CCD2BB_UserGuide_R1_2012DEC
HL7 User Guide for:
CCD to ASCII Blue Button Transform, Release 1
Blue Button Transform (U.S. Realm)
Based on HL7 Implementation Guide:
CDA Release 2.0 – Continuity of Care Document (CCD)
User Guide
December 2012
WORK IN PROCESS DRAFT v9.14
© 2012 Health Level Seven International, Inc.
Ann Arbor, MI
All rights reserved.
Acknowledgments
We wish to thank the following individuals and their organizations for their interest
and support in the development of this project.
Lenel James – Project Team co-lead
Blue Cross and Blue Shield Association
Keith Boone – Project Team co-lead
GE Healthcare
Corey Spears – lead developer
AETNA
Scott Robertson
Kaiser Permanente
Lorraine Doo
Centers for Medicare and Medicaid Services
Doug Dormer
SPINNPHR
Jan Oldenburg
Kaiser Permanente
John Ritter
Pat Van Dyke
Delta Dental Plans Association
Tim McKay
Kaiser Permanente
Chris Wolford
Kaiser Permanente
Dennis Lopes
Kaiser Permanente
Nikki Waters
Kaiser Permanente
Jim Speros
Veterans Administration
Kim Nazi
Veterans Administration
Rob Murtha
7Delta
Willie Crump
7Delta
Sean Kenney
Chameleon IT Management Services
Revision History (N/A for the initial guide)
Rev
Date
By Whom
Changes
Note
Table of Contents – TBD
1 INTRODUCTION
1.1 Overview and Purpose
1.2 Background on the Blue Button®
1.3 Audience
1.4 Selecting the Tool’s Approach
1.5 CCD to Blue Button® Transform Tool
1.6 Exclusion
2
Conventions Used in This Use Guide, including assumptions
2.1 XPath Notation
2.2 XML Samples
2.3 Content of the Implementation Guide Package
2.4 Key Assumptions in the development of the tool
3
Scope of this XSLT Style Sheet
3.1 Description on file components and how they work
3.2 There are three ways to use the transformation tool
4.
Usage, Licensing & Support
4.1
4.2
4.3
Usage of the Tool
Licensing
Support
5
HL7 Enhancements to the VA Blue Button format and content
5.1. Changes made in the current format and content:
5.2. Additions in the VA format and content:
5.3. Header and Footer Text
5.4. Other revisions to the VA text sample document
6
Recommendations for optimal use – constraints for CCD
1 INTRODUCTION
1.1 Overview and Purpose
The healthcare system is in the midst of a revolution in healthcare
information technology. Central to this revolution are technologies that
facilitate health information exchange between providers, and promote
patient engagement and self-management. The standard for exchange of
health information documents is Health Level Seven® (HL7®)
International Clinical Document Architecture (CDA). CDA is an XMLbased markup standard specifying the encoding, structure and
semantics for clinical information.
Within the CDA standard, the Continuity of Care Document (CCD)
specification focuses on a patient summary clinical document. The CCD
is intended to facilitate the exchange of information between electronic
systems (e.g., EHR-to-PHR, EHR-to-EHR, or EHR-to-HIE). Because CCD
is an XML-based standard, it will also support human readability. This
standard uses schemas that provide a high-degree of flexibility in
formatting and display options for the end-user.
An active, well-known approach to human readability is the “Blue
Button®.” The Blue Button®, developed by the Veteran’s Administration
(VA) in collaboration with the Centers for Medicare and Medicaid Services
(CMS), allows people to access and download their personal health
information as an ASCII text file or PDF® document simply by “clicking
on the Blue Button®”.
To support the Blue Button® goal for a ‘very simple’ ASCII text file and
take full advantage of the existing CCD capabilities of Meaningful Use
(MU) certified vendors at the same time, HL7 volunteers have developed a
CCD to Blue Button® Transform Tool.
This User Guide accompanies the CCD to Blue Button® Transform Tool;
the tool transforms a CDA R2 CCD file into a U.S. Department of Veteran
Affairs (VA) Blue Button® ASCII text file. The use of the tool results in a
common, consistently-formatted ASCII text file – without any substantive
additional coding effort for the MU certified systems.
Furthermore, because the Blue Button® represents copyrighted
intellectual property (originally owned and licensed by the VA), this tool
is intended to facilitate both the potential Blue Button® users of the
marks and the Department of Health and Human Services in their
mutual effort to offer greater public access to the Blue Button®.
1.2 Background on the Blue Button®
The Blue Button® initiative was made nationally available in October
2010. In December 2011, United States Office of Personnel Management
(OPM) issued a formal request to all carriers in the Federal Employee Health
Benefit Program (FEHBP) to add Blue Button® functionality to their webbased personal health record systems, thereby expanding the usage of
the Blue Button® beyond the VA and CMS.
Subsequently, the Office of the National Coordinator for Health
Information Technology (ONC), within the Department of Health and
Human Services, formed a work group within its Standards and
Interoperability Framework (S&I Framework) called the Advanced Blue
Button® Initiative (ABBI). ABBI is intended to “identify, define and
harmonize content structures and specifications so that downloaded
information is machine readable and human readable.” This charter
extends the present Blue Button® program to this larger purpose.
In September of 2012, the Office of the National Coordinator (ONC), as
part of the Stage 2 Meaningful Use final rule, strongly encouraged every
EHR technology developer to associate that certification criteria
download capability, related to a human readable file, with the ‘‘Blue
Button®’’ phrase and logo.1
1.3 Audience
The audience for the Blue Button® Transformation Tool includes software
developers and consultants responsible for implementation of the Blue
Button® on behalf of healthcare providers, as well as those providers who
are considering offering the Blue Button®. It is also expected that this
tool and User Guide will be of value for people involved in integrated
machine readable and human readable health information projects such
as the S&I Framework’s Advanced Blue Button® Initiative.
1.4 Selecting the Tool’s Approach
Given the unique requirements of this project compared to other HL7
projects, the general approach to the CCD to Blue Button® Transform
was to assess the Blue Button® sample format, compare it to the array of
data field options in CCD, and determine options to map and display the
applicable CCD elements in a comparable way.
The first step was to identify team participants appropriate to the scope
of this project. Volunteers were recruited from the VA, CMS as well as
the vendor community, with representation from nationally-recognized
1
Federal Register, Vol. 77, No. 171; Tuesday, September 4, 2012; Rules and Regulations; p. 54181
insurers and healthcare providers. Vendor representation included both
electronic health record systems used by providers and personal health
record systems and patient portals focused on consumers.
The team began by identifying the sources of information and the desired
output. For the sources of information, the team followed the guidance
in CDA R2 CCD Implementation Guide (link/reference).
With respect to the Blue Button® output, a somewhat novel approach
was required. Blue Button® is not a formal standard with detailed
specifications. Blue Button® refers to copyrighted intellectual property
owned and licensed by the VA. Rather than a standard, the copyrighted
materials include samples of Blue Button® formats. Because these have
been developed initially for use by the VA (with significant contributions
from CMS and The Markle Foundation), certain aspects of the
presentation were unique to the VA and are not found in non-VA,
commercial organizations (providers, payers and EHR/PHR vendors).
Conversely, because the VA represents a single source of services and
information, certain conventions found in the multi-stakeholder, non-VA,
commercial healthcare market required accommodation in this variation
of the Blue Button® output.
Considering various approaches, the team determined that the best
method of accomplishing the desired solution is to use Extensible
Stylesheet Language Transformations (XSLT) as the method and
technology for the transform.
1.5 CCD to Blue Button® Transform Tool
Using the Extensible Stylesheet Language Transformations (XSLT)
approach, the transform may happen as a routine batch process.
However, it is anticipated that most uses of the tool will be part of a real
time user request for a download. The consumer’s request for humanreadable download of their clinical data would be initiated by “clicking on
the Blue Button®.” This system query would result in a real-time delivery
of the Blue Button® ASCII to the consumer.
The original CCD is not changed; rather, a new document is created
based on the content of an existing CCD output file. Developers and
other providers of the system output to consumers can incorporate the
CCD to Blue Button® Transform Tool into a broad set of environments
and work flows. See section 4 of this User Guide for additional
information on the usage, licensing and support for this HL7 tool.
1.6 Exclusion
Note: For clarity, the scope of this project is focused on a CCD to ASCII
text transformation. The project explicitly excludes transforming Blue
button® ASCII into CCD. The reason for this limitation is that ASCII text
does not have the capacity to carry the key privacy, security, and date
integrity meta-data needed to ensure the reliability and quality of the
patient data for secure computer-to-computer interoperability.
2
Conventions Used in This Use Guide, including assumptions
2.3 XPath Notation
Instead of the traditional dotted notation used by Health Level Seven International
(HL7) to represent RIM classes, this appendix in this document uses XPath notation to
identify the XML elements and attributes within the CDA document instance. The
purpose of using this notation is to provide a mechanism that will be familiar to
developers for identifying parts of an XML document.
2.4 XML Samples
XML Samples appear in the appendix of this document in a fixed-width font.
Portions of the XML content may be omitted from the content for brevity, marked by an
ellipsis (…) as shown in the example below.
Figure 1: ClinicalDocument example
<ClinicalDocument xmlns='urn:h17-org:v3'>
...
</ClinicalDocument>
2.4 Content of the Implementation Guide Package
The Implementation Guide package contains the following files:
Table 1: Contents of the Implementation Guide Package
Filename
Description
CCD2BB.USERGUIDE.Oct2012.doc
This user guide
CCD2BB.FILES.zip
A zip file of all the XSLT files
described in the guide and used to
perform the Blue Button transform
of a CCD file
CCD2BB.EXAMPLES
A zip files with three sample test
files of CCD input and txt output
from the tool
CCD2BB. HL7_TOOL_LICENSE
AGREEMENT_2012.pdf
A pdf of the HL7 tool usage license
agreement that documents
copyright, usage and restrictions.
CCD2BB.VA_txt_REQUIREMENTS_2012.pdf
A pdf of the VA ASCII txt file and the
related transform tool display
requirements.
2.5 Key Assumptions in the development of the tool
2.5.2
The format, structure and sequence of data element display would be maintained to be as
consistent with the current ASCII display format as feasible
2.5.3
Any new data elements beyond what was present in the VA ASCII display would be limited to
common data elements that were present in CCD and anticipated to be present in many if not
most of the commercial systems.
