Generated Narrative: StructureDefinition eicr-anon-composition Name Flags Card. Type Description & Constraints Composition 0..* EICRComposition eICR Composition Profile text C 0..1 Narrative Text summary of the resource, for human interpretation eicr-anon-text: text.div SHALL be ' MASKED ' extension 1..* Extension Extension Slices for extension Content/Rules for all slices extension:dataAbsentReason S 1..1 (Complex) Use data-absent-reason with value 'masked' URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason value[x] 1..1 code Value of extension Fixed Value: masked div 1..1 xhtml Set to ' MASKED ' identifier 1..1 Identifier This is the identifier of this anonymized eICR, the identifier of the original eICR (before anonymization) is recorded in the relatesTo[sliceTransformed].target.identifier subject 1..1 Reference(eICR Anonymized Patient) The subject of this anonymized Composition is the eICR Anonymized Patient display 0..0 encounter 1..1 Reference(eICR Anonymized Encounter) References the eICR Anonymized Encounter display 0..0 date 1..1 dateTime The creation date of the eICR Anonymized Document (this is different to the creation date of the original (non-anonymized) eICR document) author 1..* Reference(eICR Anonymized PractitionerRole | eICR Anonymized Practitioner | US Public Health Organization | Device) References the eICR Anonymized PractitionerRole, eICR Anonymized Practitioner, US Public Health Organization, or Device display 0..0 custodian display 0..0 relatesTo 1..* BackboneElement Relationships to other compositions/documents Slices for relatesTo Content/Rules for all slices relatesTo:sliceTransformed 1..1 BackboneElement Document or Composition that this Composition is transformed from - in the case of an anonymized eICR this is the orginal eICR that has been transformed to remove identifying data Slices for section Content/Rules for all slices section:sliceReasonForVisitSection 1..1 BackboneElement Reason for Visit Section text C 1..1 Narrative Reason for Visit narrative eicr-anon-text: text.div SHALL be ' MASKED ' extension 1..* Extension Extension Slices for extension Content/Rules for all slices extension:dataAbsentReason S 1..1 (Complex) Use data-absent-reason with value 'masked' URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason value[x] 1..1 code Value of extension Fixed Value: masked div 1..1 xhtml Set to ' MASKED ' section:sliceChiefComplaintSection 1..1 BackboneElement Chief Complaint Section text C 1..1 Narrative Chief Complaint narrative eicr-anon-text: text.div SHALL be ' MASKED ' extension 1..* Extension Extension Slices for extension Content/Rules for all slices extension:dataAbsentReason S 1..1 (Complex) Use data-absent-reason with value 'masked' URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason value[x] 1..1 code Value of extension Fixed Value: masked div 1..1 xhtml Set to ' MASKED ' section:sliceHistoryOfPresentIllnessSection 1..1 BackboneElement History of Present Illness Section text C 1..1 Narrative History of Present Illness narrative eicr-anon-text: text.div SHALL be ' MASKED ' extension 1..* Extension Extension Slices for extension Content/Rules for all slices extension:dataAbsentReason S 1..1 (Complex) Use data-absent-reason with value 'masked' URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason value[x] 1..1 code Value of extension Fixed Value: masked div 1..1 xhtml Set to ' MASKED ' section:sliceProblemSection 1..1 BackboneElement Problem Section text C 1..1 Narrative Problem Section narrative eicr-anon-text: text.div SHALL be ' MASKED ' extension 1..* Extension Extension Slices for extension Content/Rules for all slices extension:dataAbsentReason S 1..1 (Complex) Use data-absent-reason with value 'masked' URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason value[x] 1..1 code Value of extension Fixed Value: masked div 1..1 xhtml Set to ' MASKED ' section:sliceMedicationsAdministeredSection 1..1 BackboneElement Medications Administered Section text C 1..1 Narrative Medications Administered Section narrative eicr-anon-text: text.div SHALL be ' MASKED ' extension 1..* Extension Extension Slices for extension Content/Rules for all slices extension:dataAbsentReason S 1..1 (Complex) Use data-absent-reason with value 'masked' URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason value[x] 1..1 code Value of extension Fixed Value: masked div 1..1 xhtml Set to ' MASKED ' section:sliceAdmissionMedicationsSection 0..1 BackboneElement Admission Medications Section text C 1..1 Narrative Admission Medications Section narrative eicr-anon-text: text.div SHALL be ' MASKED ' extension 1..* Extension Extension Slices for extension Content/Rules for all slices extension:dataAbsentReason S 1..1 (Complex) Use data-absent-reason with value 'masked' URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason value[x] 1..1 code Value of extension Fixed Value: masked div 1..1 xhtml Set to ' MASKED ' section:sliceMedicationsSection 0..1 BackboneElement Medications Section text C 1..1 Narrative Medications Section narrative eicr-anon-text: text.div SHALL be ' MASKED ' extension 1..