Difference between revisions of "Medical Document Binding to XDS, XDM and XDR/zh"
Line 19: | Line 19: | ||
|- | |- | ||
|availabilityStatus | |availabilityStatus | ||
− | | | + | |就绪状态 |
|align = "center"|R | |align = "center"|R | ||
|align = "center"|DS | |align = "center"|DS | ||
Line 25: | Line 25: | ||
|- | |- | ||
|authorInstitution | |authorInstitution | ||
− | | | + | |作者机构 |
|align = "center"|R2 | |align = "center"|R2 | ||
|align = "center"|SAT | |align = "center"|SAT | ||
Line 36: | Line 36: | ||
|- | |- | ||
− | |||
|authorPerson | |authorPerson | ||
+ | |作者人员 | ||
|align = "center"|R2 | |align = "center"|R2 | ||
|align = "center"|SAT | |align = "center"|SAT | ||
Line 47: | Line 47: | ||
|- | |- | ||
|authorRole | |authorRole | ||
− | | | + | |作者角色 |
|align = "center"|R2 | |align = "center"|R2 | ||
|align = "center"|SAT | |align = "center"|SAT | ||
Line 54: | Line 54: | ||
|- | |- | ||
|authorSpecialty | |authorSpecialty | ||
− | | | + | |作者专业 |
|align = "center"|R2 | |align = "center"|R2 | ||
|align = "center"|SAT | |align = "center"|SAT | ||
Line 61: | Line 61: | ||
|- | |- | ||
|classCode | |classCode | ||
− | | | + | |类代码 |
|align = "center"|R | |align = "center"|R | ||
|align = "center"|CADT | |align = "center"|CADT | ||
Line 67: | Line 67: | ||
|- | |- | ||
|classCodeDisplayName | |classCodeDisplayName | ||
− | | | + | |类代码显示名称 |
|align = "center"|R | |align = "center"|R | ||
|align = "center"|CADT | |align = "center"|CADT | ||
Line 73: | Line 73: | ||
|- | |- | ||
|confidentialityCode | |confidentialityCode | ||
− | | | + | |密级代码 |
|align = "center"|R | |align = "center"|R | ||
|align = "center"|CADT | |align = "center"|CADT | ||
Line 81: | Line 81: | ||
|- | |- | ||
|comments | |comments | ||
− | | | + | |注释 |
|align = "center"|O | |align = "center"|O | ||
|align = "center"|DS | |align = "center"|DS | ||
Line 87: | Line 87: | ||
|- | |- | ||
|creationTime | |creationTime | ||
− | | | + | |创建时间 |
|align = "center"|R | |align = "center"|R | ||
|align = "center"|SAT | |align = "center"|SAT | ||
Line 97: | Line 97: | ||
|- | |- | ||
|entryUUID | |entryUUID | ||
− | | | + | |条目UUID |
|align = "center"|R | |align = "center"|R | ||
|align = "center"|DS | |align = "center"|DS | ||
Line 103: | Line 103: | ||
|- | |- | ||
|eventCodeList | |eventCodeList | ||
− | | | + | |事件代码列表 |
|align = "center"|O | |align = "center"|O | ||
|align = "center"|CADT | |align = "center"|CADT | ||
Line 109: | Line 109: | ||
|- | |- | ||
|eventCodeDisplayNameList | |eventCodeDisplayNameList | ||
− | | | + | |事件代码显示名称列表 |
|align = "center"|R<br/>(if event<br/>Code is valued) | |align = "center"|R<br/>(if event<br/>Code is valued) | ||
|align = "center"|CADT | |align = "center"|CADT | ||
Line 115: | Line 115: | ||
|- | |- | ||
|formatCode | |formatCode | ||
− | | | + | |格式代码 |
|align = "center"|R | |align = "center"|R | ||
|align = "center"|FM | |align = "center"|FM | ||
Line 121: | Line 121: | ||
|- | |- | ||
|healthcareFacilityTypeCode | |healthcareFacilityTypeCode | ||
− | | | + | |医疗保健设施类型代码 |
|align = "center"|R | |align = "center"|R | ||
|align = "center"|CAD | |align = "center"|CAD | ||
Line 127: | Line 127: | ||
|- | |- | ||
