description: This template represents a risk concern. \n\nIt is a wrapper for a single risk concern which may be derived from a variety of sources within an EHR (such as Problem List, Family History, Social History, Social Worker Note, etc.). \n\nA Risk Concern Act represents a health concern that is a risk. A risk is a clinical or socioeconomic condition that the patient does not currently have, but the probability of developing that condition rises to the level of concern such that an intervention and/or monitoring is needed.
package_name: hl7.cda.us.ccda
derivation: constraint
name: RiskConcernAct
type: http://hl7.org/cda/stds/core/StructureDefinition/Act
elements:
  entryRelationship:
    short: Where a Health Concern needs to reference another entry already described in the CDA document instance, rather than repeating the full content of the entry, the Entry Reference template may be used to reference this entry.
    index: 16
    slicing:
      rules: open
      discriminator:
      - {path: observation, type: profile}
      - {path: act, type: profile}
      - {path: organizer, type: profile}
      min: null
      slices:
        caregiverCharacteristics:
          match: {}
          schema:
            array: true
            index: 95
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 96
              observation: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Observation', index: 97}
            required: [observation]
        tobaccoUse:
          match: {}
          schema:
            array: true
            index: 83
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 84
              observation: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Observation', index: 85}
            required: [observation]
        priorityPreference2:
          match: {}
          schema:
            short: The following entryRelationship represents the priority that the provider puts on the health concern.
            array: true
            index: 113
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 114
              observation: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Observation', index: 115}
            required: [observation]
        functionalStatusObservation:
          match: {}
          schema:
            array: true
            index: 50
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 51
              observation: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Observation', index: 52}
            required: [observation]
        assessmentScaleObservation:
          match: {}
          schema:
            array: true
            index: 29
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 30
              observation: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Observation', index: 31}
            required: [observation]
        priorityPreference1:
          match: {}
          schema:
            short: The following entryRelationship represents the priority that the patient puts on the health concern.
            array: true
            index: 110
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 111
              observation: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Observation', index: 112}
            required: [observation]
        problemObservation2:
          match: {}
          schema:
            short: The following entryRelationship represents the relationship Health Concern HAS SUPPORT Observation.
            array: true
            index: 92
            elements:
              typeCode:
                pattern: {type: Code, value: SPRT}
                index: 93
              observation: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Observation', index: 94}
            required: [observation]
        problemConcernAct:
          match: {}
          schema:
            array: true
            index: 116
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 117
              act: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Act', index: 118}
            required: [act]
        nutritionalStatusObservation:
          match: {}
          schema:
            array: true
            index: 104
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 105
              observation: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Observation', index: 106}
            required: [observation]
        culturalandReligiousObservation:
          match: {}
          schema:
            array: true
            index: 98
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 99
              observation: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Observation', index: 100}
            required: [observation]
        entryReferenceComp:
          match: {}
          schema:
            short: The following entryRelationship represents the relationship between two Health Concern Acts where the target is a component of the source (Health Concern HAS COMPONENT Health Concern). The Enry Reference template is used here because the target Health Concern Act will be defined elsewhere in the Health Concerns Section and thus a reference to that template is all that is required.
            array: true
            index: 26
            elements:
              typeCode:
                pattern: {type: Code, value: COMP}
                index: 27
              act: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Act', index: 28}
            required: [act]
        self-CareActivitiesADLandIADL:
          match: {}
          schema:
            array: true
            index: 35
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 36
              observation: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Observation', index: 37}
            required: [observation]
        nutritionAssessment:
          match: {}
          schema:
            array: true
            index: 56
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 57
              observation: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Observation', index: 58}
            required: [observation]
        entryReferenceRefr:
          match: {}
          schema:
            short: The following entryRelationship represents the relationship between two Health Concern Acts where there is a general relationship between the source and the target (Health Concern RELATES TO Health Concern). The Entry Reference template is used here because the target Health Concern Act will be defined elsewhere in the Health Concerns Section and thus a reference to that template is all that is required.