* Extension Extension Slices for extension Content/Rules for all slices extension:dataAbsentReason S 1..1 (Complex) Use data-absent-reason with value 'masked' URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason value[x] 1..1 code Value of extension Fixed Value: masked div 1..1 xhtml Set to ' MASKED ' section:sliceResultsSection 1..1 BackboneElement Results Section text C 1..1 Narrative Results Section narrative eicr-anon-text: text.div SHALL be ' MASKED ' extension 1..* Extension Extension Slices for extension Content/Rules for all slices extension:dataAbsentReason S 1..1 (Complex) Use data-absent-reason with value 'masked' URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason value[x] 1..1 code Value of extension Fixed Value: masked div 1..1 xhtml Set to ' MASKED ' section:slicePlanOfTreatmentSection 0..1 BackboneElement Plan of Treatment Section text C 1..1 Narrative Plan of Treatment narrative eicr-anon-text: text.div SHALL be ' MASKED ' extension 1..* Extension Extension Slices for extension Content/Rules for all slices extension:dataAbsentReason S 1..1 (Complex) Use data-absent-reason with value 'masked' URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason value[x] 1..1 code Value of extension Fixed Value: masked div 1..1 xhtml Set to ' MASKED ' section:sliceImmunizationsSection 0..1 BackboneElement Immunizations Section text C 1..1 Narrative Immunizations narrative eicr-anon-text: text.div SHALL be ' MASKED ' extension 1..* Extension Extension Slices for extension Content/Rules for all slices extension:dataAbsentReason S 1..1 (Complex) Use data-absent-reason with value 'masked' URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason value[x] 1..1 code Value of extension Fixed Value: masked div 1..1 xhtml Set to ' MASKED ' Slices for entry Content/Rules for all slices entry:sliceUSCoreImmunization 1..* Reference(eICR Anonymized Immunization) Immunization entry section:sliceProceduresSection 0..1 BackboneElement This section describes all interventional, surgical, diagnostic, or therapeutic procedures or treatments pertinent to the patient historically at the time the document is generated. text C 1..1 Narrative Procedures Section narrative eicr-anon-text: text.div SHALL be ' MASKED ' extension 1..* Extension Extension Slices for extension Content/Rules for all slices extension:dataAbsentReason S 1..1 (Complex) Use data-absent-reason with value 'masked' URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason value[x] 1..1 code Value of extension Fixed Value: masked div 1..1 xhtml Set to ' MASKED ' section:sliceVitalSignsSection 0..1 BackboneElement Vital Signs Section text C 1..1 Narrative Vital Signs narrative eicr-anon-text: text.div SHALL be ' MASKED ' extension 1..* Extension Extension Slices for extension Content/Rules for all slices extension:dataAbsentReason S 1..1 (Complex) Use data-absent-reason with value 'masked' URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason value[x] 1..1 code Value of extension Fixed Value: masked div 1..1 xhtml Set to ' MASKED ' section:sliceSocialHistorySection 1..1 BackboneElement Social History Section text C 1..1 Narrative Social History Section narrative eicr-anon-text: text.div SHALL be ' MASKED ' extension 1..* Extension Extension Slices for extension Content/Rules for all slices extension:dataAbsentReason S 1..1 (Complex) Use data-absent-reason with value 'masked' URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason value[x] 1..1 code Value of extension Fixed Value: masked div 1..1 xhtml Set to ' MASKED ' entry 1..* Reference(Resource) A reference to data that supports this section Slices for entry Content/Rules for all slices entry:sliceODHPastOrPresentJob 0..* Reference(eICR Anonymized Past or Present Job) ODH Past or Present Job entry entry:sliceExposureContactInformation 0..0 entry:sliceEICRAnonymizedCalculatedAge S 1..1 Reference(eICR Anonymized Calculated Age) Calculated Age entry section:slicePregnancySection 0..1 BackboneElement Pregnancy Section text C 1..1 Narrative Pregnancy summary Document narrative eicr-anon-text: text.div SHALL be ' MASKED ' extension 1..* Extension Extension Slices for extension Content/Rules for all slices extension:dataAbsentReason S 1..1 (Complex) Use data-absent-reason with value 'masked' URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason value[x] 1..1 code Value of extension Fixed Value: masked div 1..1 xhtml Set to ' MASKED ' section:sliceEmergencyOutbreakInformationSection 0..1 BackboneElement Emergency Outbreak Information Section text C 1..1 Narrative Emergency Outbreak Information Section narrative eicr-anon-text: text.div SHALL be ' MASKED ' extension 1..