 1589 * types may be communicated in the Diet.code attribute using domain 1590 * ActDietCode, however, the detail of the food supplied and the various 1591 * combinations of dishes should be communicated as Material instances. 1592 * 1593 * 1594 * Deprecation Note 1595 * 1596 * 1597 * 1598 * Class: Use either the Supply class (if dealing with what should be given to 1599 * the patient) or SubstanceAdministration class (if dealing with what the 1600 * patient should consume) 1601 * 1602 * 1603 * energyQuantity: This quantity can be conveyed by using a Content relationship 1604 * with a quantity attribute expressing the calories 1605 * 1606 * 1607 * carbohydrateQuantity:This quantity can be conveyed using a Content 1608 * relationship to an Entity with a code of carbohydrate and a quantity 1609 * attribute on the content relationship. 1610 */ 1611 DIET, 1612 /** 1613 * The act of putting something away for safe keeping. The "something" may be 1614 * physical object such as a specimen, or information, such as observations 1615 * regarding a specimen. 1616 */ 1617 STORE, 1618 /** 1619 * Definition: Indicates that the subject Act has undergone or should undergo 1620 * substitution of a type indicated by Act.code. 1621 * 1622 * Rationale: Used to specify "allowed" substitution when creating orders, 1623 * "actual" susbstitution when sending events, as well as the reason for the 1624 * substitution and who was responsible for it. 1625 */ 1626 SUBST, 1627 /** 1628 * Definition: The act of transferring information without the intent of 1629 * imparting understanding about a topic to the subject that is the recipient or 1630 * holder of the transferred information where the participation association 1631 * must be RCV or HLD. 1632 */ 1633 TRFR, 1634 /** 1635 * Transportation is the moving of a payload (people or material) from a 1636 * location of origin to a destination location. Thus, any transport service has 1637 * the three target instances of type payload, origin, and destination, besides 1638 * the targets that are generally used for any service (i.e., performer, device, 1639 * etc.) 1640 */ 1641 TRNS, 1642 /** 1643 * A sub-class of Act representing any transaction between two accounts whose 1644 * value is measured in monetary terms. 1645 * 1646 * In the "intent" mood, communicates a request for a transaction to be 1647 * initiated, or communicates a transfer of value between two accounts. 1648 * 1649 * In the "event" mood, communicates the posting of a transaction to an account. 1650 */ 1651 XACT, 1652 /** 1653 * ActClassContainer 1654 */ 1655 _ACTCLASSCONTAINER, 1656 /** 1657 * This context represents the information acquired and recorded for an 1658 * observation, a clinical statement such as a portion of the patient's history 1659 * or an inference or assertion, or an action that might be intended or has 1660 * actually been performed. This class may represent both the actual data 1661 * describing the observation, inference, or action, and optionally the details 1662 * supporting the clinical reasoning process such as a reference to an 1663 * electronic guideline, decision support system, or other knowledge reference. 1664 */ 1665 ENTRY, 1666 /** 1667 * Organizer of entries. Navigational. No semantic content. Knowledge of the 1668 * section code is not required to interpret contained observations. Represents 1669 * a heading in a heading structure, or "organizer tree". 1670 * 1671 * The record entries relating to a single clinical session are usually grouped 1672 * under headings that represent phases of the encounter, or assist with layout 1673 * and navigation. Clinical headings usually reflect the clinical workflow 1674 * during a care session, and might also reflect the main author's reasoning 1675 * processes. Much research has demonstrated that headings are used differently 1676 * by different professional groups and specialties, and that headings are not 1677 * used consistently enough to support safe automatic processing of the E H R. 1678 */ 1679 ORGANIZER, 1680 /** 1681 * null 1682 */ 1683 DOCCNTNT, 1684 /** 1685 * null 1686 */ 1687 DOCLIST, 1688 /** 1689 * null 1690 */ 1691 DOCLSTITM, 1692 /** 1693 * null 1694 */ 1695 DOCPARA, 1696 /** 1697 * null 1698 */ 1699 DOCTBL, 1700 /** 1701 * null 1702 */ 1703 LINKHTML, 1704 /** 1705 * null 1706 */ 1707 LOCALATTR, 1708 /** 1709 * null 1710 */ 1711 LOCALMRKP, 1712 /** 1713 * null 1714 */ 1715 ORDERED, 1716 /** 1717 * null 1718 */ 1719 REFR, 1720 /** 1721 * null 1722 */ 1723 TBLCOL, 1724 /** 1725 * null 1726 */ 1727 TBLCOLGP, 1728 /** 1729 * null 1730 */ 1731 TBLDATA, 1732 /** 1733 * null 1734 */ 1735 TBLHDR, 1736 /** 1737 * null 1738 */ 1739 TBLROW, 1740 /** 1741 * null 1742 */ 1743 TBODY, 1744 /** 1745 * null 1746 */ 1747 TFOOT, 1748 /** 1749 * null 1750 */ 1751 THEAD, 1752 /** 1753 * null 1754 */ 1755 UNORDERED, 1756 /** 1757 * added to help the parsers 1758 */ 1759 NULL; 1760 1761 public static V3ActClass fromCode(String codeString) throws FHIRException { 1762 if (codeString == null || "".equals(codeString)) 1763 return null; 1764 if ("ACT".equals(codeString)) 1765 return ACT; 1766 if ("_ActClassRecordOrganizer".equals(codeString)) 1767 return _ACTCLASSRECORDORGANIZER; 1768 if ("COMPOSITION".equals(codeString)) 1769 return COMPOSITION; 1770 if ("DOC".equals(codeString)) 1771 return DOC; 1772 if ("DOCCLIN".equals(codeString)) 1773 return DOCCLIN; 1774 if ("CDALVLONE".equals(codeString)) 1775 return CDALVLONE; 1776 if ("CONTAINER".equals(codeString)) 1777 return CONTAINER; 1778 if ("CATEGORY".equals(codeString)) 1779 return CATEGORY; 1780 if ("DOCBODY".equals(codeString)) 1781 return DOCBODY; 1782 if ("DOCSECT".equals(codeString)) 1783 return DOCSECT; 1784 if ("TOPIC".equals(codeString)) 1785 return TOPIC; 1786 if ("EXTRACT".equals(codeString)) 1787 return EXTRACT; 1788 if ("EHR".equals(codeString)) 1789 return EHR; 1790 if ("FOLDER".equals(codeString)) 1791 return FOLDER; 1792 if ("GROUPER".equals(codeString)) 1793 return GROUPER; 1794 if ("CLUSTER".equals(codeString)) 1795 return CLUSTER; 1796 if ("ACCM".equals(codeString)) 1797 return ACCM; 1798 if ("ACCT".equals(codeString)) 1799 return ACCT; 1800 if ("ACSN".equals(codeString)) 1801 return ACSN; 1802 if ("ADJUD".equals(codeString)) 1803 return ADJUD; 1804 if ("CACT".equals(codeString)) 1805 return CACT; 1806 if ("ACTN".equals(codeString)) 1807 return ACTN; 1808 if ("INFO".equals(codeString)) 1809 return INFO; 1810 if ("STC".equals(codeString)) 1811 return STC; 1812 if ("CNTRCT".equals(codeString)) 1813 return CNTRCT; 1814 if ("FCNTRCT".equals(codeString)) 1815 return FCNTRCT; 1816 if ("COV".equals(codeString)) 1817 return COV; 1818 if ("CONC".equals(codeString)) 1819 return CONC; 1820 if ("HCASE".equals(codeString)) 1821 return HCASE; 1822 if ("OUTBR".equals(codeString)) 1823 return OUTBR; 1824 if ("CONS".equals(codeString)) 1825 return CONS; 1826 if ("CONTREG".equals(codeString)) 1827 return CONTREG; 1828 if ("CTTEVENT".equals(codeString)) 1829 return CTTEVENT; 1830 if ("DISPACT".equals(codeString)) 1831 return DISPACT; 1832 if ("EXPOS".equals(codeString)) 1833 return EXPOS; 1834 if ("AEXPOS".equals(codeString)) 1835 return AEXPOS; 1836 if ("TEXPOS".equals(codeString)) 1837 return TEXPOS; 1838 if ("INC".equals(codeString)) 1839 return INC; 1840 if ("INFRM".equals(codeString)) 1841 return INFRM; 1842 if ("INVE".equals(codeString)) 1843 return INVE; 1844 if ("LIST".equals(codeString)) 1845 return LIST; 1846 if ("MPROT".equals(codeString)) 1847 return MPROT; 1848 if ("OBS".equals(codeString)) 1849 return OBS; 1850 if ("_ActClassROI".equals(codeString)) 1851 return _ACTCLASSROI; 1852 if ("ROIBND".equals(codeString)) 1853 return ROIBND; 1854 if ("ROIOVL".equals(codeString)) 1855 return ROIOVL; 1856 if ("_SubjectPhysicalPosition".equals(codeString)) 1857 return _SUBJECTPHYSICALPOSITION; 1858 if ("_SubjectBodyPosition".equals(codeString)) 1859 return _SUBJECTBODYPOSITION; 1860 if ("LLD".equals(codeString)) 1861 return LLD; 1862 if ("PRN".equals(codeString)) 1863 return PRN; 1864 if ("RLD".equals(codeString)) 1865 return RLD; 1866 if ("SFWL".equals(codeString)) 1867 return SFWL; 1868 if ("SIT".equals(codeString)) 1869 return SIT; 1870 if ("STN".equals(codeString)) 1871 return STN; 1872 if ("SUP".equals(codeString)) 1873 return SUP; 1874 if ("RTRD".equals(codeString)) 1875 return RTRD; 1876 if ("TRD".equals(codeString)) 1877 return TRD; 1878 if ("ALRT".equals(codeString)) 1879 return ALRT; 1880 if ("BATTERY".equals(codeString)) 1881 return BATTERY; 1882 if ("CLNTRL".equals(codeString)) 1883 return CLNTRL; 1884 if ("CNOD".equals(codeString)) 1885 return CNOD; 1886 if ("COND".equals(codeString)) 1887 return COND; 1888 if ("CASE".equals(codeString)) 1889 return CASE; 1890 if ("OUTB".equals(codeString)) 1891 return OUTB; 1892 if ("DGIMG".equals(codeString)) 1893 return DGIMG; 1894 if ("GEN".equals(codeString)) 1895 return GEN; 1896 if ("DETPOL".equals(codeString)) 1897 return DETPOL; 1898 if ("EXP".equals(codeString)) 1899 return EXP; 1900 if ("LOC".equals(codeString)) 1901 return LOC; 1902 if ("PHN".equals(codeString)) 1903 return PHN; 1904 if ("POL".equals(codeString)) 1905 return POL; 1906 if ("SEQ".equals(codeString)) 1907 return SEQ; 1908 if ("SEQVAR".equals(codeString)) 1909 return SEQVAR; 1910 if ("INVSTG".equals(codeString)) 1911 return INVSTG; 1912 if ("OBSSER".equals(codeString)) 1913 return OBSSER; 1914 if ("OBSCOR".equals(codeString)) 1915 return OBSCOR; 1916 if ("POS".equals(codeString)) 1917 return POS; 1918 if ("POSACC".equals(codeString)) 1919 return POSACC; 1920 if ("POSCOORD".equals(codeString)) 1921 return POSCOORD; 1922 if ("SPCOBS".equals(codeString)) 1923 return SPCOBS; 1924 if ("VERIF".equals(codeString)) 1925 return VERIF; 1926 if ("PCPR".equals(codeString)) 1927 return PCPR; 1928 if ("ENC".equals(codeString)) 1929 return ENC; 1930 if ("POLICY".equals(codeString)) 1931 return POLICY; 1932 if ("JURISPOL".equals(codeString)) 1933 return JURISPOL; 1934 if ("ORGPOL".equals(codeString)) 1935 return ORGPOL; 1936 if ("SCOPOL".equals(codeString)) 1937 return SCOPOL; 1938 if ("STDPOL".equals(codeString)) 1939 return STDPOL; 1940 if ("PROC".equals(codeString)) 1941 return PROC; 1942 if ("SBADM".equals(codeString)) 1943 return SBADM; 1944 if ("SBEXT".equals(codeString)) 1945 return SBEXT; 1946 if ("SPECCOLLECT".equals(codeString)) 1947 return SPECCOLLECT; 1948 if ("REG".equals(codeString)) 1949 return REG; 1950 if ("REV".equals(codeString)) 1951 return REV; 1952 if ("SPCTRT".equals(codeString)) 1953 return SPCTRT; 1954 if ("SPLY".equals(codeString)) 1955 return SPLY; 1956 if ("DIET".equals(codeString)) 1957 return DIET; 1958 if ("STORE".equals(codeString)) 1959 return STORE; 1960 if ("SUBST".equals(codeString)) 1961 return SUBST; 1962 if ("TRFR".equals(codeString)) 1963 return TRFR; 1964 if ("TRNS".equals(codeString)) 1965 return TRNS; 1966 if ("XACT".equals(codeString)) 1967 return XACT; 1968 if ("_ActClassContainer".equals(codeString)) 1969 return _ACTCLASSCONTAINER; 1970 if ("ENTRY".equals(codeString)) 1971 return ENTRY; 1972 if ("ORGANIZER".equals(codeString)) 1973 return ORGANIZER; 1974 if ("DOCCNTNT".equals(codeString)) 1975 return DOCCNTNT; 1976 if ("DOCLIST".equals(codeString)) 1977 return DOCLIST; 1978 if ("DOCLSTITM".equals(codeString)) 1979 return DOCLSTITM; 1980 if ("DOCPARA".equals(codeString)) 1981 return DOCPARA; 1982 if ("DOCTBL".equals(codeString)) 1983 return DOCTBL; 1984 if ("LINKHTML".equals(codeString)) 1985 return LINKHTML; 1986 if ("LOCALATTR".equals(codeString)) 1987 return LOCALATTR; 1988 if ("LOCALMRKP".equals(codeString)) 1989 return LOCALMRKP; 1990 if ("ordered".equals(codeString)) 1991 return ORDERED; 1992 if ("REFR".equals(codeString)) 1993 return REFR; 1994 if ("TBLCOL".equals(codeString)) 1995 return TBLCOL; 1996 if ("TBLCOLGP".equals(codeString)) 1997 return TBLCOLGP; 1998 if ("TBLDATA".equals(codeString)) 1999 return TBLDATA; 2000 if ("TBLHDR".equals(codeString)) 2001 return TBLHDR; 2002 if ("TBLROW".equals(codeString)) 2003 return TBLROW; 2004 if ("tbody".equals(codeString)) 2005 return TBODY; 2006 if ("tfoot".equals(codeString)) 2007 return TFOOT; 2008 if ("thead".equals(codeString)) 2009 return THEAD; 2010 if ("unordered".equals(codeString)) 2011 return UNORDERED; 2012 throw new FHIRException("Unknown V3ActClass code '" + codeString + "'"); 2013 } 2014 2015 public String toCode() { 2016 switch (this) { 2017 case ACT: 2018 return "ACT"; 2019 case _ACTCLASSRECORDORGANIZER: 2020 return "_ActClassRecordOrganizer"; 2021 case COMPOSITION: 2022 return "COMPOSITION"; 2023 case DOC: 2024 return "DOC"; 2025 case DOCCLIN: 2026 return "DOCCLIN"; 2027 case CDALVLONE: 2028 return "CDALVLONE"; 2029 case CONTAINER: 2030 return "CONTAINER"; 2031 case CATEGORY: 2032 return "CATEGORY"; 2033 case DOCBODY: 2034 return "DOCBODY"; 2035 case DOCSECT: 2036 return "DOCSECT"; 2037 case TOPIC: 2038 return "TOPIC"; 2039 case EXTRACT: 2040 return "EXTRACT"; 2041 case EHR: 2042 return "EHR"; 2043 case FOLDER: 2044 return "FOLDER"; 2045 case GROUPER: 2046 return "GROUPER"; 2047 case CLUSTER: 2048 return "CLUSTER"; 2049 case ACCM: 2050 return "ACCM"; 2051 case ACCT: 2052 return "ACCT"; 2053 case ACSN: 2054 return "ACSN"; 2055 case ADJUD: 2056 return "ADJUD"; 2057 case CACT: 2058 return "CACT"; 2059 case ACTN: 2060 return "ACTN"; 2061 case INFO: 2062 return "INFO"; 2063 case STC: 2064 return "STC"; 2065 case CNTRCT: 2066 return "CNTRCT"; 2067 case FCNTRCT: 2068 return "FCNTRCT"; 2069 case COV: 2070 return "COV"; 2071 case CONC: 2072 return "CONC"; 2073 case HCASE: 2074 return "HCASE"; 2075 case OUTBR: 2076 return "OUTBR"; 2077 case CONS: 2078 return "CONS"; 2079 case CONTREG: 2080 return "CONTREG"; 2081 case CTTEVENT: 2082 return "CTTEVENT"; 2083 case DISPACT: 2084 return "DISPACT"; 2085 case EXPOS: 2086 return "EXPOS"; 2087 case AEXPOS: 2088 return "AEXPOS"; 2089 case TEXPOS: 2090 return "TEXPOS"; 2091 case INC: 2092 return "INC"; 2093 case INFRM: 2094 return "INFRM"; 2095 case INVE: 2096 return "INVE"; 2097 case LIST: 2098 return "LIST"; 2099 case MPROT: 2100 return "MPROT"; 2101 case OBS: 2102 return "OBS"; 2103 case _ACTCLASSROI: 2104 return "_ActClassROI"; 2105 case ROIBND: 2106 return "ROIBND"; 2107 case ROIOVL: 2108 return "ROIOVL"; 2109 case _SUBJECTPHYSICALPOSITION: 2110 return "_SubjectPhysicalPosition"; 2111 case _SUBJECTBODYPOSITION: 2112 return "_SubjectBodyPosition"; 2113 case LLD: 2114 return "LLD"; 2115 case PRN: 2116 return "PRN"; 2117 case RLD: 2118 return "RLD"; 2119 case SFWL: 2120 return "SFWL"; 2121 case SIT: 2122 return "SIT"; 2123 case STN: 2124 return "STN"; 2125 case SUP: 2126 return "SUP"; 2127 case RTRD: 2128 return "RTRD"; 2129 case TRD: 2130 return "TRD"; 2131 case ALRT: 2132 return "ALRT"; 2133 case BATTERY: 2134 return "BATTERY"; 2135 case CLNTRL: 2136 return "CLNTRL"; 2137 case CNOD: 2138 return "CNOD"; 2139 case COND: 2140 return "COND"; 2141 case CASE: 2142 return "CASE"; 2143 case OUTB: 2144 return "OUTB"; 2145 case DGIMG: 2146 return "DGIMG"; 2147 case GEN: 2148 return "GEN"; 2149 case DETPOL: 2150 return "DETPOL"; 2151 case EXP: 2152 return "EXP"; 2153 case LOC: 2154 return "LOC"; 2155 case PHN: 2156 return "PHN"; 2157 case POL: 2158 return "POL"; 2159 case SEQ: 2160 return "SEQ"; 2161 case SEQVAR: 2162 return "SEQVAR"; 2163 case INVSTG: 2164 return "INVSTG"; 2165 case OBSSER: 2166 return "OBSSER"; 2167 case OBSCOR: 2168 return "OBSCOR"; 2169 case POS: 2170 return "POS"; 2171 case POSACC: 2172 return "POSACC"; 2173 case POSCOORD: 2174 return "POSCOORD"; 2175 case SPCOBS: 2176 return "SPCOBS"; 2177 case VERIF: 2178 return "VERIF"; 2179 case PCPR: 2180 return "PCPR"; 2181 case ENC: 2182 return "ENC"; 2183 case POLICY: 2184 return "POLICY"; 2185 case JURISPOL: 2186 return "JURISPOL"; 2187 case ORGPOL: 2188 return "ORGPOL"; 2189 case SCOPOL: 2190 return "SCOPOL"; 2191 case STDPOL: 2192 return "STDPOL"; 2193 case PROC: 2194 return "PROC"; 2195 case SBADM: 2196 return "SBADM"; 2197 case SBEXT: 2198 return "SBEXT"; 2199 case SPECCOLLECT: 2200 return "SPECCOLLECT"; 2201 case REG: 2202 return "REG"; 2203 case REV: 2204 return "REV"; 2205 case SPCTRT: 2206 return "SPCTRT"; 2207 case SPLY: 2208 return "SPLY"; 2209 case DIET: 2210 return "DIET"; 2211 case STORE: 2212 return "STORE"; 2213 case SUBST: 2214 return "SUBST"; 2215 case TRFR: 2216 return "TRFR"; 2217 case TRNS: 2218 return "TRNS"; 2219 case XACT: 2220 return "XACT"; 2221 case _ACTCLASSCONTAINER: 2222 return "_ActClassContainer"; 2223 case ENTRY: 2224 return "ENTRY"; 2225 case ORGANIZER: 2226 return "ORGANIZER"; 2227 case DOCCNTNT: 2228 return "DOCCNTNT"; 2229 case DOCLIST: 2230 return "DOCLIST"; 2231 case DOCLSTITM: 2232 return "DOCLSTITM"; 2233 case DOCPARA: 2234 return "DOCPARA"; 2235 case DOCTBL: 2236 return "DOCTBL"; 2237 case LINKHTML: 2238 return "LINKHTML"; 2239 case LOCALATTR: 2240 return "LOCALATTR"; 2241 case LOCALMRKP: 2242 return "LOCALMRKP"; 2243 case ORDERED: 2244 return "ordered"; 2245 case REFR: 2246 return "REFR"; 2247 case TBLCOL: 2248 return "TBLCOL"; 2249 case TBLCOLGP: 2250 return "TBLCOLGP"; 2251 case TBLDATA: 2252 return "TBLDATA"; 2253 case TBLHDR: 2254 return "TBLHDR"; 2255 case TBLROW: 2256 return "TBLROW"; 2257 case TBODY: 2258 return "tbody"; 2259 case TFOOT: 2260 return "tfoot"; 2261 case THEAD: 2262 return "thead"; 2263 case UNORDERED: 2264 return "unordered"; 2265 case NULL: 2266 return null; 2267 default: 2268 return "?"; 2269 } 2270 } 2271 2272 public String getSystem() { 2273 return "http://terminology.hl7.org/CodeSystem/v3-ActClass"; 2274 } 2275 2276 public String getDefinition() { 2277 switch (this) { 2278 case ACT: 2279 return "A record of something that is being done, has been done, can be done, or is intended or requested to be done.\r\n\n \n Examples:The kinds of acts that are common in health care are (1) a clinical observation, (2) an assessment of health condition (such as problems and diagnoses), (3) healthcare goals, (4) treatment services (such as medication, surgery, physical and psychological therapy), (5) assisting, monitoring or attending, (6) training and education services to patients and their next of kin, (7) and notary services (such as advanced directives or living will), (8) editing and maintaining documents, and many others.\r\n\n \n Discussion and Rationale: Acts are the pivot of the RIM; all domain information and processes are represented primarily in Acts. Any profession or business, including healthcare, is primarily constituted of intentional and occasionally non-intentional actions, performed and recorded by responsible actors. An Act-instance is a record of such an action.\r\n\n Acts connect to Entities in their Roles through Participations and connect to other Acts through ActRelationships. Participations are the authors, performers and other responsible parties as well as subjects and beneficiaries (which includes tools and material used in the performance of the act, which are also subjects). The moodCode distinguishes between Acts that are meant as factual records, vs. records of intended or ordered services, and the other modalities in which act can appear.\r\n\n One of the Participations that all acts have (at least implicitly) is a primary author, who is responsible of the Act and who \"owns\" the act. Responsibility for the act means responsibility for what is being stated in the Act and as what it is stated. Ownership of the act is assumed in the sense of who may operationally modify the same act. Ownership and responsibility of the Act is not the same as ownership or responsibility of what the Act-object refers to in the real world. The same real world activity can be described by two people, each being the author of their Act, describing the same real world activity. Yet one can be a witness while the other can be a principal performer. The performer has responsibilities for the physical actions; the witness only has responsibility for making a true statement to the best of his or her ability. The two Act-instances may even disagree, but because each is properly attributed to its author, such disagreements can exist side by side and left to arbitration by a recipient of these Act-instances.\r\n\n In this sense, an Act-instance represents a \"statement\" according to Rector and Nowlan (1991) [Foundations for an electronic medical record. Methods Inf Med. 30.] Rector and Nowlan have emphasized the importance of understanding the medical record not as a collection of facts, but \"a faithful record of what clinicians have heard, seen, thought, and done.\" Rector and Nowlan go on saying that \"the other requirements for a medical record, e.g., that it be attributable and permanent, follow naturally from this view.\" Indeed the Act class is this attributable statement, and the rules of updating acts (discussed in the state-transition model, see Act.statusCode) versus generating new Act-instances are designed according to this principle of permanent attributable statements.\r\n\n Rector and Nolan focus on the electronic medical record as a collection of statements, while attributed statements, these are still mostly factual statements. However, the Act class goes beyond this limitation to attributed factual statements, representing what is known as \"speech-acts\" in linguistics and philosophy. The notion of speech-act includes that there is pragmatic meaning in language utterances, aside from just factual statements; and that these utterances interact with the real world to change the state of affairs, even directly cause physical activities to happen. For example, an order is a speech act that (provided it is issued adequately) will cause the ordered action to be physically performed. The speech act theory has culminated in the seminal work by Austin (1962) [How to do things with words. Oxford University Press].