2.5.4
In the mapping of data elements to the VA ASCII Blue Button the mapping source sequence was
CCD, the CCD template of Consolidated CCD, all of Consolidated CCD, then P2PPHR (Plan-to-plan
PHR transfer IG of CDA). This is the hierarchy of sources for input to data fields and constraints.
2.5.5
It was out-of-scope to ensure that all elements of CCD where mapped to a location in the format
of the VA ASCII Blue Button.
3
Scope of this XSLT Style Sheet
3.1
Description on file components and how they work
In combination with an HL7 CDA R2 XML document file and the HL7 CCD-to-Blue Button
Transformation tool files, an ASCII text output file in format of the formal VA Blue Button will be
created. This CCD-2-BB transformation tool is comprised of a variety of XSLT files that perform a
variety of general and specialized functions to support the transformation processed.
The primary entry point of the file hierarchy is the master XSLT (CCDtoBlueButtonTxt.xsl) which is
run to execute the transformation. The top level processing files of XSLT include the Document
Header, Document Summary, Patient Demographics, Healthcare Provider, Sections, and the Footer.
During the execution of the transformation, the master XSLT calls the top level files, which in turn
call appropriate Section Support and Formatting files. These top level files are described in
Appendix C. The hierarchy of the XSLT files is diagramed below in figures 1 and 2.
The Section Support and Formatting files generate key display elements of the Blue Button file such
as Section Header, Alerts, Medications, Results and Social History. See Appendix C for a description
of each and the hierarchy figure 1 for the full list of the display element files.
Below are each of the remaining section of the tool files and their respective role in the
transformation of the CCD:






CCD Common Elements Formatting files to support consistent display and formatting of the
text comments, data sources, and coded values.
Utility Formatting files provide a common way to handle the display of dates, line splitting,
line wrapping and rendering lines in single or multiple columns – along with the related page
margins.
Resource files contains CCD template information, codes for value sets and identification of
specific concepts that are related to section labels. These files are key files for adding new
sections, new table values or new data elements – if a user would want to customize the
tool.
Configuration files are where default parameters for tool are called and section order,
currently in the same sequence as the VA Blue Button, are defined.
Extra files have a testing and development feature for the non-production display of the
output to Internet Explorer.
Preference Parameters are where default rendering and display options for how the tool
works have been set. User may elect to change one or more of the default setting in the files
of this section for items like whether line with empty data display the label (currently set to
false, to display empty label, as does the production VA Blue Button).
3.3
Use of the transformation tool
There are three ways to use the tool. See the description below:
o
o
o
Use the transformation tool “as is”, accepting the default settings of the preference
parameters, and only making edits (if any) to the header and footer text (See Appendix
X for the current header and footer text)
Use the transformation tool, with minimal changes based on configuration edits to the
preference parameters and/or text changes to the header and footer display text. See
the documentation within each parameter XSLT for any guidance on parameter edits)
Make modifications to the transformation tool to revised section display order, add new
sections or add new data elements to existing or new sections. (NOTE: Making
modifications to the tool requires strong XSLT experience.)
See the Quick Start Tips in Appendix D for how to use the tool for using the tool as-is, or
with minor preference parameter changes. See Appendix E for a description on the process
and steps to modify the tool for adding new sections, revising sequence order or adding new
data elements or code/table values.
NOTE: Three sets of sample test files, CCD input and the txt output from the tool are
included in the download zip file that provided this user guide.
Transformation File Hierarchy Diagrams (figure 2)
IE
(Primary Entry
Point)
Document
Header
(Utility and
Formatting)
Document
Footer
Document
Disclaimer
(Utility and
Formatting)
(Utility and
Formatting)
Document
Disclaimer
Patient
Demographics
Healthcare
Providers
Sections
(Utility and
Formatting)
(Utility and
Formatting)
(See Below)
(Utility and
Formatting)
Transformation File Hierarchy Diagrams (figure 3)
Sections
Section
Order (xml)
Section
Header
Comment
Source
Text
(Narrative
Formatting)
(Utility and
Formatting)
(Utility and
Formatting)
(Utility and
Formatting)
(Utility and
Formatting)
(Section
Formatting)
Payment
Sources
4.
Problems
Allergies
Results
Usage, Licensing & Support
Vitals
Medications
Immunizatio
ns
This section of the user guide describes the flexibility of the user in using and modifying the
transformation tool, HL7 licensing for the tool and the limited support that will be available for users
of the tool.
4.1
Usage of the Tool
It is anticipated that this HL7 transformation tool will be used as part of real-time or batch
processing to transform existing CCD files into Blue Button ASCII text files for download delivery to
patients, consumers or their authorized care givers. As identified in section 3 about, this can be
done with little or no modification, or with modest parameter file edits, or with customization of
selected files to change the display sequence of sections or to add new sections, data or table/code
values.
4.2
Licensing
An HL7 license agreement must be accepted as part of receiving this User Guide and the
Transformation Tool files. The tool license will apply equally to HL7 organizational members,
individual members or non-members. What follow is an informal summary of the key terms that
will apply to the usage of the tool (NOTE: None of the text below supersedes or changes the
terms and legal obligations of the HL7 license for use of the tool):
4.3.1. Tool user is allowed to modify the tool
4.3.2. The tool is provided "AS IS", without a warranty of any kind, express or implied
4.3.3.Support, updates, patches, etc may be made available, but there is no formal support
required part of the license
4.3.4. Tool users are allowed to incorporate in products for end-users, however sublicensing
the tool is only allowed to the extent necessary to sell or license using the tool to end
users
4.3.5. HL7 may modify or discontinue offering the tool at any time
4.3.6. The tool is protected by copyright laws
4.4
Support
User support for this tool will be limited. As stated in the license section above and in the term
of the HL7 license agreement, the tool is being provided “As-as”. There will be no real-time or
daily support available. However, an email can be sent by the licensee to CCD2BB-issuesEHRWG@hl7.org. On a weekly basis, members of the development team will review and
respond. Responses will typically be made as a posting to the CCD-to-Blue Button FAQ page on
the HL7 wiki http://wiki.hl7.org/index.php?title=EHR_CCD2BLUEBUTTON
Any bug or enhancement provided via email to CCD2BB-issues@hl7.org will be logged into the
HL7 GForge tracking tool. GForge will be used to maintain and document the status of any bugs,
enhancements or open questions for review.
NOTE: In the event that HL7 issues an updated version of the tool in response to questions,
comments or issues reports, the new version could require the licensee to retrofit any and all
customizations, text edits or preference parameter changes made to the previous version. A
change log will be provided as part of the User Guide for version updates, which would help the
licensee target any changes they may need to make.
5
HL7 Enhancements to the VA Blue Button Format and Content
The tool development resulted in several changes to the original VA product format and
content. Some of the general changes include:



In the title, the name of the report now includes the option for name of the software that
created the download and the version number of the software. This allows the user to
‘personalize’ the document and provider reference.
Several added CCD fields not currently present in the VA Blue Button, but available in
commercial systems, were added in proximity to the existing data element in the VA Blue
Button. The addition of more fields is not precluded---the developer is encouraged to add
those fields that provide an enhanced document for the patient.
Header and footer text suitable for the commercial sector has been provided. The
organization using the tool can leave the text as is. However, the organization is welcome
to revise the text to be more appropriate and more informative for the target consumers
for the using organization’s consumers.
The specific changes to the document are discussed in Appendix C which provides a section by
section description of tool and how it relates to the original VA Blue Button document.
6
Recommendations for optimal use of CCD
In the development and testing of the tool, it was confirmed that validated CCD files worked
effectively with the tool. It was determined that users of the tool should be aware of the following
recommendations and issues as they seek to get optimal value and quality from the txt file output of the
transformation XSLT tool:



The description field in CCD need to be used, so that the information can be displayed in the
txt download
Value code and table data elements need to be from valid and appropriate codes and tables.
Null flavor is acceptable
7
Appendix
APPENDIX A — Excerpt of Functional Requirements, Blue Button txt with annotations
APPENDIX B - Introduction and Closing text for the HL7 CCD to Blue Button XSLT
APPENDIX C - Transformation Tool – File Hierarchy and XSLT File Descriptions
APPENDIX D - Quick Start guide to using the tool
APPENDIX E -
How To Guide for Modifying the Tool
APPENDIX F -
X-Path Notation, Mapping of Blue Button fields to CCD.
APPENDIX A
Excerpt of Functional Requirements, Blue Button txt with annotations
(NOTE: The full requirements file is included in the tool download zip file)
APPENDIX B
Introduction and Closing text for the HL7 CCD to Blue Button XSLT
INTRODUCTION TEXT:
This Blue Button® summary is a copy of information which is available in your [software system name]
Personal Health Record. Your summary contains information that you entered and may include copies of
information from other sources, such as your doctor’s or your hospital’s electronic health record,
independent laboratory results, pharmacy records or claims which have been paid by your health plan.
This summary record represents available information about you as of the date and time it was created.
Newer information may be available. Please let your health care team know if you have questions
about any of your health information.
PLEASE NOTE: Once your data is downloaded to your PC, the content can easily be changed or
compromised. This information can also be easily viewed or revised by anyone that has access to your
computer. It is your responsibility to protect your private information..
Additional clinical data, such as X-ray images may be available from your [software system name] . On
the last page of this summary is more information.
LAST PAGE FOOTER:
This Blue Button® PHR summary was created using a healthcare industry data exchange standard known
as Continuity of Care Document (CCD). Additional clinical data may be available from the source CCD file
– giving your care team an option for a secure computer-to-computer exchange of your PHR summary
for use in their own Electronic Health Record (EHR) systems. Electronic health information exchange is a
key part of the healthcare industry efforts to improve care quality and effective care coordination. For
more information on the availability of the CCD source file, please contact [PHR sponsor, Blue Button file
source organization] . (note: the XSLT user is encouraged to provide a link and/or contact information on
how the patient can either download a CCD version or request a CCD be provided to their own PHR, such
as WebMD or a HealthVault partner PHR)
Physicians, Clinicians & Provider Organizations: If you would like to know more about options for a
secure CCD file exchange with your EHR system, please contact [PHR sponsor, Blue Button file source
organization] (Developer Note: the XSLT user is encouraged to provide link or contact information on
how a provider can request Direct or HIE access to the source CCD file)
IMPORTANT NOTATION ON FILE SECURITY AND DATA INTEGRITY: Once you receive this data download,
there is a risk of the file contents being viewed, changed or stolen with or without your knowledge.