* Extension Extension Slices for extension Content/Rules for all slices extension:dataAbsentReason S 1..1 (Complex) Use data-absent-reason with value 'masked' URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason value[x] 1..1 code Value of extension Fixed Value: masked div 1..1 xhtml Set to ' MASKED ' section:slicePastMedicalHistorySection 0..1 BackboneElement Past Medical History Section text C 1..1 Narrative Past Medical History Section narrative eicr-anon-text: text.div SHALL be ' MASKED ' extension 1..* Extension Extension Slices for extension Content/Rules for all slices extension:dataAbsentReason S 1..1 (Complex) Use data-absent-reason with value 'masked' URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason value[x] 1..1 code Value of extension Fixed Value: masked div 1..1 xhtml Set to ' MASKED ' section:sliceReviewOfSystemsSection 0..1 BackboneElement Review of Systems Section text C 1..1 Narrative Review of Systems narrative eicr-anon-text: text.div SHALL be ' MASKED ' extension 1..* Extension Extension Slices for extension Content/Rules for all slices extension:dataAbsentReason S 1..1 (Complex) Use data-absent-reason with value 'masked' URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason value[x] 1..1 code Value of extension Fixed Value: masked div 1..1 xhtml Set to ' MASKED ' section:sliceReportabilityResponseInformationSection 0..1 BackboneElement Reportability Response Information Section (for post-processing only) text C 1..1 Narrative Reportability Response Information Section narrative eicr-anon-text: text.div SHALL be ' MASKED ' extension 1..* Extension Extension Slices for extension Content/Rules for all slices extension:dataAbsentReason S 1..1 (Complex) Use data-absent-reason with value 'masked' URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason value[x] 1..1 code Value of extension Fixed Value: masked div 1..1 xhtml Set to ' MASKED ' Documentation for this format
This Composition profile represents an anonymized eICR Composition.
This table maps FHIR eCR profile elements to eICR/RR CDA template elements located in the CDA eICR IG (R2 STU2) and CDA RR IG (R2 STU1).
The Electronic Case Reporting Composition profile establishes the core elements, extensions, vocabularies and value sets for representing an electronic initial case report (eICR). It describes the content requirements for the initial Case Report including: - Patient demographics - Patient pregnancy status - Patient occupation and travel history - Provider and Facility information - Laboratory orders tests and results - Signs and Symptoms and Diagnosis - Medication and Immunization History - Flags for the existence of reportable condition trigger codes in diagnoses and ordered/resulted laboratory tests.
While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical.
If the resource is contained in another resource, it SHALL NOT contain nested Resources
not(parent::f:contained and f:contained)
If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))
If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
If a resource is contained in another resource, it SHALL NOT have a security label
When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.
A resource should have narrative for robust management
[eICR R2 STU3.1] 1.1.2 Initial Public Health Case Report Document (eICR) (V3)
Document[classCode="DOC" and moodCode="EVN" and isNormalAct()]
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
A set of rules under which this content was created
A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
The base language in which the resource is written.
Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Text summary of the resource, for human interpretation
A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
text.div SHALL be ' MASKED '
exists() implies `div`.toString().matches(' \\s* MASKED \\s* ')
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Extensions are always sliced by (at least) url
Must have either extensions or value[x], not both
exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
Use data-absent-reason with value 'masked'
Provides a reason why the expected value or elements in the element that is extended are missing.
Source of the definition for the extension code - a logical name or a URL.
The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R5/extensibility.html) for a list).
generated | extensions | additional | empty
The status of the narrative - whether it's entirely generated (from just the defined data or the extensions too), or whether a human authored it and it may contain additional data.
Set to ' MASKED '
The actual narrative content, a stripped down version of XHTML.
The contents of the html element are an XHTML fragment containing only the basic html formatting elements described in chapters 7-11 and 15 of the HTML 4.0 standard, elements (either name or href), images and internally contained stylesheets. The XHTML content SHALL NOT contain a head, a body, external stylesheet references, scripts, forms, base/link/xlink, frames, iframes and objects.
