HL7 Terminology
2.0.0 - Publication

This page is part of the HL7 Terminology (v2.0.0: Release) based on FHIR R4. The current version which supercedes this version is 5.2.0. For a full list of available versions, see the Directory of published versions

: CDA Rendering Manifest - XML Representation

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<List xmlns="http://hl7.org/fhir">
  <id value="cda-Rendering"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><h2>CDA Rendering Manifest</h2><table class="clstu"><tr><td>Mode: workingStatus: currentCode: UTG Control Manifest</td></tr><tr><td>Order: Sorted Alphabetically</td></tr></table><table class="grid"><tr style="backgound-color: #eeeeee"><td><b>Items</b></td></tr><tr><td><a href="CodeSystem-v3-ActClass.html">Generated Summary: language: en; url: http://terminology.hl7.org/CodeSystem/v3-ActClass; id: urn:oid:2.16.840.1.113883.5.6; version: 3.0.0; name: ActClass; title: ActClass; status: active; date: 2019-03-20; publisher: Health Level 7; Health Level Seven: ; hierarchyMeaning: is-a; content: complete</a></td></tr><tr><td><a href="CodeSystem-v3-Confidentiality.html">Generated Summary: language: en; url: http://terminology.hl7.org/CodeSystem/v3-Confidentiality; id: urn:oid:2.16.840.1.113883.5.25; version: 2.1.0; name: Confidentiality; title: Confidentiality; status: active; date: 2019-12-15; publisher: Health Level 7; Health Level Seven: ; description: A set of codes specifying the security classification of acts and roles in accordance with the definition for concept domain "Confidentiality".; hierarchyMeaning: is-a; content: complete</a></td></tr><tr><td><a href="CodeSystem-v3-RoleStatus.html">Generated Summary: language: en; url: http://terminology.hl7.org/CodeSystem/v3-RoleStatus; id: urn:oid:2.16.840.1.113883.5.1068; version: 2.0.0; name: RoleStatus; title: RoleStatus; status: active; date: 2019-03-20; publisher: Health Level 7; Health Level Seven: ; description: Codes representing the defined possible states of an Role, as defined by the Role class state machine.; hierarchyMeaning: is-a; content: complete</a></td></tr><tr><td><a href="CodeSystem-v3-ActMood.html">Generated Summary: language: en; url: http://terminology.hl7.org/CodeSystem/v3-ActMood; id: urn:oid:2.16.840.1.113883.5.1001; version: 2.0.0; name: ActMood; title: ActMood; status: active; date: 2019-03-20; publisher: Health Level 7; Health Level Seven: ; description: OpenIssue: In Ballot 2009May, a strong Negative vote was lodged against several of the concept definitions in the vocabulary used for Act.moodCode. The vote was found "Persuasive With Mod", with the understanding that M and M would undertake a detailed review of these concept definitions for a future release of the RIM.; hierarchyMeaning: is-a; content: complete</a></td></tr><tr><td><a href="CodeSystem-v3-ActRelationshipType.html">Generated Summary: language: en; url: http://terminology.hl7.org/CodeSystem/v3-ActRelationshipType; id: urn:oid:2.16.840.1.113883.5.1002; version: 3.0.0; name: ActRelationshipType; title: ActRelationshipType; status: active; date: 2019-03-20; publisher: Health Level 7; Health Level Seven: ; description: The source is an excerpt from the target.; hierarchyMeaning: is-a; content: complete</a></td></tr><tr><td><a href="CodeSystem-v3-NullFlavor.html">Generated Summary: language: en; url: http://terminology.hl7.org/CodeSystem/v3-NullFlavor; id: urn:oid:2.16.840.1.113883.5.1008; version: 2.0.0; name: NullFlavor; title: NullFlavor; status: active; date: 2019-03-20; publisher: Health Level 7; Health Level Seven: ; description: A collection of codes specifying why a valid value is not present.; hierarchyMeaning: is-a; content: complete</a></td></tr><tr><td><a href="CodeSystem-v3-ContextControl.html">Generated Summary: language: en; url: http://terminology.hl7.org/CodeSystem/v3-ContextControl; id: urn:oid:2.16.840.1.113883.5.1057; version: 2.0.0; name: ContextControl; title: ContextControl; status: active; date: 2019-03-20; publisher: Health Level 7; Health Level Seven: ; description: A code that specifies how an ActRelationship or Participation contributes to the context of an Act, and whether it may be propagated to descendent Acts whose association allows such propagation (see also attributes Participation.contextControlCode, ActRelationship.contextControlCode, ActRelationship.contextConductionInd).; hierarchyMeaning: is-a; content: complete</a></td></tr><tr><td><a href="CodeSystem-v3-EntityClass.html">Generated Summary: language: en; url: http://terminology.hl7.org/CodeSystem/v3-EntityClass; id: urn:oid:2.16.840.1.113883.5.41; version: 2.0.0; name: EntityClass; title: EntityClass; status: active; date: 2019-03-20; publisher: Health Level 7; Health Level Seven: ; description: Classifies the Entity class and all of its subclasses. The terminology is hierarchical. At the top is this HL7-defined domain of high-level categories (such as represented by the Entity subclasses). Each of these terms must be harmonized and is specializable. The value sets beneath are drawn from multiple, frequently external, domains that reflect much more fine-grained typing.; hierarchyMeaning: is-a; content: complete</a></td></tr><tr><td><a href="CodeSystem-v3-EntityDeterminer.html">Generated Summary: language: en; url: http://terminology.hl7.org/CodeSystem/v3-EntityDeterminer; id: urn:oid:2.16.840.1.113883.5.30; version: 2.0.0; name: EntityDeterminer; title: EntityDeterminer; status: active; date: 2019-03-20; publisher: Health Level 7; Health Level Seven: ; description: EntityDeterminer in natural language grammar is the class of words that comprises articles, demonstrative pronouns, and quantifiers. In the RIM, determiner is a structural code in the Entity class to distinguish whether any given Entity object stands for some, any one, or a specific thing.; hierarchyMeaning: is-a; content: complete</a></td></tr><tr><td><a href="CodeSystem-v3-ParticipationFunction.html">Generated Summary: language: en; url: http://terminology.hl7.org/CodeSystem/v3-ParticipationFunction; id: urn:oid:2.16.840.1.113883.5.88; version: 2.0.0; name: ParticipationFunction; title: ParticipationFunction; status: active; date: 2019-03-20; publisher: Health Level 7; Health Level Seven: ; description: This code is used to specify the exact function an actor had in a service in all necessary detail. This domain may include local extensions (CWE).; hierarchyMeaning: is-a; content: complete</a></td></tr><tr><td><a href="CodeSystem-v3-ParticipationType.html">Generated Summary: language: en; url: http://terminology.hl7.org/CodeSystem/v3-ParticipationType; id: urn:oid:2.16.840.1.113883.5.90; version: 3.0.0; name: ParticipationType; title: ParticipationType; status: active; date: 2019-03-20; publisher: Health Level 7; Health Level Seven: ; hierarchyMeaning: is-a; content: complete</a></td></tr><tr><td><a href="CodeSystem-v3-RoleClass.html">Generated Summary: language: en; url: http://terminology.hl7.org/CodeSystem/v3-RoleClass; id: urn:oid:2.16.840.1.113883.5.110; version: 3.0.0; name: RoleClass; title: RoleClass; status: active; date: 2019-03-20; publisher: Health Level 7; Health Level Seven: ; description: Codes for the Role class hierarchy. The values in this hierarchy, represent a Role which is an association or relationship between two entities - the entity that plays the role and the entity that scopes the role. Roles names are derived from the name of the playing entity in that role.

