TEMPLATE Modify CG treatment (fa81ca62-6dfd-49c2-a33b-b1c081041dfb)

TEMPLATE IDfa81ca62-6dfd-49c2-a33b-b1c081041dfb
ConceptModify CG treatment
DescriptionTo schedule and register the outcomes of the corresponding therapeutic procedure in the event that the glaucoma specialist considers that adjusting the current treatment is warranted.
PurposeTo schedule and register the outcomes of the corresponding therapeutic procedure in the event that the glaucoma specialist considers that adjusting the current treatment is warranted.
References
Authorsname: Aitor Eguzkitza; organisation: Universidad Pública de Navarra - Complejo Hospitalario de Navarra; email: aitor.eguzkiza@unavarra.es; date: 2016-07-24
Other Details Languagename: Aitor Eguzkitza; organisation: Universidad Pública de Navarra - Complejo Hospitalario de Navarra; email: aitor.eguzkiza@unavarra.es; date: 2016-07-24
OtherDetails Language Independent{MetaDataSet:Sample Set =MetaDataSet:Sample Set , Copyright=Copyright, Owner=Owner, Speciality=Speciality}
Language useden
Citeable Identifier1013.26.150
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This data element allows multiple occurrences and should be coded with a reference terminology, where possible. 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Coding of the clinical indication with a terminology is preferred, where possible. 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example: To record that the patient had been taking antibiotics three days prior to hospital admission, in the context of a 7-day course., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.medication_administration.v0]/items[openEHR-EHR-INSTRUCTION.medication_order.v0]/activities[at0001]/description[at0002]/items[at0113]/items[at0050], code=at0050, itemType=ELEMENT, level=6, text=Duration of course already complete, description=The time period during which the patient has already been using the medication, vaccine or other therapeutic good, as a part of the proposed overall course but prior to the issue of this order., comment=For example: To record that the patient had been taking antibiotics 3 days prior to hospital admission, in the context of a 7 day course., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DURATION, bindings=null, values=Units:
  • Week
  • Day
  • Hour
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  • Baseline electrolyte infusion  [The infusion provides baseline hydration.]
  • Active medication infusion  [The infusion carries an active pharmaceutical ingredient.]
  • Nutritional infusion  [The infusion provides parenteral nutrition.]
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Coding of the body site with a terminology is preferred, where possible., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.medication_administration.v0]/items[openEHR-EHR-INSTRUCTION.medication_order.v0]/activities[at0001]/description[at0002]/items[at0133]/items[at0094], code=at0094, itemType=ELEMENT, level=6, text=Delivery method, description=The method by which the medication is to be delivered., comment=For example: 'via nebuliser'., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.medication_administration.v0]/items[openEHR-EHR-INSTRUCTION.medication_order.v0]/activities[at0001]/description[at0002]/items[at0167], code=at0167, itemType=ELEMENT, level=5, text=Comment, description=Additional narrative about the medication order not captured in other fields., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.medication_administration.v0]/items[openEHR-EHR-INSTRUCTION.medication_order.v0]/protocol[at0005], code=at0005, itemType=UNSUPPORTEDTOPLEVELATTRIBUTE, level=3, text=Protocol, description=The amount and units of the medication, vaccine or other therapeutic good to be used or administered at one time., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=UNSUPPORTEDTOPLEVELATTRIBUTE, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.medication_administration.v0]/items[openEHR-EHR-INSTRUCTION.medication_order.v0]/protocol[at0005]/items[at0004], code=at0004, itemType=ELEMENT, level=4, text=Order identifier, description=Unique identifier for the medication order., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_IDENTIFIER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.medication_administration.v0]/items[openEHR-EHR-INSTRUCTION.medication_order.v0]/protocol[at0005]/items[at0135], code=at0135, itemType=ELEMENT, level=4, text=Dosage formula, description=The formula used to calculate the Dose amount or administration rate where this is dependent on some other factor such as patient weight. For example: 10mg/kg/day., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.medication_administration.v0]/items[openEHR-EHR-ACTION.medication.v0], code=at0000, itemType=ACTION, level=2, text=Medication, description=Details of use, administration, dispensing or other care step relating to a medicine, vaccine or other therapeutic good which may arise from an instruction from a