The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, elements (either name or href), images and internally contained style attributes
not(descendant-or-self::*[not(local-name(.)=('a', 'abbr', 'acronym', 'b', 'big', 'blockquote', 'br', 'caption', 'cite', 'code', 'col', 'colgroup', 'dd', 'dfn', 'div', 'dl', 'dt', 'em', 'h1', 'h2', 'h3', 'h4', 'h5', 'h6', 'hr', 'i', 'img', 'li', 'ol', 'p', 'pre', 'q', 'samp', 'small', 'span', 'strong', 'sub', 'sup', 'table', 'tbody', 'td', 'tfoot', 'th', 'thead', 'tr', 'tt', 'ul', 'var'))]) and not(descendant-or-self::*/@*[not(name(.)=('abbr', 'accesskey', 'align', 'alt', 'axis', 'bgcolor', 'border', 'cellhalign', 'cellpadding', 'cellspacing', 'cellvalign', 'char', 'charoff', 'charset', 'cite', 'class', 'colspan', 'compact', 'coords', 'dir', 'frame', 'headers', 'height', 'href', 'hreflang', 'hspace', 'id', 'lang', 'longdesc', 'name', 'nowrap', 'rel', 'rev', 'rowspan', 'rules', 'scope', 'shape', 'span', 'src', 'start', 'style', 'summary', 'tabindex', 'title', 'type', 'valign', 'value', 'vspace', 'width'))])
The narrative SHALL have some non-whitespace content
descendant::text()[normalize-space(.)!=''] or descendant::h:img[@src]
These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Public Health Composition versionNumber. This is equivalent to ClinicalDocument.versionNumber in CDA. The identifier of the containing Bundle is equivalent to ClinicalDocument.id in CDA and Composition.identifier is equivalent to ClinicalDocument.setId in CDA. This is a version specific identifier for the composition, assigned when each version is created/updated. While each resource, including the composition itself, has its own version identifier, this is a formal identifier for the logical version of the composition as a whole. It would remain constant if the resources were moved to a new server, and all got new individual resource versions, for example.
While each resource, including the composition itself, has its own version identifier, this is a formal identifier for the logical version of the composition as a whole. It would remain constant if the resources were moved to a new server, and all got new individual resource versions, for example.
exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
When set to "PHC1464: Manually Initiated eICR", indicates that this document is manually initiated. When set to "PHC2235: Alternately Initiated eICR", indicates that this eICR document was initiated by automated process and is intended to force reporting to the responsible Public Health Agency (PHA) for the jurisdiction of care. Unlike eICRs manually initiated by a provider, which are force reported to all relevant jurisdictions, PHC2235 will be sent to, and only to, the PHA of the jurisdiction of care. If a reportable condition is found by public health decision support then the alternately initiated eICR may also be reported to the jurisdiction of residence PHA.
[eICR R2 STU3.1] ClinicalDocument/documentationOf/serviceEvent/code
An explanation for the manual or alternate initiation of the eICR.
[eICR R2 STU3.1] Initial Case Report initiation Reason (V2)/value
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
This is the identifier of this anonymized eICR, the identifier of the original eICR (before anonymization) is recorded in the relatesTo[sliceTransformed].target.identifier
Public Health Composition identifier. This is equivalent to ClinicalDocument.setId in CDA. The identifier of the containing Bundle is equivalent to ClinicalDocument.id in CDA and Composition.sliceExtensionVersionNumber is equivalent to ClinicalDocument.versionNumber in CDA.
Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how these relate.
preliminary | final | amended | entered-in-error
The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document.
If a composition is marked as withdrawn, the compositions/documents in the series, or data from the composition or document series, should never be displayed to a user without being clearly marked as untrustworthy. The flag "entered-in-error" is why this element is labeled as a modifier of other elements. Some reporting work flows require that the original narrative of a final document never be altered; instead, only new narrative can be added. The composition resource has no explicit status for explicitly noting whether this business rule is in effect. This would be handled by an extension if required.
Need to be able to mark interim, amended, or withdrawn compositions or documents.
This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
The workflow/clinical status of the composition.
interim: .completionCode="IN" & ./statusCode[isNormalDatatype()]="active"; final: .completionCode="AU" && ./statusCode[isNormalDatatype()]="complete" and not(./inboundRelationship[typeCode="SUBJ" and isNormalActRelationship()]/source[subsumesCode("ActClass#CACT") and moodCode="EVN" and domainMember("ReviseComposition", code) and isNormalAct()]); amended: .completionCode="AU" && ./statusCode[isNormalDatatype()]="complete" and ./inboundRelationship[typeCode="SUBJ" and isNormalActRelationship()]/source[subsumesCode("ActClass#CACT") and moodCode="EVN" and domainMember("ReviseComposition", code) and isNormalAct() and statusCode="completed"]; withdrawn : .completionCode=NI && ./statusCode[isNormalDatatype()]="obsolete"
The type of this Composition is a Public Health Case Report
For Composition type, LOINC is ubiquitous and strongly endorsed by HL7. Most implementation guides will require a specific LOINC code, or use LOINC as an extensible binding.
Key metadata element describing the composition, used in searching/filtering.
A categorization for the type of the composition - helps for indexing and searching. This may be implied by or derived from the code specified in the Composition Type.