The role hierarchy stems from three core concepts, or abstract domains:

 *  **RoleClassOntological** is an abstract domain that collects roles in which the playing entity is defined or specified by the scoping entity.
 *  **RoleClassPartitive** collects roles in which the playing entity is in some sense a "part" of the scoping entity.
 *  **RoleClassAssociative** collects all of the remaining forms of association between the playing entity and the scoping entity. This set of roles is further partitioned between:
    
     *  **RoleClassPassive** which are roles in which the playing entity is used, known, treated, handled, built, or destroyed, etc. under the auspices of the scoping entity. The playing entity is passive in these roles in that the role exists without an agreement from the playing entity.
     *  **RoleClassMutualRelationship** which are relationships based on mutual behavior of the two entities. The basis of these relationship may be formal agreements or they may be *de facto* behavior. Thus, this sub-domain is further divided into:
        
         *  **RoleClassRelationshipFormal** in which the relationship is formally defined, frequently by a contract or agreement.
         *  **Personal relationship** which inks two people in a personal relationship.

The hierarchy discussed above is represented In the current vocabulary tables as a set of abstract domains, with the exception of the "Personal relationship" which is a leaf concept.

*OpenIssue:* Description copied from Concept Domain of same name. Must be verified.; hierarchyMeaning: is-a; content: complete</a></td></tr><tr><td><a href="ValueSet-v3-ActStatus.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-ActStatus; id: urn:oid:2.16.840.1.113883.1.11.15933; version: 2.0.0; name: ActStatus; title: ActStatus; status: active; date: 2014-03-26; description: Contains the names (codes) for each of the states in the state-machine of the RIM Act class.; immutable</a></td></tr><tr><td><a href="ValueSet-v3-ActClassClinicalDocument.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-ActClassClinicalDocument; id: urn:oid:2.16.840.1.113883.1.11.13948; version: 2.0.0; name: ActClassClinicalDocument; title: ActClassClinicalDocument; status: active; date: 2014-03-26; description: A clinical document is a documentation of clinical observations and services, with the following characteristics: (1) Persistence - A clinical document continues to exist in an unaltered state, for a time period defined by local and regulatory requirements; (2) Stewardship - A clinical document is maintained by a person or organization entrusted with its care; (3) Potential for authentication - A clinical document is an assemblage of information that is intended to be legally authenticated; (4) Wholeness - Authentication of a clinical document applies to the whole and does not apply to portions of the document without the full context of the document; (5) Human readability - A clinical document is human readable."; immutable</a></td></tr><tr><td><a href="ValueSet-v3-ActMood.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-ActMood; id: urn:oid:2.16.840.1.113883.1.11.10196; version: 2.0.0; name: ActMood; title: ActMood; status: active; date: 2014-03-26; description: A code distinguishing whether an Act is conceived of as a factual statement or in some other manner as a command, possibility, goal, etc.

*Constraints:* An Act-instance must have one and only one moodCode value.

The moodCode of a single Act-instance never changes. Mood is not state.

To describe the progression of a business activity from defined to planned to executed, etc. one must instantiate different Act-instances in the different moods and link them using ActRelationship of general type "sequel". (See ActRelationship.type.); immutable</a></td></tr><tr><td><a href="ValueSet-v3-xBasicConfidentialityKind.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-xBasicConfidentialityKind; id: urn:oid:2.16.840.1.113883.1.11.16926; version: 2.0.0; name: XBasicConfidentialityKind; title: x_BasicConfidentialityKind; status: active; date: 2014-03-26; description: **Description:** Used to enumerate the typical confidentiality constraints placed upon a clinical document.