clinician., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=ACTION, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.medication_administration.v0]/items[openEHR-EHR-ACTION.medication.v0]/description[at0017], code=at0017, itemType=UNSUPPORTEDTOPLEVELATTRIBUTE, level=3, text=Description, description=, comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=UNSUPPORTEDTOPLEVELATTRIBUTE, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.medication_administration.v0]/items[openEHR-EHR-ACTION.medication.v0]/description[at0017]/items[at0020], code=at0020, itemType=ELEMENT, level=4, text=Medication, description=The medicine, vaccine or other therapeutic good which was the focus of the action. This element will normally be coded with a medicines terminology but free text may be required in some cases., comment=For example: 'Atenolol 100mg' or 'Atenolol tablets 100mg'., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=termset: external, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.medication_administration.v0]/items[openEHR-EHR-ACTION.medication.v0]/description[at0017]/items[at0082], code=at0082, itemType=CLUSTER, level=4, text=Product, description=Details of the product dispensed, authorised or administered., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.medication_administration.v0]/items[openEHR-EHR-ACTION.medication.v0]/description[at0017]/items[at0082]/items[at0130], code=at0130, itemType=ELEMENT, level=5, text=Manufacturer, description=The manufacturer of the medication., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.medication_administration.v0]/items[openEHR-EHR-ACTION.medication.v0]/description[at0017]/items[at0082]/items[at0083], code=at0083, itemType=ELEMENT, level=5, text=Batch ID, description=Assigned by the manufacturer to identify the manufacturing batch of the item., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.medication_administration.v0]/items[openEHR-EHR-ACTION.medication.v0]/description[at0017]/items[at0082]/items[at0084], code=at0084, itemType=ELEMENT, level=5, text=Expiry date, description=The expiry date of the medicine administered as documented by the manufacturer., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.medication_administration.v0]/items[openEHR-EHR-ACTION.medication.v0]/description[at0017]/items[at0082]/items[at0105], code=at0105, itemType=ELEMENT, level=5, text=Max class dose administered, description=The proportion of the maximum allowed dose equivalent administered., comment=Used in mental health to allow monitoring of total amount of a drug class andministered e.g. anti-psychotics, where each medication is associated with a percentage contribution towards a total daily maximum, normally 100%., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_PROPORTION, bindings=null, values=
  • Percent
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.medication_administration.v0]/items[openEHR-EHR-ACTION.medication.v0]/description[at0017]/items[at0082]/items[at0132], code=at0132, itemType=ELEMENT, level=5, text=Dispensing substitution, description=Subsitution action taken by the dispenser., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Substitute product dispensed  [A medication was dispensed which is bioequivalent to that ordered.]
  • Substitute product not dispensed  [Although allowed by the medication order a substitute bioequvalent medication was not dispensed.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.medication_administration.v0]/items[openEHR-EHR-ACTION.medication.v0]/description[at0017]/items[at0082]/items[at0133], code=at0133, itemType=ELEMENT, level=5, text=Dispensing substitution reason, description=The reason or justification for the substitution action taken., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.medication_administration.v0]/items[openEHR-EHR-ACTION.medication.v0]/description[at0017]/items[at0043], code=at0043, itemType=ELEMENT, level=4, text=Order scheduled datetime, description=The datetime at which the medication order was scheduled to occur., comment=Used to compare variance from actual action time where this is not readily calculable from the original instruction., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.medication_administration.v0]/items[openEHR-EHR-ACTION.medication.v0]/description[at0017]/items[at0021], code=at0021, itemType=ELEMENT, level=4, text=Reason, description=The reason(s) the specific action or step was carried out. Note: This is not the reason for the medication instruction, rather the specific reason e.g. for administration., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.medication_administration.v0]/items[openEHR-EHR-ACTION.medication.v0]/description[at0017]/items[at0117], code=at0117, itemType=ELEMENT, level=4, text=Reason course amended/stopped, description=The reason(s) for amending or stopping a course of medication., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=
  •  Coded Text
    • Allergy/Adverse Reaction/ Intolerance  [The patient experienced an adverse reaction.]
