1.3.6.1.4.1.19376.1.5.3.1.1.11.2
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Development Only
The PCC Wiki Content is used only for development of IHE PCC Content. The Normative content of the PCC Technical Framework and the current supplements can be found at http://www.ihe.net/Technical_Framework/index.cfm#PCC
Antepartum Summary Form C, F & G Specification 1.3.6.1.4.1.19376.1.5.3.1.1.11.2
The Anetpartum Summary Form C represents a summary of the most critical information to Obstetrician regarding the status of the pregnancy.
Standards
- HL7 CDA Release 2
- HL7 CCD Implementation guide
- American College of Obstretricians and Gynecologists (ACOG), Antepartum Record
- LOINC
- SNOMED : Systemized Nomenclature for Medicine
Specification
Data Element Name | Opt | Template ID |
---|---|---|
Allergies Must include observation of Latex Allergy |
R | 1.3.6.1.4.1.19376.1.5.3.1.3.13 |
Advance Directives APS includes an explicit check of patients preference for blood transfusion. This SHALL be recorded in the Advance Directives section. APS Form C documents SHALL include a simple observation of "blood transfusion acceptable?" |
R | 1.3.6.1.4.1.19376.1.5.3.1.3.39 |
Plan of Care Must include observation stating if an anesthesia consult is planned |
R | 1.3.6.1.4.1.19376.1.5.3.1.3.31 |
Medications Medications should include start and stop date if known. |
R | 1.3.6.1.4.1.19376.1.5.3.1.3.19 |
Problems Related Plans should be included in the Plan of Care section. |
R | 1.3.6.1.4.1.19376.1.5.3.1.3.6 |
Estimated Due Dates | R | 1.3.6.1.4.1.19376.1.5.3.1.11.2.1 |
ACOG Visit Summary Flowsheet | R | 1.3.6.1.4.1.19376.1.5.3.1.11.2.2 |
Conformance
CDA Release 2.0 documents that conform to the requirements of this content module shall indicate their conformance by the inclusion of the appropriate <templateId> elements in the header of the document. This is shown in the sample document below.
<ClinicalDocument xmlns='urn:hl7-org:v3'> <typeId extension="POCD_HD000040" root="2.16.840.1.113883.1.3"/> <templateId root='1.3.6.1.4.1.19376.1.5.3.1.1.11.2'/> <id root=' ' extension=' '/> <code code=' ' displayName=' ' codeSystem='2.16.840.1.113883.6.1' codeSystemName='LOINC'/> <title>Antepartum Summary Form C, F & G</title> <effectiveTime value='20240430012005'/> <confidentialityCode code='N' displayName='Normal' codeSystem='2.16.840.1.113883.5.25' codeSystemName='Confidentiality' /> <languageCode code='en-US'/> : <component><structuredBody> </structuredBody></component> </ClinicalDocument> |
<!-- Verify the document type code --> <assert test='cda:code[@code = "{{{LOINC}}}"]'> Error: The document type code of a Antepartum Summary Form C, F & G must be {{{LOINC}}} </assert> <assert test='cda:code[@codeSystem = "2.16.840.1.113883.6.1"]'> Error: The document type code must come from the LOINC code system (2.16.840.1.113883.6.1). </assert>
Categories:
- Pages needing work
- Templates using 1.3.6.1.4.1.19376.1.5.3.1.3.13
- Templates using 1.3.6.1.4.1.19376.1.5.3.1.3.39
- Templates using 1.3.6.1.4.1.19376.1.5.3.1.3.31
- Templates using 1.3.6.1.4.1.19376.1.5.3.1.3.19
- Templates using 1.3.6.1.4.1.19376.1.5.3.1.3.6
- Templates using 1.3.6.1.4.1.19376.1.5.3.1.11.2.1
- Templates using 1.3.6.1.4.1.19376.1.5.3.1.11.2.2
- CDA Document Templates