| All | OperationalTemplate [rootArchetypeId=openEHR-EHR-COMPOSITION.adverse_reaction_list.v1, otherContributors=Tony Shannon; Shane McKee; Ian McNicoll; Hildi McNicoll; Paul Miller; Susan Veitch; Mark Wardle, tshis=[ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1], code=at0000, itemType=COMPOSITION, level=0, text=NWIS - Adverse Reactions List, description=A persistent and managed list of adverse reactions experienced by the subject that may influence clinical decision-making and care provision., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=COMPOSITION, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=null, code=null, itemType=UNSUPPORTEDTOPLEVELATTRIBUTE, level=1, text=Other Context, description=null, comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=UNSUPPORTEDTOPLEVELATTRIBUTE, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/context/other_context[at0001]/items[openEHR-EHR-CLUSTER.xds_metadata.v0], code=at0000, itemType=CLUSTER, level=2, text=XDS Metadata, description=Additional composition metadata aligned with IHE-XDS which is not already available from the Reference Model COMPOSITION class., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/context/other_context[at0001]/items[openEHR-EHR-CLUSTER.xds_metadata.v0]/items[at0001], code=at0001, itemType=ELEMENT, level=3, text=Author specialty, description=The speciality of the author/composer of the document., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/context/other_context[at0001]/items[openEHR-EHR-CLUSTER.xds_metadata.v0]/items[at0002], code=at0002, itemType=ELEMENT, level=3, text=Class code, description=A high-level document class code, normally selected from a valueset provided by the IHE-XDS Affinity Domain., comment=For example: Report, Summary, Images, Plan, Patient Preferences, Workflow.
These codes are specific to an XDS Affinity Domain., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/context/other_context[at0001]/items[openEHR-EHR-CLUSTER.xds_metadata.v0]/items[at0003], code=at0003, itemType=ELEMENT, level=3, text=Document type, description=The code specifying the precise type of document from the user perspective. Normally selected from a valueset provided by the local IHE-XDS Affinity Domain or national standard., comment=for example: Pulmonary History and Physical, Discharge Summary, Ultrasound Report.
These codes are specific to an XDS Affinity Domain., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=Default value: SNOMED-CT::163221000000102::Allergies and adverse reactions, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/context/other_context[at0001]/items[openEHR-EHR-CLUSTER.xds_metadata.v0]/items[at0004], code=at0004, itemType=ELEMENT, level=3, text=Confidentiality code, description=A term specifying the level of confidentiality of the XDS Document., comment=Coded text is preferred, normally specific to an XDS Affinity Domain., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/context/other_context[at0001]/items[openEHR-EHR-CLUSTER.xds_metadata.v0]/items[at0007], code=at0007, itemType=ELEMENT, level=3, text=Health care facility type, description=A term defining the healthcare facility type., comment=Coded text is preferred. The codes are specific to an XDS Affinity Domain., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/context/other_context[at0001]/items[openEHR-EHR-CLUSTER.xds_metadata.v0]/items[at0009], code=at0009, itemType=ELEMENT, level=3, text=Practice setting code, description=The code specifying the clinical specialty where the act that resulted in the document was performed., comment=For example: Family Practice, Laboratory, Radiology.