    • Inadequate clinical response  [The clinical response to the medication was inadequate.]
    • Patient choice / difficulty  [The course was changed because of patient preference or difficulty.]
    • Prescribed in error  [The medication was prescribed in error.]
    • Additional information available  [Addiotnal information informed the amendment.]
    • Temporarily suspended  [The medication was suspended for a temporary period only.]
    • Change to dose form/ strength /route  [The dose form/strength and or route were changed.]
  •  Text
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.medication_administration.v0]/items[openEHR-EHR-ACTION.medication.v0]/description[at0017]/items[at0116], code=at0116, itemType=ELEMENT, level=4, text=Reason dose not administered, description=The reason(s) why a particular dose administration did not take place, including complte omission of the dose and deferral of the dose., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Patient refused  [The patient refused to take the medication.]
  • Nil by mouth  [The patient is on a nil-by-mouth regime.]
  • Medicine unavailable  [The medicine was unavailable.]
  • Patient unavailable  [The patient was not available.]
  • Clinical reason  [The medication administration was withheld/deferred for a clinical reason.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.medication_administration.v0]/items[openEHR-EHR-ACTION.medication.v0]/description[at0017]/items[at0140], code=at0140, itemType=CLUSTER, level=4, text=Delivery details, description=Details of body site and delivery of the medication., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.medication_administration.v0]/items[openEHR-EHR-ACTION.medication.v0]/description[at0017]/items[at0140]/items[at0141], code=at0141, itemType=ELEMENT, level=5, text=Body site, description=Identification of the site of administration of the medication, vaccine or therapeutic good., comment=For example: 'left upper arm', 'intravenous catheter right hand'. Coding of the body site with a terminology is preferred, where possible., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.medication_administration.v0]/items[openEHR-EHR-ACTION.medication.v0]/description[at0017]/items[at0140]/items[at0143], code=at0143, itemType=ELEMENT, level=5, text=Delivery method, description=The method by which the medication is to be delivered., comment=For example: 'via nebuliser'., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.medication_administration.v0]/items[openEHR-EHR-ACTION.medication.v0]/description[at0017]/items[at0033], code=at0033, itemType=ELEMENT, level=4, text=Patient guidance, description=Any guidance, instructions or advice given to the subject of care or carer at the time of the action., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.medication_administration.v0]/items[openEHR-EHR-ACTION.medication.v0]/description[at0017]/items[at0025], code=at0025, itemType=ELEMENT, level=4, text=Sequence number, description=The sequence number specific to the action being recorded., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.medication_administration.v0]/items[openEHR-EHR-ACTION.medication.v0]/description[at0017]/items[at0024], code=at0024, itemType=ELEMENT, level=4, text=Comment, description=A comment on the action taken including details of any variance between the intended action and the action actually performed., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.medication_administration.v0]/items[openEHR-EHR-ACTION.medication.v0]/protocol[at0030], code=at0030, itemType=UNSUPPORTEDTOPLEVELATTRIBUTE, level=3, text=Protocol, description=, comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=UNSUPPORTEDTOPLEVELATTRIBUTE, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.medication_administration.v0]/items[openEHR-EHR-ACTION.medication.v0]/protocol[at0030]/items[at0103], code=at0103, itemType=ELEMENT, level=4, text=Order ID, description=The identifier assigned with the original order., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_IDENTIFIER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0], code=at0000, itemType=SECTION, level=1, text=Ophthalmic laser procedure, description=Defines any procedure involving treatment of ophthalmic diseases by means of techniques based in laser., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=SECTION, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0], code=at0000.1, itemType=INSTRUCTION, level=2, text=Procedure request, description=Request for a procedure to be performed by a healthcare provider or agency., comment=For example equipment request.!, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=INSTRUCTION, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/activities[at0001], code=at0001, itemType=ACTIVITY, level=3, text=Request, description=Description of the requested service., comment=null, uncommonOntologyItems=null, occurencesFormal=1..