*Usage Note:*x\_BasicConfidentialityKind is a subset of Confidentiality codes that are used as metadata indicating the receiver responsibility to comply with normally applicable jurisdictional privacy law or disclosure authorization; that the receiver may not disclose this information except as directed by the information custodian, who may be the information subject; or that the receiver may not disclose this information except as directed by the information custodian, who may be the information subject.</a></td></tr><tr><td><a href="ValueSet-v3-ContextControl.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-ContextControl; id: urn:oid:2.16.840.1.113883.1.11.16478; version: 2.0.0; name: ContextControl; title: ContextControl; status: active; date: 2014-03-26; description: A code that specifies how an ActRelationship or Participation contributes to the context of an Act, and whether it may be propagated to descendent Acts whose association allows such propagation (see also attributes Participation.contextControlCode, ActRelationship.contextControlCode, ActRelationship.contextConductionInd).</a></td></tr><tr><td><a href="ValueSet-v3-RoleClass.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-RoleClass; id: urn:oid:2.16.840.1.113883.1.11.11555; version: 2.0.0; name: RoleClass; title: RoleClass; status: active; date: 2014-03-26; description: This table includes codes for the Role class hierarchy. The values in this hierarchy, represent a Role which is an association or relationship between two entities - the entity that plays the role and the entity that scopes the role. Roles names are derived from the name of the playing entity in that role.

The role hierarchy stems from three core concepts, or abstract domains:

 *  **RoleClassOntological** is an abstract domain that collects roles in which the playing entity is defined or specified by the scoping entity.
 *  **RoleClassPartitive** collects roles in which the playing entity is in some sense a "part" of the scoping entity.
 *  **RoleClassAssociative** collects all of the remaining forms of association between the playing entity and the scoping entity. This set of roles is further partitioned between:
    
     *  **RoleClassPassive** which are roles in which the playing entity is used, known, treated, handled, built, or destroyed, etc. under the auspices of the scoping entity. The playing entity is passive in these roles in that the role exists without an agreement from the playing entity.
     *  **RoleClassMutualRelationship** which are relationships based on mutual behavior of the two entities. The basis of these relationship may be formal agreements or they may be *de facto* behavior. Thus, this sub-domain is further divided into:
        
         *  **RoleClassRelationshipFormal** in which the relationship is formally defined, frequently by a contract or agreement.
         *  **Personal relationship** which inks two people in a personal relationship.

The hierarchy discussed above is represented In the current vocabulary tables as a set of abstract domains, with the exception of the "Personal relationship" which is a leaf concept.; immutable</a></td></tr><tr><td><a href="ValueSet-v3-EntityClass.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-EntityClass; id: urn:oid:2.16.840.1.113883.1.11.10882; version: 2.0.0; name: EntityClass; title: EntityClass; status: active; date: 2014-03-26; description: Classifies the Entity class and all of its subclasses. The terminology is hierarchical. At the top is this HL7-defined domain of high-level categories (such as represented by the Entity subclasses). Each of these terms must be harmonized and is specializable.

The value sets beneath are encoded in Entity.code and are drawn from multiple, frequently external, domains that reflect much more fine-grained typing.; immutable</a></td></tr><tr><td><a href="ValueSet-v3-EntityDeterminer.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-EntityDeterminer; id: urn:oid:2.16.840.1.113883.1.11.10878; version: 2.0.0; name: EntityDeterminer; title: EntityDeterminer; status: active; date: 2014-03-26; description: EntityDeterminer in natural language grammar is the class of words that comprises articles, demonstrative pronouns, and quantifiers. In the RIM, determiner is a structural code in the Entity class to distinguish whether any given Entity object stands for some, any one, or a specific thing.; immutable</a></td></tr><tr><td><a href="ValueSet-v3-EntityClassPlace.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-EntityClassPlace; id: urn:oid:2.16.840.1.113883.1.11.10892; version: 2.0.0; name: EntityClassPlace; title: EntityClassPlace; status: active; date: 2014-03-26; description: A physicial place or site with its containing structure. May be natural or man-made. The geographic position of a place may or may not be constant.; immutable</a></td></tr><tr><td><a href="ValueSet-v3-EntityClassOrganization.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-EntityClassOrganization; id: urn:oid:2.16.840.1.113883.1.11.10889; version: 2.0.0; name: EntityClassOrganization; title: EntityClassOrganization; status: active; date: 2014-03-26; description: A social or legal structure formed by human beings.; immutable</a></td></tr><tr><td><a href="ValueSet-v3-RoleStatus.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-RoleStatus; id: urn:oid:2.16.840.1.113883.1.11.15999; version: 2.0.0; name: RoleStatus; title: RoleStatus; status: active; date: 2014-03-26; description: Codes representing the defined possible states of an Role, as defined by the Role class state machine.; immutable</a></td></tr><tr><td><a href="ValueSet-v3-RoleClassAssignedEntity.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-RoleClassAssignedEntity; id: urn:oid:2.16.840.1.113883.1.11.11595; version: 2.0.0; name: RoleClassAssignedEntity; title: RoleClassAssignedEntity; status: active; date: 2014-03-26; description: An agent role in which the agent is an Entity acting in the employ of an organization. The focus is on functional role on behalf of the organization, unlike the Employee role where the focus is on the 'Human Resources' relationship between the employee and the organization.</a></td></tr><tr><td><a href="ValueSet-v3-RoleClassContact.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-RoleClassContact; id: urn:oid:2.16.840.1.113883.1.11.12205; version: 2.0.0; name: RoleClassContact; title: RoleClassContact; status: active; date: 2014-03-26; description: A person or an organization (player) which provides or receives information regarding another entity (scoper). Examples; patient NOK and emergency contacts; guarantor contact; employer contact.; immutable</a></td></tr><tr><td><a href="ValueSet-v3-EntityClassDevice.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-EntityClassDevice; id: urn:oid:2.16.840.1.113883.1.11.11623; version: 2.0.0; name: EntityClassDevice; title: EntityClassDevice; status: active; date: 2014-03-26; description: A subtype of ManufacturedMaterial used in an activity, without being substantially changed through that activity. The kind of device is identified by the code attribute inherited from Entity.