Coded text is preferred, normally specific to an XDS Affinity Domain., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/content[openEHR-EHR-SECTION.adverse_list.v0], code=at0000, itemType=SECTION, level=1, text=Adverse Reaction List, description=Suggested design pattern for including an Adverse Reaction List in a template., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=SECTION, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/content[openEHR-EHR-SECTION.adverse_list.v0]/items[openEHR-EHR-EVALUATION.adverse_reaction_risk.v1], code=at0000, itemType=EVALUATION, level=2, text=Adverse reaction risk, description=Risk of harmful or undesirable physiological response which is unique to an individual and associated with exposure to a substance., comment=Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings., uncommonOntologyItems={source=openEHR,FHIR}, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=EVALUATION, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/content[openEHR-EHR-SECTION.adverse_list.v0]/items[openEHR-EHR-EVALUATION.adverse_reaction_risk.v1]/data[at0001], code=at0001, itemType=UNSUPPORTEDTOPLEVELATTRIBUTE, level=3, text=Data, description=, comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=UNSUPPORTEDTOPLEVELATTRIBUTE, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/content[openEHR-EHR-SECTION.adverse_list.v0]/items[openEHR-EHR-EVALUATION.adverse_reaction_risk.v1]/data[at0001]/items[at0002], code=at0002, itemType=ELEMENT, level=4, text=Substance, description=Identification of a substance, or substance class, that is considered to put the individual at risk of an adverse reaction event., comment=Both an individual substance and a substance class are valid entries in 'Substance'. A substance may be a compound of simpler substances, for example a medicinal product. If the value in 'Substance' is an individual substance, it may be duplicated in 'Specific substance'. It is strongly recommended that both 'Substance' and 'Specific substance' be coded with a terminology capable of triggering decision support, where possible. For example: Snomed CT, DM+D, RxNorm, NDFRT, ATC, New Zealand Universal List of Medicines and Australian Medicines Terminology. Free text entry should only be used if there is no appropriate terminology available., uncommonOntologyItems={source=openEHR,FHIR,DAM}, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/content[openEHR-EHR-SECTION.adverse_list.v0]/items[openEHR-EHR-EVALUATION.adverse_reaction_risk.v1]/data[at0001]/items[at0063], code=at0063, itemType=ELEMENT, level=4, text=Status, description=Assertion about the certainty of the propensity, or potential future risk, of the identified 'Substance' to cause a reaction., comment=Decision support would typically raise alerts for 'Suspected', 'Likely', 'Confirmed', and ignore a 'Refuted' reaction. Clinical systems may choose not to display Adverse reaction entries with a
'Refuted' status in the Adverse Reaction List.
However, 'Refuted' may be useful for reconciliation of the adverse reaction list or when communicating between systems
. Some implementations may choose to make this field mandatory.
'Resolved' may be used variably across systems, depending on clinical use and context - there appears to be differing opinion whether this should still be used to raise potential alerts or to display in an Adverse Reaction List. The free text data type will allow for local variation by enabling other value sets to be applied to this data element in a template - in this situation it is recommended that values should be coded using a terminology., uncommonOntologyItems={source=FHIR, DAM}, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values= Coded Text- Suspected
- Likely
- Confirmed
- Resolved
- Refuted
 Text
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/content[openEHR-EHR-SECTION.adverse_list.v0]/items[openEHR-EHR-EVALUATION.adverse_reaction_risk.v1]/data[at0001]/items[at0101], code=at0101, itemType=ELEMENT, level=4, text=Criticality, description=An indication of the potential for critical system organ damage or life threatening consequence., comment=This can be regarded as a predictive judgement of a 'worst case scenario'.
In most contexts 'Low' would be regarded as the default value., uncommonOntologyItems={source=DAM, openEHR}, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/content[openEHR-EHR-SECTION.adverse_list.v0]/items[openEHR-EHR-EVALUATION.adverse_reaction_risk.v1]/data[at0001]/items[at0120], code=at0120, itemType=ELEMENT, level=4, text=Category, description=Category of the identified 'Substance'., comment=This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the Substance where coding systems are used, and is effectively redundant in that situation., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=- Coded Text
- Text
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/content[openEHR-EHR-SECTION.adverse_list.v0]/items[openEHR-EHR-EVALUATION.adverse_reaction_risk.v1]/data[at0001]/items[at0117], code=at0117, itemType=ELEMENT, level=4, text=Onset of last reaction, description=The date and/or time of the onset of the last known occurrence of a reaction event., comment=This date may be be a duplicate of the most recent 'Onset of reaction' date.