\r\n\n An activity in the real world may progress from defined, through planned and ordered to executed, which is represented as the mood of the Act. Even though one might think of a single activity as progressing from planned to executed, this progression is reflected by multiple Act-instances, each having one and only one mood that will not change along the Act-instance life cycle. This is because the attribution and content of speech acts along this progression of an activity may be different, and it is often critical that a permanent and faithful record be maintained of this progression. The specification of orders or promises or plans must not be overwritten by the specification of what was actually done, so as to allow comparing actions with their earlier specifications. Act-instances that describe this progression of the same real world activity are linked through the ActRelationships (of the relationship category \"sequel\").\r\n\n Act as statements or speech-acts are the only representation of real world facts or processes in the HL7 RIM. The truth about the real world is constructed through a combination (and arbitration) of such attributed statements only, and there is no class in the RIM whose objects represent \"objective state of affairs\" or \"real processes\" independent from attributed statements. As such, there is no distinction between an activity and its documentation. Every Act includes both to varying degrees. For example, a factual statement made about recent (but past) activities, authored (and signed) by the performer of such activities, is commonly known as a procedure report or original documentation (e.g., surgical procedure report, clinic note etc.). Conversely, a status update on an activity that is presently in progress, authored by the performer (or a close observer) is considered to capture that activity (and is later superceded by a full procedure report). However, both status update and procedure report are acts of the same kind, only distinguished by mood and state (see statusCode) and completeness of the information."; 2280 case _ACTCLASSRECORDORGANIZER: 2281 return "Used to group a set of acts sharing a common context. Organizer structures can nest within other context structures - such as where a document is contained within a folder, or a folder is contained within an EHR extract."; 2282 case COMPOSITION: 2283 return "A context representing a grouped commitment of information to the EHR. It is considered the unit of modification of the record, the unit of transmission in record extracts, and the unit of attestation by authorizing clinicians.\r\n\n A composition represents part of a patient record originating from a single interaction between an authenticator and the record.\r\n\n Unless otherwise stated all statements within a composition have the same authenticator, apply to the same patient and were recorded in a single session of use of a single application.\r\n\n A composition contains organizers and entries."; 2284 case DOC: 2285 return "The notion of a document comes particularly from the paper world, where it corresponds to the contents recorded on discrete pieces of paper. In the electronic world, a document is a kind of composition that bears resemblance to their paper world counter-parts. Documents typically are meant to be human-readable.\r\n\n HL7's notion of document differs from that described in the W3C XML Recommendation, in which a document refers specifically to the contents that fall between the root element's start-tag and end-tag. Not all XML documents are HL7 documents."; 2286 case DOCCLIN: 2287 return "A clinical document is a documentation of clinical observations and services, with the following characteristics:\r\n\n \n \n Persistence - A clinical document continues to exist in an unaltered state, for a time period defined by local and regulatory requirements; \r\n\n \n \n Stewardship - A clinical document is maintained by a person or organization entrusted with its care; \r\n\n \n \n Potential for authentication - A clinical document is an assemblage of information that is intended to be legally authenticated; \r\n\n \n \n Wholeness - Authentication of a clinical document applies to the whole and does not apply to portions of the document without the full context of the document;\r\n\n \n \n Human readability - A clinical document is human readable."; 2288 case CDALVLONE: 2289 return "A clinical document that conforms to Level One of the HL7 Clinical Document Architecture (CDA)"; 2290 case CONTAINER: 2291 return "Description: Container of clinical statements. Navigational. No semantic content. Knowledge of the section code is not required to interpret contained observations. Represents a heading in a heading structure, or \"container tree\".\r\n\n The record entries relating to a single clinical session are usually grouped under headings that represent phases of the encounter, or assist with layout and navigation. Clinical headings usually reflect the clinical workflow during a care session, and might also reflect the main author's reasoning processes. Much research has demonstrated that headings are used differently by different professional groups and specialties, and that headings are not used consistently enough to support safe automatic processing of the E H R."; 2292 case CATEGORY: 2293 return "A group of entries within a composition or topic that have a common characteristic - for example, Examination, Diagnosis, Management OR Subjective, Objective, Analysis, Plan.\r\n\n The distinction from Topic relates to value sets. For Category there is a bounded list of things like \"Examination\", \"Diagnosis\" or SOAP categories. For Topic the list is wide open to any clinical condition or reason for a part of an encounter.\r\n\n A CATEGORY MAY CONTAIN ENTRIES."; 2294 case DOCBODY: 2295 return "A context that distinguishes the body of a document from the document header. This is seen, for instance, in HTML documents, which have discrete <head> and <body> elements."; 2296 case DOCSECT: 2297 return "A context that subdivides the body of a document. Document sections are typically used for human navigation, to give a reader a clue as to the expected content. Document sections are used to organize and provide consistency to the contents of a document body. Document sections can contain document sections and can contain entries."; 2298 case TOPIC: 2299 return "A group of entries within a composition that are related to a common clinical theme - such as a specific disorder or problem, prevention, screening and provision of contraceptive services.\r\n\n A topic may contain categories and entries."; 2300 case EXTRACT: 2301 return "This context represents the part of a patient record conveyed in a single communication. It is drawn from a providing system for the purposes of communication to a requesting process (which might be another repository, a client application or a middleware service such as an electronic guideline engine), and supporting the faithful inclusion of the communicated data in the receiving system.\r\n\n An extract may be the entirety of the patient record as held by the sender or it may be a part of that record (e.g. changes since a specified date).\r\n\n An extract contains folders or compositions.\r\n\n An extract cannot contain another extract."; 2302 case EHR: 2303 return "A context that comprises all compositions. The EHR is an extract that includes the entire chart.\r\n\n \n NOTE: In an exchange scenario, an EHR is a specialization of an extract."; 2304 case FOLDER: 2305 return "A context representing the high-level organization of an extract e.g. to group parts of the record by episode, care team, clinical specialty, clinical condition, or source application. Internationally, this kind of organizing structure is used variably: in some centers and systems the folder is treated as an informal compartmentalization of the overall health record; in others it might represent a significant legal portion of the EHR relating to the originating enterprise or team.\r\n\n A folder contains compositions.\r\n\n Folders may be nested within folders."; 2306 case GROUPER: 2307 return "Definition: An ACT that organizes a set of component acts into a semantic grouping that share a particular context such as timeframe, patient, etc.\r\n\n \n UsageNotes: The focus in a GROUPER act is the grouping of the contained acts. For example \"a request to group\" (RQO), \"a type of grouping that is allowed to occur\" (DEF), etc.\r\n\n Unlike WorkingList, which represents a dynamic, shared, continuously updated collection to provide a \"view\" of a set of objects, GROUPER collections tend to be static and simply indicate a shared set of semantics. Note that sharing of semantics can be achieved using ACT as well. However, with GROUPER, the sole semantic is of grouping."; 2308 case CLUSTER: 2309 return "Description:An ACT that organizes a set of component acts into a semantic grouping that have a shared subject. The subject may be either a subject participation (SBJ), subject act relationship (SUBJ), or child participation/act relationship types.\r\n\n \n Discussion: The focus in a CLUSTER act is the grouping of the contained acts. For example \"a request to cluster\" (RQO), \"a type of cluster that is allowed to occur\" (DEF), etc.\r\n\n \n Examples: \n \r\n\n \n \n Radiologic investigations that might include administration of a dye, followed by radiographic observations;\r\n\n \n \n \"Isolate cluster\" which includes all testing and specimen processing performed on a specific isolate;\r\n\n \n \n a set of actions to perform at a particular stage in a clinical trial."; 2310 case ACCM: 2311 return "An accommodation is a service provided for a Person or other LivingSubject in which a place is provided for the subject to reside for a period of time. Commonly used to track the provision of ward, private and semi-private accommodations for a patient."; 2312 case ACCT: 2313 return "A financial account established to track the net result of financial acts."; 2314 case ACSN: 2315 return "A unit of work, a grouper of work items as defined by the system performing that work. Typically some laboratory order fulfillers communicate references to accessions in their communications regarding laboratory orders. Often one or more specimens are related to an accession such that in some environments the accession number is taken as an identifier for a specimen (group)."; 2316 case ADJUD: 2317 return "A transformation process where a requested invoice is transformed into an agreed invoice. Represents the adjudication processing of an invoice (claim). Adjudication results can be adjudicated as submitted, with adjustments or refused.