This is a metadata field from [XDS/MHD](http://wiki.ihe.net/index.php?title=Mobile_access_to_Health_Documents_(MHD)).
Helps humans to assess whether the composition is of interest when viewing an index of compositions or documents.
High-level kind of a clinical document at a macro level.
.outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
The subject of this anonymized Composition is the eICR Anonymized Patient
The subject of this Composition is the patient.
For clinical documents, this is usually the patient.
Essential metadata for searching for the composition. Identifies who and/or what the composition/document is about.
Additional content defined by implementations
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Literal reference, Relative, internal or absolute URL
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Type the reference refers to (e.g. "Patient")
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
Aa resource (or, for logical models, the URI of the logical model).
Logical reference, when literal reference is not known
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Plain text narrative that identifies the resource in addition to the resource reference.
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
References the eICR Anonymized Encounter
This Encounter profile represents the encounter related to the public health event.
Provides context for the composition and supports searching.
unique(highest(./outboundRelationship[typeCode="SUBJ" and isNormalActRelationship()], priorityNumber)/target[moodCode="EVN" and classCode=("ENC", "PCPR") and isNormalAct])
The creation date of the eICR Anonymized Document (this is different to the creation date of the original (non-anonymized) eICR document)
The composition editing time, when the composition was last logically changed by the author.
The Last Modified Date on the composition may be after the date of the document was attested without being changed.
dateTime is used for tracking, organizing versions and searching. Note that this is the time of *authoring*. When packaged in a document, [Bundle.timestamp](http://hl7.org/fhir/R4/bundle-definitions.html#Bundle.timestamp) is the date of packaging.
DocumentReference.content.attachment.date, DocumentReference.created
References the eICR Anonymized PractitionerRole, eICR Anonymized Practitioner, US Public Health Organization, or Device
It is possible to have multiple authors - especially in the case where the default author is the organization. For public health reporting this could contain the contact details for the Infection Control Professional (ICP) specific to the condition being reported on. If the main author of the document is not a person, it is recommended to have an additional person author contact who is specific for a disease for follow-up requirements. This person could be the ICP. Where a trigger occurs outside of an encounter the author will represent the Provider and Facility for reporting purposes.
Identifies who is responsible for the content.
Official human-readable label for the composition.
For many compositions, the title is the same as the text or a display name of Composition.type (e.g. a "consultation" or "progress note"). Note that CDA does not make title mandatory, but there are no known cases where it is useful for title to be omitted, so it is mandatory here. Feedback on this requirement is welcome during the trial use period.
DocumentReference.description, DocumentReference.content.attachment.title
The code specifying the level of confidentiality of the Composition.
The exact use of this element, and enforcement and issues related to highly sensitive documents are out of scope for the base specification, and delegated to implementation profiles (see security section). This element is labeled as a modifier because highly confidential documents must not be treated as if they are not.
Codes specifying the level of confidentiality of the composition.
A participant who has attested to the accuracy of the composition/document.
Identifies responsibility for the accuracy of the composition content.
Extensions that cannot be ignored even if unrecognized
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
personal | professional | legal | official
The type of attestation the authenticator offers.
Indicates the level of authority of the attestation.
The way in which a person authenticated a composition.
implied by .authenticator/.legalAuthenticator
When the composition was attested by the party.
Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).
./time[type="TS" and isNormalDatatype()]
Who attested the composition in the specified way.
Identifies who has taken on the responsibility for accuracy of the composition content.
./role[classCode="ASSIGNED" and isNormalRole]/player[determinerCode="INST" and classCode=("DEV", "PSN") and isNormalEntity()] or ./role[classCode="ASSIGNED" and isNormalRole and not(player)]/scoper[determinerCode="INST" and classCode="ORG" and isNormalEntity()]
Organization which maintains the composition
Identifies the organization or group who is responsible for ongoing maintenance of and access to the composition/document information.
This is useful when documents are derived from a composition - provides guidance for how to get the latest version of the document. This is optional because this is sometimes not known by the authoring system, and can be inferred by context. However, it is important that this information be known when working with a derived document, so providing a custodian is encouraged.
Identifies where to go to find the current version, where to report issues, etc.
.participation[typeCode="RCV"].role[classCode="CUST"].scoper[classCode="ORG" and determinerCode="INST"]
Relationships to other compositions/documents
Relationships that this composition has with other compositions or documents that already exist.
A document is a version specific composition.
The type of relationship that this composition has with anther composition or document.
If this document appends another document, then the document cannot be fully understood without also accessing the referenced document.
The type of relationship between documents.
The target composition/document of this relationship.