|healthcareFacility<br/>TypeCodeDisplay<br/>Name | |healthcareFacility<br/>TypeCodeDisplay<br/>Name | ||
− | | | + | |医疗保健设施类型代码显示名称 |
|align = "center"|R | |align = "center"|R | ||
|align = "center"|CAD | |align = "center"|CAD | ||
Line 133: | Line 133: | ||
|- | |- | ||
|intendedRecipient (for XDR, XDM) | |intendedRecipient (for XDR, XDM) | ||
− | | | + | |预定接收者 |
|align = "center"|O | |align = "center"|O | ||
|align = "center"|SAT | |align = "center"|SAT | ||
Line 152: | Line 152: | ||
|- | |- | ||
|languageCode | |languageCode | ||
− | | | + | |语言代码 |
|align = "center"|R | |align = "center"|R | ||
|align = "center"|SA | |align = "center"|SA | ||
Line 158: | Line 158: | ||
|- | |- | ||
|legalAuthenticator | |legalAuthenticator | ||
− | | | + | |法定审核者 |
|align = "center"|O | |align = "center"|O | ||
|align = "center"|SAT | |align = "center"|SAT | ||
Line 167: | Line 167: | ||
|- | |- | ||
|mimeType | |mimeType | ||
− | | | + | |MIME类型 |
|align = "center"|R | |align = "center"|R | ||
|align = "center"|FM | |align = "center"|FM | ||
Line 173: | Line 173: | ||
|- | |- | ||
|parentDocumentRelationship | |parentDocumentRelationship | ||
− | | | + | |父文档关系 |
|align = "center"|R<br/>(when applicable) | |align = "center"|R<br/>(when applicable) | ||
|align = "center"|DS | |align = "center"|DS | ||
Line 179: | Line 179: | ||
|- | |- | ||
|parentDocumentId | |parentDocumentId | ||
− | | | + | |父文档标识符 |
|align = "center"|R<br/>(when parent<br/>Document<br/>Relationship is present) | |align = "center"|R<br/>(when parent<br/>Document<br/>Relationship is present) | ||
|align = "center"|DS | |align = "center"|DS | ||
Line 187: | Line 187: | ||
|- | |- | ||
|patientId | |patientId | ||
− | | | + | |病人标识符 |
|align = "center"|R | |align = "center"|R | ||
|align = "center"|DS | |align = "center"|DS | ||
Line 194: | Line 194: | ||
|- | |- | ||
|practiceSettingCode | |practiceSettingCode | ||
− | | | + | |执业环境代码 |
|align = "center"|R | |align = "center"|R | ||
|align = "center"|CAD | |align = "center"|CAD | ||
Line 200: | Line 200: | ||
|- | |- | ||
|practiceSettingCodeDisplayName | |practiceSettingCodeDisplayName | ||
− | | | + | |执业环境代码显示名称 |
|align = "center"|R | |align = "center"|R | ||
|align = "center"|CAD | |align = "center"|CAD | ||
Line 206: | Line 206: | ||
|- | |- | ||
|serviceStartTime | |serviceStartTime | ||
− | | | + | |服务开始时间 |
|align = "center"|R2 | |align = "center"|R2 | ||
|align = "center"|SAT | |align = "center"|SAT | ||
Line 214: | Line 214: | ||
|- | |- | ||
|serviceStopTime | |serviceStopTime | ||
− | | | + | |服务停止时间 |
|align = "center"|R2 | |align = "center"|R2 | ||
|align = "center"|SAT | |align = "center"|SAT | ||
Line 222: | Line 222: | ||
|- | |- | ||
|sourcePatientId | |sourcePatientId | ||
− | | | + | |来源病人标识符 |
|align = "center"|R | |align = "center"|R | ||
|align = "center"|SAT | |align = "center"|SAT | ||
Line 230: | Line 230: | ||
|- | |- | ||
|sourcePatientInfo | |sourcePatientInfo | ||
− | | | + | |来源病人信息 |
|align = "center"|R | |align = "center"|R | ||
|align = "center"|SAT | |align = "center"|SAT | ||
Line 238: | Line 238: | ||
|- | |- | ||
|title | |title | ||
− | | | + | |标题 |
|align = "center"|O | |align = "center"|O | ||
|align = "center"|SA | |align = "center"|SA | ||
