CDA Module Mappings for ImportExperimental
All of the mappings for CDA Import are based on the Consolidated CDA Templates for Clinical Notes Release 2.1.
- "Continuity of Care Document" (template id 2.16.840.1.113883.10.20.22.1.2)
- "Discharge Summary" (template id 2.16.840.1.113883.10.20.22.1.8)
Resources derived from the headerExperimental
- recordTarget:
Patient
- author:
Practitioner
- custodian:
Organization
- legalAuthenticator:
Practitioner
- authenticator:
Practitioner
- documentationOf:
Composition.event
There is currently no support for the following optional header tags:
- dataEnterer
- informant
- informationRecipient
- participant
- inFulfillmentOf
- authorization
- componentOf
Admission Diagnosis SectionExperimental
Supported CDA Entries:
- Hospital Admission Diagnosis
- The section is expected to contain a single Hospital Admission Diagnosis entry, which contains one or more nested Problem Observation entries.
- Each Problem Observation entry will be converted to a
Condition
resource.
Admission Medication SectionExperimental
Supported CDA Entries:
- Admission Medication
- Each Medication Activity entry within a Admission Medication will be converted to a
MedicationStatement
resource.
Allergy and Intolerances SectionExperimental
Supported CDA Entries:
- Allergy Concern Act
- Each Allergy Concern Act entry will be converted to an
AllergyIntolerance
resource.
Supported CDA Entries:
The Care Plan section as a whole will be converted to a CarePlan
resource.
Supported CDA Entries:
The Care Team section as a whole will be converted to a CareTeam
resource.
- Care Team Performer Act
- Each Care Team Performer Act entry will be converted to a
Practitioner
resource and added to the CareTeam
as a participant
.
Discharge Diagnosis SectionExperimental
Supported CDA Entries:
- Hospital Discharge Diagnosis
- The section is expected to contain a single Hospital Discharge Diagnosis entry, which contains one or more nested Problem Observation entries.
- Each Problem Observation entry will be converted to a
Condition
resource.
Discharge Medication SectionExperimental
Supported CDA Entries:
- Discharge Medication
- Each Medication Activity entry within a Discharge Medication will be converted to a
MedicationStatement
resource.
Supported CDA Entries:
- Encounter Activity
- Each Encounter Activity entry will be converted to an
Encounter
resource.
Supported CDA Entries:
- Family History Observation
- Each Family History Observation entry will be converted to a
FamilyMemberHistory
resource.
Functional Status SectionExperimental
Supported CDA Entries:
- Functional Status Observation
- Each Functional Status Observation entry will be converted to an
Observation
resource.
Supported CDA Entries:
- Goal Observation
- Each Goal Observation entry will be converted to a
Goal
resource.
Supported CDA Entries:
- Health Status Observation
- Each Health Status Observation entry will be converted to an
Observation
resource.
- Health Concern Act
- Each Health Concern Act entry will be converted to a
Condition
resource.
Supported CDA Entries:
- Immunization Activity
- Each Immunization Activity entry will be converted to an
Immunization
resource.
Medical Equipment SectionExperimental
Supported CDA Entries:
- Procedure Activity Procedure
- Each Procedure Activity Procedure entry will be converted to a
Procedure
resource.
Supported CDA Entries:
- Medication Activity
- Each Medication Activity entry with
moodCode="EVN"
will be converted to a MedicationStatement
resource. Each Medication Activity entry with moodCode="INT"
will be converted to a MedicationRequest
resource. Entries with other values of the moodCode
attribute are not supported.
Medications Administered SectionExperimental
Supported CDA Entries:
- Medication Activity
- Each Medication Activity entry will be converted to a
MedicationStatement
resource.
Supported CDA Entries:
- Mental Status Organizer
- Each of the Mental Status Observation entries contained in the Mental Status Organizer will be converted to an
Observation
resource.
- Assessment Scale Observation
- Each Assessment Scale Observation entry will be converted to an
Observation
resource.
- Assessment Scale Supporting Observation
- Each Assessment Scale Supporting Observation contained in the Assessment Scale Observation will be converted into an
Observation
resource and referenced in the Assessment Scale Observation Observation.hasMember
property.
Past Medical History SectionExperimental
Supported CDA Entries:
- Past Medical History
- The section is expected to contain one or more nested Problem Observation entries.
- Each Problem Observation entry will be converted to a
Condition
resource.
Supported CDA Entries:
- Coverage Activity
- Each Policy Activity contained within a Coverage Activity entry will be converted to a
Coverage
resource.
- A General Status narrative-only section will be created within the
Composition
resource
History of Present Illness SectionExperimental
- A History of Present Illness narrative-only section will be created within the
Composition
resource
Review of Systems SectionExperimental
- A Review of Systems narrative-only section will be created within the
Composition
resource
Plan of Treatment SectionExperimental
Supported CDA Entries:
- Planned Observation
- Each Planned Observation entry will be converted to a
ServiceRequest
resource.
- Planned Encounter
- Each Encounter Observation entry will be converted to a
Encounter
resource.
- Planned Act
- Each Act Observation entry will be converted to a
ServiceRequest
resource.
- Planned Procedure
- Each Planned Procedure entry will be converted to a
ServiceRequest
resource.
- Planned Medication
- Each Planned Medication entry will be converted to a
MedicationRequest
resource.
- Planned Immunization
- Each Planned Immunization entry will be converted to a
MedicationRequest
resource.
Supported CDA Entries:
- Problem Concern Act
- Each Problem Concern Act entry will be converted to a
Condition
resource.
- Health Status Observation
- The Health Status Observation entry is not supported.
Supported CDA Entries:
- Procedure Activity Procedure
- Each Procedure Activity Procedure entry will be converted to a
Procedure
resource.
Supported CDA Entries:
- Result Organizer
- Each Result Organizer entry will be converted to a
DiagnosticReport
resource.
- Any Result Observation entry within the Result Organizer will be converted to an
Observation
resource and added to the result
list of the DiagnosticReport
.
Supported CDA Entries:
- Pregnancy Observation
- Caregiver Characteristics
- Characteristics of Home Environment
- Cultural and Religious Observation
- Smoking Status - Meaningful Use
- Tobacco Use
- Social History Observation
- Each entry in the section will be converted to an
Observation
resource.
Supported CDA Entries:
- Vital Signs Organizer
- Each Vital Sign Organizer entry in the section will be converted to a nested section within the
Composition.section
.
- Each Vital Sign Observation entry within a Vital Signs Organizer will be converted to an
Observation
resource within the corresponding nested section.
Supported CDA Entries:
- Note Act
- Each Note Act will be converted to a
DocumentReference
resource
- Currently only supports note sections with the LOINC code
34109-9
, but individual Note Acts can have more specific codes.
Admission Medications SectionExperimental
Supported CDA Entries:
- Admission Medication
- The section is expected to contain a single Admission Medication entry, which contains one or more nested Medication Activity entries.
- Each Medication Activity entry will be converted to a
MedicationStatement
resource.
Discharge Medications SectionExperimental
Supported CDA Entries:
- Discharge Medication
- The section is expected to contain a single Discharge Medication entry, which contains one or more nested Medication Activity entries.
- Each Medication Activity entry will be converted to a
MedicationStatement
resource.