.target[classCode="DOC", moodCode="EVN"].id
Document or Composition that this Composition is transformed from - in the case of an anonymized eICR this is the orginal eICR that has been transformed to remove identifying data
Document of Composition that this Composition is transformed from - in the case of an anonymized eICR this is the orginal eICR that has been transformed to remove identifying data
Identifier of the Document or Composition transformed
Document or Composition that this Composition replaces
Identifier/Reference to the Document or Composition transformed
The clinical service(s) being documented
The clinical service, such as a colonoscopy or an appendectomy, being documented.
The event needs to be consistent with the type element, though can provide further information if desired.
Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event.
Code(s) that apply to the event being documented
This list of codes represents the main clinical acts, such as a colonoscopy or an appendectomy, being documented. In some cases, the event is inherent in the typeCode, such as a "History and Physical Report" in which the procedure being documented is necessarily a "History and Physical" act.
An event can further specialize the act inherent in the typeCode, such as where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more eventCodes are included, they SHALL NOT conflict with the values inherent in the classCode, practiceSettingCode or typeCode, as such a conflict would create an ambiguous situation. This short list of codes is provided to be used as key words for certain types of queries.
This list of codes represents the main clinical acts being documented.
The period of time covered by the documentation. There is no assertion that the documentation is a complete representation for this period, only that it documents events during this time.
The description and/or reference of the event(s) being documented. For example, this could be used to document such a colonoscopy or an appendectomy.
The root of the sections that make up the composition.
A section must contain at least one of text, entries, or sub-sections
text.exists() or entry.exists() or section.exists()
exists(f:text) or exists(f:entry) or exists(f:section)
A section can only have an emptyReason if it is empty
not(exists(f:emptyReason) and exists(f:entry))
./outboundRelationship[typeCode="COMP" and isNormalActRelationship()]/target[moodCode="EVN" and classCode="DOCSECT" and isNormalAct]
The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.
The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.
Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
A code identifying the kind of content contained within the section. This must be consistent with the section title.
The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document. If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.
Provides computable standardized labels to topics within the document.
Classification of a section of a composition/document.
Identifies who is responsible for the information in this section, not necessarily who typed it in.
Who/what the section is about, when it is not about the subject of composition
The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).
Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.
.subject? (CDA did not differentiate between subject and focus)
Text summary of the section, for human interpretation
A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.
Document profiles may define what content should be represented in the narrative to ensure clinical safety.
How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.
This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
The processing mode that applies to this section.
Specifies the order applied to the items in the section entries.
Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.
Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
What order applies to the items in the entry.
.outboundRelationship[typeCode=COMP].sequenceNumber > 1
A reference to data that supports this section
A reference to the actual resource from which the narrative in the section is derived.
If there are no entries in the list, an emptyReason SHOULD be provided.
.outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]
If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.
Allows capturing things like "none exist" or "not asked" which can be important for most lists.
A nested sub-section within this section.
Nested sections are primarily used to help human readers navigate to particular portions of the document.
This section records the reason for the patient's visit (the provider’s description of the reason for visit).
[eICR R2 STU3.1] Reason for Visit Section
[eICR R2 STU3.1] Reason for Visit Section/code
[eICR R2 STU3.1] Reason for Visit Section/text
This section records the patient's chief complaint (the patient’s own description).
[eICR R2 STU3.1] Chief Complaint Section
[eICR R2 STU3.1] Chief Complaint Section/code
[eICR R2 STU3.1] Chief Complaint Section/text
The History of Present Illness section describes the history related to the reason for the encounter. It contains the historical details leading up to and pertaining to the patient’s current complaint or reason for seeking medical care.
[eICR R2 STU3.1] History of Present Illness Section
[eICR R2 STU3.1] History of Present Illness Section/code
[eICR R2 STU3.1] History of Present Illness Section/text
This section lists and describes all the patient's current problems on the maintained problem list.
[eICR R2 STU3.1] Problem Section (entries required) (V3)
[eICR R2 STU3.1] Problem Section (entries required) (V3)/code
[eICR R2 STU3.1] Problem Section (entries required) (V3)/text
The eICR Trigger Code Flag (extension) is present for an eICR Condition (diagnosis), based on a trigger code match of the diagnosis (condition.code) to the eRSD PlanDefinition Diagnosis Trigger.
[eICR R2 STU3.1] Problem Observation (V3) + Initial Case Report Trigger Code Problem Observation (V2)
A flag to indicate that the **target** reference represents a triggering event and caused the eCR to be generated.
[eICR R2 STU3.1] Initial Case Report Trigger Code Problem Observation
The Medications Administered Section defines medications administered during the encounter.
[eICR R2 STU3.1] Medications Administered Section (V2)
[eICR R2 STU3.1] Medications Administered Section (V2)/code
Medications Administered Section narrative
[eICR R2 STU3.1] Medications Administered Section (V2)/text
The eICR Trigger Code Flag (extension) is present for an MedicationAdministration, based on a trigger code match of the medication (MedicationAdministration.medicationCodeableConcept) to the eRSD PlanDefinition Medications Trigger.