*, occurencesText=Mandatory, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=ACTIVITY, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/activities[at0001]/description[at0009], code=at0009, itemType=UNSUPPORTEDTOPLEVELATTRIBUTE, level=4, text=Description, description=, comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=UNSUPPORTEDTOPLEVELATTRIBUTE, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/activities[at0001]/description[at0009]/items[at0121.1], code=at0121.1, itemType=ELEMENT, level=5, text=Procedure name, description=Identification of the procedure requested, by name., comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=termset: external, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/activities[at0001]/description[at0009]/items[at0148.1], code=at0148.1, itemType=ELEMENT, level=5, text=Procedure type, description=Category of procedure requested., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/activities[at0001]/description[at0009]/items[at0135], code=at0135, itemType=ELEMENT, level=5, text=Description, description=Narrative description of the service requested., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/activities[at0001]/description[at0009]/items[at0.150], code=at0.150, itemType=ELEMENT, level=5, text=Body site, description=Identification of the body site for the procedure., comment=Occurrences for this data element are unbounded to allow for clinical scenarios such as removing multiple skin lesions in different places, but where all of the other attributes are identical. Use this data element to record simple terms or precoordinated anatomical locations. If the requirements for recording the anatomical location are determined at run-time by the application or require more complex modelling such as relative locations then use the CLUSTER.anatomical_location or CLUSTER.relative_location within the 'Procedure detail' SLOT in this archetype. If the anatomical location is included in the 'Procedure name' via precoordinated codes, this data element becomes redundant., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/activities[at0001]/description[at0009]/items[at0062.1], code=at0062.1, itemType=ELEMENT, level=5, text=Indication, description=A short phrase describing the indication for the procedure., comment=May be narrative or a coded value set., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=
  • Known intolerance or allergy to topical agents
  • Suspected poor compliance of topical agents
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/activities[at0001]/description[at0009]/items[at0064.1], code=at0064.1, itemType=ELEMENT, level=5, text=Indication description, description=Narrative description about the indication for the procedure., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/activities[at0001]/description[at0009]/items[at0065.1], code=at0065.1, itemType=ELEMENT, level=5, text=Objective, description=Description of the objective of the procedure., comment=May be narrative or a coded value set., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/activities[at0001]/description[at0009]/items[at0068], code=at0068, itemType=ELEMENT, level=5, text=Urgency, description=Urgency of the request for service., comment=Specific definitions of emergency and urgent will vary between clinical contexts, clinical systems and the nature of the request itself, so have not be defined in this archetype. If explicit timing is required then the Service period should be clearly stated., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=
  •  Coded Text
    • Emergency  [The request requires immediate attention.]
    • Urgent  [The request requires prioritised attention.]
    • Routine  [The request does not require prioritised scheduling.]
  •  Text
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/activities[at0001]/description[at0009]/items[at0040], code=at0040, itemType=ELEMENT, level=5, text=Service due, description=The date/time, or acceptable interval of date/time, for provision of the service., comment=In practice, clinicians will often think in terms of ordering services as approximate timing, for example: review in 3 months, 6 months or 12 months. As clinical systems need more exact parameters to operate on, this '3 months' will usually be converted to an exact date 3 months from the date of recording and stored using this data element., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/activities[at0001]/description[at0009]/items[at0145], code=at0145, itemType=ELEMENT, level=5, text=Service period start, description=The date/time that marks the beginning of the valid period of time for delivery of this service., comment=This date/time is the equivalent to the earliest possible date for service delivery. For example: sometimes a certain amount of time must pass before a service can be performed, for example some procedures can only be performed once the patient has stopped taking medications for a specific amount of time., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/activities[at0001]/description[at0009]/items[at0144], code=at0144, itemType=ELEMENT, level=5, text=Service period expiry, description=The date/time that marks the conclusion of the valid period of time for delivery of this service., comment=This date/time is the equivalent to the latest possible date for service delivery or to the date of expiry for this request. For example: a service may be required to be completed before another event, such as scheduled surgery., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/activities[at0001]/description[at0009]/items[openEHR-EHR-CLUSTER.ophthalmic_laser_details.v0], code=at0000, itemType=CLUSTER, level=5, text=Ophthalmic laser procedure details, description=Specific details concerning ophthalmic therapies involving the use of laser., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/activities[at0001]/description[at0009]/items[openEHR-EHR-CLUSTER.ophthalmic_laser_details.v0]/items[at0001], code=at0001, itemType=ELEMENT, level=6, text=Laterality, description=Eyes in which the laser-based treatment is applied., comment=null, uncommonOntologyItems=null, occurencesFormal=1..2, occurencesText=Mandatory, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Left eye  [Left eye observation.]