            array: true
            index: 23
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 24
              act: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Act', index: 25}
            required: [act]
        mentalStatusObservation1:
          match: {}
          schema:
            array: true
            index: 32
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 33
              observation: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Observation', index: 34}
            required: [observation]
        entryRelationship11:
          match: {}
          schema:
            array: true
            index: 47
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 48
              organizer: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Organizer', index: 49}
            required: [organizer]
        problemObservation1:
          match: {}
          schema:
            array: true
            index: 17
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 18
              observation: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Observation', index: 19}
            required: [observation]
        hospitalAdmissionDiagnosis:
          match: {}
          schema:
            array: true
            index: 53
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 54
              act: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Act', index: 55}
            required: [act]
        socialHistoryObservation:
          match: {}
          schema:
            array: true
            index: 77
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 78
              observation: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Observation', index: 79}
            required: [observation]
        preoperativeDiagnosis:
          match: {}
          schema:
            array: true
            index: 65
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 66
              act: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Act', index: 67}
            required: [act]
        resultOrganizer:
          match: {}
          schema:
            array: true
            index: 107
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 108
              organizer: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Organizer', index: 109}
            required: [organizer]
        reactionObservation:
          match: {}
          schema:
            array: true
            index: 68
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 69
              observation: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Observation', index: 70}
            required: [observation]
        allergy-IntoleranceObservation:
          match: {}
          schema:
            array: true
            index: 20
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 21
              observation: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Observation', index: 22}
            required: [observation]
        characteristicsofHomeEnvironment:
          match: {}
          schema:
            array: true
            index: 101
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 102
              observation: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Observation', index: 103}
            required: [observation]
        longitudinalCareWoundObservation:
          match: {}
          schema:
            array: true
            index: 89
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 90
              observation: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Observation', index: 91}
            required: [observation]
        vitalSignObservation:
          match: {}
          schema:
            array: true
            index: 86
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 87
              observation: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Observation', index: 88}
            required: [observation]
        mentalStatusObservation2:
          match: {}
          schema:
            array: true
            index: 38
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 39
              observation: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Observation', index: 40}
            required: [observation]
        encounterDiagnosis:
          match: {}
          schema:
            array: true
            index: 44
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 45
              act: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Act', index: 46}
            required: [act]
        sensoryStatus:
          match: {}
          schema:
            array: true
            index: 74
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 75
              observation: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Observation', index: 76}
            required: [observation]
        resultObservation:
          match: {}
          schema:
            array: true
            index: 71
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 72
              observation: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Observation', index: 73}
            required: [observation]
        postprocedureDiagnosis:
          match: {}
          schema:
            array: true
            index: 59
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 60
              act: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Act', index: 61}
            required: [act]
        smokingStatus-MeaningfulUse:
          match: {}
          schema:
            array: true
            index: 41
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 42
              observation: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Observation', index: 43}
            required: [observation]
        pregnancyObservation:
          match: {}
          schema:
            array: true
            index: 62
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 63
              observation: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Observation', index: 64}
            required: [observation]
        substanceorDeviceAllergy-IntoleranceObservation:
          match: {}
          schema:
            array: true
            index: 80
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 81
              observation: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Observation', index: 82}
            required: [observation]
        entryReference3:
          match: {}
          schema:
            array: true
            index: 119
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 120
              act: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Act', index: 121}
            required: [act]
  classCode:
    pattern: {type: Code, value: ACT}
    index: 4
  author: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Author', index: 15}
  reference:
    index: 122
    elements:
      typeCode:
        pattern: {type: Code, value: REFR}
        index: 123
      externalDocument: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/ExternalDocument', index: 124}
    required: [externalDocument]
  id: {index: 6}
  code:
    index: 7
    elements:
      code:
        pattern: {type: Code, value: '281694009'}
        index: 8
      codeSystem:
        pattern: {type: String, value: 2.16.840.1.113883.6.96}
        index: 9
    required: [codeSystem, code]
  moodCode:
    pattern: {type: Code, value: EVN}
    index: 5
  effectiveTime: {index: 14}
  templateId:
    index: 0
    slicing:
      rules: open
      discriminator:
      - {path: root, type: value}
      - {path: extension, type: value}
      min: 1
      slices:
        risk-concern-act:
          match: {root: 2.16.840.1.113883.10.20.22.4.136, extension: '2015-08-01'}
          schema:
            _required: true
            index: 1
            elements:
              root:
                pattern: {type: String, value: 2.16.840.1.113883.10.20.22.4.136}
                index: 2
              extension:
                pattern: {type: String, value: '2015-08-01'}
                index: 3
            required: [root, extension]
            extensions: {}
  statusCode:
    index: 12
    elements:
      code:
        binding: {strength: required, valueSet: 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.19'}
        index: 13
    required: [code]
  text:
    short: SHOULD reference the portion of section narrative text corresponding to this entry
    index: 10
    elements:
      reference:
        constraint:
          value-starts-octothorpe: {human: 'If reference/@value is present, it SHALL begin with a ''#'' and SHALL point to its corresponding narrative', source: 'http://hl7.org/cda/us/ccda/StructureDefinition/RiskConcernAct', severity: error, expression: value.exists() implies value.startsWith('#')}
        index: 11
package_version: 3.0.0-ballot
class: logical
kind: logical
url: http://hl7.org/cda/us/ccda/StructureDefinition/RiskConcernAct
base: http://hl7.org/cda/stds/core/StructureDefinition/Act
version: 3.0.0-ballot
required: [id, statusCode, templateId]