*Usage:* This includes durable (reusable) medical equipment as well as disposable equipment.; immutable</a></td></tr><tr><td><a href="ValueSet-v3-RoleClassAssignedEntity.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-RoleClassAssignedEntity; id: urn:oid:2.16.840.1.113883.1.11.11595; version: 2.0.0; name: RoleClassAssignedEntity; title: RoleClassAssignedEntity; status: active; date: 2014-03-26; description: An agent role in which the agent is an Entity acting in the employ of an organization. The focus is on functional role on behalf of the organization, unlike the Employee role where the focus is on the 'Human Resources' relationship between the employee and the organization.</a></td></tr><tr><td><a href="ValueSet-v3-ActRelationshipFulfills.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-ActRelationshipFulfills; id: urn:oid:2.16.840.1.113883.1.11.10342; version: 2.0.0; name: ActRelationshipFulfills; title: ActRelationshipFulfills; status: active; date: 2014-03-26; description: The source act fulfills (in whole or in part) the target act. Source act must be in a mood equal or more actual than the target act.; immutable</a></td></tr><tr><td><a href="ValueSet-v3-ActClassRoot.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-ActClassRoot; id: urn:oid:2.16.840.1.113883.1.11.13856; version: 2.0.0; name: ActClassRoot; title: ActClassRoot; status: active; date: 2014-03-26; description: A record of something that is being done, has been done, can be done, or is intended or requested to be done.

*Examples:*The kinds of acts that are common in health care are (1) a clinical observation, (2) an assessment of health condition (such as problems and diagnoses), (3) healthcare goals, (4) treatment services (such as medication, surgery, physical and psychological therapy), (5) assisting, monitoring or attending, (6) training and education services to patients and their next of kin, (7) and notary services (such as advanced directives or living will), (8) editing and maintaining documents, and many others.

*Discussion and Rationale:* Acts are the pivot of the RIM; all domain information and processes are represented primarily in Acts. Any profession or business, including healthcare, is primarily constituted of intentional and occasionally non-intentional actions, performed and recorded by responsible actors. An Act-instance is a record of such an action.

Acts connect to Entities in their Roles through Participations and connect to other Acts through ActRelationships. Participations are the authors, performers and other responsible parties as well as subjects and beneficiaries (which includes tools and material used in the performance of the act, which are also subjects). The moodCode distinguishes between Acts that are meant as factual records, vs. records of intended or ordered services, and the other modalities in which act can appear.

One of the Participations that all acts have (at least implicitly) is a primary author, who is responsible of the Act and who "owns" the act. Responsibility for the act means responsibility for what is being stated in the Act and as what it is stated. Ownership of the act is assumed in the sense of who may operationally modify the same act. Ownership and responsibility of the Act is not the same as ownership or responsibility of what the Act-object refers to in the real world. The same real world activity can be described by two people, each being the author of their Act, describing the same real world activity. Yet one can be a witness while the other can be a principal performer. The performer has responsibilities for the physical actions; the witness only has responsibility for making a true statement to the best of his or her ability. The two Act-instances may even disagree, but because each is properly attributed to its author, such disagreements can exist side by side and left to arbitration by a recipient of these Act-instances.

In this sense, an Act-instance represents a "statement" according to Rector and Nowlan (1991) \[Foundations for an electronic medical record. Methods Inf Med. 30.\] Rector and Nowlan have emphasized the importance of understanding the medical record not as a collection of facts, but "a faithful record of what clinicians have heard, seen, thought, and done." Rector and Nowlan go on saying that "the other requirements for a medical record, e.g., that it be attributable and permanent, follow naturally from this view." Indeed the Act class is this attributable statement, and the rules of updating acts (discussed in the state-transition model, see Act.statusCode) versus generating new Act-instances are designed according to this principle of permanent attributable statements.

Rector and Nolan focus on the electronic medical record as a collection of statements, while attributed statements, these are still mostly factual statements. However, the Act class goes beyond this limitation to attributed factual statements, representing what is known as "speech-acts" in linguistics and philosophy. The notion of speech-act includes that there is pragmatic meaning in language utterances, aside from just factual statements; and that these utterances interact with the real world to change the state of affairs, even directly cause physical activities to happen. For example, an order is a speech act that (provided it is issued adequately) will cause the ordered action to be physically performed. The speech act theory has culminated in the seminal work by Austin (1962) \[How to do things with words. Oxford University Press\].

An activity in the real world may progress from defined, through planned and ordered to executed, which is represented as the mood of the Act. Even though one might think of a single activity as progressing from planned to executed, this progression is reflected by multiple Act-instances, each having one and only one mood that will not change along the Act-instance life cycle. This is because the attribution and content of speech acts along this progression of an activity may be different, and it is often critical that a permanent and faithful record be maintained of this progression. The specification of orders or promises or plans must not be overwritten by the specification of what was actually done, so as to allow comparing actions with their earlier specifications. Act-instances that describe this progression of the same real world activity are linked through the ActRelationships (of the relationship category "sequel").

Act as statements or speech-acts are the only representation of real world facts or processes in the HL7 RIM. The truth about the real world is constructed through a combination (and arbitration) of such attributed statements only, and there is no class in the RIM whose objects represent "objective state of affairs" or "real processes" independent from attributed statements. As such, there is no distinction between an activity and its documentation. Every Act includes both to varying degrees. For example, a factual statement made about recent (but past) activities, authored (and signed) by the performer of such activities, is commonly known as a procedure report or original documentation (e.g., surgical procedure report, clinic note etc.). Conversely, a status update on an activity that is presently in progress, authored by the performer (or a close observer) is considered to capture that activity (and is later superceded by a full procedure report). However, both status update and procedure report are acts of the same kind, only distinguished by mood and state (see statusCode) and completeness of the information.; immutable</a></td></tr><tr><td><a href="ValueSet-v3-ActClass.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-ActClass; id: urn:oid:2.16.840.1.113883.1.11.11527; version: 2.0.0; name: ActClass; title: ActClass; status: active; date: 2014-03-26; description: A code specifying the major type of Act that this Act-instance represents.

*Constraints:* The classCode domain is a tightly controlled vocabulary, not an external or user-defined vocabulary.

Every Act-instance must have a classCode. If the act class is not further specified, the most general Act.classCode (ACT) is used.