Line 244: | Line 244: | ||
|- | |- | ||
|typeCode | |typeCode | ||
− | | | + | |类型代码 |
|align = "center"|R | |align = "center"|R | ||
|align = "center"|CADT | |align = "center"|CADT | ||
Line 252: | Line 252: | ||
|- | |- | ||
|typeCodeDisplay<br/>Name | |typeCodeDisplay<br/>Name | ||
− | | | + | |类型代码显示名称 |
|align = "center"|R | |align = "center"|R | ||
|align = "center"|CADT | |align = "center"|CADT | ||
Line 258: | Line 258: | ||
|- | |- | ||
|uniqueId | |uniqueId | ||
− | | | + | |唯一标识符 |
|align = "center"|R | |align = "center"|R | ||
|align = "center"|SAT | |align = "center"|SAT |
Revision as of 10:01, 21 March 2010
针对XDS、XDM和XDR的医疗文档绑定
这种绑定(binding)规定的是一种转换机制(transformation)。在存在来自其他来源的某份医疗文档以及信息的情况下,这种转换机制所产生的是来自XDS、XDM和XDR概貌的适当交易的XDS文档条目元数据(XDSDocumentEntry)要素。医疗文档(medical document,医疗文书)指的是存储在某个储存库(repository)之中并将在注册库(registry)之中加以引用的文档。其他信息来源包括文档来源角色(Document Source actor)的配置、共享域、地点或设施、本地协议、注册库/储存库之中的其他文档以及这份内容概貌。
在许多的情况下,CDA文档的创建针对的是特定共享域(affinity domain)之内不同的共享目的。在这些情况下,CDA的语境与共享域的语境并无两样;此时,必须运用下列映射关系。
在其他情况下,CDA文档可能是事先已经为内部用途而创建的,而后来又要加以共享。在这些情况下,CDA的语境并不一定会与共享域的语境相符。因此,下列映射关系此时并不一定会适用。
请注意如下表格之中所给出的具体细节。
XDS文档条目元数据
XDSDocumentEntry Attribute | XDS文档条目属性 | 可选程度 | 来源类型 | 来源/取值 |
---|---|---|---|---|
availabilityStatus | 就绪状态 | R | DS | |
authorInstitution | 作者机构 | R2 | SAT |
$inst <=
/ClinicalDocument/author |
authorPerson | 作者人员 | R2 | SAT |
$person <= /ClinicalDocument/author
|
authorRole | 作者角色 | R2 | SAT | This metadata element should be based on a mapping of the participation function defined in the CDA document to the set of author roles configured for the affinity domain. If the context of the CDA coincides with that of the affinity domain, then the following x-path may be appropriate: /ClincicalDocument/author/ participationFunction |
authorSpecialty | 作者专业 | R2 | SAT | This metadata element should be based on a mapping of the code associated with the assignedAuthor to detailed defined classification system for healthcare providers such configured in the affinitity domain. Possible classifications include those found in SNOMED-CT, or the HIPAA Healthcare Provider Taxonomy. If the context of the CDA coincides with that of the affinity domain, then the following x-path may be appropriate: /ClinicalDocument/author/ assignedAuthor/code |
classCode | 类代码 | R | CADT | Derived from a mapping of /ClinicalDocument/code/@code to an Affinity Domain specified coded value to use and coding system. Affinity Domains are encouraged to use the appropriate value for Type of Service, based on the LOINC Type of Service (see Page 53 of the LOINC User's Manual). Must be consistent with /ClinicalDocument/code/@code |
classCodeDisplayName | 类代码显示名称 | R | CADT | DisplayName of the classCode derived. Derived from a mapping of /ClinicalDocument/code/@code to the appropriate Display Name based on the Type of Service. Must be Consitent with /ClinicalDocument/code/@code |
confidentialityCode | 密级代码 | R | CADT | Derived from a mapping of /ClinicalDocument/confidentialityCode/@code to an Affinity Domain specified coded value and coding system. When using the BPPC profile, the confidentialyCode may also be obtained from the <authorization> element.
