This
page
is
part
of
the
FHIR
Specification
(v3.0.2:
STU
3).
(v3.3.0:
R4
Ballot
2).
The
current
version
which
supercedes
this
version
is
5.0.0
.
For
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list
of
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see
the
Directory
of
published
versions
.
Page
versions:
R4
R3
Vocabulary
Work
Group
|
Maturity Level : N/A | External | Use Context : Any |
This code system (http://hl7.org/fhir/v3/ActRelationshipType) is defined as part of HL7 v3.
Summary
| Defining URL: |
http://hl7.org/fhir/v3/ActRelationshipType
|
| Name: | v3 Code System ActRelationshipType |
| Definition: |
The source is an excerpt from the target. |
| OID: | 2.16.840.1.113883.5.1002 (for OID based terminology systems) |
| Source Resource | XML / JSON |
This Code system is used in the following value sets:
Release
Date:
2016-11-11
2018-04-01
| Level | Code | Display | Definition |
| 1 | ART | act relationship type |
Description:
A
directed
association
between
a
source
Act
and
a
target
Act.
Usage Note: This code should never be transmitted in an instance as the value of ActRelationship.typeCode (attribute) |
| 2 | (_ActClassTemporallyPertains) Abstract | ||
| 2 | (_ActRelationshipAccounting) Abstract |
Codes
that
describe
the
relationship
between
an
Act
and
a
financial
instrument
such
as
a
financial
transaction,
account
or
invoice
element.
|
|
| 3 | (_ActRelationshipCostTracking) Abstract |
Expresses
values
for
describing
the
relationship
relationship
between
an
InvoiceElement
or
InvoiceElementGroup
and
a
billable
act.
|
|
| 4 | CHRG | has charge |
A
relationship
that
provides
an
ability
to
associate
a
financial
transaction
(target)
as
a
charge
to
a
clinical
act
(source).
A
clinical
act
may
have
a
charge
associated
with
the
execution
or
delivery
of
the
service.
The financial transaction will define the charge (bill) for delivery or performance of the service. Charges and costs are distinct terms. A charge defines what is charged or billed to another organization or entity within an organization. The cost defines what it costs an organization to perform or deliver a service or product. |
| 4 | COST | has cost |
A
relationship
that
provides
an
ability
to
associate
a
financial
transaction
(target)
as
a
cost
to
a
clinical
act
(source).
A
clinical
act
may
have
an
inherit
cost
associated
with
the
execution
or
delivery
of
the
service.
The financial transaction will define the cost of delivery or performance of the service. Charges and costs are distinct terms. A charge defines what is charged or billed to another organization or entity within an organization. The cost defines what it costs an organization to perform or deliver a service or product. |
| 3 | (_ActRelationshipPosting) Abstract |
Expresses
values
for
describing
the
relationship
between
a
FinancialTransaction
and
an
Account.
|
|
| 4 | CREDIT | has credit |
A
credit
relationship
ties
a
financial
transaction
(target)
to
an
account
(source).
A
credit,
once
applied
(posted),
may
have
either
a
positive
or
negative
effect
on
the
account
balance,
depending
on
the
type
of
account.
An
asset
account
credit
will
decrease
the
account
balance.
A
non-asset
account
credit
will
decrease
the
account
balance.
|
| 4 | DEBIT | has debit |
A
debit
relationship
ties
a
financial
transaction
(target)
to
an
account
(source).
A
debit,
once
applied
(posted),
may
have
either
a
positive
or
negative
effect
on
the
account
balance,
depending
on
the
type
of
account.
An
asset
account
debit
will
increase
the
account
balance.
A
non-asset
account
debit
will
decrease
the
account
balance.
|
| 2 | (_ActRelationshipConditional) Abstract |
Specifies
under
what
circumstances
(target
Act)
the
source-Act
may,
must,
must
not
or
has
occurred
|
|
| 3 | CIND | has contra-indication |
A
contraindication
is
just
a
negation
of
a
reason,
i.e.
it
gives
a
condition
under
which
the
action
is
not
to
be
done.
Both,
source
and
target
can
be
any
kind
of
service;
target
service
is
in
criterion
mood.
How
the
strength
of
a
contraindication
is
expressed
(e.g.,
relative,
absolute)
is
left
as
an
open
issue.
The
priorityNumber
attribute
could
be
used.
|
| 3 | PRCN | has pre-condition |
A
requirement
to
be
true
before
a
service
is
performed.
The
target
can
be
any
service
in
criterion
mood.
For
multiple
pre-conditions
a
conjunction
attribute
(AND,
OR,
XOR)
is
applicable.
|
| 3 | RSON | has reason |
Description:
The
reason
or
rationale
for
a
service.