These data integrity and data security risks can be very high if your personal computer is shared with
others, or your PC virus protection for the internet is not current, or strong password access control is
not maintained at all times. Accidental or malicious changes to the file could compromise the quality of
your care. Also, if you chose to store the file, it is not encrypted, so be careful about sharing this file with
others. Protect your personal health data as you would your credit card number or your social security
number.
The name “Blue Button,” the Blue Button logo, and the slogan “Download My Data” are registered
Service Marks of the U.S. Department of Health and Human Services .
APENDIX C
Table of Contents
1 INTRODUCTION................................................................................................................. 5
1.1 OVERVIEW AND PURPOSE ............................................................................................. 5
1.3 AUDIENCE ...................................................................................................................... 6
1.4 SELECTING THE TOOL’S APPROACH ............................................................................. 6
1.5 CCD TO BLUE BUTTON® TRANSFORM TOOL .................................................................. 7
1.6 EXCLUSION .................................................................................................................... 8
2.1
XPath Notation ......................................................................................................... 8
2.2
XML Samples ....................................................................................................... 8
2.3
Content of the Implementation Guide Package .................................................... 8
CCD TO BLUEBUTTON TRANSFORMATION FILE DESCRIPTIONS ........................................ 21
Top Level Files .................................................................................................................. 21
CCDtoBlueButtonTxt.xsl ................................................................................................ 21
CCDtoBlueButtonTxt_DocumentHeader.xsl .................................................................... 21
CCDtoBlueButtonTxt_DocumentSummary.xsl ................................................................ 21
CCDtoBlueButtonTxt_Disclaimer.xsl .............................................................................. 21
CCDtoBlueButtonTxt_PatientDemographics.xsl .............................................................. 21
CCDtoBlueButtonTxt_HealthcareProviders.xsl ................................................................ 21
CCDtoBlueButtonTxt_Sections.xsl ................................................................................. 22
CCDtoBlueButtonTxt_TreatmentFacilities.xsl ................................................................. 22
CCDtoBlueButtonTxt_DocumentFooter.xsl ..................................................................... 22
Section Support and Formatting Files ............................................................................... 22
CCDtoBlueButtonTxt_SectionHeader.xsl ........................................................................ 22
CCDtoBlueButtonTxt_Alert.xsl ....................................................................................... 22
CCDtoBlueButtonTxt_Encounter.xsl .............................................................................. 22
CCDtoBlueButtonTxt_FamilyHistory.xsl ......................................................................... 23
CCDtoBlueButtonTxt_Immunization.xsl ......................................................................... 23
CCDtoBlueButtonTxt_Medication.xsl .............................................................................. 23
CCDtoBlueButtonTxt_PaymentSource.xsl ....................................................................... 23
CCDtoBlueButtonTxt_PlanOfCare.xsl ............................................................................. 23
CCDtoBlueButtonTxt_Problem.xsl .................................................................................. 23
CCDtoBlueButtonTxt_Procedure.xsl ............................................................................... 23
CCDtoBlueButtonTxt_Result.xsl..................................................................................... 23
CCDtoBlueButtonTxt_SocialHistory.xsl .......................................................................... 23
CCDtoBlueButtonTxt_Vital.xsl ....................................................................................... 23
CCD Common Element Formatting Files ........................................................................... 24
CCDtoBlueButtonTxt_Comment.xsl................................................................................ 24
CCDtoBlueButtonTxt_Source.xsl .................................................................................... 24
CCDToBlueButtonTxt_Text.xsl ....................................................................................... 24
CCDtoBlueButtonTxt_CE.xsl .......................................................................................... 24
CCDtoBlueButtonTxt_Formatting.xsl ............................................................................. 24
Utility Formatting Files ..................................................................................................... 24
split.xsl 24
str-foldl.xsl .................................................................................................................... 24
utility_date.xsl ............................................................................................................... 25
utility_string.xsl ............................................................................................................. 25
Resource Files .................................................................................................................. 25
CCDtoBlueButtonTxt_Labels.xsl .................................................................................... 25
CCDtoBlueButtonTxt_Resource.xsl ................................................................................ 25
CCDToBlueButtonTxt_ValueSet.xml ............................................................................... 25
CCDToBlueButtonTxt_TranslationValueSet.xml ............................................................. 25
CCDToBlueButtonTxt_ConceptValueSet.xml .................................................................. 26
Configuration Files ........................................................................................................... 26
CCDtoBlueButtonTxt_Preferences.xsl ............................................................................. 26
CCDToBlueButtonTxt_SectionOrder.xml ........................................................................ 26
Extra Files ........................................................................................................................ 27
CCDtoBlueButtonTxt_IE.xsl ........................................................................................... 27
PREFERENCE PARAMETERS ............................................................................................... 28
renderOriginalText ......................................................................................................... 28
hideEmptyLabels ........................................................................................................... 28
systemName .................................................................................................................. 28
systemType ................................................................................................................... 28
sourceContact ............................................................................................................... 29
valueSetURI................................................................................................................... 29
conceptValueSetURI ...................................................................................................... 29
translationValueSetURI ................................................................................................. 29
sectionOrder .................................................................................................................. 29
QUICK START ........................................................................................................................ 30
CCD TO BLUEBUTTON
TRANSFORMATION FILE
DESCRIPTIONS
Top Level Files
CCDtoBlueButtonTxt.xsl
The file contains the highest level Blue button constructs including, but not necessarily
limited to, the document header, patient identity header, document summary, patient
demographics, healthcare providers, document sections and document footer.
This is the primary xslt transform file. Run the CCD xml transformation using this file.
CCDtoBlueButtonTxt_DocumentHeader.xsl
This file contains the Document Header for the CCD to VA Blue Button transformation.
The disclaimer and information content in the footer can be modified in the
CCDToBlueButtonTxt_Disclaimer.xsl file.
CCDtoBlueButtonTxt_DocumentSummary.xsl
This file contains the Document Footer formatting for the CCD to VA Blue Button
transformation. This file provides the summary about the document (including name
and date) as well as what sections are included in the document.
CCDtoBlueButtonTxt_Disclaimer.xsl
This file contains the Disclaimer for the CCD to VA Blue Button transformation. If the
BlueButton disclaimer (header or footer) needs to be specialized for your
implementation, that change should be made here.
CCDtoBlueButtonTxt_PatientDemographics.xsl
This file contains the Document Footer formatting for the CCD to VA Blue Button
transformation.
This file provides the formatting for both the patient identification header, which
appears before the document summary, and the full set of patient demographics in the
patient demographics section.
CCDtoBlueButtonTxt_HealthcareProviders.xsl
This file contains the Healthcare Providers section formatting for the CCD to VA Blue
Button transformation.
CCDtoBlueButtonTxt_Sections.xsl
This file contains the Sections Handler for the CCD to VA Blue Button transformation.
All sections are called and ordered in this file. The order of the sections is defined in the
CCDtoBulueButtonTxt_SectionOrder.xml file. This file uses that order file to order the
sections. Any sections included in the document but are not found in the order
document will appear after all ordered =sections and will appear in the order that they
otherwise appear in the originating CCD document.
Sections are formatted per the “Section Support and Formatting Files” defined below. If
new sections need to be specifically formatted, a new Section formatting file should be
created and referenced in this file. Sections that do not have a Section Formatting File
will contain only the narrative text (if configured so in the
CCDToBuleButtonTxt_Preferences.xsl file). A section is identified by the templateId
which will need to be added to the CCDToBlueButtonTxt_Resource.xsl file and the
variable referenced in this file, and the matching Section Formatting File.
CCDtoBlueButtonTxt_TreatmentFacilities.xsl
This file contains the Treatment facilities section formatting for the CCD to Blue Button
Transformation. Treatment facilities are taken from the CCD serviceEvent performers.
CCDtoBlueButtonTxt_DocumentFooter.xsl
This file contains the Document Footer formatting for the CCD to VA Blue Button
transformation. The disclaimer and information content in the footer can be modified
in the CCDToBlueButtonTxt_Disclaimer.xsl file.
Section Support and Formatting Files
CCDtoBlueButtonTxt_SectionHeader.xsl
This file contains the Section Header for the CCD to VA Blue Button transformation.
All section header formatting is handled in this file. (Section header includes the
separator characters and title of the section (e.g. Problems, Allergies, etc.)).
CCDtoBlueButtonTxt_Alert.xsl
This file contains the Allergies, Adverse Reactions, and Alerts section formatting for the
CCD to VA Blue Button transformation.
CCDtoBlueButtonTxt_Encounter.xsl
This file contains the Encounters section formatting for the CCD to VA Blue Button
transformation.
CCDtoBlueButtonTxt_FamilyHistory.xsl
This file contains the Family History section formatting for the CCD to VA Blue Button
transformation.
CCDtoBlueButtonTxt_Immunization.xsl
This file contains the Medications section formatting for the CCD to VA Blue Button
transformation.
CCDtoBlueButtonTxt_Medication.xsl
This file contains the Medications section formatting for the CCD to VA Blue Button
transformation.
CCDtoBlueButtonTxt_PaymentSource.xsl
This file contains the Payment Sources section formatting for the CCD to VA Blue Button
transformation.
CCDtoBlueButtonTxt_PlanOfCare.xsl
This file contains the Plan of Care section formatting for the CCD to VA Blue Button
transformation.
CCDtoBlueButtonTxt_Problem.xsl
This file contains the Problems section formatting for the CCD to VA Blue Button
transformation.
CCDtoBlueButtonTxt_Procedure.xsl
This file contains the Procedures section formatting for the CCD to VA Blue Button
transformation.
CCDtoBlueButtonTxt_Result.xsl
This file contains the Results section formatting for the CCD to VA Blue Button
transformation.
CCDtoBlueButtonTxt_SocialHistory.xsl
This file contains the Social History section formatting for the CCD to VA Blue Button
transformation.
CCDtoBlueButtonTxt_Vital.xsl
This file contains the Vital Signs section formatting for the CCD to VA Blue Button
transformation.
CCD Common Element Formatting Files
CCDtoBlueButtonTxt_Comment.xsl
This file contains the data comment formatting for the CCD to VA Blue Button
transformation.