Where a textual representation of the date of last occurrence is required e.g 'In Childhood, '10 years ago' the Comment element should be used., uncommonOntologyItems={source=IMH}, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/content[openEHR-EHR-SECTION.adverse_list.v0]/items[openEHR-EHR-EVALUATION.adverse_reaction_risk.v1]/data[at0001]/items[at0058], code=at0058, itemType=ELEMENT, level=4, text=Reaction mechanism, description=Identification of the underlying physiological mechanism for the adverse reaction., comment=Immune-mediated responses have been traditionally regarded as an indicator for escalation of significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune are actually non-immune and still carry life threatening risk.
Immunological testing may provide supporting evidence for the mechanism and causative substance , but no tests are 100% sensitive or specific for a sensitivity.
It is acknowledged that most clinicians will NOT be able to distinguish the mechanism of any specific reaction. However this data element is included because many legacy systems have captured this attribute., uncommonOntologyItems={source=FHIR, DAM}, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=- Coded Text
- Immune mediated
- Non-immune mediated
- Indeterminate
- Text
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/content[openEHR-EHR-SECTION.adverse_list.v0]/items[openEHR-EHR-EVALUATION.adverse_reaction_risk.v1]/data[at0001]/items[at0009], code=at0009, itemType=CLUSTER, level=4, text=Reaction event, description=Details about each adverse reaction event linked to exposure to the identified 'Substance'., comment=null, uncommonOntologyItems={source=openEHR,FHIR,DAM}, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/content[openEHR-EHR-SECTION.adverse_list.v0]/items[openEHR-EHR-EVALUATION.adverse_reaction_risk.v1]/data[at0001]/items[at0009]/items[at0010], code=at0010, itemType=ELEMENT, level=5, text=Specific substance, description=Identification of the substance considered to be responsible for the specific adverse reaction event., comment=For example: 'Amoxycillin'. Only an individual substance is a valid entry in 'Specific substance'. A substance may be a compound of simpler substances, for example a medicinal product. If the value in 'Substance' is an individual substance and not a substance class, then it may be duplicated in this data element. It is strongly recommended that 'Specific substance' be coded with a terminology capable of triggering decision support, where possible. For example: RxNorm, Snomed CT, DM+D, NDFRT, ICD-9, ICD-10, UNI, ATC and CPT. Free text entry should only be used if there is no appropriate terminology available., uncommonOntologyItems={source=FHIR, openEHR,DAM}, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/content[openEHR-EHR-SECTION.adverse_list.v0]/items[openEHR-EHR-EVALUATION.adverse_reaction_risk.v1]/data[at0001]/items[at0009]/items[at0011], code=at0011, itemType=ELEMENT, level=5, text=Manifestation, description=Clinical symptoms and/or signs that are observed or associated with the adverse reaction., comment=Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash. 'No reaction'may be appropriate where a previous reaction has been noted but the reaction did not re-occur after further exposure. It is preferable that 'Manifestation' should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines.
Terminologies commonly used include, but are not limited to, SNOMED-CT or ICD10., uncommonOntologyItems={source=FHIR, openEHR,DAM}, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/content[openEHR-EHR-SECTION.adverse_list.v0]/items[openEHR-EHR-EVALUATION.adverse_reaction_risk.v1]/data[at0001]/items[at0009]/items[at0027], code=at0027, itemType=ELEMENT, level=5, text=Onset of reaction, description=Record of the date and/or time of the onset of the reaction., comment=null, uncommonOntologyItems={source=openEHR, FHIR, DAM}, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/content[openEHR-EHR-SECTION.adverse_list.v0]/items[openEHR-EHR-EVALUATION.adverse_reaction_risk.v1]/data[at0001]/items[at0009]/items[at0020], code=at0020, itemType=ELEMENT, level=5, text=Initial exposure, description=Record of the date and/or time of the first exposure to the Substance for this Reaction Event., comment=Exposure can be more complicated by more than one exposure events leading to a reaction. Further details about the nature of the exposure can be provided by use of additional archetypes in the 'Exposure details' SLOT or as text in the 'Exposure description'., uncommonOntologyItems={source=FHIR, openEHR,DAM}, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/content[openEHR-EHR-SECTION.adverse_list.v0]/items[openEHR-EHR-EVALUATION.adverse_reaction_risk.v1]/data[at0001]/items[at0009]/items[at0106], code=at0106, itemType=ELEMENT, level=5, text=Route of exposure, description=Identification of the route by which the subject was exposed to the identified 'Specific substance'., comment=Coding of the Route of Exposure with a terminology should be used wherever possible., uncommonOntologyItems={source=FHIR, DAM}, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/content[openEHR-EHR-SECTION.adverse_list.v0]/items[openEHR-EHR-EVALUATION.adverse_reaction_risk.v1]/data[at0001]/items[at0009]/items[openEHR-EHR-CLUSTER.witnessed_by_clinician.v0], code=at0000, itemType=CLUSTER, level=5, text=Witnessed by Clinician, description=Cluster archetype to be used to confirm an event was witnessed by a clinical staff member.