A
reason
link
is
weaker
than
a
trigger,
it
only
suggests
that
some
service
may
be
or
might
have
been
a
reason
for
some
action,
but
not
that
this
reason
requires/required
the
action
to
be
taken.
Also,
as
opposed
to
the
trigger,
there
is
no
strong
timely
relation
between
the
reason
and
the
action.
As
well
as
providing
various
types
of
information
about
the
rationale
for
a
service,
the
RSON
act
relationship
is
routinely
used
between
a
SBADM
act
and
an
OBS
act
to
describe
the
indication
for
use
of
a
medication.
Child
concepts
may
be
used
to
describe
types
of
indication.
Discussion: In prior releases, the code |
| 4 | BLOCK | blocks |
Definition:
The
source
act
is
performed
to
block
the
effects
of
the
target
act.
This
act
relationship
should
be
used
when
describing
near
miss
type
incidents
where
potential
harm
could
have
occurred,
but
the
action
described
in
the
source
act
blocked
the
potential
harmful
effects
of
the
incident
actually
occurring.
|
| 4 | DIAG | diagnoses |
Description:
The
source
act
is
intended
to
help
establish
the
presence
of
a
(an
adverse)
situation
described
by
the
target
act.
This
is
not
limited
to
diseases
but
can
apply
to
any
adverse
situation
or
condition
of
medical
or
technical
nature.
|
| 4 | IMM | immunization against |
Description:
The
source
act
is
intented
to
provide
immunity
against
the
effects
of
the
target
act
(the
target
act
describes
an
infectious
disease)
|
| 5 | ACTIMM | active immunization against |
Description:
The
source
act
is
intended
to
provide
active
immunity
against
the
effects
of
the
target
act
(the
target
act
describes
an
infectious
disease)
|
| 5 | PASSIMM | passive immunization against |
Description:
The
source
act
is
intended
to
provide
passive
immunity
against
the
effects
of
the
target
act
(the
target
act
describes
an
infectious
disease).
|
| 4 | MITGT | mitigates |
The
source
act
removes
or
lessens
the
occurrence
or
effect
of
the
target
act.
|
| 5 | RCVY | recovers |
Definition:
The
source
act
is
performed
to
recover
from
the
effects
of
the
target
act.
|
| 4 | PRYLX | prophylaxis of |
Description:
The
source
act
is
intended
to
reduce
the
risk
of
of
an
adverse
situation
to
emerge
as
described
by
the
target
act.
This
is
not
limited
to
diseases
but
can
apply
to
any
adverse
situation
or
condition
of
medical
or
technical
nature.
|
| 4 | TREAT | treats |
Description:
The
source
act
is
intended
to
improve
a
pre-existing
adverse
situation
described
by
the
target
act.
This
is
not
limited
to
diseases
but
can
apply
to
any
adverse
situation
or
condition
of
medical
or
technical
nature.
|
| 5 | ADJUNCT | adjunctive treatment |
Description:
The
source
act
is
intended
to
offer
an
additional
treatment
for
the
management
or
cure
of
a
pre-existing
adverse
situation
described
by
the
target
act.
This
is
not
limited
to
diseases
but
can
apply
to
any
adverse
situation
or
condition
of
medical
or
technical
nature.
It
is
not
a
requirement
that
the
non-adjunctive
treatment
is
explicitly
specified.
|
| 5 | MTREAT | maintenance treatment |
Description:
The
source
act
is
intended
to
provide
long
term
maintenance
improvement
or
management
of
a
pre-existing
adverse
situation
described
by
the
target
act.
This
is
not
limited
to
diseases
but
can
apply
to
any
adverse
situation
or
condition
of
medical
or
technical
nature.
|
| 5 | PALLTREAT | palliates |
Description:
The
source
act
is
intended
to
provide
palliation
for
the
effects
of
the
target
act.
|
| 5 | SYMP | symptomatic relief |
Description:
The
source
act
is
intented
to
provide
symptomatic
relief
for
the
effects
of
the
target
act.
|
| 3 | TRIG | has trigger |
A
pre-condition
that
if
true
should
result
in
the
source
Act
being
executed.
The
target
is
in
typically
in
criterion
mood.
When
reported
after
the
fact
(i.e.
the
criterion
has
been
met)
it
may
be
in
Event
mood.
A
delay
between
the
trigger
and
the
triggered
action
can
be
specified.