All comments for data entries and sections are handled the same in this file.
CCDtoBlueButtonTxt_Source.xsl
This file contains the data source formatting for the CCD to VA Blue Button
transformation.
All data sources for data entries and sections are handled the same in this file.
CCDToBlueButtonTxt_Text.xsl
This file contains the entry point for the narrative text formatting for the CCD to VA Blue
Button transformation. This file is used if the CCDToBlueButtonTxt_Preferences.xsl
renderOriginalText para is set to ‘true’.
CCDtoBlueButtonTxt_CE.xsl
This file contains the coded entries and values formatting for the CCD to VA Blue Button
transformation.
CCDtoBlueButtonTxt_Formatting.xsl
This file contains the general and lower level element formatting for the CCD to VA Blue
Button transformation.
Utility Formatting Files
split.xsl
This file contains the logic necessary to handle line splitting which allows for line
wrapping (e.g. splitting at the end of words). It comes from FXSL (the Functional
Programming Library for XSLT http://fxsl.sourceforge.net/) which is released under the
Mozilla Public License (MPL 1.1)
str-foldl.xsl
This file contains the logic necessary to handle line wrapping. It comes from FXSL (the
Functional Programming Library for XSLT http://fxsl.sourceforge.net/) which is released
under the Mozilla Public License (MPL 1.1)
utility_date.xsl
This contains the date rendering of CCD compliant date and time element attributes. It
enables the rendering of a long date format, which includes month name and day of
week, as well as short sort format rendering.
utility_string.xsl
This file contains the string and line formatting. This includes margin handling, line
wrapping, line justification, and rendering of multiple columns. This formatting is for
the specifically formatted BlueButton text and not the formatting of the CCD narrative
sections.
Resource Files
CCDtoBlueButtonTxt_Labels.xsl
This file contains the Labels for the CCD to VA Blue Button transformation.
The VA Blue Button format contains label value pairs. This file contains all of the labels.
Any labels that need to be modified or added should be done so in this file.
CCDtoBlueButtonTxt_Resource.xsl
This file contains the CCD and other CDA Template Identifiers (templateId) for the CCD
to VA Blue Button transformation.
Any new section, entry, or other template identifiers that need to be modified or added
should be done so in this file.
CCDToBlueButtonTxt_ValueSet.xml
This file contains value sets that allow for the translation of codes to human readable
text. In general for the purpose of the CCD to BlueButton text tranfrom should have a
displayName attribute, which will be used in the rendering. However, if the
displayName attribute is not available, the value set can be added here and referenced
in the appropriate place. Examples of displayNames not available include country codes
and nullFlavor values.
CCDToBlueButtonTxt_TranslationValueSet.xml
This file contains codes in value sets that are to be translated (mapped) to other
concepts. This file should not be used to express the human readable text
representation of a code (which should be defined in the
CCDToBlueButtonTxt_ValueSet.xml file), but rather to enable mapping of a concept
based on a code value. One example of this is to determine the regional designation
type (e.g. state or province), based on country (e.g. “US” country code is mapped to
“state” as the regional designation type and “CA country code is mapped to “province”
as the regional designation type.)
CCDToBlueButtonTxt_ConceptValueSet.xml
This file contains value sets that enable to identification of specific concepts that need
to be identified in the CCD for formatting under a specific label.
For example, BlueButton includes Blood type in the patient demographics section. In
CCD there is no special location designated for Blood Type. Instead a blood type would
be one of possibly many observations in the results section. Observations are identified
by a code (LOINC or SNOMED). Blood Type in either code system has a number of
possible codes. The list of all possible codes that designate a blood type result are
included in this file. The transform will compare all observation codes in the CCD with
all codes in the identified code set in this file and choose the first match to place in the
appropriate location as defined in the Section Format file (including
CCDToBlueButtonTxt_PatientDemographics.xsl file).
At the release of the CCD to BlueButton text xsl transformation file set, the included
concept value sets include BloodType Blood Pressure (systolic and diastolic), organ
donor, and Occupation.
Note: The comparison operation is processor intensive and causes the biggest reduction
on performance. It will likely be the biggest bottleneck to efficient transformation of
CCD to BlueButton text. If the transformation is being used in an environment where a
lot of files are to be transformed and fast performance is a requirement, it is suggested
that the user look for more effective processing options that are specific to their system.
For example, if the Blood Type in the originating system will always be expressed in one
or two codes, all other codes should either be removed from the concept value set or
the codes could be hardcoded in the Section Formatting File.
Configuration Files
CCDtoBlueButtonTxt_Preferences.xsl
This file contains the user preferences for the CCD to VA Blue Button transformation.
Edit the file to set all user preferences supported in this release.
The preferences can be modified in this file or passed in through programmatically to
the xslt processor.
See Preference parameters section.
CCDToBlueButtonTxt_SectionOrder.xml
This XML file indicates the section order. Edit the order of the elements to change the
order they show up in the output. Sections are identified via their templateId.
Extra Files
CCDtoBlueButtonTxt_IE.xsl
This file contains a wrapper to allow the CCD BlueButton rendering that will be
displayed in internet explorer. This file should only be used for testing and development
purposes only and is not meant for production use (The xsl in it is not 100% conformant
to the standard). For testing and development purposes, you can use this file as the
primary stylesheet for rendering of a CCD document.
PREFERENCE PARAMETER S
Preference parameters for rendering of the CCD to BlueButton text can be found in the
CCDToBlueBUttonTxt_Preferences.xsl file. Below is a description of the preference
parameters available. These parameters can be set in this file or passed in
programmatically to an xslt processor.
renderOriginalText
Set to 'true' if the original section/text sections are to be rendered at the end of each
BlueButton section.
This is the document wide setting, which has a default of true. Set to 'false' to disable.
- If set to true, section level settings can be made in
CCDtoBlueButtonTxt_SectionOrder.xml
- If set to false, no sections original text will be rendered regardless of section
setting identified in CCDtoBlueButtonTxt_SectionOrder.xml
Rendering original text does not apply to demographics, healthcare Providers, or
treatment facility section
hideEmptyLabels
Set to 'true' to hide lines with labels that are empty.
This is the document wide setting, which has a default of false. Set to 'true' to hide.
-
If set to true, section level settings can be made in
CCDtoBlueButtonTxt_SectionOrder.xml
If set to false, all labels will show regardless of section setting identified in
CCDtoBlueButtonTxt_SectionOrder.xml
This setting applies to demographics, healthcare Providers, or treatment facility sections
(not related to section settings)
systemName
System name producing the CCD/BlueButton.
Put a value here if it is to override the authoringDevice or authoring organization name.
systemType
System type producing the CCD/BlueButton. (Usually PHR or EHR)
sourceContact
System contact information (for patient in the event they have questions.)
Note: the XSLT user is encouraged to provide link or contact information on how a
provider can request Direct or HIE access to the source CCD file.
valueSetURI
This parameter specifies the location of the Value Set configuration file.
The default value is the same relative path as the entry point xslt with the name
‘CCDToBlueButtonTxt_ValueSet.xml’
conceptValueSetURI
This parameter specifies the location of the Concept Value Set configuration file.
The default value is the same relative path as the entry point xslt with the name
‘CCDToBlueButtonTxt_ConceptValueSet.xml
translationValueSetURI
This parameter specifies the location of the Value Set translation configuration file.
The default value is the same relative path as the entry point xslt with the name
‘CCDToBlueButtonTxt_TranslationValueSet.xml’
sectionOrder
This parameter specifies the location of the Section Ordering configuration file.
The default value is the same relative path as the entry point xslt with the name
‘CCDToBlueButtonTxt_SectionOrder.xml’
APPENDIX D
Quick Start
The HL7 CCD to BlueButton Text tool is a set of xslt transforms that enable the transformation
of CCD, C32 (version 2.5), and Consolidated CDA CCD (DSTU release 1.0) files into a Blue Button
text file that closely resembles the VA’s own Blue Button text file extracts. This set of
transformation files, when applied to one of the aforementioned CCD versions will create a
Blue Button text file that a patient can use to view their own clinical data as well as pass it on to
a care giver or provider.
This tool is meant to enable software developers to add the support of create Blue Button text
files into their own already existing CCD implementations. With this set of transforms, it is
expected that a developer should be able to create Blue Button text files with minimal effort
and configuration. Please note however, that in order to render a human readable and usable
Blue Button text file, certain requirements are expected of the source CCD file (such as
displayName attributes for coded elements in order to provide a human readable description of
the concept being expressed). Please see Section 6 regarding these additional CCD
requirements for more information.
To get started a developer will need to download all of the xslt and xml files in the tool package.
Currently the source files are located in Google code SVN repository at ccdbluebutton.googlecode.com/svn .(It is expected that this tool once complete and reviewed will
be placed in the HL7 Source Forge repository and made available to HL7 members.) This
repository is currently open for anonymous download (note that check-ins are not allowed).
Download all of the files in the “http://ccd-bluebutton.googlecode.com...xxxxxx” (replace with
an EHR WG wiki page) folder, including the xslt and xml files. These files will all need to be
placed in the same source folder being used to transform the source CCD file.
Once this is done, it will be up to the developer to determine how to apply the xslt transforms.
There are a number of XSLT processors available including open source and widely utilized
toolsets (including Microsoft .NET framework, xalan, saxon, and others.). It will be left up to the
developer to determine the best mechanism to meet their needs.
To apply the transform “Out of the box”, the CCD source file (supplied by the users system)
should be transformed via the CCDtoBlueButtonTxt.xsl, which is the primary transform file.
This is the primary entry point transform file that in turn imports the rest of the files, directly or
indirectly, to transform a CCD to a Blue Button Text file.
APPENDIX E
Modifying and Adding to the Tool
While this tool attempts to be applicable right “Out of the box”, there may be situations where
a user needs to make modifications. Users of the CCD to Blue Button transformation tool are of
course allowed to modify the content of their transforms pursuant any legal and license
requirements from HL7 and the Blue Button license.
Some needed modifications may be simple, such as a modification to a label, a change to the
system name or type that has generated the file, or turning off the CCD text section being
included in the output. Other modifications may be more complex, such as adding a the
support for a new section.