The Act.classCode must be a generalization of the specific Act concept (e.g., as expressed in Act.code), in other words, the Act concepts conveyed in an Act must be specializations of the Act.classCode. Especially, Act.code is not a "modifier" that can alter the meaning of a class code. (See Act.code for contrast.); immutable</a></td></tr><tr><td><a href="ValueSet-v3-ActRelationshipHasComponent.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-ActRelationshipHasComponent; id: urn:oid:2.16.840.1.113883.1.11.10318; version: 2.0.0; name: ActRelationshipHasComponent; title: ActRelationshipHasComponent; status: active; date: 2014-03-26; description: A collection of sub-services as steps or subtasks performed for the source service. Services may be performed sequentially or concurrently.; immutable</a></td></tr><tr><td><a href="ValueSet-v3-ActEncounterCode.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-ActEncounterCode; id: urn:oid:2.16.840.1.113883.1.11.13955; version: 2.0.0; name: ActEncounterCode; title: ActEncounterCode; status: active; date: 2014-03-26; description: Domain provides codes that qualify the ActEncounterClass (ENC)</a></td></tr><tr><td><a href="ValueSet-v3-xEncounterParticipant.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-xEncounterParticipant; id: urn:oid:2.16.840.1.113883.1.11.19600; version: 2.0.0; name: XEncounterParticipant; title: x_EncounterParticipant; status: active; date: 2014-03-26; description: Clones using this x\_domain should have a name "encounterParticipant".</a></td></tr><tr><td><a href="ValueSet-v3-ParticipationTargetLocation.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-ParticipationTargetLocation; id: urn:oid:2.16.840.1.113883.1.11.10302; version: 2.0.0; name: ParticipationTargetLocation; title: ParticipationTargetLocation; status: active; date: 2014-03-26; description: The facility where the service is done. May be a static building (or room therein) or a moving location (e.g., ambulance, helicopter, aircraft, train, truck, ship, etc.); immutable</a></td></tr><tr><td><a href="ValueSet-v3-RoleClassServiceDeliveryLocation.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-RoleClassServiceDeliveryLocation; id: urn:oid:2.16.840.1.113883.1.11.16927; version: 2.0.0; name: RoleClassServiceDeliveryLocation; title: RoleClassServiceDeliveryLocation; status: active; date: 2014-03-26; description: A role played by a place at which services may be provided.; immutable</a></td></tr><tr><td><a href="ValueSet-v3-ServiceDeliveryLocationRoleType.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType; id: urn:oid:2.16.840.1.113883.1.11.17660; version: 2.0.0; name: ServiceDeliveryLocationRoleType; title: ServiceDeliveryLocationRoleType; status: active; date: 2014-03-26; description: A role of a place that further classifies the setting (e.g., accident site, road side, work site, community location) in which services are delivered.</a></td></tr><tr><td><a href="ValueSet-v3-ParticipationTargetSubject.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-ParticipationTargetSubject; id: urn:oid:2.16.840.1.113883.1.11.19584; version: 2.0.0; name: ParticipationTargetSubject; title: ParticipationTargetSubject; status: active; date: 2014-03-26; description: The principle target that the service acts on. E.g. the patient in physical examination, a specimen in a lab observation. May also be a patient's family member (teaching) or a device or room (cleaning, disinfecting, housekeeping). Note: not all direct targets are subjects, consumables, and devices used as tools for a service are not subjects. However, a device may be a subject of a maintenance service.; immutable</a></td></tr><tr><td><a href="ValueSet-v3-RoleClassSpecimen.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-RoleClassSpecimen; id: urn:oid:2.16.840.1.113883.1.11.11591; version: 2.0.0; name: RoleClassSpecimen; title: RoleClassSpecimen; status: active; date: 2014-03-26; description: A role played by a material entity that is a specimen for an act. It is scoped by the source of the specimen.; immutable</a></td></tr><tr><td><a href="ValueSet-v3-EntityClassRoot.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-EntityClassRoot; id: urn:oid:2.16.840.1.113883.1.11.13922; version: 2.0.0; name: EntityClassRoot; title: EntityClassRoot; status: active; date: 2014-03-26; description: Corresponds to the Entity class; immutable</a></td></tr><tr><td><a href="ValueSet-v3-ParticipationPhysicalPerformer.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-ParticipationPhysicalPerformer; id: urn:oid:2.16.840.1.113883.1.11.10248; version: 2.0.0; name: ParticipationPhysicalPerformer; title: ParticipationPhysicalPerformer; status: active; date: 2014-03-26; description: A person who actually and principally carries out the action. Need not be the principal responsible actor, e.g. a surgery resident operating under supervision of attending surgeon, and may be the patient in self-care, e.g. fingerstick blood sugar. The traditional order filler is a performer. This information should accompany every service event.; immutable</a></td></tr><tr><td><a href="ValueSet-v3-RoleClassRoot.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-RoleClassRoot; id: urn:oid:2.16.840.1.113883.1.11.13940; version: 2.0.0; name: RoleClassRoot; title: RoleClassRoot; status: active; date: 2014-03-26; description: Corresponds to the Role class; immutable</a></td></tr><tr><td><a href="ValueSet-v3-ActClassObservation.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-ActClassObservation; id: urn:oid:2.16.840.1.113883.1.11.11529; version: 2.0.0; name: ActClassObservation; title: ActClassObservation; status: active; date: 2014-03-26; description: **Description:**An act that is intended to result in new information about a subject. The main difference between Observations and other Acts is that Observations have a value attribute. The **code** attribute of Observation and the **value** attribute of Observation must be considered in combination to determine the semantics of the observation.

**Discussion:**

Structurally, many observations are name-value-pairs, where the Observation.code (inherited from Act) is the name and the Observation.value is the value of the property. Such a construct is also known as a variable (a named feature that can assume a value) hence, the Observation class is always used to hold generic name-value-pairs or variables, even though the variable valuation may not be the result of an elaborate observation method. It may be a simple answer to a question or it may be an assertion or setting of a parameter.