\r\n\n Adjudication results comprise 2 components: the adjudication processing results and a restated (or adjudicated) invoice or claim"; 2318 case CACT: 2319 return "An act representing a system action such as the change of state of another act or the initiation of a query. All control acts represent trigger events in the HL7 context. ControlActs may occur in different moods."; 2320 case ACTN: 2321 return "Sender asks addressee to do something depending on the focal Act of the payload. An example is \"fulfill this order\". Addressee has responsibilities to either reject the message or to act on it in an appropriate way (specified by the specific receiver responsibilities for the interaction)."; 2322 case INFO: 2323 return "Sender sends payload to addressee as information. Addressee does not have responsibilities beyond serving addressee's own interest (i.e., read and memorize if you see fit). This is equivalent to an FYI on a memo."; 2324 case STC: 2325 return "Description: Sender transmits a status change pertaining to the focal act of the payload. This status of the focal act is the final state of the state transition. This can be either a request or an event, according to the mood of the control act."; 2326 case CNTRCT: 2327 return "An agreement of obligation between two or more parties that is subject to contractual law and enforcement."; 2328 case FCNTRCT: 2329 return "A contract whose value is measured in monetary terms."; 2330 case COV: 2331 return "When used in the EVN mood, this concept means with respect to a covered party:\r\n\n \n \n A health care insurance policy or plan that is contractually binding between two or more parties; or \r\n\n \n \n A health care program, usually administered by government entities, that provides coverage to persons determined eligible under the terms of the program.\r\n\n \n \n \n \n When used in the definition (DEF) mood, COV means potential coverage for a patient who may or may not be a covered party.\r\n\n \n \n The concept's meaning is fully specified by the choice of ActCoverageTypeCode (abstract) ActProgramCode or ActInsurancePolicyCode."; 2332 case CONC: 2333 return "Definition: A worry that tends to persist over time and has as its subject a state or process. The subject of the worry has the potential to require intervention or management.\r\n\n \n Examples: an observation result, procedure, substance administration, equipment repair status, device recall status, a health risk, a financial risk, public health risk, pregnancy, health maintenance, allergy, and acute or chronic illness."; 2334 case HCASE: 2335 return "A public health case is a Concern about an observation or event that has a specific significance for public health. The creation of a PublicHealthCase initiates the tracking of the object of concern. The decision to track is related to but somewhat independent of the underlying event or observation.\r\n\n \n UsageNotes: Typically a Public Health Case involves an instance or instances of a reportable infectious disease or other condition. The public health case can include a health-related event concerning a single individual or it may refer to multiple health-related events that are occurrences of the same disease or condition of interest to public health.\r\n\n A public health case definition (Act.moodCode = \"definition\") includes the description of the clinical, laboratory, and epidemiologic indicators associated with a disease or condition of interest to public health. There are case definitions for conditions that are reportable, as well as for those that are not. A public health case definition is a construct used by public health for the purpose of counting cases, and should not be used as clinical indications for treatment. Examples include AIDS, toxic-shock syndrome, and salmonellosis and their associated indicators that are used to define a case."; 2336 case OUTBR: 2337 return "An Outbreak is a concern resulting from a series of public health cases.\r\n\n \n UsageNotes: The date on which an outbreak starts is the earliest date of onset among the cases assigned to the outbreak and its ending date is the last date of onset among the cases assigned to the outbreak. The effectiveTime attribute is used to convey the relevant dates for the case. An outbreak definition (Act.moodCode = \"definition\" includes the criteria for the number, types and occurrence pattern of cases necessary to declare an outbreak and to judge the severity of an outbreak."; 2338 case CONS: 2339 return "The Consent class represents informed consents and all similar medico-legal transactions between the patient (or his legal guardian) and the provider. Examples are informed consent for surgical procedures, informed consent for clinical trials, advanced beneficiary notice, against medical advice decline from service, release of information agreement, etc.\r\n\n The details of consents vary. Often an institution has a number of different consent forms for various purposes, including reminding the physician about the topics to mention. Such forms also include patient education material. In electronic medical record communication, consents thus are information-generating acts on their own and need to be managed similar to medical activities. Thus, Consent is modeled as a special class of Act.\r\n\n The \"signatures\" to the consent document are represented electronically through Participation instances to the consent object. Typically an informed consent has Participation.typeCode of \"performer\", the healthcare provider informing the patient, and \"consenter\", the patient or legal guardian. Some consent may associate a witness or a notary public (e.g., living wills, advanced directives). In consents where a healthcare provider is not required (e.g. living will), the performer may be the patient himself or a notary public.\r\n\n Some consent has a minimum required delay between the consent and the service, so as to allow the patient to rethink his decisions. This minimum delay can be expressed in the act definition by the ActRelationship.pauseQuantity attribute that delays the service until the pause time has elapsed after the consent has been completed."; 2340 case CONTREG: 2341 return "An Act where a container is registered either via an automated sensor, such as a barcode reader, or by manual receipt"; 2342 case CTTEVENT: 2343 return "An identified point during a clinical trial at which one or more actions are scheduled to be performed (definition mood), or are actually performed (event mood). The actions may or may not involve an encounter between the subject and a healthcare professional."; 2344 case DISPACT: 2345 return "An action taken with respect to a subject Entity by a regulatory or authoritative body with supervisory capacity over that entity. The action is taken in response to behavior by the subject Entity that body finds to be undesirable.\r\n\n Suspension, license restrictions, monetary fine, letter of reprimand, mandated training, mandated supervision, etc.Examples:"; 2346 case EXPOS: 2347 return "An interaction between entities that provides opportunity for transmission of a physical, chemical, or biological agent from an exposure source entity to an exposure target entity.\r\n\n \n Examples: The following examples are provided to indicate what interactions are considered exposures rather than other types of Acts:\r\n\n \n \n A patient accidentally receives three times the recommended dose of their medication due to a dosing error. \r\n\n \n \n This is a substance administration. Public health and/or safety authorities may also be interested in documenting this with an associated exposure.\r\n\n \n \n \n \n A patient accidentally is dispensed an incorrect medicine (e.g., clomiphene instead of clomipramine). They have taken several doses before the mistake is detected. They are therefore \"exposed\" to a medicine that there was no therapeutic indication for them to receive. \r\n\n \n \n There are several substance administrations in this example. Public health and/or safety authorities may also be interested in documenting this with associated exposures.\r\n\n \n \n \n \n In a busy medical ward, a patient is receiving chemotherapy for a lymphoma. Unfortunately, the IV infusion bag containing the medicine splits, spraying cytotoxic medication over the patient being treated and the patient in the adjacent bed. \r\n\n \n \n There are three substance administrations in this example. The first is the intended one (IV infusion) with its associated (implicit) exposure. There is an incident with an associated substance administration to the same patient involving the medication sprayed over the patient as well as an associated exposure. Additionally, the incident includes a substance administration involving the spraying of medication on the adjacent patient, also with an associated exposure.\r\n\n \n \n \n \n A patient who is a refugee from a war-torn African nation arrives in a busy inner city A&E department suffering from a cough with bloody sputum. Not understanding the registration and triage process, they sit in the waiting room for several hours before it is noticed that they have not booked in. As soon as they are being processed, it is suspected that they are suffering from TB. Vulnerable (immunosuppressed) patients who were sharing the waiting room with this patient may have been exposed to the tubercule bacillus, and must be traced for investigation. \r\n\n \n \n This is an exposure (or possibly multiple exposures) in the waiting room involving the refugee and everyone else in the waiting room during the period. There might also be a number of known or presumed substance administrations (coughing) via several possible routes. The substance administrations are only hypotheses until confirmed by further testing.\r\n\n \n \n \n \n A patient who has received an elective total hip replacement procedure suffers a prolonged stay in hospital, due to contracting an MRSA infection in the surgical wound site after the surgery. \r\n\n \n \n This is an exposure to MRSA. Although there was some sort of substance administration, it's possible the exact mechanism for introduction of the MRSA into the wound will not be identified.\r\n\n \n \n \n \n Routine maintenance of the X-ray machines at a local hospital reveals a serious breach of the shielding on one of the machines. Patients who have undergone investigations using that machine in the last month are likely to have been exposed to significantly higher doses of X-rays than was intended, and must be tracked for possible adverse effects. \r\n\n \n \n There has been an exposure of each patient who used the machine in the past 30 days. Some patients may have had substance administrations.\r\n\n \n \n \n \n A new member of staff is employed in the laundry processing room of a small cottage hospital, and a misreading of the instructions for adding detergents results in fifty times the usual concentration of cleaning materials being added to a batch of hospital bedding. As a result, several patients have been exposed to very high levels of detergents still present in the \"clean\" bedding, and have experienced dermatological reactions to this. \r\n\n \n \n There has been an incident with multiple exposures to several patients. Although there are substance administrations involving the application of the detergent to the skin of the patients, it is expected that the substance administrations would not be directly documented.