Discussion: This includes the concept of a required act for a service or financial instrument such as an insurance plan or policy. In such cases, the trigger is the occurrence of a specific condition such as coverage limits being exceeded. |
| 2 | (_ActRelationshipTemporallyPertains) Abstract |
Abstract
collector
for
ActRelationhsip
types
that
relate
two
acts
by
their
timing.
|
|
| 3 | (_ActRelationshipTemporallyPertainsApproximates) Abstract |
Abstract
collector
for
ActRelationship
types
that
relate
two
acts
by
their
approximate
timing.
|
|
| 4 | ENE | ends near end |
A
relationship
in
which
the
source
act's
effective
time
ends
near
the
end
of
the
target
act's
effective
time.
Near
is
defined
separately
as
a
time
interval.
Usage Note: Inverse code is ENS |
| 5 | ECW | ends concurrent with |
A
relationship
in
which
the
source
act's
effective
time
ends
with
the
end
of
the
target
act's
effective
time.
UsageNote: This code is reflexive. Therefore its inverse code is itself. |
| 6 | CONCURRENT | concurrent with |
A
relationship
in
which
the
source
act's
effective
time
is
the
same
as
the
target
act's
effective
time.
UsageNote: This code is reflexive. Therefore its inverse code is itself. |
| 6 | SBSECWE | starts before start of, ends with |
The
source
Act
starts
before
the
start
of
the
target
Act,
and
ends
with
the
target
Act.
UsageNote: Inverse code is SASECWE |
| 4 | ENS | ends near start |
A
relationship
in
which
the
source
act's
effective
time
ends
near
the
start
of
the
target
act's
effective
time.
Near
is
defined
separately
as
a
time
interval.
Usage Note: Inverse code is ENE |
| 5 | ECWS | ends concurrent with start of |
The
source
Act
ends
when
the
target
act
starts
(i.e.
if
we
say
UsageNote: Inverse code is SCWE |
| 4 | SNE | starts near end |
A
relationship
in
which
the
source
act's
effective
time
starts
near
the
end
of
the
target
act's
effective
time.
Near
is
defined
separately
as
a
time
interval.
Usage Note: Inverse code is SNS |
| 5 | SCWE | starts concurrent with end of |
The
source
Act
starts
when
the
target
act
ends
(i.e.
if
we
say
UsageNote: Inverse code is SBSECWS |
| 4 | SNS | starts near start |
A
relationship
in
which
the
source
act's
effective
time
starts
near
the
start
of
the
target
act's
effective
time.
Near
is
defined
separately
as
a
time
interval.
Usage Note: Inverse code is SNE |
| 5 | SCW | starts concurrent with |
A
relationship
in
which
the
source
act's
effective
time
starts
with
the
start
of
the
target
act's
effective
time.
UsageNote: This code is reflexive. Therefore its inverse code is itself. |
| 6 | CONCURRENT | ||
| 6 | SCWSEBE | starts with. ends before end of |
The
source
Act
starts
with.the
target
Act
and
ends
before
the
end
of
the
target
Act.
UsageNote: Inverse code is SCWSEAE |
| 6 | SCWSEAE | starts with, ends after end of | The source Act starts with the target Act, and ends after the end of the target Act. |
| 3 | EAS | ends after start of |
A
relationship
in
which
the
source
act
ends
after
the
target
act
starts.
UsageNote: Inverse code is SBE |
| 4 | EAE | ends after end of |
A
relationship
in
which
the
source
act
ends
after
the
target
act
ends.
UsageNote: Inverse code is EBE |
| 5 | SASEAE | starts after start of, ends after end of |
The
source
Act
starts
after
start
of
the
target
Act
and
ends
after
end
of
the
target
Act.
UsageNote: Inverse code is SBSEBE |
| 6 | SBEEAE | contains end of |
The
source
Act
contains
the
end
of
the
target
Act.
UsageNote: Inverse code is EDU |
| 7 | SASSBEEAS | start after start of, contains end of |
The
source
Act
start
after
the
start
of
the
target
Act,
and
contains
the
end
of
the
target
Act.
UsageNote: Inverse code is SBSEASEBE |
| 7 | SBSEAE | contains time of |
The
source
Act
contains
the
time
of
the
target
Act.
UsageNote: Inverse code is DURING |
| 7 | SCWSEAE | ||
| 6 | SASSBEEAS | ||
| 4 | SAS | starts after start of |
The
source
Act
starts
after
the
start
of
the
target
Act
(i.e.
if
we
say
UsageNote: Inverse code is SBS |
| 5 | SASEAE | ||
| 5 | SAE | starts after end of |
A
relationship
in
which
the
source
act
starts
after
the
target
act
ends.