[eICR R2 STU3.1] Medication Activity (V2)/Medication Information (V2) + Medication Activity (V2)/Initial Case Report Trigger Code Medication Information
A flag to indicate that the **target** reference represents a triggering event and caused the eICR to be generated.
The Admissions Medications Section contains the medications taken by the patient prior to and at the time of admission to the facility.
[eICR R2 STU3.1] Admission Medications Section (V3)
[eICR R2 STU3.1] Admission Medications Section (V3)/code
[eICR R2 STU3.1] Admission Medications Administered Section (V3)/text
[eICR R2 STU3.1] Admission Medication (V2)
The Medications Section contains a patient's current medications and pertinent medication history. At a minimum, the currently active medications are listed. An entire medication history is an option.
[eICR R2 STU3.1] Medications Section (V2)
[eICR R2 STU3.1] Medications Section (V2)/code
[eICR R2 STU3.1] Medications Section (V2)/text
The Results Section contains observations of results generated by laboratories, imaging procedures, and other procedures. The scope includes observations such as hematology, chemistry, serology, virology, toxicology, microbiology, plain x-ray, ultrasound, CT, MRI, angiography, echocardiography, nuclear medicine, pathology, and procedure observations. The section often includes notable results such as abnormal values or relevant trends, and could contain all results for the period of time being documented. Laboratory results are typically generated by laboratories providing analytic services in areas such as chemistry, hematology, serology, histology, cytology, anatomic pathology, microbiology, and/or virology. These observations are based on analysis of specimens obtained from the patient and submitted to the laboratory. Imaging results are typically generated by a clinician reviewing the output of an imaging procedure, such as where a cardiologist reports the left ventricular ejection fraction based on the review of a cardiac echocardiogram. Procedure results are typically generated by a clinician to provide more granular information about component observations made during a procedure, such as where a gastroenterologist reports the size of a polyp observed during a colonoscopy.
[eICR R2 STU3.1] Results Section (entries required) (V3)
[eICR R2 STU3.1] Results Section (entries required) (V3)/code
[eICR R2 STU3.1] Results Section (entries required) (V3)/text
The eICR Trigger Code Flag (extension) is present for a laboratory result, based on a trigger code match of either the lab test (observation.code) to the eRSD PlanDefinition Lab Obs Test Name Trigger or the lab test result (observation.value) to the eRSD PlanDefinition Organism Substance Trigger.
[eICR R2 STU3.1] Result Observation (V3) + Initial Case Report Trigger Code Result Observation (V2)
A flag to indicate that the **target** reference represents one or more (lab result observations can contain hasMember) triggering events and caused the eCR to be generated.
This section, contains data that define pending orders, interventions, encounters, services, and procedures for the patient. It is limited to prospective, unfulfilled, or incomplete orders and requests only. All active, incomplete, or pending orders, appointments, referrals, procedures, services, or any other pending event of clinical significance to the current care of the patient should be listed.
[eICR R2 STU3.1] Plan of Treatment Section (V2)
[eICR R2 STU3.1] Plan of Treatment Section (V2)/code
[eICR R2 STU3.1] Plan of Treatment Section (V2)/text
The eICR Trigger Code Flag (extension) is present for a laboratory test order, based on a trigger code match of the lab test (observation.code) to the eRSD PlanDefinition Lab Obs Test Name Trigger or the lab test result (observation.value) to the eRSD PlanDefinition Organism Substance Trigger.
[eICR R2 STU3.1] Planned Observation (V2) + Initial Case Report Trigger Code Lab Test Order (V2)
The eICR Trigger Code Flag (extension) is present for a MedicationRequest, based on a trigger code match of the medication (MedicationRequest.medicationCodeableConcept) to the eRSD PlanDefinition Medications Trigger.
[eICR R2 STU3.1] Planned Medication Activity (V2)/Medication Information (V2) + Planned Medication Activity (V2)/Initial Case Report Trigger Code Medication Information
The Immunizations Section defines a patient's current immunization status and pertinent immunization history. The primary use case for the Immunization Section is to enable communication of a patient's immunization status. The section should include current immunization status, and may contain the entire immunization history that is relevant to the period of time being summarized.
[eICR R2 STU3.1] Immunizations Section (entries required) (V3)
[eICR R2 STU3.1] Immunizations Section (entries required) (V3)/code
[eICR R2 STU3.1] Immunizations Section (entries required) (V3)/text
The eICR Trigger Code Flag (extension) is present for an Immunization, based on a trigger code match of the vaccine (Immunization.vaccineCode) to the eRSD PlanDefinition Immunizations Trigger.