As with all Act statements, Observation statements describe what was done, and in the case of Observations, this includes a description of what was actually observed (results or answers); and those results or answers are part of the observation and not split off into other objects.

The method of action is asserted by the Observation classCode or its subclasses at the least granular level, by the Observation.code attribute value at the medium level of granularity, and by the attribute value of observation.methodCode when a finer level of granularity is required. The method in whole or in part may also appear in the attribute value of Observation.value when using coded data types to express the value of the attribute. Relevant aspects of methodology may also be restated in value when the results themselves imply or state a methodology.

An observation may consist of component observations each having their own Observation.code and Observation.value. In this case, the composite observation may not have an Observation.value for itself. For instance, a white blood cell count consists of the sub-observations for the counts of the various granulocytes, lymphocytes and other normal or abnormal blood cells (e.g., blasts). The overall white blood cell count Observation itself may therefore not have a value by itself (even though it could have one, e.g., the sum total of white blood cells). Thus, as long as an Act is essentially an Act of recognizing and noting information about a subject, it is an Observation, regardless of whether it has a simple value by itself or whether it has sub-observations.

Even though observations are professional acts (see Act) and as such are intentional actions, this does not require that every possible outcome of an observation be pondered in advance of it being actually made. For instance, differential white blood cell counts (WBC) rarely show blasts, but if they do, this is part of the WBC observation even though blasts might not be predefined in the structure of a normal WBC.

Clinical documents commonly have Subjective and Objective findings, both of which are kinds of Observations. In addition, clinical documents commonly contain Assessments, which are also kinds of Observations. Thus, the establishment of a diagnosis is an Observation.

**Examples:**

 *  Recording the results of a Family History Assessment
 *  Laboratory test and associated result
 *  Physical exam test and associated result
 *  Device temperature
 *  Soil lead level; immutable</a></td></tr><tr><td><a href="ValueSet-v3-ActClassDocument.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-ActClassDocument; id: urn:oid:2.16.840.1.113883.1.11.18938; version: 2.0.0; name: ActClassDocument; title: ActClassDocument; status: active; date: 2014-03-26; description: Specialization of Act to add the characteristics unique to document management services.; immutable</a></td></tr><tr><td><a href="ValueSet-v3-ActRelationshipType.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-ActRelationshipType; id: urn:oid:2.16.840.1.113883.1.11.10317; version: 2.0.0; name: ActRelationshipType; title: ActRelationshipType; status: active; date: 2014-03-26; description: A code specifying the meaning and purpose of every ActRelationship instance. Each of its values implies specific constraints to what kinds of Act objects can be related and in which way.

*Discussion:* The types of act relationships fall under one of 5 categories:

1.) (De)-composition, with composite (source) and component (target)

2.) Sequel which includes follow-up, fulfillment, instantiation, replacement, transformation, etc. that all have in common that source and target are Acts of essentially the same kind but with variances in mood and other attributes, and where the target exists before the source and the source refers to the target that it links back to.

3.) Pre-condition, trigger, reason, contraindication, with the conditioned Act at the source and the condition or reason at the target.

4.) Post-condition, outcome, goal and risk, with the Act at the source having the outcome or goal at the target.

5.) A host of functional relationships including support, cause, derivation, etc. generalized under the notion of "pertinence".; immutable</a></td></tr><tr><td><a href="ValueSet-v3-ActRelationshipType.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-ActRelationshipType; id: urn:oid:2.16.840.1.113883.1.11.10317; version: 2.0.0; name: ActRelationshipType; title: ActRelationshipType; status: active; date: 2014-03-26; description: A code specifying the meaning and purpose of every ActRelationship instance. Each of its values implies specific constraints to what kinds of Act objects can be related and in which way.

*Discussion:* The types of act relationships fall under one of 5 categories:

1.) (De)-composition, with composite (source) and component (target)

2.) Sequel which includes follow-up, fulfillment, instantiation, replacement, transformation, etc. that all have in common that source and target are Acts of essentially the same kind but with variances in mood and other attributes, and where the target exists before the source and the source refers to the target that it links back to.

3.) Pre-condition, trigger, reason, contraindication, with the conditioned Act at the source and the condition or reason at the target.

4.) Post-condition, outcome, goal and risk, with the Act at the source having the outcome or goal at the target.

5.) A host of functional relationships including support, cause, derivation, etc. generalized under the notion of "pertinence".; immutable</a></td></tr><tr><td><a href="ValueSet-v3-EntityClassManufacturedMaterial.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-EntityClassManufacturedMaterial; id: urn:oid:2.16.840.1.113883.1.11.13934; version: 2.0.0; name: EntityClassManufacturedMaterial; title: EntityClassManufacturedMaterial; status: active; date: 2014-03-26; description: Corresponds to the ManufacturedMaterial class; immutable</a></td></tr><tr><td><a href="ValueSet-v3-EntityDeterminerDetermined.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-EntityDeterminerDetermined; id: urn:oid:2.16.840.1.113883.1.11.10879; version: 2.0.0; name: EntityDeterminerDetermined; title: EntityDeterminerDetermined; status: active; date: 2014-03-26; description: The described determiner is used to indicate that the given Entity is taken as a general description of a kind of thing that can be taken in whole, in part, or in multiples.; immutable</a></td></tr><tr><td><a href="ValueSet-v3-EntityDeterminerDetermined.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-EntityDeterminerDetermined; id: urn:oid:2.16.840.1.113883.1.11.10879; version: 2.0.0; name: EntityDeterminerDetermined; title: EntityDeterminerDetermined; status: active; date: 2014-03-26; description: The described determiner is used to indicate that the given Entity is taken as a general description of a kind of thing that can be taken in whole, in part, or in multiples.; immutable</a></td></tr><tr><td><a href="ValueSet-v3-HumanLanguage.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-HumanLanguage; id: urn:oid:2.16.840.1.113883.1.11.11526; version: 2.0.0; name: HumanLanguage; title: HumanLanguage; status: active; date: 2014-03-26; description: Codes for the representation of the names of human languages.</a></td></tr><tr><td><a href="ValueSet-v3-ParticipationSignature.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-ParticipationSignature; id: urn:oid:2.16.840.1.113883.1.11.10282; version: 2.0.0; name: ParticipationSignature; title: ParticipationSignature; status: active; date: 2014-03-26; description: A code specifying whether and how the participant has attested his participation through a signature and or whether such a signature is needed.