UsageNote: Inverse code is EBS |
| 5 | DURING | occurs during |
A
relationship
in
which
the
source
act's
effective
time
is
wholly
within
the
target
act's
effective
time
(including
end
points,
as
defined
in
the
act's
effective
times)
UsageNote: Inverse code is SBSEAE |
| 5 | SASECWE | starts after start of, ends with |
The
source
Act
starts
after
start
of
the
target
Act,
and
ends
with
the
target
Act.
UsageNote: Inverse code is SBSECWE |
| 3 | EASORECWS | ends after or concurrent with start of |
A
relationship
in
which
the
source
act's
effective
time
ends
after
or
concurrent
with
the
start
of
the
target
act's
effective
time.
Usage Note: Inverse code is EBSORECWS |
| 4 | EAS | ||
| 4 | EAEORECW | ends after or concurrent with end of |
A
relationship
in
which
the
source
act's
effective
time
ends
after
or
concurrent
with
the
end
of
the
target
act's
effective
time.
Usage Note: Inverse code is EBEORECW |
| 5 | EAE | ||
| 5 | ECW | ||
| 4 | ECWS | ||
| 3 | INDEPENDENT | independent of time of |
The
source
Act
is
independent
of
the
time
of
the
target
Act.
UsageNote: This code is reflexive. Therefore its inverse code is itself. |
| 3 | SAEORSCWE | starts after or concurrent with end of |
A
relationship
in
which
the
source
act's
effective
time
starts
after
or
concurrent
with
the
end
of
the
target
act's
effective
time.
Usage Note: Inverse code is SBEORSCWE |
| 4 | SCWE | ||
| 4 | SAE | ||
| 3 | SASORSCW | starts after or concurrent with start of |
A
relationship
in
which
the
source
act's
effective
time
starts
after
or
concurrent
with
the
start
of
the
target
act's
effective
time.
Usage Note: Inverse code is SBSORSCW |
| 4 | SAS | ||
| 4 | SCW | ||
| 3 | SBEORSCWE | starts before or concurrent with end of |
A
relationship
in
which
the
source
act's
effective
time
starts
before
or
concurrent
with
the
end
of
the
target
act's
effective
time.
Usage Note: Inverse code is SAEORSCWE |
| 4 | OVERLAP | overlaps with |
A
relationship
in
which
the
source
act's
effective
time
overlaps
the
target
act's
effective
time
in
any
way.
UsageNote: This code is reflexive. Therefore its inverse code is itself. |
| 5 | ECW | ||
| 5 | EDU | ends during |
A
relationship
in
which
the
source
act
ends
within
the
target
act's
effective
time
(including
end
points,
as
defined
in
the
act's
effective
times)
UsageNote: Inverse code is SBEEAE |
| 6 | SBSEASEBE | contains start of, ends before end of |
The
source
Act
contains
the
start
of
the
target
Act,
and
ends
before
the
end
of
the
target
Act.
UsageNote: Inverse code is SASSBEEAS |
| 6 | SCWSEBE | ||
| 5 | SBEEAE | ||
| 5 | SBSEAS | contains start of |
The
source
Act
contains
the
start
of
the
target
Act.
UsageNote: Inverse code is SDU |
| 6 | SBSECWE | ||
| 6 | SBSEASEBE | ||
| 6 | SBSEAE | ||
| 5 | SCW | ||
| 5 | SCWE | ||
| 5 | SDU | starts during |
A
relationship
in
which
the
source
act
starts
within
the
target
act's
effective
time
(including
end
points,
as
defined
in
the
act's
effective
times)
UsageNote: Inverse code is SBSEAS |
| 6 | SASSBEEAS | ||
| 4 | SBE | starts before end of |
The
source
Act
starts
before
the
end
of
the
target
Act
(i.e.
if
we
say
UsageNote: Inverse code is EAS |
| 5 | EBE | ends before end of |
The
source
Act
ends
before
the
end
of
the
target
Act
(i.e.
if
we
say
UsageNote: Inverse code is EAE |
| 6 | SBSEBE | starts before start of, ends before end of |
The
source
Act
starts
before
the
start
of
the
target
Act,
and
ends
before
the
end
of
the
target
Act.
UsageNote: Inverse code is SASEAE |
| 7 | SBSEASEBE | ||
| 7 | EBSORECWS | ends before or concurrent with start of |
A
relationship
in
which
the
source
act's
effective
time
ends
before
or
concurrent
with
the
start
of
the
target
act's
effective
time.
Usage Note: Inverse code is EASORECWS |
| 8 | ECWS | ||
| 8 | EBS | ends before start of |
A
relationship
in
which
the
source
act
ends
before
the
target
act
starts.