Configuring the Tool
Many of the simpler modification likely to be needed have been extracted into a limited set of
files that should be easy to find and configure. Most of the configuration changes can be made
in the preferences file CCDtoBlueButtonTxt_Preferences.xsl. The settings of this file are set up
as parameters (xsl:param), so a developer that is familiar with using xslt processors should be
able to set the values of the parameters at run time should they desire.
Please see the section Preference Parameters for more details about the configuration
parameters available.
More Complex Modifications
The potential areas for more complex modification of the transforms of course is limitless, so all
the possibilities cannot be detailed. However, the most likely way a user may wish to modify
the transforms is to add support for a new CCD section. The information in this portion of the
user guide is meant to quickly outline the process and point out areas a developer will need to
modify in order to get started. A developer could also choose to look at a section already
supported for more guidance on how to add their own section support. It is expected that the
developer would have an intimate knowledge of xml, xslt, and CDA before attempting to make
any such modifications.
To add support for a new section, the following files will need to be modified. Below is a
description of each file and how they will need to be modified.
CCDtoBlueButtonTxt_Labels.xsl
This file contains the Labels for the CCD to VA Blue Button transformation. The VA Blue Button
format contains label value pairs. This file contains all of the labels that show up in the Blue
Button output.
Any labels that need to be modified or added should be done so in this file, rather than directly
in the section formatting file. This enables a developer to look in one spot to correct or make
most necessary label changes.
CCDtoBlueButtonTxt_Resource.xsl
This file contains the CCD and other CDA Template Identifiers (templateId) for the CCD to VA
Blue Button transformation. Any new section, entry, or other template identifiers that need to
be modified or added should be done so in this file.
In this file templateIds for both the section level and entry (or a descendant child of an entry
element, such as act or observation), should be included. This file contains multiple
templateIds for sections that are very similar (e.g . CCD_idSectionFamilyHistoryand
CCDA_idSectionFamilyHistory). This is because the tool supports multiple standards. This is
supported by the tool and a user adding a section can replicate the same type of functionality.
CCDtoBlueButtonTxt_Sections.xsl
This file contains the Sections Handler for the CCD to VA Blue Button transformation.
All sections are called and ordered in this file (Note that this file does not specify the order, but
rather, handles the processing to order the sections as they are included in the
CCDtoBlueButtonTxt_SectionOrder.xml file). Any sections included in the document but are
not found in the order document will appear after all ordered sections and will appear in the
order that they otherwise appear in the originating CCD document.
Sections are formatted per the “Section Support and Formatting Files” defined above. If new
sections need to be specifically formatted, a new Section formatting file should be created and
referenced in this file. Sections that do not have a Section Formatting File will contain only the
narrative text (if configured so in the CCDToBuleButtonTxt_Preferences.xsl file). A section is
identified by the templateId which will need to be added to the
CCDToBlueButtonTxt_Resource.xsl file and the variable referenced in this file, and the matching
Section Formatting File.
If the section formatting requires special handling based on the type of or data inside the
entries contained in the section (e.g. output future appointment and then past appointments),
that special handling should be done in this file.
CCDtoBlueButtonTxt_SectionOrder.xml
This XML file indicates the section order. Edit the order of the elements to change the order
they show up in the output. Sections are identified via their templateId. Duplicate order
numbers are acceptable where a set of templateIds refer to the same conceptual section, but
have differing OIDs (e.g. CCD uses an OID of “2.16.840.1.113883.10.20.1.8” and Consolidated
CDA uses an OID of “2.16.840.1.113883.10.20.22.2.1”.) It is expected however that templateIds
that use the same order number will not appear for more than one section in the originating
document.
Section Formatting
The last and one of the most important parts to adding a new section is a section formatting
transform. The naming of the file is up to the developer, but it is recommended that the
naming convention used in the original transform tool be adopted (e.g.
CCDtoBlueButtonTxt_XXXXX.xsl, where XXXX represents the type of data in the section. The
section formatting processes entries in a CCD section (i.e. the section formatting file only
formats the individual entries in each section, through an apply-templates operation that will
repeat on the entries.
The developer may want to add certain formatting constructs like multiple columns. If this is
desired it is recommended that the developer look at an example of how this is done in existing
transforms. An example of a relatively simple section formatting file is
CCDtoBlueButtonTxt_SocialHistory.xsl. An example of a more complex section formatting file is
CCDtoBlueButtonTxt_Medication.xsl. This file has several formatting constructs that should
illustrate their usage (such as multiple columns utilizing the PrintColumns template)
APPENDIX E
CCD to Blue Button Field Mapping
Number of sections: 16
Number of total elements: 120
Alert (5 elements)
Allergy Name
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.2' or
@root='2.16.840.1.113883.10.20.22.2.6']/cda:entry/cda:act[cda:templateId/@root='2.16.840.1.113883.10.20.1.27'
or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.30']/cda:entryRelationship[@typeCode='SUBJ']/cda:observatio
n/cda:participant[@typeCode='CSM']/cda:participantRole[@classCode='MANU']/cda:playingEntity[@classCode='MMAT'
]/cda:name
Date Entered
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.2' or
@root='2.16.840.1.113883.10.20.22.2.6']/cda:entry/cda:act[cda:templateId/@root='2.16.840.1.113883.10.20.1.27'
or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.30']/cda:entryRelationship[@typeCode='SUBJ']/cda:observatio
n/cda:effectiveTime/cda:low
Reaction
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.2' or
@root='2.16.840.1.113883.10.20.22.2.6']/cda:entry/cda:act[cda:templateId/@root='2.16.840.1.113883.10.20.1.27'
or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.30']/cda:entryRelationship[@typeCode='SUBJ']/cda:observatio
n/cda:entryRelationship[@typeCode='MFST']/cda:observation[cda:templateId/@root='2.16.840.1.113883.10.20.1.54'
or cda:templateId/@root='2.16.840.1.113883.10.20.22.4.9']/cda:text
Severity
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.2' or
@root='2.16.840.1.113883.10.20.22.2.6']/cda:entry/cda:act[cda:templateId/@root='2.16.840.1.113883.10.20.1.27'
or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.30']/cda:entryRelationship[@typeCode='SUBJ']/cda:observatio
n/cda:entryRelationship[@typeCode='SUBJ']/cda:observation[cda:templateId/@root='2.16.840.1.113883.10.20.1.55'
or cda:templateId/@root='2.16.840.1.113883.10.20.22.4.8']/cda:text
Allergy Type
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.2' or
@root='2.16.840.1.113883.10.20.22.2.6']/cda:entry/cda:act[cda:templateId/@root='2.16.840.1.113883.10.20.1.27'
or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.30']/cda:entryRelationship[@typeCode='SUBJ']/cda:observatio
n/cda:participant[@typeCode='CSM']/cda:participantRole[@classCode='MANU']/cda:playingEntity[@classCode='MMAT'
]/cda:name
Comment
//cda:entryRelationship/cda:act[cda:templateId/@root='2.16.840.1.113883.10.20.1.40' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.64']/cda:text
Comment (1 elements)
Encounter (6 elements)
Encounter Location
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.3' or
@root='2.16.840.1.113883.10.20.22.2.22']/cda:entry/cda:encounter[cda:templateId/@root='2.16.840.1.113883.10.2
0.1.21' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.49']/cda:participant[@typeCode='LOC']/cda:participantRole[@
classCode='SDLOC']/cda:addr
Encounter contact
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.3' or
@root='2.16.840.1.113883.10.20.22.2.22']/cda:entry/cda:encounter[cda:templateId/@root='2.16.840.1.113883.10.2
0.1.21' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.49']/cda:participant[@typeCode='LOC']/cda:participantRole[@
classCode='SDLOC']/cda:telecom
Date/Time
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.3' or
@root='2.16.840.1.113883.10.20.22.2.22']/cda:entry/cda:encounter[cda:templateId/@root='2.16.840.1.113883.10.2
0.1.21' or cda:templateId/@root='2.16.840.1.113883.10.20.22.4.49']/cda:effectiveTime/cda:low
Place
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.3' or
@root='2.16.840.1.113883.10.20.22.2.22']/cda:entry/cda:encounter[cda:templateId/@root='2.16.840.1.113883.10.2
0.1.21' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.49']/[cda:participant[@typeCode='LOC']/cda:participantRole[
@classCode='SDLOC']/cda:playingEntity/cda:name or
cda:performer/cda:assignedEntity/cda:representedOrganization/cda:name]
Reason
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.3' or
@root='2.16.840.1.113883.10.20.22.2.22']/cda:entry/cda:encounter[cda:templateId/@root='2.16.840.1.113883.10.2
0.1.21' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.49']/cda:entryRelationship[@typeCode='RSON']/cda:observati
on/cda:value
Type
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.3' or
@root='2.16.840.1.113883.10.20.22.2.22']/cda:entry/cda:encounter[cda:templateId/@root='2.16.840.1.113883.10.2
0.1.21' or cda:templateId/@root='2.16.840.1.113883.10.20.22.4.49']/cda:code
FamilyHistory (7 elements)
Family Member name
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.4' or
@root='2.16.840.1.113883.10.20.22.2.15']/cda:entry/cda:organizer/cda:subject/cda:relatedSubject/cda:subject/cda:
name[@use='L' or @use='C'][1]
Relationship
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.4' or