  • Right eye  [Right eye observation.]
  • Both eyes  [Treatment performed on both eyes of the patient.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/activities[at0001]/description[at0009]/items[openEHR-EHR-CLUSTER.ophthalmic_laser_details.v0]/items[at0012], code=at0012, itemType=CLUSTER, level=6, text=Laser procedure, description=Details of the laser procedure., comment=null, uncommonOntologyItems=null, occurencesFormal=1..*, occurencesText=Mandatory, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/activities[at0001]/description[at0009]/items[openEHR-EHR-CLUSTER.ophthalmic_laser_details.v0]/items[at0012]/items[at0013], code=at0013, itemType=ELEMENT, level=7, text=Laser technique, description=Method chosen for the laser treatment., comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=termset: ac0001, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/activities[at0001]/description[at0009]/items[openEHR-EHR-CLUSTER.ophthalmic_laser_details.v0]/items[at0012]/items[at0008], code=at0008, itemType=ELEMENT, level=7, text=Laser device, description=Identifies the type of laser device needed to perform the treatment., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=termset: ac0002, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/activities[at0001]/description[at0009]/items[openEHR-EHR-CLUSTER.ophthalmic_laser_details.v0]/items[at0012]/items[at0014], code=at0014, itemType=ELEMENT, level=7, text=Laser type, description=How laser burns are distributed along eye surface., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Focal laser  [Focal laser.]
  • Grid photocoagulation  [Grid photocoagulation.]
  • Focal macular  [Focal macular laser therapy.]
  • Grid macular  [Grid macular laser therapy.]
  • PRP  [Panretinal laser photocoagulation.]
  • Sector PRP  [Panretinal laser photocoagulation focused on a specific sector of posterior pole.]
  • Circle of laser  [Photocoagulation delimits a ring around a specific eye structure.]
  • Laser demarcation  [Laser demarcation.]
  • Other  [Another type of laser therapy.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/protocol[at0008], code=at0008, itemType=UNSUPPORTEDTOPLEVELATTRIBUTE, level=3, text=Protocol, description=, comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=UNSUPPORTEDTOPLEVELATTRIBUTE, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/protocol[at0008]/items[at0010], code=at0010, itemType=ELEMENT, level=4, text=Requestor Identifier, description=The local ID assigned to the order by the healthcare provider or organisation requesting the service. This is also referred to as Placer Order Identifier., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/protocol[at0008]/items[at0011], code=at0011, itemType=ELEMENT, level=4, text=Receiver identifier, description=The ID assigned to the order by the healthcare provider or organisation receiving the request for service. This is also referred to as Filler Order Identifier., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/protocol[at0008]/items[at0127], code=at0127, itemType=ELEMENT, level=4, text=Request status, description=The status of the request for service as indicated by the requester. Status is used to denote whether this is the initial request, or a follow-up request to change or provide supplementary information., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-ACTION.procedure.v1], code=at0000, itemType=ACTION, level=2, text=Procedure, description=A clinical activity carried out for screening, investigative, diagnostic, curative, therapeutic, evaluative or palliative purposes., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=ACTION, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-ACTION.procedure.v1]/description[at0001], code=at0001, itemType=UNSUPPORTEDTOPLEVELATTRIBUTE, level=3, text=Description, description=, comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=UNSUPPORTEDTOPLEVELATTRIBUTE, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-ACTION.procedure.v1]/description[at0001]/items[at0002], code=at0002, itemType=ELEMENT, level=4, text=Procedure name, description=Identification of the procedure by name., comment=Coding of the specific procedure with a terminology is preferred, where possible., uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=termset: external, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-ACTION.procedure.v1]/description[at0001]/items[at0049], code=at0049, itemType=ELEMENT, level=4, text=Description, description=Narrative description about the procedure, as appropriate for the pathway step., comment=For example: description about the performance and findings from the the procedure, the aborted attempt or the cancellation of the