*Examples:* A surgical Procedure act object (representing a procedure report) requires a signature of the performing and responsible surgeon, and possibly other participants. (See also: Participation.signatureText.)</a></td></tr><tr><td><a href="ValueSet-v3-ParticipationType.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-ParticipationType; id: urn:oid:2.16.840.1.113883.1.11.10901; version: 2.0.0; name: ParticipationType; title: ParticipationType; status: active; date: 2014-03-26; description: A code specifying the meaning and purpose of every Participation instance. Each of its values implies specific constraints on the Roles undertaking the participation.; immutable</a></td></tr><tr><td><a href="ValueSet-v3-ROIOverlayShape.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-ROIOverlayShape; id: urn:oid:2.16.840.1.113883.1.11.16117; version: 2.0.0; name: ROIOverlayShape; title: ROIOverlayShape; status: active; date: 2014-03-26; description: Shape of the region on the object being referenced</a></td></tr><tr><td><a href="ValueSet-v3-RoleClassAssociative.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-RoleClassAssociative; id: urn:oid:2.16.840.1.113883.1.11.19313; version: 2.0.0; name: RoleClassAssociative; title: RoleClassAssociative; status: active; date: 2014-03-26; description: A general association between two entities that is neither partitive nor ontological.; immutable</a></td></tr><tr><td><a href="ValueSet-v3-RoleClassMutualRelationship.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-RoleClassMutualRelationship; id: urn:oid:2.16.840.1.113883.1.11.19316; version: 2.0.0; name: RoleClassMutualRelationship; title: RoleClassMutualRelationship; status: active; date: 2014-03-26; description: A relationship that is based on mutual behavior of the two Entities as being related. The basis of such relationship may be agreements (e.g., spouses, contract parties) or they may be *de facto* behavior (e.g. friends) or may be an incidental involvement with each other (e.g. parties over a dispute, siblings, children).; immutable</a></td></tr><tr><td><a href="ValueSet-v3-RoleStatusActive.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-RoleStatusActive; id: urn:oid:2.16.840.1.113883.1.11.20187; version: 2.0.0; name: RoleStatusActive; title: RoleStatusActive; status: active; date: 2014-03-26; description: The state representing the fact that the Entity is currently active in the Role.; immutable</a></td></tr><tr><td><a href="ValueSet-v3-xActClassDocumentEntryAct.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct; id: urn:oid:2.16.840.1.113883.1.11.19599; version: 2.0.0; name: XActClassDocumentEntryAct; title: x_ActClassDocumentEntryAct; status: active; date: 2014-03-26; description: The set of Act class codes allowed for the ACT class clone in the CDA Clinical Statement model. The scope of this value set are those Act class codes not otherwise covered by specific classes in the CDA Clinical Statement model and required to enable representation of Clinical Statement in CDA.</a></td></tr><tr><td><a href="ValueSet-v3-xActClassDocumentEntryOrganizer.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryOrganizer; id: urn:oid:2.16.840.1.113883.1.11.19598; version: 2.0.0; name: XActClassDocumentEntryOrganizer; title: x_ActClassDocumentEntryOrganizer; status: active; date: 2014-03-26</a></td></tr><tr><td><a href="ValueSet-v3-xActMoodDocumentObservation.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation; id: urn:oid:2.16.840.1.113883.1.11.18943; version: 2.0.0; name: XActMoodDocumentObservation; title: x_ActMoodDocumentObservation; status: active; date: 2014-03-26; description: Used to enumerate the moods that an observation can take within the body of a clinical document.</a></td></tr><tr><td><a href="ValueSet-v3-xActRelationshipDocument.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-xActRelationshipDocument; id: urn:oid:2.16.840.1.113883.1.11.11610; version: 2.0.0; name: XActRelationshipDocument; title: x_ActRelationshipDocument; status: active; date: 2014-03-26; description: Used to enumerate the relationships between two clinical documents for document management.</a></td></tr><tr><td><a href="ValueSet-v3-xActRelationshipEntry.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntry; id: urn:oid:2.16.840.1.113883.1.11.19446; version: 2.0.0; name: XActRelationshipEntry; title: x_ActRelationshipEntry; status: active; date: 2014-03-26; description: Used to enumerate the relationships between a CDA section and its contained entries.</a></td></tr><tr><td><a href="ValueSet-v3-xActRelationshipEntryRelationship.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship; id: urn:oid:2.16.840.1.113883.1.11.19447; version: 2.0.0; name: XActRelationshipEntryRelationship; title: x_ActRelationshipEntryRelationship; status: active; date: 2014-03-26; description: Used to enumerate the relationships between two CDA entries.</a></td></tr><tr><td><a href="ValueSet-v3-xActRelationshipExternalReference.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-xActRelationshipExternalReference; id: urn:oid:2.16.840.1.113883.1.11.19000; version: 2.0.0; name: XActRelationshipExternalReference; title: x_ActRelationshipExternalReference; status: active; date: 2014-03-26; description: Used to enumerate the relationships between a CDA entry and an externally referenced act.</a></td></tr><tr><td><a href="ValueSet-v3-xDocumentActMood.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-xDocumentActMood; id: urn:oid:2.16.840.1.113883.1.11.19458; version: 2.0.0; name: XDocumentActMood; title: x_DocumentActMood; status: active; date: 2014-03-26; description: Used to enumerate the moods that an act can take within the body of a clinical document.</a></td></tr><tr><td><a href="ValueSet-v3-xDocumentEncounterMood.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-xDocumentEncounterMood; id: urn:oid:2.16.840.1.113883.1.11.19459; version: 2.0.0; name: XDocumentEncounterMood; title: x_DocumentEncounterMood; status: active; date: 2014-03-26; description: Used to enumerate the moods that an encounter can take within the body of a clinical document.</a></td></tr><tr><td><a href="ValueSet-v3-xDocumentProcedureMood.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-xDocumentProcedureMood; id: urn:oid:2.16.840.1.113883.1.11.19460; version: 2.0.0; name: XDocumentProcedureMood; title: x_DocumentProcedureMood; status: active; date: 2014-03-26; description: Used to enumerate the moods that a procedure can take within the body of a clinical document.</a></td></tr><tr><td><a href="ValueSet-v3-xDocumentSubject.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-xDocumentSubject; id: urn:oid:2.16.840.1.113883.1.11.19368; version: 2.0.0; name: XDocumentSubject; title: x_DocumentSubject; status: active; date: 2014-03-26</a></td></tr><tr><td><a href="ValueSet-v3-xDocumentSubstanceMood.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-xDocumentSubstanceMood; id: urn:oid:2.16.840.1.113883.1.11.19461; version: 2.0.0; name: XDocumentSubstanceMood; title: x_DocumentSubstanceMood; status: active; date: 2014-03-26; description: Used to enumerate the moods that a substance administration can take within the body of a clinical document.</a></td></tr><tr><td><a href="ValueSet-v3-xInformationRecipient.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-xInformationRecipient; id: urn:oid:2.16.840.1.113883.1.11.19366; version: 2.0.0; name: XInformationRecipient; title: x_InformationRecipient; status: active; date: 2014-03-26; description: Used to represent participant(s) who should receive a copy of a document.</a></td></tr><tr><td><a href="ValueSet-v3-xInformationRecipientRole.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-xInformationRecipientRole; id: urn:oid:2.16.840.1.113883.1.11.16772; version: 2.0.0; name: XInformationRecipientRole; title: x_InformationRecipientRole; status: active; date: 2014-03-26; description: Used to represent the role(s) of those who should receive a copy of a document.</a></td></tr><tr><td><a href="ValueSet-v3-xServiceEventPerformer.html">Generated Summary: language: en; url: http://terminology.hl7.org/ValueSet/v3-xServiceEventPerformer; id: urn:oid:2.16.840.1.113883.1.11.19601; version: 2.0.0; name: XServiceEventPerformer; title: x_ServiceEventPerformer; status: active; date: 2014-03-26; description: Clones using this x\_domain should have a name "performer".</a></td></tr></table></div>