@root='2.16.840.1.113883.10.20.22.2.15']/cda:entry/cda:organizer/cda:subject/cda:relatedSubject/cda:code
Living or Deceased
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.4' or
@root='2.16.840.1.113883.10.20.22.2.15']/cda:entry/cda:organizer/cda:subject/cda:relatedSubject/cda:subject/sdtc:
deceasedInd/@value='true'
Cause of Death
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.4' or
@root='2.16.840.1.113883.10.20.22.2.15']/cda:entry/cda:organizer/cda:component/cda:observation/cda:subject/cda
:relatedSubject/cda:subject/sdtc:deceasedInd/@value='true'
Cause of Death
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.4' or
@root='2.16.840.1.113883.10.20.22.2.15']/cda:entry/cda:organizer/cda:component/cda:observation/cda:templateId/
@root='2.16.840.1.113883.10.20.1.42'and cda:entryRelationship/@typeCode='CAUS'
Diagnosis date
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.4' or
@root='2.16.840.1.113883.10.20.22.2.15']/cda:entry/cda:organizer/cda:component/cda:observation/cda:effectiveTi
me
Diagnosis age
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.4' or
@root='2.16.840.1.113883.10.20.22.2.15']/cda:entry/cda:organizer/cda:component/cda:observation/cda:entryRelatio
nship/cda:observation[cda:templateId/@root='2.16.840.1.113883.10.20.22.4.31']/cda:value
Provide contact
/cda:ClinicalDocument/cda:documentationOf/cda:serviceEvent/cda:performer[@typeCode='PRF']/cda:assignedEntity/c
da:telecom
Provider Name
/cda:ClinicalDocument/cda:documentationOf/cda:serviceEvent/cda:performer[@typeCode='PRF']/cda:assignedEntity/c
da:assignedPerson/cda:name/cda:assignedEntity/cda:assignedPerson/cda:name
Provider Name
/cda:ClinicalDocument/cda:documentationOf/cda:serviceEvent/cda:performer[@typeCode='PRF']/cda:assignedEntity/c
da:assignedPerson/cda:name
Type of Provider
/cda:ClinicalDocument/cda:documentationOf/cda:serviceEvent/cda:performer[@typeCode='PRF']/cda:functionCode
Healthcare Providers (5 elements)
Other Clinician
Information
/cda:ClinicalDocument/cda:documentationOf/cda:serviceEvent/cda:performer[@typeCode='PRF']/cda:assignedEntity/c
da:code
Immunization
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.6' or
@root='2.16.840.1.113883.10.20.22.2.2']/cda:entry/cda:substanceAdministration[cda:templateId/@root='2.16.840.1
.113883.10.20.1.24' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.52']/cda:consumable/cda:manufacturedProduct/cda:manufact
uredMaterial/cda:code/cda:originalText
Indication
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.6' or
@root='2.16.840.1.113883.10.20.22.2.2']/cda:entry/cda:substanceAdministration[cda:templateId/@root='2.16.840.1
.113883.10.20.1.24' or cda:templateId/@root='2.16.840.1.113883.10.20.22.4.52']/descendant-orself::cda:observation[cda:templateId/@root = '2.16.840.1.113883.10.20.1.28' or cda:templateId/@root =
'2.16.840.1.113883.10.20.22.4.19']/cda:value
Instructions
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.6' or
@root='2.16.840.1.113883.10.20.22.2.2']/cda:entry/cda:substanceAdministration[cda:templateId/@root='2.16.840.1
.113883.10.20.1.24' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.52']/cda:entryRelationship/cda:act[cda:templateId/@root =
'2.16.840.1.113883.10.20.1.49' or cda:templateId/@root = '2.16.840.1.113883.10.20.22.4.20']/cda:text
Refusal Reason
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.6' or
@root='2.16.840.1.113883.10.20.22.2.2']/cda:entry/cda:substanceAdministration[cda:templateId/@root='2.16.840.1
.113883.10.20.1.24' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.52']/cda:entryRelationship/cda:observation[cda:templateId/@r
oot = '2.16.840.1.113883.10.20.22.4.53']/cda:code
Method
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.6' or
@root='2.16.840.1.113883.10.20.22.2.2']/cda:entry/cda:substanceAdministration[cda:templateId/@root='2.16.840.1
.113883.10.20.1.24' or cda:templateId/@root='2.16.840.1.113883.10.20.22.4.52']/cda:routeCode
Immunization (7 elements)
Date Received
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.6' or
@root='2.16.840.1.113883.10.20.22.2.2']/cda:entry/cda:substanceAdministration[cda:templateId/@root='2.16.840.1
.113883.10.20.1.24' or cda:templateId/@root='2.16.840.1.113883.10.20.22.4.52']/cda:effectiveTime
Reactions
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.6' or
@root='2.16.840.1.113883.10.20.22.2.2']/cda:entry/cda:substanceAdministration[cda:templateId/@root='2.16.840.1
.113883.10.20.1.24' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.52']/cda:entryRelationship/cda:observation[cda:templateId/@r
oot = '2.16.840.1.113883.10.20.1.54' or cda:templateId/@root = '2.16.840.1.113883.10.20.22.4.9']/cda:value
Initially Ordered On
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.8' or
@root='2.16.840.1.113883.10.20.22.2.1']/cda:entry/cda:substanceAdministration[cda:templateId/@root='2.16.840.1
.113883.10.20.1.24' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.16']/cda:entryRelationship/cda:supply[cda:templateId/@root
= '2.16.840.1.113883.10.20.1.34'and @moodCode = 'INT']/cda:author/cda:time
Pharmacy Contact
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.8' or
@root='2.16.840.1.113883.10.20.22.2.1']/cda:entry/cda:substanceAdministration[cda:templateId/@root='2.16.840.1
.113883.10.20.1.24' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.16']/cda:entryRelationship/cda:supply[(cda:templateId/@root
= '2.16.840.1.113883.10.20.1.34' or cda:templateId/@root = '2.16.840.1.113883.10.20.22.4.18') and @moodCode =
'EVN']/cda:performer/cda:assignedEntity/cda:telecom/cda:author/cda:time
Status
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.8' or
@root='2.16.840.1.113883.10.20.22.2.1']/cda:entry/cda:substanceAdministration[cda:templateId/@root='2.16.840.1
.113883.10.20.1.24' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.16']/cda:entryRelationship/cda:observation[cda:templateId/@r
oot = '2.16.840.1.113883.10.20.1.47']/cda:value
Status
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.8' or
@root='2.16.840.1.113883.10.20.22.2.1']/cda:entry/cda:substanceAdministration[cda:templateId/@root='2.16.840.1
Medication (19 elements)
.113883.10.20.1.24' or cda:templateId/@root='2.16.840.1.113883.10.20.22.4.16']/cda:statusCode/@code
Category
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.8' or
@root='2.16.840.1.113883.10.20.22.2.1']/cda:entry/cda:substanceAdministration[cda:templateId/@root='2.16.840.1
.113883.10.20.1.24' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.16']/cda:entryRelationship[@typeCode='SUBJ']/cda:observatio
n[cda:templateId/@root='2.16.840.1.113883.3.88.11.83.8.1']/cda:value
Drug Name
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.8' or
@root='2.16.840.1.113883.10.20.22.2.1']/cda:entry/cda:substanceAdministration[cda:templateId/@root='2.16.840.1
.113883.10.20.1.24' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.16']/cda:consumable/cda:manufacturedProduct/cda:manufact
uredMaterial/cda:code/cda:originalText
Dose
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.8' or
@root='2.16.840.1.113883.10.20.22.2.1']/cda:entry/cda:substanceAdministration[cda:templateId/@root='2.16.840.1
.113883.10.20.1.24' or cda:templateId/@root='2.16.840.1.113883.10.20.22.4.16']/cda:doseQuantity/@value
Rate
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.8' or
@root='2.16.840.1.113883.10.20.22.2.1']/cda:entry/cda:substanceAdministration[cda:templateId/@root='2.16.840.1
.113883.10.20.1.24' or cda:templateId/@root='2.16.840.1.113883.10.20.22.4.16']/cda:rateQuantity/@value
When
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.8' or
@root='2.16.840.1.113883.10.20.22.2.1']/cda:entry/cda:substanceAdministration[cda:templateId/@root='2.16.840.1
.113883.10.20.1.24' or cda:templateId/@root='2.16.840.1.113883.10.20.22.4.16']/cda:effectiveTime[@xsi:type =
'EIVL_TS' or @xsi:type = 'EIVL']
Interval
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.8' or
@root='2.16.840.1.113883.10.20.22.2.1']/cda:entry/cda:substanceAdministration[cda:templateId/@root='2.16.840.1
.113883.10.20.1.24' or cda:templateId/@root='2.16.840.1.113883.10.20.22.4.16']/cda:effectiveTime[@xsi:type =
'PIVL_TS' and @institutionSpecified='true']
Frequency
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.8' or
@root='2.16.840.1.113883.10.20.22.2.1']/cda:entry/cda:substanceAdministration[cda:templateId/@root='2.16.840.1
.113883.10.20.1.24' or cda:templateId/@root='2.16.840.1.113883.10.20.22.4.16']/cda:effectiveTime[@xsi:type =
'PIVL_TS']
Instructions
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.8' or
@root='2.16.840.1.113883.10.20.22.2.1']/cda:entry/cda:substanceAdministration[cda:templateId/@root='2.16.840.1
.113883.10.20.1.24' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.16']/cda:entryRelationship/cda:act[cda:templateId/@root='2.1
6.840.1.113883.10.20.1.49' or cda:templateId/@root='2.16.840.1.113883.10.20.22.4.20']/cda:text
Supply
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.8' or
@root='2.16.840.1.113883.10.20.22.2.1']/cda:entry/cda:substanceAdministration[cda:templateId/@root='2.16.840.1
.113883.10.20.1.24' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.16']/cda:entryRelationship[@typeCode='REFR']/cda:supply[@
moodCode='INT' or @moodCode='EVN']/cda:expectedUseTime
Refills Remaining
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.8' or
@root='2.16.840.1.113883.10.20.22.2.1']/cda:entry/cda:substanceAdministration[cda:templateId/@root='2.16.840.1
.113883.10.20.1.24' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.16']/cda:entryRelationship[@typeCode='REFR']/cda:supply[@
moodCode='INT' or @moodCode='EVN']/cda:repeatNumber/@value
Start Date
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.8' or
@root='2.16.840.1.113883.10.20.22.2.1']/cda:entry/cda:substanceAdministration[cda:templateId/@root='2.16.840.1
.113883.10.20.1.24' or cda:templateId/@root='2.16.840.1.113883.10.20.22.4.16']/cda:effectiveTime[1]/cda:low
Stop Date
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.8' or
@root='2.16.840.1.113883.10.20.22.2.1']/cda:entry/cda:substanceAdministration[cda:templateId/@root='2.16.840.1
.113883.10.20.1.24' or cda:templateId/@root='2.16.840.1.113883.10.20.22.4.16']/cda:effectiveTime[1]/cda:high
Last Filled On
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.8' or
@root='2.16.840.1.113883.10.20.22.2.1']/cda:entry/cda:substanceAdministration[cda:templateId/@root='2.16.840.1