UsageNote: Inverse code is SAE |
| 5 | SBSEASEBE | ||
| 5 | SCWSEBE | ||
| 5 | EBEORECW | ends before or concurrent with end of |
A
relationship
in
which
the
source
act's
effective
time
ends
before
or
concurrent
with
the
end
of
the
target
act's
effective
time.
Usage Note: Inverse code is EAEORECW |
| 6 | ECW | ||
| 6 | EBE | ||
| 5 | SBSORSCW | starts before or concurrent with start of |
A
relationship
in
which
the
source
act's
effective
time
starts
before
or
concurrent
with
the
start
of
the
target
act's
effective
time.
Usage Note: Inverse code is SASORSCW |
| 6 | SCW | ||
| 6 | SBS | starts before start of |
A
relationship
in
which
the
source
act
begins
before
the
target
act
begins.
UsageNote: Inverse code is SAS |
| 7 | SBSEBE | ||
| 7 | SBSEAS | ||
| 2 | AUTH | authorized by |
A
relationship
in
which
the
target
act
authorizes
or
certifies
the
source
act.
|
| 2 | CAUS | is etiology for |
Description:
An
assertion
that
an
act
was
the
cause
of
another
act.This
is
stronger
and
more
specific
than
the
support
link.
The
source
(cause)
is
typically
an
observation,
but
may
be
any
act,
while
the
target
may
be
any
act.
Examples: a growth of Staphylococcus aureus may be considered the cause of an abscess contamination of the infusion bag was deemed to be the cause of the infection that the patient experienced lack of staff on the shift was deemed to be a supporting factor (proximal factor) causing the patient safety incident where the patient fell out of bed because the bed-sides had not been put up which caused the night patient to fall out of bed |
| 2 | COMP | has component |
The
target
act
is
a
component
of
the
source
act,
with
no
semantics
regarding
composition
or
aggregation
implied.
|
| 3 | CTRLV | has control variable |
A
relationship
from
an
Act
to
a
Control
Variable.
For
example,
if
a
Device
makes
an
Observation,
this
relates
the
Observation
to
its
Control
Variables
documenting
the
device's
settings
that
influenced
the
observation.
|
| 3 | MBR | has member |
The
target
Acts
are
aggregated
by
the
source
Act.
Target
Acts
may
have
independent
existence,
participate
in
multiple
ActRelationships,
and
do
not
contribute
to
the
meaning
of
the
source.
UsageNotes: This explicitly represents the conventional notion of aggregation. The target Act is part of a collection of Acts (no implication is made of cardinality, a source of Acts may contain zero, one, or more member target Acts). It is expected that this will be primarily used with _ActClassRecordOrganizer, BATTERY, and LIST |
| 4 | STEP | has step |
A
collection
of
sub-services
as
steps
or
subtasks
performed
for
the
source
service.
Services
may
be
performed
sequentially
or
concurrently.
UsageNotes: Sequence of steps may be indicated by use of _ActRelationshipTemporallyPertains, as well as via ActRelationship.sequenceNumber, ActRelationship.pauseQuantity, Target.priorityCode. OpenIssue: Need Additional guidelines on when each approach should be used. |
| 5 | ARR | arrival |
The
relationship
that
links
to
a
Transportation
Act
(target)
from
another
Act
(source)
indicating
that
the
subject
of
the
source
Act
entered
into
the
source
Act
by
means
of
the
target
Transportation
act.
|
| 5 | DEP | departure |
The
relationship
that
links
to
a
Transportation
Act
(target)
from
another
Act
(source)
indicating
that
the
subject
of
the
source
Act
departed
from
the
source
Act
by
means
of
the
target
Transportation
act.
|
| 3 | PART | has part |
The
source
Act
is
a
composite
of
the
target
Acts.
The
target
Acts
do
not
have
an
existence
independent
of
the
source
Act.
UsageNote: In UML 1.1, this is a |
| 2 | COVBY | covered by |
A
relationship
in
which
the
source
act
is
covered
by
or
is
under
the
authority
of
a
target
act.
A
financial
instrument
such
as
an
Invoice
Element
is
covered
by
one
or
more
specific
instances
of
an
Insurance
Policy.
|
| 2 | DRIV | is derived from |
Associates
a
derived
Act
with
its
input
parameters.
E.G.,
an
anion-gap
observation
can
be
associated
as
being
derived
from
given
sodium-,
(potassium-,),
chloride-,
and
bicarbonate-observations.
