1.3.6.1.4.1.19376.1.5.3.1.1.16.1.4

This is a draft of a History and Physical Template. This draft is a work in progress, not the official supplement or profile.

The intention of this work is to provide a parent template for the History and Physical specifications needed in Antepartum Summary Forms A&B (History and Physical).

Document Specification

Antepartum History and Physical Constraints

Data Element	Opt	Section	Template ID	Comments
Header	R		2.16.840.1.113883.10.20.2
Reason for Visit/Chief Complaint	R		2.16.840.1.113883.10.20.2.9	CDA4CDT requires this, but not so sure if it should be required here.
History of Present Illness	R		1.3.6.1.4.1.19376.1.5.3.1.3.4	existing IHE Section
Past Medical History	R		2.16.840.1.113883.10.20.2.9	new IHE section
Social History	R		1.3.6.1.4.1.19376.1.5.3.1.3.16
Family History	R		2.16.840.1.113883.10.20.1.4
Review of Systems	R		3.6.1.4.1.19376.1.5.3.1.3.18
Physical Examination	R		2.16.840.1.113883.10.20.2.10