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Advance Directive

Reference:2.2.2.12
Definition:Within a CDA document, the following information maps to the HITSP/C154 Data Dictionary. See the HL7 Continuity of Care Document Section 3.2 for constraints applicable to these data elements. This module contains data describing the patient's Advance Directives and any reference to supporting documentation. This section contains data such as the existence of living wills, healthcare proxies and CPR and resuscitation status. The custodian of these documents may be described. See the HL7 Continuity of Care Document Section 3.2 for constraints applicable to this module.
OID:2.16.840.1.113883.3.88.11.83.12
CDA Data Location HITSP Data Element Identifier and Name O/R Additional Specification
cda:observation[cda:templateId/@root= '2.16.840.1.113883.10.20.1.17'] Advance Directive Event Entry See Below21
cda:code/@code 12.01 - Advance Directive Type R2/N 2.2.2.12.2
cda:originalText/cda:reference/@value 12.02 - Advance Directive Free Text Type R/N 2.2.2.12.3
cda:effectiveTime 12.03 - Effective Date R/N 2.2.2.12.4
cda:participant[@typeCode='CST']/ cda:participantRole[@classCode='AGNT'] 12.04 - Custodian of the Document R/N 2.2.2.12.5

Optionality Legend: “R” for Required, “R2” for Required if known, “O” for Optional and Repeat = “Y” for Yes or “N” for No

Advance Directive Example

<!-- These examples assume the default namespace is 'urn:hl7-org:v3' -->
<observation classCode='OBS' moodCode='EVN'>
<templateId root='2.16.840.1.113883.10.20.1.17'/>
<templateId root='2.16.840.1.113883.3.88.11.83.12'/>
<templateId root='1.3.6.1.4.1.19376.1.5.3.1.4.13.7'/>
<code code='...' displayName='...' codeSystem='2.16.840.1.113883.6.96' codeSystemName='SNOMED CT'>
<originalText><reference value='#directive-1'/></originalText>
</code>
<effectiveTime>
<low value='...'/>
<high value='...'/>
</effectiveTime>
<participant typeCode='CST'>
<participantRole classCode='AGNT'>
<addr>...</addr>
<telecom>...</telecom>
<playingEntity>
<name>...</name>
</playingEntity>
</participantRole>
</participant>
</observation>

Section ID Constraint ID Definition
2.2.2.12.1 Advance Directive Module Constraints Not Provided
C83-[DE-12-CDA-1] A CDA Document SHALL declare conformance for the Advance Directive module by including a <templateID> element with the root set to the value 2.16.840.1.113883.3.88.11.83.12
C83-[DE-12-CDA-2] An advance directive data element attribute SHALL declare conformance to the IHE Advance Directive Observation by including a <templateID> element with the root attribute set to the value 1.3.6.1.4.1.19376.1.5.3.1.4.13.7
2.2.2.12.2 Advance Directive Coded Type Constraints Not Provided
C154-[DE-12.01-1] The advance directive SHALL be coded as specified in HITSP/C80 Section 2.2.3.10.1 Advance Directive Type
2.2.2.12.3 Advance Directive Free Text Type Constraints Not Provided
C83-[DE-12.CDA-3] The human readable description of the type of Advance Directive SHALL appear in the narrative text and SHALL be pointed to by the value attribute of the <reference> element inside the <originalText> element of the <code>
2.2.2.12.4 Effective Date Constraints Not Provided
C83-[DE-12.CDA-6] The ending time of the Advance Directive SHALL be recorded in the element SHALL have the nullFlavor attribute set to UNK <high> element of the <effectiveTime> element in the Advance Directive
C83-[DE-12.CDA-7] If the ending time is unknown, the <observation> <high>
C83-[DE-12CDA-4] The starting time of the Advance Directive SHALL be recorded in the <low> element of the <effectiveTime> element in the Advance Directive <observation>
C83-[DE-12CDA-5] If the starting time is unknown, the <low>
C83-[DE-12CDA-8] If the Advance Directive does not have a specified ending time, the element SHALL have the nullFlavor attribute set to UNK <high>
2.2.2.12.5 Custodian of the Document Constraints Not Provided
C83-[DE-12.CDA-10] The classCode of the <participant> element SHALL be CST
C83-[DE-12.CDA-11] The classCode of <participantRole> the element SHALL be AGNT
C83-[DE-12.CDA-9] Information required to obtain a copy of the Advance Directive SHALL be recorded in a <participantRole> element within a <participant> element of the Advance Directive
C83-[DE-12CDA-12] The address of the agent SHALL be recorded in an element <addr> element when known
C83-[DE-12CDA-13] The telephone number or other electronic communications address for the agent SHALL be recorded in a <telecom> element when known
C83-[DE-12CDA-14] The name of the agent who can provide a copy of the Advance Directive SHALL be recorded in the <name> element inside the <playingEntity> element
C32-[CT1--1] Advance Directive See HITSP/C83 Section 2.2.2.12 Advance Directives Section
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