The
narrative
content
(Act.text)
of
a
source
act
is
wholly
machine-derived
from
the
collection
of
target
acts.
|
| 2 | ELNK | episodeLink |
Expresses
an
association
that
links
two
instances
of
the
same
act
over
time,
indicating
that
the
instance
are
part
of
the
same
episode,
e.g.
linking
two
condition
nodes
for
episode
of
illness;
linking
two
encounters
for
episode
of
encounter.
|
| 2 | EVID | provides evidence for |
Indicates
that
the
target
Act
provides
evidence
in
support
of
the
action
represented
by
the
source
Act.
The
target
is
not
a
'reason'
for
the
source
act,
but
rather
gives
supporting
information
on
why
the
source
act
is
an
appropriate
course
of
action.
Possible
targets
might
be
clinical
trial
results,
journal
articles,
similar
successful
therapies,
etc.
Rationale: Provides a mechanism for conveying clinical justification for non-approved or otherwise non-traditional therapies. |
| 2 | EXACBY | exacerbated by |
Description:The
source
act
is
aggravated
by
the
target
act.
(Example
|
| 2 | EXPL | has explanation |
This
is
the
inversion
of
support.
Used
to
indicate
that
a
given
observation
is
explained
by
another
observation
or
condition.
|
| 2 | INTF | interfered by |
the
target
act
documents
a
set
of
circumstances
(events,
risks)
which
prevent
successful
completion,
or
degradation
of
quality
of,
the
source
Act.
UsageNote: This provides the semantics to document barriers to care |
| 2 | ITEMSLOC | items located |
Items
located
|
| 2 | LIMIT | limited by |
A
relationship
that
limits
or
restricts
the
source
act
by
the
elements
of
the
target
act.
For
example,
an
authorization
may
be
limited
by
a
financial
amount
(up
to
$500).
Target
Act
must
be
in
EVN.CRIT
mood.
|
| 2 | META | has metadata |
Definition:
Indicates
that
the
attributes
and
associations
of
the
target
act
provide
metadata
(for
example,
identifiers,
authorship,
etc.)
for
the
source
act.
Constraint: Source act must have either a mood code that is not |
| 2 | MFST | is manifestation of |
An
assertion
that
a
new
observation
may
be
the
manifestation
of
another
existing
observation
or
action.
This
assumption
is
attributed
to
the
same
actor
who
asserts
the
manifestation.
This
is
stronger
and
more
specific
than
an
inverted
support
link.
For
example,
an
agitated
appearance
can
be
asserted
to
be
the
manifestation
(effect)
of
a
known
hyperthyroxia.
This
expresses
that
one
might
not
have
realized
a
symptom
if
it
would
not
be
a
common
manifestation
of
a
known
condition.
The
target
(cause)
may
be
any
service,
while
the
source
(manifestation)
must
be
an
observation.
|
| 2 | NAME | assigns name |
Used
to
assign
a
|
| 2 | OUTC | has outcome |
An
observation
that
should
follow
or
does
actually
follow
as
a
result
or
consequence
of
a
condition
or
action
(sometimes
called
|
| 3 | (_ActRelationsipObjective) Abstract |
The
target
act
is
a
desired
outcome
of
the
source
act.
Source
is
any
act
(typically
an
intervention).
Target
must
be
an
observation
in
criterion
mood.
|
|
| 4 | OBJC | has continuing objective |
A
desired
state
that
a
service
action
aims
to
maintain.
E.g.,
keep
systolic
blood
pressure
between
90
and
110
mm
Hg.
Source
is
an
intervention
service.
Target
must
be
an
observation
in
criterion
mood.
|
| 4 | OBJF | has final objective |
A
desired
outcome
that
a
service
action
aims
to
meet
finally.
Source
is
any
service
(typically
an
intervention).
Target
must
be
an
observation
in
criterion
mood.
|
| 3 | GOAL | has goal |
A
goal
that
one
defines
given
a
patient's
health
condition.
Subsequently
planned
actions
aim
to
meet
that
goal.
Source
is
an
observation
or
condition
node,
target
must
be
an
observation
in
goal
mood.
|
| 3 | RISK | has risk |
A
noteworthy
undesired
outcome
of
a
patient's
condition
that
is
either
likely
enough
to
become
an
issue
or
is
less
likely
but
dangerous
enough
to
be
addressed.
|
| 2 | PERT | has pertinent information |
This
is
a
very
unspecific
relationship
from
one
item
of
clinical
information
to
another.
It
does
not
judge
about
the
role
the
pertinent
information
plays.
|
| 2 | PREV | has previous instance |
A
relationship
in
which
the
target
act
is
a
predecessor
instance
to
the
source
act.
Generally
each
of
these
instances
is
similar,
but
no
identical.