|
comments | 注释 | O | DS | |
creationTime | 创建时间 | R | SAT | /ClinicalDocument/effectiveTime
|
entryUUID | 条目UUID | R | DS | |
eventCodeList | 事件代码列表 | O | CADT | These values express a collection of keywords that may be relevant to the consumer of the documents in the registry. They may come from anywhere in the CDA document, according to its purpose. |
eventCodeDisplayNameList | 事件代码显示名称列表 | R (if event Code is valued) |
CADT | These are the display names for the collection of keywords described above. |
formatCode | 格式代码 | R | FM | The format code for each PCC Document content profile is provided within the document specifications. |
healthcareFacilityTypeCode | 医疗保健设施类型代码 | R | CAD | A fixed value assigned to the Document Source and configured form a set of Affinity Domain defined values. Must be concistent with /clinicalDocument/code |
healthcareFacility TypeCodeDisplay Name |
医疗保健设施类型代码显示名称 | R | CAD | Must be concistent with /clinicalDocument/code |
intendedRecipient (for XDR, XDM) | 预定接收者 | O | SAT |
$person <=
/ClinicalDocument/intendedRecipient
"^^^^^&", |
languageCode | 语言代码 | R | SA | /ClinicalDocument/languageCode |
legalAuthenticator | 法定审核者 | O | SAT | $person <= /ClinicalDocument/ legalAuthenticator
|
mimeType | MIME类型 | R | FM | text/xml |
parentDocumentRelationship | 父文档关系 | R (when applicable) |
DS | Local document versions need not always be published, and so no exact mapping can be determined from the content of the CDA document. The parentDocumentRelationship may be determined in some configurations from the relatedDocument element present in the CDA dsocument. If the context of the CDA coincides with that of the affinity domain, then the following x-path may be appropriate: /ClinicalDocument/relatedDocument/@typeCode |
parentDocumentId | 父文档标识符 | R (when parent Document Relationship is present) |
DS | Local document versions need not always be published, and so no exact mapping can be determined from the content of the CDA document. The parentDocumentId may be determined in some configurations from the relatedDocument element present in the CDA dsocument. If the context of the CDA coincides with that of the affinity domain, then the following x-path may be appropriate: $docID <= /ClinicalDocument/ relatedDocument/parentDocument/id
|
patientId | 病人标识符 | R | DS | The XDS Affinity Domain patient ID can be mapped from the patientRole/id element using transactions from the ITI PIX or PDQ profiles. See sourcePatientId below. If the context of the CDA coincides with that of the affinity domain, then the following x-path may be appropriate:
|
practiceSettingCode | 执业环境代码 | R | CAD | This elements should be based on a coarse classification system for the class of specialty practice. Recommend the use of the classification system for Practice Setting, such as that described by the Subject Matter Domain in LOINC. |
practiceSettingCodeDisplayName | 执业环境代码显示名称 | R | CAD | This element shall contain the display names associated with the codes described above. |
serviceStartTime | 服务开始时间 | R2 | SAT | /ClinicalDocument/documentationOf/ serviceEvent/effectiveTime/low/ @value
|
serviceStopTime | 服务停止时间 | R2 | SAT | /ClinicalDocument/documentationOf/ serviceEvent/effectiveTime/high/ @value
|
sourcePatientId | 来源病人标识符 | R | SAT | $patID <= /ClinicalDocument/recordTarget/ patientRole/id
|
sourcePatientInfo | 来源病人信息 | R | SAT | /ClinicalDocument/recordTarget/ patientRole
|
title | 标题 | O | SA | /ClinicalDocument/title |
typeCode | 类型代码 | R | CADT | /ClinicalDocument/code/@code
|
typeCodeDisplay Name |
类型代码显示名称 | R | CADT | /ClinicalDocument/code/@displayName |
uniqueId | 唯一标识符 | R | SAT | $docID <= /ClinicalDocument/id
|
XDS提交集元数据
The submission set metadata is as defined for XDS, and is not necessarily affected by the content of the clinical document. Metadata values in an XDSSubmissionSet with names identical to those in the XDSDocumentEntry may be inherited from XDSDocumentEntry metadata, but this is left to affinity domain policy and/or application configuration.
XDS提交集的使用
This content format uses the XDS Submission Set to create a package of information to send from one provider to another. All documents referenced by the Medical Summary in this Package must be in the submission set.
XDS文件夹的使用
No specific requirements identified.
配置
IHE Content Profiles using this binding require that Content Creators and Content Consumers be configurable with institution and other specific attributes or parameters. Implementers should be aware of these requirements to make such attributes easily configurable. There shall be a mechanism for the publishing and distribution of style sheets used to view clinical documents.