[eICR R2 STU3.1] Immunization Activity (V3)/Immunization Medication Information (V2) + Immunization Activity (V3)/Initial Case Report Trigger Code Immunization Medication Information
This section describes all interventional, surgical, diagnostic, or therapeutic procedures or treatments pertinent to the patient historically at the time the document is generated.
This section describes all interventional, surgical, diagnostic, or therapeutic procedures or treatments pertinent to the patient historically at the time the document is generated. The section should include notable procedures, but can contain all procedures for the period of time being summarized.
[eICR R2 STU3] Procedures Section (entries required) (V2)
[eICR R2 STU3] Procedures Section (entries required) (V2)/code
[eICR R2 STU3] Procedures Section (entries required) (V2)/text
The eICR Trigger Code Flag (extension) is present for a procedure, based on a trigger code match of the procedure (procedure.code) to the eRSD PlanDefinition Procedure Trigger.
[eICR R2 STU3.1] Procedure Activity Act (V2) + Procedure Activity Observation (V2) + Procedure Activity Procedure (V2) + Initial Case Report Trigger Code Procedure Activity Act + Initial Case Report Trigger Code Procedure Activity Observation + Initial Case Report Trigger Code Procedure Activity Procedure
[eICR R2 STU3] Initial Case Report Trigger Code Procedure Activity Act + Initial Case Report Trigger Code Procedure Activity Observation + Initial Case Report Trigger Code Procedure Activity Procedure
The Vital Signs Section contains relevant vital signs for the eICR. The section should include notable vital signs such as the most recent, maximum and/or minimum, baseline, or relevant trends. Vital signs are represented in the same way as other results, but are aggregated into their own section to follow clinical conventions.
[eICR R2 STU3.1] Vital Signs Section (entries required) (V3)
[eICR R2 STU3.1] Vital Signs Section (entries required) (V3)/code
[eICR R2 STU3.1] Vital Signs Section (entries required) (V3)/text
[eICR R2 STU3.1] Vital Signs Organizer (V3)/Vital Sign Observation (V2)
This section contains social history data that influence a patient’s physical, psychological or emotional health such as occupation, home environment, travel history, and disability status.
[eICR R2 STU3.1] Social History Section (V3)
[eICR R2 STU3.1] Social History Section (V3)/code
[eICR R2 STU3.1] Social History Section (V3)/text
If the patient is homeless, complete as much address information as possible (city, zip, county, etc.) and use the Characteristics of Home Environment profile to indicate that the patient is homeless.
[eICR R2 STU3.1] Past or Present Occupation Observation
Current Occupation, Current Industry, Current Job Title, Current Employer Name, Current Employer Phone, Current Employer Address
[eICR R2 STU3.1] Usual Occupation Observation
Usual Occupation, Usual Industry, Occupational Exposure
The Pregnancy Section contains a patient's current and past pregnancy history information.
[eICR R2 STU3.1] Pregnancy Status Observation (SUPPLEMENTAL PREGNANCY)
[eICR R2 STU3.1] Last Menstrual Period (V2)
This section represents information that is required during a public health emergency/outbreak.
Emergency Outbreak Information Section code
Emergency Outbreak Information Section narrative
This section contains a record of the patient’s past complaints, problems, and diagnoses. It contains data from the patient’s past up to the patient’s current complaint or reason for seeking medical care.
[eICR R2 STU3.1] Past Medical History Section (V3)
[eICR R2 STU3.1] Past Medical History Section (V3)/code
[eICR R2 STU3.1] Past Medical History Section (V3)/text
The Review of Systems Section contains a relevant collection of symptoms and functions systematically gathered by a clinician. It includes symptoms the patient is currently experiencing, some of which were not elicited during the history of present illness, as well as a potentially large number of pertinent negatives, for example, symptoms that the patient denied experiencing.
[eICR R2 STU3.1] Review of Systems Section
[eICR R2 STU3.1] Review of Systems Section/code
[eICR R2 STU3.1] Review of Systems Section/text
Reportability Response Information Section (for post-processing only)
The Reportability Response Information Section contains information from a Reportability Response that was generated in response to this eICR. This section is to be used for the Public Health agency to receive the eICR with the RR included (after the RR has been created). This is needed to help the PHA ingest the information. As part of the PHA's process they will put parts of the RR into the eICR. This is useful for working with the surveillance vendors. All this work will be done within the internal data integration processes of the PHA. It is a placeholder so it can be used in the future. A number of surveillance systems need to include specific data that is not available until the eICR and RR are available inside of the receiving organization (PHA). This is important to ensure that they have a consistent, documented way of including the data.
Reportability response report Document Public health
Reportability Response Information Section narrative