\r\n\n \n \n \n \n Seven patients who are residents in a health care facility for the elderly mentally ill have developed respiratory problems. After several months of various tests having been performed and various medications prescribed to these patients, the problem is traced to their being \"sensitive\" to a new fungicide used in the wall plaster of the ward where these patients reside.\r\n\n \n \n The patients have been continuously exposed to the fungicide. Although there have been continuous substance administrations (via breathing) this would not normally be documented as a substance administration.\r\n\n \n \n \n \n A patient with osteoarthritis of the knees is treated symptomatically using analgesia, paracetamol (acetaminophen) 1g up to four times a day for pain relief. His GP does not realize that the patient has, 20 years previously (while at college) had severe alcohol addiction problems, and now, although this is completely under control, his liver has suffered significantly, leaving him more sensitive to hepatic toxicity from paracetamol use. Later that year, the patient returns with a noticeable level of jaundice. Paracetamol is immediately withdrawn and alternative solutions for the knee pain are sought. The jaundice gradually subsides with conservative management, but referral to the gastroenterologist is required for advice and monitoring. \r\n\n \n \n There is a substance administration with an associated exposure. The exposure component is based on the relative toxic level of the substance to a patient with a compromised liver function.\r\n\n \n \n \n \n A patient goes to their GP complaining of abdominal pain, having been discharged from the local hospital ten days' previously after an emergency appendectomy. The GP can find nothing particularly amiss, and presumes it is post operative surgical pain that will resolve. The patient returns a fortnight later, when the GP prescribes further analgesia, but does decide to request an outpatient surgical follow-up appointment. At this post-surgical outpatient review, the registrar decides to order an ultrasound, which, when performed three weeks later, shows a small faint inexplicable mass. A laparoscopy is then performed, as a day case procedure, and a piece of a surgical swab is removed from the patient's abdominal cavity. Thankfully, a full recovery then takes place. \r\n\n \n \n This is a procedural sequelae. There may be an Incident recorded for this also.\r\n\n \n \n \n \n A patient is slightly late for a regular pacemaker battery check in the Cardiology department of the local hospital. They are hurrying down the second floor corridor. A sudden summer squall has recently passed over the area, and rain has come in through an open corridor window leaving a small puddle on the corridor floor. In their haste, the patient slips in the puddle and falls so badly that they have to be taken to the A&E department, where it is discovered on investigation they have slightly torn the cruciate ligament in their left knee. \r\n\n \n \n This is not an exposure. There has been an incident. \r\n\n \n \n \n \n \n Usage Notes: This class deals only with opportunity and not the outcome of the exposure; i.e. not all exposed parties will necessarily experience actual harm or benefit.\r\n\n Exposure differs from Substance Administration by the absence of the participation of a performer in the act. \r\n\n The following participations SHOULD be used with the following participations to distinguish the specific entities:\r\n\n \n \n The exposed entity participates via the \"exposure target\" (EXPTRGT) participation.\r\n\n \n \n An entity that has carried the agent transmitted in the exposure participates via the \"exposure source\" (EXSRC) participation. For example: \r\n\n \n \n a person or animal who carried an infectious disease and interacts (EXSRC) with another person or animal (EXPTRGT) transmitting the disease agent;\r\n\n \n \n a place or other environment (EXSRC) and a person or animal (EXPTRGT) who is exposed in the presence of this environment.\r\n\n \n \n \n \n When it is unknown whether a participating entity is the source of the agent (EXSRC) or the target of the transmission (EXPTRGT), the \"exposure participant\" (EXPART) is used.\r\n\n \n \n The physical (including energy), chemical or biological substance which is participating in the exposure uses the \"exposure agent\" (EXPAGNT) participation. There are at least three scenarios:\r\n\n \n \n the player of the Role that participates as EXPAGNT is the chemical or biological substance mixed or carried by the scoper-entity of the Role (e.g., ingredient role); or \r\n\n \n \n the player of the Role that participates as EXPAGNT is a mixture known to contain the chemical, radiological or biological substance of interest; or \r\n\n \n \n the player of the Role that participates as a EXPAGNT is known to carry the agent (i.e., the player is a fomite, vector, etc.).\r\n\n \n \n \n \n The Exposure.statusCode attribute should be interpreted as the state of the Exposure business object (e.g., active, aborted, completed) and not the clinical status of the exposure (e.g., probable, confirmed). The clinical status of the exposure should be associated with the exposure via a subject observation.\r\n\n \n Design Comment: The usage notes require a clear criterion for determining whether an act is an exposure or substance administration-deleterious potential, uncertainty of actual transmission, or otherwise. SBADM states that the criterion is the presence of a performer-but there are examples above that call this criterion into question (e.g., the first one, concerning a dosing error)."; 2348 case AEXPOS: 2349 return "Description: \n \r\n\n An acquisition exposure act describes the proximity (location and time) through which the participating entity was potentially exposed to a physical (including energy), chemical or biological agent from another entity. The acquisition exposure act is used in conjunction with transmission exposure acts as part of an analysis technique for contact tracing. Although an exposure can be decomposed into transmission and acquisition exposures, there is no requirement that all exposures be treated in this fashion.\r\n\n \n Constraints: The Acquisition Exposure inherits the participation constraints that apply to Exposure with the following exception. The EXPSRC (exposure source) participation must never be associated with the Transmission Exposure either directly or via context conduction."; 2350 case TEXPOS: 2351 return "Description: \n \r\n\n A transmission exposure act describes the proximity (time and location) over which the participating source entity was capable of transmitting a physical (including energy), chemical or biological substance agent to another entity. The transmission exposure act is used in conjunction with acquisition exposure acts as part of an analysis technique for contact tracing. Although an exposure can be decomposed into transmission and acquisition exposures, there is no requirement that all exposures be treated in this fashion.\r\n\n \n Constraints: The Transmission Exposure inherits the participation constraints that apply to Exposure with the following exception. The EXPTRGT (exposure target) participation must never be associated with the Transmission Exposure either directly or via context conduction."; 2352 case INC: 2353 return "An event that occurred outside of the control of one or more of the parties involved. Includes the concept of an accident."; 2354 case INFRM: 2355 return "The act of transmitting information and understanding about a topic to a subject where the participation association must be SBJ.\r\n\n \n Discussion: This act may be used to request that a patient or provider be informed about an Act, or to indicate that a person was informed about a particular act."; 2356 case INVE: 2357 return "Represents concepts related to invoice processing in health care"; 2358 case LIST: 2359 return "Working list collects a dynamic list of individual instances of Act via ActRelationship which reflects the need of an individual worker, team of workers, or an organization to manage lists of acts for many different clinical and administrative reasons. Examples of working lists include problem lists, goal lists, allergy lists, and to-do lists."; 2360 case MPROT: 2361 return "An officially or unofficially instituted program to track acts of a particular type or categorization."; 2362 case OBS: 2363 return "Description:An act that is intended to result in new information about a subject. The main difference between Observations and other Acts is that Observations have a value attribute. The code attribute of Observation and the value attribute of Observation must be considered in combination to determine the semantics of the observation.\r\n\n \n Discussion:\n \r\n\n Structurally, many observations are name-value-pairs, where the Observation.code (inherited from Act) is the name and the Observation.value is the value of the property. Such a construct is also known as a variable (a named feature that can assume a value) hence, the Observation class is always used to hold generic name-value-pairs or variables, even though the variable valuation may not be the result of an elaborate observation method. It may be a simple answer to a question or it may be an assertion or setting of a parameter.\r\n\n As with all Act statements, Observation statements describe what was done, and in the case of Observations, this includes a description of what was actually observed (results or answers); and those results or answers are part of the observation and not split off into other objects. \r\n\n The method of action is asserted by the Observation classCode or its subclasses at the least granular level, by the Observation.code attribute value at the medium level of granularity, and by the attribute value of observation.methodCode when a finer level of granularity is required. The method in whole or in part may also appear in the attribute value of Observation.value when using coded data types to express the value of the attribute. Relevant aspects of methodology may also be restated in value when the results themselves imply or state a methodology.\r\n\n An observation may consist of component observations each having their own Observation.code and Observation.value. In this case, the composite observation may not have an Observation.value for itself. For instance, a white blood cell count consists of the sub-observations for the counts of the various granulocytes, lymphocytes and other normal or abnormal blood cells (e.g., blasts). The overall white blood cell count Observation itself may therefore not have a value by itself (even though it could have one, e.g., the sum total of white blood cells). Thus, as long as an Act is essentially an Act of recognizing and noting information about a subject, it is an Observation, regardless of whether it has a simple value by itself or whether it has sub-observations.