  </text>
  <status value="current"/>
  <mode value="working"/>
  <title value="CDA Rendering Manifest"/>
  <code>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/hl7TermMaintInfra"/>
      <code value="UTGCTGManifest"/>
    </coding>
  </code>
  <orderedBy>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/list-order"/>
      <code value="alphabetic"/>
    </coding>
  </orderedBy>
  <entry>
    <item>
      <reference value="CodeSystem/v3-ActClass"/>
      <type value="CodeSystem"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="CodeSystem/v3-Confidentiality"/>
      <type value="CodeSystem"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="CodeSystem/v3-RoleStatus"/>
      <type value="CodeSystem"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="CodeSystem/v3-ActMood"/>
      <type value="CodeSystem"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="CodeSystem/v3-ActRelationshipType"/>
      <type value="CodeSystem"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="CodeSystem/v3-NullFlavor"/>
      <type value="CodeSystem"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="CodeSystem/v3-ContextControl"/>
      <type value="CodeSystem"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="CodeSystem/v3-EntityClass"/>
      <type value="CodeSystem"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="CodeSystem/v3-EntityDeterminer"/>
      <type value="CodeSystem"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="CodeSystem/v3-ParticipationFunction"/>
      <type value="CodeSystem"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="CodeSystem/v3-ParticipationType"/>
      <type value="CodeSystem"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="CodeSystem/v3-RoleClass"/>
      <type value="CodeSystem"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-ActStatus"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-ActClassClinicalDocument"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-ActMood"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-xBasicConfidentialityKind"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-ContextControl"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-RoleClass"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-EntityClass"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-EntityDeterminer"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-EntityClassPlace"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-EntityClassOrganization"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-RoleStatus"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-RoleClassAssignedEntity"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-RoleClassContact"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-EntityClassDevice"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-RoleClassAssignedEntity"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-ActRelationshipFulfills"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-ActClassRoot"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-ActClass"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-ActRelationshipHasComponent"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-ActEncounterCode"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-xEncounterParticipant"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-ParticipationTargetLocation"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-RoleClassServiceDeliveryLocation"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-ServiceDeliveryLocationRoleType"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-ParticipationTargetSubject"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-RoleClassSpecimen"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-EntityClassRoot"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-ParticipationPhysicalPerformer"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-RoleClassRoot"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-ActClassObservation"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-ActClassDocument"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-ActRelationshipType"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-ActRelationshipType"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-EntityClassManufacturedMaterial"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-EntityDeterminerDetermined"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-EntityDeterminerDetermined"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-HumanLanguage"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-ParticipationSignature"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-ParticipationType"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-ROIOverlayShape"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-RoleClassAssociative"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-RoleClassMutualRelationship"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-RoleStatusActive"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-xActClassDocumentEntryAct"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-xActClassDocumentEntryOrganizer"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-xActMoodDocumentObservation"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-xActRelationshipDocument"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-xActRelationshipEntry"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-xActRelationshipEntryRelationship"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-xActRelationshipExternalReference"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-xDocumentActMood"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-xDocumentEncounterMood"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-xDocumentProcedureMood"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-xDocumentSubject"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-xDocumentSubstanceMood"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-xInformationRecipient"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-xInformationRecipientRole"/>
      <type value="ValueSet"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="ValueSet/v3-xServiceEventPerformer"/>
      <type value="ValueSet"/>
    </item>
  </entry>
</List>