.113883.10.20.1.24' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.16']/cda:entryRelationship/cda:supply[(cda:templateId/@root
= '2.16.840.1.113883.10.20.1.34' or cda:templateId/@root = '2.16.840.1.113883.10.20.22.4.18') and @moodCode =
'EVN']/cda:effectiveTime
Pharmacy Name
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.8' or
@root='2.16.840.1.113883.10.20.22.2.1']/cda:entry/cda:substanceAdministration[cda:templateId/@root='2.16.840.1
.113883.10.20.1.24' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.16']/cda:entryRelationship/cda:supply[(cda:templateId/@root
= '2.16.840.1.113883.10.20.1.34' or cda:templateId/@root = '2.16.840.1.113883.10.20.22.4.18') and @moodCode =
'EVN']/cda:performer/cda:assignedEntity/cda:representedOrganization/cda:name
Reason for taking
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.8' or
@root='2.16.840.1.113883.10.20.22.2.1']/cda:entry/cda:substanceAdministration[cda:templateId/@root='2.16.840.1
.113883.10.20.1.24' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.16']/cda:entryRelationship[@typeCode='RSON']/cda:observati
on[cda:templateId/@root='2.16.840.1.113883.10.20.1.28' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.19']/cda:text
Name
/cda:ClinicalDocument/cda:recordTarget/cda:patientRole/cda:patient/cda:name[@use='L' or @use='C' or stringlength(@use)=0][1]
Date of Birth
/cda:ClinicalDocument/cda:recordTarget/cda:patientRole/cda:patient/cda:birthTime
Patient Name
/cda:ClinicalDocument/cda:recordTarget/cda:patientRole/cda:patient/cda:name[@use='L' or @use='C'][1]
Patient Address
/cda:ClinicalDocument/cda:recordTarget/cda:patientRole/cda:addr
Patient Contact Info
/cda:ClinicalDocument/cda:recordTarget/cda:patientRole/cda:telecom
PatientDemographics (17 elements)
Emergency Contact
Name
/cda:ClinicalDocument/cda:participant[cda:associatedEntity/@classCode='ECON']/cda:associatedEntity/cda:associated
Person/cda:name
Emergency Contact
Contact Info
/cda:ClinicalDocument/cda:participant[cda:associatedEntity/@classCode='ECON']/cda:associatedEntity/cda:telecom
Emergency Contact
Address
/cda:ClinicalDocument/cda:participant[cda:associatedEntity/@classCode='ECON']/cda:associatedEntity/cda:addr
Gender
/cda:ClinicalDocument/cda:recordTarget/cda:patientRole/cda:patient/cda:administrativeGenderCode
Gender
/cda:ClinicalDocument/cda:recordTarget/cda:patientRole/cda:patient/cda:administrativeGenderCode
Blood Type
/cda:ClinicalDocument///cda:observation[cda:code/@code =
document(CCDToBlueButtonTxt_ConceptValueSet.xml)/svs:ValueSets/svs:ValueSet[@id='BloodType']//svs:Concept/@
code][1]
Organ Donor
/cda:ClinicalDocument///cda:observation[(cda:templateId/@root = '2.16.840.1.113883.10.20.1.17' or
cda:templateId/@root = '2.16.840.1.113883.10.20.22.4.48') and cda:code/@code =
document(CCDToBlueButtonTxt_ConceptValueSet.xml)/svs:ValueSets/svs:ValueSet[@id='OrganDonor']//svs:Concept/
@code][1]
Birth Date
/cda:ClinicalDocument/cda:recordTarget/cda:patientRole/cda:patient/cda:birthTime
Marital Status
/cda:ClinicalDocument/cda:recordTarget/cda:patientRole/cda:patient/cda:maritalStatusCode
Current Occupation
/cda:ClinicalDocument///cda:observation[(cda:templateId/@root = '2.16.840.1.113883.10.20.1.33' or
cda:templateId/@root = '2.16.840.1.113883.10.20.22.4.38') and cda:code/@code =
document(CCDToBlueButtonTxt_ConceptValueSet.xml)/svs:ValueSets/svs:ValueSet[@id='Occupation']//svs:Concept/
@code][1]
Emergency Contact
Relationship
/cda:ClinicalDocument/cda:participant[cda:associatedEntity/@classCode='ECON']/cda:associatedEntity/cda:code
Emergency Contact
/cda:ClinicalDocument/cda:participant[cda:associatedEntity/@classCode='ECON']/cda:time
Relationship Dates
PaymentSource (9 elements)
Health Insurance
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[cda:templateId/@root='2.16.
840.1.113883.10.20.1.9' or
cda:templateId/@root='2.16.840.1.113883.10.20.1.9']/cda:entry/cda:act[cda:templateId/@root='2.16.840.1.113883.
10.20.1.20' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.60']/cda:entryRelationship[@typeCode='COMP']/cda:act[@clas
sCode='ACT']/cda:performer/cda:assignedEntity/cda:telecom
Health Insurance
Company
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[cda:templateId/@root='2.16.
840.1.113883.10.20.1.9' or
cda:templateId/@root='2.16.840.1.113883.10.20.1.9']/cda:entry/cda:act[cda:templateId/@root='2.16.840.1.113883.
10.20.1.20' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.60']/cda:entryRelationship[@typeCode='COMP']/cda:act[@clas
sCode='ACT']/cda:performer/cda:assignedEntity/cda:representedOrganization/cda:name
Primary Insurance
Provider
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[cda:templateId/@root='2.16.
840.1.113883.10.20.1.9' or
cda:templateId/@root='2.16.840.1.113883.10.20.1.9']/cda:entry/cda:act[cda:templateId/@root='2.16.840.1.113883.
10.20.1.20' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.60']/cda:entryRelationship[@typeCode='COMP']/cda:sequence
Number/@value
Member ID
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[cda:templateId/@root='2.16.
840.1.113883.10.20.1.9' or
cda:templateId/@root='2.16.840.1.113883.10.20.1.9']/cda:entry/cda:act[cda:templateId/@root='2.16.840.1.113883.
10.20.1.20' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.60']/cda:entryRelationship[@typeCode='COMP']/cda:act[@clas
sCode='ACT']/cda:participant[@typeCode='COV']/cda:participantRole[@classCode='PAT']/cda:id/@extension
Group Number
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[cda:templateId/@root='2.16.
840.1.113883.10.20.1.9' or
cda:templateId/@root='2.16.840.1.113883.10.20.1.9']/cda:entry/cda:act[cda:templateId/@root='2.16.840.1.113883.
10.20.1.20' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.60']/cda:entryRelationship[@typeCode='COMP']/cda:act[@clas
sCode='ACT']/cda:id/@extension
Insured
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[cda:templateId/@root='2.16.
840.1.113883.10.20.1.9' or
cda:templateId/@root='2.16.840.1.113883.10.20.1.9']/cda:entry/cda:act[cda:templateId/@root='2.16.840.1.113883.
10.20.1.20' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.60']/cda:entryRelationship[@typeCode='COMP']/cda:act[@clas
sCode='ACT']/cda:participant[@typeCode='HLD']/cda:participantRole/cda:playingEntity/cda:name
Subscriber ID
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[cda:templateId/@root='2.16.
840.1.113883.10.20.1.9' or
cda:templateId/@root='2.16.840.1.113883.10.20.1.9']/cda:entry/cda:act[cda:templateId/@root='2.16.840.1.113883.
10.20.1.20' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.60']/cda:entryRelationship[@typeCode='COMP']/cda:act[@clas
sCode='ACT']/cda:participant[@typeCode='HLD']/cda:participantRole/cda:id/@extension
Start Date
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[cda:templateId/@root='2.16.
840.1.113883.10.20.1.9' or
cda:templateId/@root='2.16.840.1.113883.10.20.1.9']/cda:entry/cda:act[cda:templateId/@root='2.16.840.1.113883.
10.20.1.20' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.60']/cda:entryRelationship[@typeCode='COMP']/cda:act[@clas
sCode='ACT']/cda:participant[@typeCode='COV']/cda:time/cda:low
Stop Date
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[cda:templateId/@root='2.16.
840.1.113883.10.20.1.9' or
cda:templateId/@root='2.16.840.1.113883.10.20.1.9']/cda:entry/cda:act[cda:templateId/@root='2.16.840.1.113883.
10.20.1.20' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.60']/cda:entryRelationship[@typeCode='COMP']/cda:act[@clas
sCode='ACT']/cda:participant[@typeCode='COV']/cda:time/cda:high
PlanOfCare (3 elements)
Activity
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[cda:templateId/@root='2.16.
840.1.113883.10.20.1.12' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.2.7']]/cda:entry[cda:templateId/@root='2.16.840.1.113883.10.
20.1.25' or cda:templateId/@root='2.16.840.1.113883.10.20.22.4.39' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.40' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.44' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.41' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.42' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.43']/cda:code
Status
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[cda:templateId/@root='2.16.
840.1.113883.10.20.1.12' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.2.7']]/cda:entry[cda:templateId/@root='2.16.840.1.113883.10.
20.1.25' or cda:templateId/@root='2.16.840.1.113883.10.20.22.4.39' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.40' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.44' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.41' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.42' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.43']/cda:statusCode
Due Date
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[cda:templateId/@root='2.16.
840.1.113883.10.20.1.12' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.2.7']]/cda:entry[cda:templateId/@root='2.16.840.1.113883.10.
20.1.25' or cda:templateId/@root='2.16.840.1.113883.10.20.22.4.39' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.40' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.44' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.41' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.42' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.43']/cda:effectiveTime
Problem (5 elements)
Treating Provider
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[templateId/@root='2.16.840.
1.113883.10.20.1.11' or
templateId/@root='2.16.840.1.113883.10.20.22.2.5']/cda:entry/cda:act[cda:templateId/@root='2.16.840.1.113883.
10.20.1.27' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.3']/cda:entryRelationship[@typeCode='SUBJ']/cda:observation
[cda:templateId/@root='2.16.840.1.113883.10.20.1.28' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.4']/../cda:performer/cda:assignedEntity/cda:telecom
Problem Name
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[templateId/@root='2.16.840.
1.113883.10.20.1.11' or
templateId/@root='2.16.840.1.113883.10.20.22.2.5']/cda:entry/cda:act[cda:templateId/@root='2.16.840.1.113883.
10.20.1.27' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.3']/cda:entryRelationship[@typeCode='SUBJ']/cda:observation
[cda:templateId/@root='2.16.840.1.113883.10.20.1.28' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.4']/[cda:value or cda:text]
Problem Type
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[templateId/@root='2.16.840.