\r\n\n Even though observations are professional acts (see Act) and as such are intentional actions, this does not require that every possible outcome of an observation be pondered in advance of it being actually made. For instance, differential white blood cell counts (WBC) rarely show blasts, but if they do, this is part of the WBC observation even though blasts might not be predefined in the structure of a normal WBC. \r\n\n Clinical documents commonly have Subjective and Objective findings, both of which are kinds of Observations. In addition, clinical documents commonly contain Assessments, which are also kinds of Observations. Thus, the establishment of a diagnosis is an Observation. \r\n\n \n Examples:\n \r\n\n \n \n Recording the results of a Family History Assessment\r\n\n \n \n Laboratory test and associated result\r\n\n \n \n Physical exam test and associated result\r\n\n \n \n Device temperature\r\n\n \n \n Soil lead level"; 2364 case _ACTCLASSROI: 2365 return "Regions of Interest (ROI) within a subject Act. Primarily used for making secondary observations on a subset of a subject observation. The relationship between a ROI and its referenced Act is specified through an ActRelationship of type \"subject\" (SUBJ), which must always be present."; 2366 case ROIBND: 2367 return "A Region of Interest (ROI) specified for a multidimensional observation, such as an Observation Series (OBSSER). The ROI is specified using a set of observation criteria, each delineating the boundary of the region in one of the dimensions in the multidimensional observation. The relationship between a ROI and its referenced Act is specified through an ActRelationship of type subject (SUBJ), which must always be present. Each of the boundary criteria observations is connected with the ROI using ActRelationships of type \"has component\" (COMP). In each boundary criterion, the Act.code names the dimension and the Observation.value specifies the range of values inside the region. Typically the bounded dimension is continuous, and so the Observation.value will be an interval (IVL) data type. The Observation.value need not be specified if the respective dimension is only named but not constrained. For example, an ROI for the QT interval of a certain beat in ECG Lead II would contain 2 boundary criteria, one naming the interval in time (constrained), and the other naming the interval in ECG Lead II (only named, but not constrained)."; 2368 case ROIOVL: 2369 return "A Region of Interest (ROI) specified for an image using an overlay shape. Typically used to make reference to specific regions in images, e.g., to specify the location of a radiologic finding in an image or to specify the site of a physical finding by \"circling\" a region in a schematic picture of a human body. The units of the coordinate values are in pixels. The origin is in the upper left hand corner, with positive X values going to the right and positive Y values going down. The relationship between a ROI and its referenced Act is specified through an ActRelationship of type \"subject\" (SUBJ), which must always be present."; 2370 case _SUBJECTPHYSICALPOSITION: 2371 return "The spatial relationship of a subject whether human, other animal, or plant, to a frame of reference such as gravity or a collection device."; 2372 case _SUBJECTBODYPOSITION: 2373 return "Contains codes for defining the observed, physical position of a subject, such as during an observation, assessment, collection of a specimen, etc. ECG waveforms and vital signs, such as blood pressure, are two examples where a general, observed position typically needs to be noted.\r\n\n \n \n Deprecation Comment: \n This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation. The same code has been added to the ObservationValue code system."; 2374 case LLD: 2375 return "Lying on the left side.\r\n\n \n \n Deprecation Comment: \n This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation. The same code has been added to the ObservationValue code system."; 2376 case PRN: 2377 return "Lying with the front or ventral surface downward; lying face down.\r\n\n \n \n Deprecation Comment: \n This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation. The same code has been added to the ObservationValue code system."; 2378 case RLD: 2379 return "Lying on the right side.\r\n\n \n \n Deprecation Comment: \n This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation. The same code has been added to the ObservationValue code system."; 2380 case SFWL: 2381 return "A semi-sitting position in bed with the head of the bed elevated approximately 45 degrees.\r\n\n \n \n Deprecation Comment: \n This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation. The same code has been added to the ObservationValue code system."; 2382 case SIT: 2383 return "Resting the body on the buttocks, typically with upper torso erect or semi erect.\r\n\n \n \n Deprecation Comment: \n This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation. The same code has been added to the ObservationValue code system."; 2384 case STN: 2385 return "To be stationary, upright, vertical, on one's legs.\r\n\n \n \n Deprecation Comment: \n This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation. The same code has been added to the ObservationValue code system."; 2386 case SUP: 2387 return "Deprecation Comment: \n This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation. The same code has been added to the ObservationValue code system."; 2388 case RTRD: 2389 return "Lying on the back, on an inclined plane, typically about 30-45 degrees with head raised and feet lowered.\r\n\n \n \n Deprecation Comment: \n This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation. The same code has been added to the ObservationValue code system."; 2390 case TRD: 2391 return "Lying on the back, on an inclined plane, typically about 30-45 degrees, with head lowered and feet raised.\r\n\n \n \n Deprecation Comment: \n This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation. The same code has been added to the ObservationValue code system."; 2392 case ALRT: 2393 return "An observation identifying a potential adverse outcome as a result of an Act or combination of Acts.\r\n\n \n Examples: Detection of a drug-drug interaction; Identification of a late-submission for an invoice; Requesting discharge for a patient who does not meet hospital-defined discharge criteria.\r\n\n \n Discussion: This class is commonly used for identifying 'business rule' or 'process' problems that may result in a refusal to carry out a particular request. In some circumstances it may be possible to 'bypass' a problem by modifying the request to acknowledge the issue and/or by providing some form of mitigation.\r\n\n \n Constraints: the Act or Acts that may cause the the adverse outcome are the target of a subject ActRelationship. The subbtypes of this concept indicate the type of problem being detected (e.g. drug-drug interaction) while the Observation.value is used to repesent a specific problem code (e.g. specific drug-drug interaction id)."; 2394 case BATTERY: 2395 return "Definition: An observation that is composed of a set of observations. These observations typically have a logical or practical grouping for generally accepted clinical or functional purposes, such as observations that are run together because of automation. A battery can define required and optional component observations and, in some cases, will define complex rules that determine whether or not a particular observation is made. BATTERY is a constraint on the Observation class in that it is understood to always be composed of component observations.\r\n\n \n UsageNotes: The focus in a BATTERY is that it is composed of individual observations. In request (RQO) mood, a battery is a request to perform the component observations. In event (EVN) mood a battery is a reporting of associated set of observation events. In definition mood a battery is the definition of the associated set of observations.\r\n\n \n Examples: Vital signs, Full blood count, Chemistry panel."; 2396 case CLNTRL: 2397 return "The set of actions that define an experiment to assess the effectiveness and/or safety of a biopharmaceutical product (food, drug, device, etc.). In definition mood, this set of actions is often embodied in a clinical trial protocol; in event mood, this designates the aggregate act of applying the actions to one or more subjects."; 2398 case CNOD: 2399 return "An instance of Observation of a Condition at a point in time that includes any Observations or Procedures associated with that Condition as well as links to previous instances of Condition Node for the same Condition\r\n\n \n \n Deprecation Comment: \n This concept has been deprecated because an alternative structure for tracking the evolution of a problem has been presented and adopted by the Care Provision Work Group."; 2400 case COND: 2401 return "An observable finding or state that persists over time and tends to require intervention or management, and, therefore, distinguished from an Observation made at a point in time; may exist before an Observation of the Condition is made or after interventions to manage the Condition are undertaken. Examples: equipment repair status, device recall status, a health risk, a financial risk, public health risk, pregnancy, health maintenance, chronic illness"; 2402 case CASE: 2403 return "A public health case is an Observation representing a condition or event that has a specific significance for public health. Typically it involves an instance or instances of a reportable infectious disease or other condition. The public health case can include a health-related event concerning a single individual or it may refer to multiple health-related events that are occurrences of the same disease or condition of interest to public health. An outbreak involving multiple individuals may be considered as a type of public health case. A public health case definition (Act.moodCode = \"definition\") includes the description of the clinical, laboratory, and epidemiologic indicators associated with a disease or condition of interest to public health. There are case definitions for conditions that are reportable, as well as for those that are not. There are also case definitions for outbreaks. A public health case definition is a construct used by public health for the purpose of counting cases, and should not be used as clinical indications for treatment. Examples include AIDS, toxic-shock syndrome, and salmonellosis and their associated indicators that are used to define a case."; 2404 case OUTB: 2405 return "An outbreak represents a series of public health cases. The date on which an outbreak starts is the earliest date of onset among the cases assigned to the outbreak, and its