For example, adverse reaction to exposure of a causative agent which was observed by a Nurse., comment=Used as part of NHS Wales Adverse Reaction record., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/content[openEHR-EHR-SECTION.adverse_list.v0]/items[openEHR-EHR-EVALUATION.adverse_reaction_risk.v1]/data[at0001]/items[at0009]/items[openEHR-EHR-CLUSTER.witnessed_by_clinician.v0]/items[at0001], code=at0001, itemType=ELEMENT, level=6, text=Witnessed by clinician, description=To confirm if an event was witnessed by a clinician., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_BOOLEAN, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/content[openEHR-EHR-SECTION.adverse_list.v0]/items[openEHR-EHR-EVALUATION.adverse_reaction_risk.v1]/data[at0001]/items[at0009]/items[at0032], code=at0032, itemType=ELEMENT, level=5, text=Reaction comment, description=Additional narrative about the adverse reaction event not captured in other fields., comment=null, uncommonOntologyItems={source=openEHR}, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/content[openEHR-EHR-SECTION.adverse_list.v0]/items[openEHR-EHR-EVALUATION.adverse_reaction_risk.v1]/protocol[at0042], code=at0042, itemType=UNSUPPORTEDTOPLEVELATTRIBUTE, level=3, text=Protocol, description=, comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=UNSUPPORTEDTOPLEVELATTRIBUTE, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/content[openEHR-EHR-SECTION.adverse_list.v0]/items[openEHR-EHR-EVALUATION.adverse_reaction_risk.v1]/protocol[at0042]/items[at0062], code=at0062, itemType=ELEMENT, level=4, text=Last updated, description=Date when the propensity or the reaction event was updated., comment=Note: maps to recordedDate in FHIR., uncommonOntologyItems={source=openEHR, FHIR, DAM}, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/content[openEHR-EHR-SECTION.adverse_list.v0]/items[openEHR-EHR-EVALUATION.exclusion_global.v1], code=at0000, itemType=EVALUATION, level=2, text=Exclusion - global, description=An overall statement of exclusion about all Problems/diagnoses, Family history, Medications, Procedures, Adverse reactions or other clinical items that are either not currently present, or have not been present in the past., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=EVALUATION, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/content[openEHR-EHR-SECTION.adverse_list.v0]/items[openEHR-EHR-EVALUATION.exclusion_global.v1]/data[at0001], code=at0001, itemType=UNSUPPORTEDTOPLEVELATTRIBUTE, level=3, text=Data, description=, comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=UNSUPPORTEDTOPLEVELATTRIBUTE, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/content[openEHR-EHR-SECTION.adverse_list.v0]/items[openEHR-EHR-EVALUATION.exclusion_global.v1]/data[at0001]/items[at0002], code=at0002, itemType=ELEMENT, level=4, text=Global exclusion of adverse reactions, description=Overall statement of exclusion about all adverse reactions at the time of recording., comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=Default value: Patient has no known adverse reactions, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/content[openEHR-EHR-SECTION.adverse_list.v0]/items[openEHR-EHR-EVALUATION.absence.v1], code=at0000, itemType=EVALUATION, level=2, text=Absence of information, description=Statement that specified health information is not available for inclusion in the health record or extract at the time of recording., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=EVALUATION, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/content[openEHR-EHR-SECTION.adverse_list.v0]/items[openEHR-EHR-EVALUATION.absence.v1]/data[at0001], code=at0001, itemType=UNSUPPORTEDTOPLEVELATTRIBUTE, level=3, text=Data, description=, comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=UNSUPPORTEDTOPLEVELATTRIBUTE, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/content[openEHR-EHR-SECTION.adverse_list.v0]/items[openEHR-EHR-EVALUATION.absence.v1]/data[at0001]/items[at0002], code=at0002, itemType=ELEMENT, level=4, text=Absence