IHE Cardiology Technical Framework Supplement Cardiac Imaging ...

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IHE Cardiology Technical Framework Supplement – Cardiac Imaging Report Content (CIRC)______________________________________________________________________________715header of the document. A CDA Document may conform to more than one template. Thiscontent module inherits from the CDTPN and the PCCMD content modules, and so mustconform to the requirements of those templates as well the Cardiac Imaging Report templates.This is shown in the sample document below, which includes elements for theOIDs of all three templates.720725730735740Cardiac Imaging Report::Figure 6.2.1.1.7-1 Cardiac Imaging Report Example Extract__________________________________________________________________________28Rev. 1.0 – 2011-04-22Copyright © 2011: IHE International, Inc.
IHE Cardiology Technical Framework Supplement – Cardiac Imaging Report Content (CIRC)______________________________________________________________________________6.2.2 Section Modules6.2.2.1 Medical History (Cardiac) SectionTemplate ID 1.3.6.1.4.1.19376.1.4.1.2.1Parent Template 2.16.840.1.113883.10.20.18.2.5General DescriptionLOINC Code11329-0 Medical HistoryThe Medical History Section records past and current problems relevant to thepatient’s cardiac presentation. Other non-cardiac medical history may also berecorded.DescriptionSubsections Opt Description1.3.6.1.4.1.19376.1.4.1.2.1 O Problems (PCC TF-2)1.3.6.1.4.1.19376.1.5.3.1.3.4 O History of Present Illness (PCC TF-2)2.16.840.1.113883.10.20.2.9 O History of Past Illness (CDTPN)Entries Opt Description1.3.6.1.4.1.19376.1.5.3.1.4.5.2 R2 Problem Concern Entry (PCC TF-2)1.3.6.1.4.1.19376.1.4.1.4.1 R2 Diabetes Problem Concern Entry (Card TF-2: 6.2.4.1)1.3.6.1.4.1.19376.1.4.1.4.2 R2 Angina Problem Concern Entry (Card TF-2: 6.2.4.2)1.3.6.1.4.1.19376.1.5.3.1.4.13 O Simple Observation (PCC TF-2)745750755A Content Creator SHALL be able to include a Problem Concern Entry for each of theconditions identified in Value Set 1.3.6.1.4.1.19376.1.4.1.5.4 Cardiac Problems/Concerns.A Problem Concern Entry for diabetes (SNOMED-CT code 73211009) SHALL use thespecialization of Problem Concern (OID = 1.3.6.1.4.1.19376.1.4.1.4.1) to indicate whethertreatment with insulin is required.A Problem Concern Entry for angina (SNOMED-CT code 194828000) SHALL use thespecialization of Problem Concern (OID = 1.3.6.1.4.1.19376.1.4.1.4.2) to indicate angina type.The Medical History section MAY contain a Simple Observation entry for each of the conditionslisted in value set 1.3.6.1.4.1.19376.1.4.1.5.4 Cardiac Problems/Concerns indicating absence ofthe condition for the patient, represented with a compositional SNOMED CT code with qualifier[ 408729009 | finding context | = 410516002 | known absent ].6.2.2.2 Medications (Cardiac) SectionTemplate ID 1.3.6.1.4.1.19376.1.4.1.2.2Parent Template 1.3.6.1.4.1.19376.1.5.3.1.3.19__________________________________________________________________________29Rev. 1.0 – 2011-04-22Copyright © 2011: IHE International, Inc.
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IHE Cardiology Technical Framework Supplement Cardiac Imaging ...

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