In
healthcare
coverage
it
is
used
to
link
a
claim
item
to
a
previous
claim
item
that
might
have
claimed
for
the
same
set
of
services.
|
| 2 | REFR | refers to |
A
relationship
in
which
the
target
act
is
referred
to
by
the
source
act.
This
permits
a
simple
reference
relationship
that
distinguishes
between
the
referent
and
the
referee.
|
| 3 | USE | uses |
Indicates
that
the
source
act
makes
use
of
(or
will
make
use
of)
the
information
content
of
the
target
act.
UsageNotes: A usage relationship only makes sense if the target act is authored and occurs independently of the source act. Otherwise a simpler relationship such as COMP would be appropriate. Rationale: There is a need when defining a clinical trial protocol to indicate that the protocol makes use of other protocol or treatment specifications. This is stronger than the assertion of |
| 2 | REFV | has reference values |
Reference
ranges
are
essentially
descriptors
of
a
class
of
result
values
assumed
to
be
|
| 2 | RELVBY | relieved by |
Description:The
source
act
is
wholly
or
partially
alleviated
by
the
target
act.
(Example
|
| 2 | SEQL | is sequel |
An
act
relationship
indicating
that
the
source
act
follows
the
target
act.
The
source
act
should
in
principle
represent
the
same
kind
of
act
as
the
target.
Source
and
target
need
not
have
the
same
mood
code
(mood
will
often
differ).
The
target
of
a
sequel
is
called
antecedent.
Examples
for
sequel
relationships
are:
revision,
transformation,
derivation
from
a
prototype
(as
a
specialization
is
a
derivation
of
a
generalization),
followup,
realization,
instantiation.
|
| 3 | APND | is appendage |
An
addendum
(source)
to
an
existing
service
object
(target),
containing
supplemental
information.
The
addendum
is
itself
an
original
service
object
linked
to
the
supplemented
service
object.
The
supplemented
service
object
remains
in
place
and
its
content
and
status
are
unaltered.
|
| 3 | BSLN | has baseline |
Indicates
that
the
target
observation(s)
provide
an
initial
reference
for
the
source
observation
or
observation
group.
UsageConstraints: Both source and target must be Observations or specializations thereof. |
| 3 | COMPLY | complies with |
Description:The
source
act
complies
with,
adheres
to,
conforms
to,
or
is
permissible
under
(in
whole
or
in
part)
the
policy,
contract,
agreement,
law,
conformance
criteria,
certification
guidelines
or
requirement
conveyed
by
the
target
act.
Examples for compliance relationships are: audits of adherence with a security policy, certificate of conformance to system certification requirements, or consent directive in compliance with or permissible under a privacy policy. |
| 3 | DOC | documents |
The
source
act
documents
the
target
act.
|
| 3 | FLFS | fulfills |
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.
|
| 4 | OCCR | occurrence |
The
source
act
is
a
single
occurrence
of
a
repeatable
target
act.
The
source
and
target
act
can
be
in
any
mood
on
the
|
| 4 | OREF | references order |
Relates
either
an
appointment
request
or
an
appointment
to
the
order
for
the
service
being
scheduled.
|
| 4 | SCH | schedules request |
Associates
a
specific
time
(and
associated
resources)
with
a
scheduling
request
or
other
intent.
|
| 3 | GEN | has generalization |
The
generalization
relationship
can
be
used
to
express
categorical
knowledge
about
services
(e.g.,
amilorid,
triamterene,
and
spironolactone
have
the
common
generalization
potassium
sparing
diuretic).
|
| 3 | GEVL | evaluates (goal) |
A
goal-evaluation
links
an
observation
(intent
or
actual)
to
a
goal
to
indicate
that
the
observation
evaluates
the
goal.
Given
the
goal
and
the
observation,
a
|
| 3 | INST | instantiates (master) |
Used
to
capture
the
link
between
a
potential
service
|
| 3 | MOD | modifies |
Definition:
Used
to
link
a
newer
version
or
'snapshot'
of
a
business
object
(source)
to
an
older
version
or
'snapshot'
of
the
same
business
object
(target).
Usage:The identifier of the Act should be the same for both source and target. If the identifiers are distinct, RPLC should be used instead. Name from source to target = Name from target to source = |
| 3 | MTCH | matches (trigger) |
A
trigger-match
links
an
actual
service
(e.g.,
an
observation
or
procedure
that
took
place)
with
a
service
in
criterion
mood.
For
example
if
the
trigger
is
|
| 3 | OPTN | has option |
A
relationship
between
a
source
Act
that
provides
more
detailed
properties
to
the
target
Act.