statement, description=Positive statement that no information is available., comment=For example: "No information available about adverse reactions"; No information available about problems or diagnoses"; "No information available about previous procedures performed"; or "No information available about medications used"., uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=Default value: No information for known allergies and adverse reactions, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/content[openEHR-EHR-SECTION.adverse_list.v0]/items[openEHR-EHR-EVALUATION.absence.v1]/protocol[at0003], code=at0003, itemType=UNSUPPORTEDTOPLEVELATTRIBUTE, level=3, text=Protocol, description=, comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=UNSUPPORTEDTOPLEVELATTRIBUTE, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/content[openEHR-EHR-SECTION.adverse_list.v0]/items[openEHR-EHR-EVALUATION.absence.v1]/protocol[at0003]/items[at0004], code=at0004, itemType=ELEMENT, level=4, text=Last updated, description=The date at which the absence was last updated., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/content[openEHR-EHR-ACTION.review.v1], code=at0000, itemType=ACTION, level=1, text=Review, description=Clinical activity regarding the performance of a formal clinical review of a subject's clinical situation, a specific aspect of their clinical care or a specified part of the health record., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=ACTION, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/content[openEHR-EHR-ACTION.review.v1]/description[at0001], code=at0001, itemType=UNSUPPORTEDTOPLEVELATTRIBUTE, level=2, text=Description, description=, comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=UNSUPPORTEDTOPLEVELATTRIBUTE, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/content[openEHR-EHR-ACTION.review.v1]/description[at0001]/items[at0002], code=at0002, itemType=ELEMENT, level=3, text=Review Activity, description=Identification of the item or activity that is being reviewed., comment=Coding with a terminology is preferred, if available. For example: Medicines List; Care Plan Review; or File Review., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=Default value: Adverse reaction list review, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/content[openEHR-EHR-ACTION.review.v1]/description[at0001]/items[at0015], code=at0015, itemType=ELEMENT, level=3, text=Description, description=Narrative description of the Review Activity relevant for the care pathway step., comment=For example: description of the Medicines Review that was performed; or the Care Plan review that is planned or scheduled., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/content[openEHR-EHR-ACTION.review.v1]/description[at0001]/items[at0014], code=at0014, itemType=ELEMENT, level=3, text=Reason, description=Reason that the care pathway step for the identified Review Activity was carried out., comment=For example, the reason for the cancellation or suspension of the Review Activity, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/content[openEHR-EHR-ACTION.review.v1]/protocol[at0017], code=at0017, itemType=UNSUPPORTEDTOPLEVELATTRIBUTE, level=2, text=Protocol, description=, comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=UNSUPPORTEDTOPLEVELATTRIBUTE, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.adverse_reaction_list.v1]/content[openEHR-EHR-ACTION.review.v1]/protocol[at0017]/items[at0018], code=at0018, itemType=ELEMENT, level=3, text=Start Date/Time, description=The start date and/or time for the Review activity., comment=This will indicate the scheduled date/time when recorded against the Scheduled care pathway step or the actual Start date/time in the Procedure performed step., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null]], templateType=normal] |