ending date is the last date of onset among the cases assigned to the outbreak."; 2406 case DGIMG: 2407 return "Class for holding attributes unique to diagnostic images."; 2408 case GEN: 2409 return "Description:An observation of genomic phenomena."; 2410 case DETPOL: 2411 return "Description:A determinant peptide in a polypeptide as described by polypeptide."; 2412 case EXP: 2413 return "Description:An expression level of genes/proteins or other expressed genomic entities."; 2414 case LOC: 2415 return "Description:The position of a gene (or other significant sequence) on the genome."; 2416 case PHN: 2417 return "Description:A genomic phenomenon that is expressed externally in the organism."; 2418 case POL: 2419 return "Description:A polypeptide resulting from the translation of a gene."; 2420 case SEQ: 2421 return "Description:A sequence of biomolecule like the DNA, RNA, protein and the like."; 2422 case SEQVAR: 2423 return "Description:A variation in a sequence as described by BioSequence."; 2424 case INVSTG: 2425 return "An formalized inquiry into the circumstances surrounding a particular unplanned event or potential event for the purposes of identifying possible causes and contributing factors for the event. This investigation could be conducted at a local institutional level or at the level of a local or national government."; 2426 case OBSSER: 2427 return "Container for Correlated Observation Sequences sharing a common frame of reference. All Observations of the same cd must be comparable and relative to the common frame of reference. For example, a 3-channel ECG device records a 12-lead ECG in 4 steps (3 leads at a time). Each of the separate 3-channel recordings would be in their own \"OBSCOR\". And, all 4 OBSCOR would be contained in one OBSSER because all the times are relative to the same origin (beginning of the recording) and all the ECG signals were from a fixed set of electrodes."; 2428 case OBSCOR: 2429 return "Container for Observation Sequences (Observations whose values are contained in LIST<>'s) having values correlated with each other. Each contained Observation Sequence LIST<> must be the same length. Values in the LIST<>'s are correlated based on index. E.g. the values in position 2 in all the LIST<>'s are correlated. This is analogous to a table where each column is an Observation Sequence with a LIST<> of values, and each row in the table is a correlation between the columns. For example, a 12-lead ECG would contain 13 sequences: one sequence for time, and a sequence for each of the 12 leads."; 2430 case POS: 2431 return "An observation denoting the physical location of a person or thing based on a reference coordinate system."; 2432 case POSACC: 2433 return "Description:An observation representing the degree to which the assignment of the spatial coordinates, based on a matching algorithm by a geocoding engine against a reference spatial database, matches true or accepted values."; 2434 case POSCOORD: 2435 return "Description:An observation representing one of a set of numerical values used to determine the position of a place. The name of the coordinate value is determined by the reference coordinate system."; 2436 case SPCOBS: 2437 return "An observation on a specimen in a laboratory environment that may affect processing, analysis or result interpretation"; 2438 case VERIF: 2439 return "An act which describes the process whereby a 'verifying party' validates either the existence of the Role attested to by some Credential or the actual Vetting act and its details."; 2440 case PCPR: 2441 return "An Act that of taking on whole or partial responsibility for, or attention to, safety and well-being of a subject of care. \r\n\n \n Discussion: A care provision event may exist without any other care actions taking place. For example, when a patient is assigned to the care of a particular health professional.\r\n\n In request (RQO) mood care provision communicates a referral, which is a request:\r\n\n \n \n from one party (linked as a participant of type author (AUT)),\r\n\n \n \n to another party (linked as a participant of type performer (PRF),\r\n\n \n \n to take responsibility for a scope specified by the code attribute, \r\n\n \n \n for an entity (linked as a participant of type subject (SBJ)).\r\n\n \n \n The scope of the care for which responsibility is taken is identified by code attribute.\r\n\n In event (EVN) mood care provision indicates the effective time interval of a specified scope of responsibility by a performer (PRF) or set of performers (PRF) for a subject (SBJ).\r\n\n \n Examples:\n \r\n\n \n \n Referral from GP to a specialist.\r\n\n \n \n Assignment of a patient or group of patients to the case list of a health professional.\r\n\n \n \n Assignment of inpatients to the care of particular nurses for a working shift."; 2442 case ENC: 2443 return "An interaction between a patient and healthcare participant(s) for the purpose of providing patient service(s) or assessing the health status of a patient. For example, outpatient visit to multiple departments, home health support (including physical therapy), inpatient hospital stay, emergency room visit, field visit (e.g., traffic accident), office visit, occupational therapy, telephone call."; 2444 case POLICY: 2445 return "Description:A mandate, regulation, obligation, requirement, rule, or expectation unilaterally imposed by one party on:\r\n\n \n \n The activity of another party\r\n\n \n \n The behavior of another party\r\n\n \n \n The manner in which an act is executed"; 2446 case JURISPOL: 2447 return "Description:A mandate, regulation, obligation, requirement, rule, or expectation unilaterally imposed by a jurisdiction on:\r\n\n \n \n The activity of another party\r\n\n \n \n The behavior of another party\r\n\n \n \n The manner in which an act is executed\r\n\n \n \n \n Examples:A jurisdictional mandate regarding the prescribing and dispensing of a particular medication. A jurisdictional privacy or security regulation dictating the manner in which personal health information is disclosed. A jurisdictional requirement that certain services or health conditions are reported to a monitoring program, e.g., immunizations, methadone treatment, or cancer registries."; 2448 case ORGPOL: 2449 return "Description:A mandate, obligation, requirement, rule, or expectation unilaterally imposed by an organization on:\r\n\n \n \n The activity of another party\r\n\n \n \n The behavior of another party\r\n\n \n \n The manner in which an act is executed\r\n\n \n \n \n Examples:A clinical or research protocols imposed by a payer, a malpractice insurer, or an institution to which a provider must adhere. A mandate imposed by a denominational institution for a provider to provide or withhold certain information from the patient about treatment options."; 2450 case SCOPOL: 2451 return "Description:An ethical or clinical obligation, requirement, rule, or expectation imposed or strongly encouraged by organizations that oversee particular clinical domains or provider certification which define the boundaries within which a provider may practice and which may have legal basis or ramifications on:\r\n\n \n \n The activity of another party\r\n\n \n \n The behavior of another party\r\n\n \n \n The manner in which an act is executed\r\n\n \n \n \n Examples:An ethical obligation for a provider to fully inform a patient about all treatment options. An ethical obligation for a provider not to disclose personal health information that meets certain criteria, e.g., where disclosure might result in harm to the patient or another person. The set of health care services which a provider is credentialed or privileged to provide."; 2452 case STDPOL: 2453 return "Description:A requirement, rule, or expectation typically documented as guidelines, protocols, or formularies imposed or strongly encouraged by an organization that oversees or has authority over the practices within a domain, and which may have legal basis or ramifications on:\r\n\n \n \n The activity of another party\r\n\n \n \n The behavior of another party\r\n\n \n \n The manner in which an act is executed\r\n\n \n \n \n Examples:A payer may require a prescribing provider to adhere to formulary guidelines. An institution may adopt clinical guidelines and protocols and implement these within its electronic health record and decision support systems."; 2454 case PROC: 2455 return "An Act whose immediate and primary outcome (post-condition) is the alteration of the physical condition of the subject.\r\n\n \n Examples: : Procedures may involve the disruption of some body surface (e.g. an incision in a surgical procedure), but they also include conservative procedures such as reduction of a luxated join, chiropractic treatment, massage, balneotherapy, acupuncture, shiatsu, etc. Outside of clinical medicine, procedures may be such things as alteration of environments (e.g. straightening rivers, draining swamps, building dams) or the repair or change of machinery etc."; 2456 case SBADM: 2457 return "The act of introducing or otherwise applying a substance to the subject.\r\n\n \n Discussion: The effect of the substance is typically established on a biochemical basis, however, that is not a requirement. For example, radiotherapy can largely be described in the same way, especially if it is a systemic therapy such as radio-iodine. This class also includes the application of chemical treatments to an area.\r\n\n \n Examples: Chemotherapy protocol; Drug prescription; Vaccination record"; 2458 case SBEXT: 2459 return "Description: The act of removing a substance from the subject."; 2460 case SPECCOLLECT: 2461 return "A procedure for obtaining a specimen from a source entity."; 2462 case REG: 2463 return "Represents the act of maintaining information about the registration of its associated registered subject. The subject can be either an Act or a Role, and includes subjects such as lab exam definitions, drug protocol definitions, prescriptions, persons, patients, practitioners, and equipment.\r\n\n The registration may have a unique identifier - separate from the unique identification of the subject - as well as a core set of related participations and act relationships that characterize the registration event and aid in the disposition of the subject information by a receiving system."; 2464 case REV: 2465 return "The act of examining and evaluating the subject, usually another act. For example, \"This prescription needs to be reviewed in 2 months.