The source act thus is a specialization of the target act, but instead of mentioning all the inherited properties it only mentions new property bindings or refinements. The typical use case is to specify certain alternative variants of one kind of Act. The priorityNumber attribute is used to weigh refinements as preferred over other alternative refinements. Example: several routing options for a drug are specified as one SubstanceAdministration for the general treatment with attached refinements for the various routing options. |
| 3 | RCHAL | re-challenge |
Description:A
relationship
in
which
the
target
act
is
carried
out
to
determine
whether
an
effect
attributed
to
the
source
act
can
be
recreated.
|
| 3 | REV | reverses |
A
relationship
between
a
source
Act
that
seeks
to
reverse
or
undo
the
action
of
the
prior
target
Act.
Example: A posted financial transaction (e.g., a debit transaction) was applied in error and must be reversed (e.g., by a credit transaction) the credit transaction is identified as an undo (or reversal) of the prior target transaction. Constraints: the |
| 3 | RPLC | replaces |
A
replacement
source
act
replaces
an
existing
target
act.
The
state
of
the
target
act
being
replaced
becomes
obselete,
but
the
act
is
typically
still
retained
in
the
system
for
historical
reference.
The
source
and
target
must
be
of
the
same
type.
|
| 3 | SUCC | succeeds |
Definition:
A
new
act
that
carries
forward
the
intention
of
the
original
act,
but
does
not
completely
replace
it.
The
status
of
the
predecessor
act
must
be
'completed'.
The
original
act
is
the
target
act
and
the
successor
is
the
source
act.
|
| 3 | UPDT | updates (condition) |
A
condition
thread
relationship
specifically
links
condition
nodes
together
to
form
a
condition
thread.
The
source
is
the
new
condition
node
and
the
target
links
to
the
most
recent
node
of
the
existing
condition
thread.
|
| 3 | XCRPT | Excerpts |
The
source
is
an
excerpt
from
the
target.
|
| 4 | VRXCRPT | Excerpt verbatim |
The
source
is
a
direct
quote
from
the
target.
|
| 3 | XFRM | transformation |
Used
when
the
target
Act
is
a
transformation
of
the
source
Act.
(For
instance,
used
to
show
that
a
CDA
document
is
a
transformation
of
a
DICOM
SR
document.)
|
| 2 | SPRT | has support |
Used
to
indicate
that
an
existing
service
is
suggesting
evidence
for
a
new
observation.
The
assumption
of
support
is
attributed
to
the
same
actor
who
asserts
the
observation.
Source
must
be
an
observation,
target
may
be
any
service
(e.g.,
to
indicate
a
status
post).
|
| 3 | SPRTBND | has bounded support |
A
specialization
of
|
| 2 | SUBJ | has subject |
Relates
an
Act
to
its
subject
Act
that
the
first
Act
is
primarily
concerned
with.
Examples The first Act may be a ControlAct manipulating the subject Act The first act is a region of interest (ROI) that defines a region within the subject Act. The first act is a reporting or notification Act, that echos the subject Act for a specific new purpose. Constraints An Act may have multiple subject acts. Rationale The ActRelationshipType |
| 3 | QUALF | has qualifier |
The
target
observation
qualifies
(refines)
the
semantics
of
the
source
observation.
UsageNote: This is not intended to replace concept refinement and qualification via vocabulary. It is used when there are multiple components which together provide the complete understanding of the source Act. |
| 2 | SUMM | summarized by |
An
act
that
contains
summary
values
for
a
list
or
set
of
subordinate
acts.
For
example,
a
summary
of
transactions
for
a
particular
accounting
period.
|
| 2 | VALUE | has value |
Description:Indicates
that
the
target
Act
represents
the
result
of
the
source
observation
Act.
FormalConstraint: Source Act must be an Observation or specialization there-of. Source Act must not have the value attribute specified UsageNote: This relationship allows the result of an observation to be fully expressed as RIM acts as opposed to being embedded in the value attribute. For example, sending a Document act as the result of an imaging observation, sending a list of Procedures and/or other acts as the result of a medical history observation. The valueNegationInd attribute on the source Act has the same semantics of OpenIssue: The implications of negationInd on ActRelationship and the valueNegationind on Observation. |
| 1 | CURE | curative indication | |
| 1 | CURE.ADJ | adjunct curative indication | |
| 1 | MTGT.ADJ | adjunct mitigation | |
| 1 | RACT | ||
| 1 | SUGG |
®©
HL7.org
2011+.
FHIR
Release
3
(STU;
v3.0.2-11200)
Mixed
Nomative/Trial
Use
Ballot
(v3.3.0-13671)
generated
on
Thurs,
Oct
24,
2019
11:53+1100.
Tue,
Apr
3,
2018
12:20+1000.
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