1.113883.10.20.1.11' or
templateId/@root='2.16.840.1.113883.10.20.22.2.5']/cda:entry/cda:act[cda:templateId/@root='2.16.840.1.113883.
10.20.1.27' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.3']/cda:entryRelationship[@typeCode='SUBJ']/cda:observation
[cda:templateId/@root='2.16.840.1.113883.10.20.1.28' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.4']/cda:code
Status
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[templateId/@root='2.16.840.
1.113883.10.20.1.11' or
templateId/@root='2.16.840.1.113883.10.20.22.2.5']/cda:entry/cda:act[cda:templateId/@root='2.16.840.1.113883.
10.20.1.27' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.3']/cda:entryRelationship[@typeCode='SUBJ']/cda:observation
[cda:templateId/@root='2.16.840.1.113883.10.20.1.28' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.4']/cda:entryRelationship/cda:observation[cda:templateId/@ro
ot='2.16.840.1.113883.10.20.1.50' or cda:templateId/@root='2.16.840.1.113883.10.20.22.4.6']/cda:value
Date Diagnosed
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[templateId/@root='2.16.840.
1.113883.10.20.1.11' or
templateId/@root='2.16.840.1.113883.10.20.22.2.5']/cda:entry/cda:act[cda:templateId/@root='2.16.840.1.113883.
10.20.1.27' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.3']/cda:entryRelationship[@typeCode='SUBJ']/cda:observation
[cda:templateId/@root='2.16.840.1.113883.10.20.1.28' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.4']/cda:effectiveTime
Procedure (5 elements)
Medical Event
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[cda:templateId/@root='2.16.
840.1.113883.10.20.1.12' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.2.7']]/cda:entry[cda:templateId/@root='2.16.840.1.113883.10.
20.1.29' or cda:templateId/@root='2.16.840.1.113883.10.20.22.4.14' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.13' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.12']/cda:code
Status
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[cda:templateId/@root='2.16.
840.1.113883.10.20.1.12' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.2.7']]/cda:entry[cda:templateId/@root='2.16.840.1.113883.10.
20.1.29' or cda:templateId/@root='2.16.840.1.113883.10.20.22.4.14' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.13' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.12']/cda:statusCode
Date(s)
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[cda:templateId/@root='2.16.
840.1.113883.10.20.1.12' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.2.7']]/cda:entry[cda:templateId/@root='2.16.840.1.113883.10.
20.1.29' or cda:templateId/@root='2.16.840.1.113883.10.20.22.4.14' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.13' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.12']/cda:effectiveTime
Site
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[cda:templateId/@root='2.16.
840.1.113883.10.20.1.12' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.2.7']]/cda:entry[cda:templateId/@root='2.16.840.1.113883.10.
20.1.29' or cda:templateId/@root='2.16.840.1.113883.10.20.22.4.14' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.13' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.12']/cda:targetSiteCode
Provider
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[cda:templateId/@root='2.16.
840.1.113883.10.20.1.12' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.2.7']]/cda:entry[cda:templateId/@root='2.16.840.1.113883.10.
20.1.29' or cda:templateId/@root='2.16.840.1.113883.10.20.22.4.14' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.13' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.12']/cda:performer/cda:assignedEntity/cda:assignedPerson/cd
a:name
Result (12 elements)
Performing Location
Address
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.11' or
@root='2.16.840.1.113883.10.20.22.2.5']/cda:entry/cda:organizer/cda:component/cda:observation/cda:author/cda:a
ssignedAuthor/cda:addr
Result test comment
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.11' or
@root='2.16.840.1.113883.10.20.22.2.5']/cda:entry/cda:organizer/cda:component/cda:observation/descendant-orself::cda:entryRelationship/cda:act[cda:templateId/@root='2.16.840.1.113883.10.20.1.40' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.64']
Lab Test
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.11' or @root='2.16.840.1.113883.10.20.22.2.5']/cda:entry/cda:organizer/cda:code
Specimen
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.11' or
@root='2.16.840.1.113883.10.20.22.2.5']/cda:entry/cda:organizer/cda:specimen/cda:specimenRole/cda:specimenPla
yingEntity/cda:code
Date/Time Collected
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.11' or @root='2.16.840.1.113883.10.20.22.2.5']/cda:entry/cda:organizer/cda:effectiveTime
Test Name
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.11' or
@root='2.16.840.1.113883.10.20.22.2.5']/cda:entry/cda:organizer/cda:component/cda:observation/cda:code
Result
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.11' or
@root='2.16.840.1.113883.10.20.22.2.5']/cda:entry/cda:organizer/cda:component/cda:observation/cda:value/@valu
e
Units
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.11' or
@root='2.16.840.1.113883.10.20.22.2.5']/cda:entry/cda:organizer/cda:component/cda:observation/cda:value/@units
Reference Range
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.11' or
@root='2.16.840.1.113883.10.20.22.2.5']/cda:entry/cda:organizer/cda:component/cda:observation/cda:referenceRan
ge/cda:observationRange
Interpretation
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.11' or
@root='2.16.840.1.113883.10.20.22.2.5']/cda:entry/cda:organizer/cda:component/cda:observation/cda:interpretatio
nCode
Performing Location
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.11' or
@root='2.16.840.1.113883.10.20.22.2.5']/cda:entry/cda:organizer/cda:component/cda:observation/cda:author/cda:a
ssignedAuthor/cda:representedOrganization/cda:name
Status
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.11' or
@root='2.16.840.1.113883.10.20.22.2.5']/cda:entry/cda:organizer/cda:component/cda:observation/cda:statusCode/
@code
Observation Title
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.15' or @root='2.16.840.1.113883.10.20.22.2.17']/cda:entry/cda:observation/cda:code
Dates
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.15' or @root='2.16.840.1.113883.10.20.22.2.17']/cda:entry/cda:observation/cda:effectiveTime
Value
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.15' or @root='2.16.840.1.113883.10.20.22.2.17']/cda:entry/cda:observation/cda:value
Estimated Date of
Delivery
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.15' or
@root='2.16.840.1.113883.10.20.22.2.17']/cda:entry/cda:observation/cda:entryRelationship/cda:observation[cda:te
mplateId/@root='2.16.840.1.113883.10.20.15.3.1']/cda:value
Treatment facility
contact
/cda:ClinicalDocument/cda:documentationOf/cda:serviceEvent/cda:performer/cda:assignedEntity/cda:representedOrg
anization[generate-id() = generate-id(key('organizationIds', cda:id/@extension)[1])]/cda:assignedEntity/cda:telecom
SocialHistory (4 elements)
TreatmentFacilities (3 elements)
Facility Name
/cda:ClinicalDocument/cda:documentationOf/cda:serviceEvent/cda:performer/cda:assignedEntity/cda:representedOrg
anization[generate-id() = generate-id(key('organizationIds', cda:id/@extension)[1])]/cda:name
Facility Type
/cda:ClinicalDocument/cda:documentationOf/cda:serviceEvent/cda:performer/cda:assignedEntity/cda:representedOrg
anization[generate-id() = generate-id(key('organizationIds', cda:id/@extension)[1])]/cda:standardIndustryClassCode
Vital (12 elements)
Blood Pressure
comments
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.16' or
@root='2.16.840.1.113883.10.20.22.2.4']/cda:entry/cda:organizer/cda:component/cda:observation[cda:code/@code
=
document(CCDToBlueButtonTxt_ConceptValueSet.xml)/svs:ValueSets/svs:ValueSet[@id='BloodPressureSystolic']//svs
:Concept/@code][1]/cda:entryRelationship/cda:act[cda:templateId/@root='2.16.840.1.113883.10.20.1.40' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.64']
Blood Pressure
comments
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.16' or
@root='2.16.840.1.113883.10.20.22.2.4']/cda:entry/cda:organizer/cda:component/cda:observation[cda:code/@code
=
document(CCDToBlueButtonTxt_ConceptValueSet.xml)/svs:ValueSets/svs:ValueSet[@id='BloodPressureDiastolic']//sv
s:Concept/@code][1]/cda:entryRelationship/cda:act[cda:templateId/@root='2.16.840.1.113883.10.20.1.40' or
cda:templateId/@root='2.16.840.1.113883.10.20.22.4.64']
Measurement Type:
Blood Pressure
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.16' or
@root='2.16.840.1.113883.10.20.22.2.4']/cda:entry/cda:organizer/cda:component/cda:observation[cda:code/@code
=
document(CCDToBlueButtonTxt_ConceptValueSet.xml)/svs:ValueSets/svs:ValueSet[@id='BloodPressureSystolic']//svs
:Concept/@code][1])&gt;0 and count(cda:component/cda:observation[cda:code/@code =
document(CCDToBlueButtonTxt_ConceptValueSet.xml)/svs:ValueSets/svs:ValueSet[@id='BloodPressureDiastolic']//sv
s:Concept/@code][1]
Measurement Type:
Blood Pressure
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.16' or
@root='2.16.840.1.113883.10.20.22.2.4']/cda:entry/cda:organizer/cda:component/cda:observation[cda:code/@code
=
document(CCDToBlueButtonTxt_ConceptValueSet.xml)/svs:ValueSets/svs:ValueSet[@id='BloodPressureSystolic']//svs
:Concept/@code][1])&gt;0 and count(cda:component/cda:observation[cda:code/@code =
document(CCDToBlueButtonTxt_ConceptValueSet.xml)/svs:ValueSets/svs:ValueSet[@id='BloodPressureDiastolic']//sv
s:Concept/@code][1]
Time
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.16' or @root='2.16.840.1.113883.10.20.22.2.4']/cda:entry/cda:organizer/cda:effectiveTime
Blood Pressure
Systolic
/cda:ClinicalDocument/cda:component/cda:structuredBody/cda:component/cda:section[@root='2.16.840.1.113883.10
.20.1.16' or
@root='2.16.840.1.113883.10.20.22.2.4']/cda:entry/cda:organizer/cda:component/cda:observation[cda:code/@code
=
document(CCDToBlueButtonTxt_ConceptValueSet.xml)/svs:ValueSets/svs:ValueSet[@id='BloodPressureSystolic']//svs
:Concept/@code][1]/cda:value/@value
Blood Pressure
Diastolic
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Measurement Type
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Date
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Time
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Measurement Type
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Method
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