\""; 2466 case SPCTRT: 2467 return "A procedure or treatment performed on a specimen to prepare it for analysis"; 2468 case SPLY: 2469 return "Supply orders and deliveries are simple Acts that focus on the delivered product. The product is associated with the Supply Act via Participation.typeCode=\"product\". With general Supply Acts, the precise identification of the Material (manufacturer, serial numbers, etc.) is important. Most of the detailed information about the Supply should be represented using the Material class. If delivery needs to be scheduled, tracked, and billed separately, one can associate a Transportation Act with the Supply Act. Pharmacy dispense services are represented as Supply Acts, associated with a SubstanceAdministration Act. The SubstanceAdministration class represents the administration of medication, while dispensing is supply."; 2470 case DIET: 2471 return "Diet services are supply services, with some aspects resembling Medication services: the detail of the diet is given as a description of the Material associated via Participation.typeCode=\"product\". Medically relevant diet types may be communicated in the Diet.code attribute using domain ActDietCode, however, the detail of the food supplied and the various combinations of dishes should be communicated as Material instances.\r\n\n \n Deprecation Note\n \r\n\n \n Class: Use either the Supply class (if dealing with what should be given to the patient) or SubstanceAdministration class (if dealing with what the patient should consume)\r\n\n \n energyQuantity: This quantity can be conveyed by using a Content relationship with a quantity attribute expressing the calories\r\n\n \n carbohydrateQuantity:This quantity can be conveyed using a Content relationship to an Entity with a code of carbohydrate and a quantity attribute on the content relationship."; 2472 case STORE: 2473 return "The act of putting something away for safe keeping. The \"something\" may be physical object such as a specimen, or information, such as observations regarding a specimen."; 2474 case SUBST: 2475 return "Definition: Indicates that the subject Act has undergone or should undergo substitution of a type indicated by Act.code.\r\n\n Rationale: Used to specify \"allowed\" substitution when creating orders, \"actual\" susbstitution when sending events, as well as the reason for the substitution and who was responsible for it."; 2476 case TRFR: 2477 return "Definition: The act of transferring information without the intent of imparting understanding about a topic to the subject that is the recipient or holder of the transferred information where the participation association must be RCV or HLD."; 2478 case TRNS: 2479 return "Transportation is the moving of a payload (people or material) from a location of origin to a destination location. Thus, any transport service has the three target instances of type payload, origin, and destination, besides the targets that are generally used for any service (i.e., performer, device, etc.)"; 2480 case XACT: 2481 return "A sub-class of Act representing any transaction between two accounts whose value is measured in monetary terms.\r\n\n In the \"intent\" mood, communicates a request for a transaction to be initiated, or communicates a transfer of value between two accounts.\r\n\n In the \"event\" mood, communicates the posting of a transaction to an account."; 2482 case _ACTCLASSCONTAINER: 2483 return "ActClassContainer"; 2484 case ENTRY: 2485 return "This context represents the information acquired and recorded for an observation, a clinical statement such as a portion of the patient's history or an inference or assertion, or an action that might be intended or has actually been performed. This class may represent both the actual data describing the observation, inference, or action, and optionally the details supporting the clinical reasoning process such as a reference to an electronic guideline, decision support system, or other knowledge reference."; 2486 case ORGANIZER: 2487 return "Organizer of entries. Navigational. No semantic content. Knowledge of the section code is not required to interpret contained observations. Represents a heading in a heading structure, or \"organizer tree\".\r\n\n The record entries relating to a single clinical session are usually grouped under headings that represent phases of the encounter, or assist with layout and navigation. Clinical headings usually reflect the clinical workflow during a care session, and might also reflect the main author's reasoning processes. Much research has demonstrated that headings are used differently by different professional groups and specialties, and that headings are not used consistently enough to support safe automatic processing of the E H R."; 2488 case DOCCNTNT: 2489 return ""; 2490 case DOCLIST: 2491 return ""; 2492 case DOCLSTITM: 2493 return ""; 2494 case DOCPARA: 2495 return ""; 2496 case DOCTBL: 2497 return ""; 2498 case LINKHTML: 2499 return ""; 2500 case LOCALATTR: 2501 return ""; 2502 case LOCALMRKP: 2503 return ""; 2504 case ORDERED: 2505 return ""; 2506 case REFR: 2507 return ""; 2508 case TBLCOL: 2509 return ""; 2510 case TBLCOLGP: 2511 return ""; 2512 case TBLDATA: 2513 return ""; 2514 case TBLHDR: 2515 return ""; 2516 case TBLROW: 2517 return ""; 2518 case TBODY: 2519 return ""; 2520 case TFOOT: 2521 return ""; 2522 case THEAD: 2523 return ""; 2524 case UNORDERED: 2525 return ""; 2526 case NULL: 2527 return null; 2528 default: 2529 return "?"; 2530 } 2531 } 2532 2533 public String getDisplay() { 2534 switch (this) { 2535 case ACT: 2536 return "act"; 2537 case _ACTCLASSRECORDORGANIZER: 2538 return "record organizer"; 2539 case COMPOSITION: 2540 return "composition"; 2541 case DOC: 2542 return "document"; 2543 case DOCCLIN: 2544 return "clinical document"; 2545 case CDALVLONE: 2546 return "CDA Level One clinical document"; 2547 case CONTAINER: 2548 return "record container"; 2549 case CATEGORY: 2550 return "category"; 2551 case DOCBODY: 2552 return "document body"; 2553 case DOCSECT: 2554 return "document section"; 2555 case TOPIC: 2556 return "topic"; 2557 case EXTRACT: 2558 return "extract"; 2559 case EHR: 2560 return "electronic health record"; 2561 case FOLDER: 2562 return "folder"; 2563 case GROUPER: 2564 return "grouper"; 2565 case CLUSTER: 2566 return "Cluster"; 2567 case ACCM: 2568 return "accommodation"; 2569 case ACCT: 2570 return "account"; 2571 case ACSN: 2572 return "accession"; 2573 case ADJUD: 2574 return "financial adjudication"; 2575 case CACT: 2576 return "control act"; 2577 case ACTN: 2578 return "action"; 2579 case INFO: 2580 return "information"; 2581 case STC: 2582 return "state transition control"; 2583 case CNTRCT: 2584 return "contract"; 2585 case FCNTRCT: 2586 return "financial contract"; 2587 case COV: 2588 return "coverage"; 2589 case CONC: 2590 return "concern"; 2591 case HCASE: 2592 return "public health case"; 2593 case OUTBR: 2594 return "outbreak"; 2595 case CONS: 2596 return "consent"; 2597 case CONTREG: 2598 return "container registration"; 2599 case CTTEVENT: 2600 return "clinical trial timepoint event"; 2601 case DISPACT: 2602 return "disciplinary action"; 2603 case EXPOS: 2604 return "exposure"; 2605 case AEXPOS: 2606 return "acquisition exposure"; 2607 case TEXPOS: 2608 return "transmission exposure"; 2609 case INC: 2610 return "incident"; 2611 case INFRM: 2612 return "inform"; 2613 case INVE: 2614 return "invoice element"; 2615 case LIST: 2616 return "working list"; 2617 case MPROT: 2618 return "monitoring program"; 2619 case OBS: 2620 return "observation"; 2621 case _ACTCLASSROI: 2622 return "ActClassROI"; 2623 case ROIBND: 2624 return "bounded ROI"; 2625 case ROIOVL: 2626 return "overlay ROI"; 2627 case _SUBJECTPHYSICALPOSITION: 2628 return "subject physical position"; 2629 case _SUBJECTBODYPOSITION: 2630 return "subject body position"; 2631 case LLD: 2632 return "left lateral decubitus"; 2633 case PRN: 2634 return "prone"; 2635 case RLD: 2636 return "right lateral decubitus"; 2637 case SFWL: 2638 return "Semi-Fowler's"; 2639 case SIT: 2640 return "sitting"; 2641 case STN: 2642 return "standing"; 2643 case SUP: 2644 return "supine"; 2645 case RTRD: 2646 return "reverse trendelenburg"; 2647 case TRD: 2648 return "trendelenburg"; 2649 case ALRT: 2650 return "detected issue"; 2651 case BATTERY: 2652 return "battery"; 2653 case CLNTRL: 2654 return "clinical trial"; 2655 case CNOD: 2656 return "Condition Node"; 2657 case COND: 2658 return "Condition"; 2659 case CASE: 2660 return "public health case"; 2661 case OUTB: 2662 return "outbreak"; 2663 case DGIMG: 2664 return "diagnostic image"; 2665 case GEN: 2666 return "genomic observation"; 2667 case DETPOL: 2668 return "determinant peptide"; 2669 case EXP: 2670 return "expression level"; 2671 case LOC: 2672 return "locus"; 2673 case PHN: 2674 return "phenotype"; 2675 case POL: 2676 return "polypeptide"; 2677 case SEQ: 2678 return "bio sequence"; 2679 case SEQVAR: 2680 return "bio sequence variation"; 2681 case INVSTG: 2682 return "investigation"; 2683 case OBSSER: 2684 return "observation series"; 2685 case OBSCOR: 2686 return "correlated observation sequences"; 2687 case POS: 2688 return "position"; 2689 case POSACC: 2690 return "position accuracy"; 2691 case POSCOORD: 2692 return "position coordinate"; 2693 case SPCOBS: 2694 return "specimen observation"; 2695 case VERIF: 2696 return "Verification"; 2697 case PCPR: 2698 return "care provision"; 2699 case ENC: 2700 return "encounter"; 2701 case POLICY: 2702 return "policy"; 2703 case JURISPOL: 2704 return "jurisdictional policy"; 2705 case ORGPOL: 2706 return "organizational policy"; 2707 case SCOPOL: 2708 return "scope of practice policy"; 2709 case STDPOL: 2710 return "standard of practice policy"; 2711 case PROC: 2712 return "procedure"; 2713 case SBADM: 2714 return "substance administration"; 2715 case SBEXT: 2716 return "Substance Extraction"; 2717 case SPECCOLLECT: 2718 return "Specimen Collection"; 2719 case REG: 2720 return "registration"; 2721 case REV: 2722 return "review"; 2723 case SPCTRT: 2724 return "specimen treatment"; 2725 case SPLY: 2726 return "supply"; 2727 case DIET: 2728 return "diet"; 2729 case STORE: 2730 return "storage"; 2731 case SUBST: 2732 return "Substitution"; 2733 case TRFR: 2734 return "transfer"; 2735 case TRNS: 2736 return "transportation"; 2737 case XACT: 2738 return "financial transaction"; 2739 case _ACTCLASSCONTAINER: 2740 return "ActClassContainer"; 2741 case ENTRY: 2742 return "entry"; 2743 case ORGANIZER: 2744 return "organizer"; 2745 case DOCCNTNT: 2746 return "DOCCNTNT"; 2747 case DOCLIST: 2748 return "DOCLIST"; 2749 case DOCLSTITM: 2750 return "DOCLSTITM"; 2751 case DOCPARA: 2752 return "DOCPARA"; 2753 case DOCTBL: 2754 return "DOCTBL"; 2755 case LINKHTML: 2756 return "LINKHTML"; 2757 case LOCALATTR: 2758 return "LOCALATTR"; 2759 case LOCALMRKP: 2760 return "LOCALMRKP"; 2761 case ORDERED: 2762 return "ordered"; 2763 case REFR: 2764 return "REFR"; 2765 case TBLCOL: 2766 return "TBLCOL"; 2767 case TBLCOLGP: 2768 return "TBLCOLGP"; 2769 case TBLDATA: 2770 return "TBLDATA"; 2771 case TBLHDR: 2772 return "TBLHDR"; 2773 case TBLROW: 2774 return "TBLROW"; 2775 case TBODY: 2776 return "tbody"; 2777 case TFOOT: 2778 return "tfoot"; 2779 case THEAD: 2780 return "thead"; 2781 case UNORDERED: 2782 return "unordered"; 2783 case NULL: 2784 return null; 2785 default: 2786 return "?"; 2787 } 2788 } 2789 2790}