procedure., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-ACTION.procedure.v1]/description[at0001]/items[at0065], code=at0065, itemType=ELEMENT, level=4, text=Method, description=Identification of specific method or technique for the procedure., comment=Use this data element to record simple terms or a narrative description. If the requirements for recording the method require more complex modelling then this can be represented by additional archetypes within the 'Procedure detail' SLOT in this archetype. If the method is included in the 'Procedure name' via precoordinated codes, this data element becomes redundant., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-ACTION.procedure.v1]/description[at0001]/items[at0058], code=at0058, itemType=ELEMENT, level=4, text=Urgency, description=Urgency of the procedure., comment=Coding with a terminology is preferred, where possible., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-ACTION.procedure.v1]/description[at0001]/items[at0063], code=at0063, itemType=ELEMENT, level=4, text=Body site, description=Identification of the body site for the procedure., comment=Occurrences for this data element are unbounded to allow for clinical scenarios such as removing multiple skin lesions in different places, but where all of the other attributes are identical. Use this data element to record simple terms or precoordinated anatomical locations. If the requirements for recording the anatomical location are determined at run-time by the application or require more complex modelling such as relative locations then use the CLUSTER.anatomical_location or CLUSTER.relative_location within the 'Procedure detail' SLOT in this archetype. If the anatomical location is included in the 'Procedure name' via precoordinated codes, this data element becomes redundant., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-ACTION.procedure.v1]/description[at0001]/items[openEHR-EHR-CLUSTER.ophthalmic_laser_details.v0], code=at0000, itemType=CLUSTER, level=4, text=Ophthalmic laser procedure details, description=Specific details concerning ophthalmic therapies involving the use of laser., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-ACTION.procedure.v1]/description[at0001]/items[openEHR-EHR-CLUSTER.ophthalmic_laser_details.v0]/items[at0001], code=at0001, itemType=ELEMENT, level=5, text=Laterality, description=Eyes in which the laser-based treatment is applied., comment=null, uncommonOntologyItems=null, occurencesFormal=1..2, occurencesText=Mandatory, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Left eye  [Left eye observation.]
  • Right eye  [Right eye observation.]
  • Both eyes  [Treatment performed on both eyes of the patient.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-ACTION.procedure.v1]/description[at0001]/items[openEHR-EHR-CLUSTER.ophthalmic_laser_details.v0]/items[at0012], code=at0012, itemType=CLUSTER, level=5, text=Laser procedure, description=Details of the laser procedure., comment=null, uncommonOntologyItems=null, occurencesFormal=1..*, occurencesText=Mandatory, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-ACTION.procedure.v1]/description[at0001]/items[openEHR-EHR-CLUSTER.ophthalmic_laser_details.v0]/items[at0012]/items[at0013], code=at0013, itemType=ELEMENT, level=6, text=Laser technique, description=Method chosen for the laser treatment., comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=termset: ac0001, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-ACTION.procedure.v1]/description[at0001]/items[openEHR-EHR-CLUSTER.ophthalmic_laser_details.v0]/items[at0012]/items[at0008], code=at0008, itemType=ELEMENT, level=6, text=Laser device, description=Identifies the type of laser device needed to perform the treatment., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=termset: ac0002, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-ACTION.procedure.v1]/description[at0001]/items[openEHR-EHR-CLUSTER.ophthalmic_laser_details.v0]/items[at0012]/items[at0014], code=at0014, itemType=ELEMENT, level=6, text=Laser type, description=How laser burns are distributed along eye surface., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Focal laser  [Focal laser.]
  • Grid photocoagulation  [Grid photocoagulation.]
  • Focal macular  [Focal macular laser therapy.]
  • Grid macular  [Grid macular laser therapy.]
  • PRP  [Panretinal laser photocoagulation.]
  • Sector PRP  [Panretinal laser photocoagulation focused on a specific sector of posterior pole.]
  • Circle of laser  [Photocoagulation delimits a ring around a specific eye structure.]
  • Laser demarcation  [Laser demarcation.]
  • Other  [Another type of laser therapy.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-ACTION.procedure.v1]/description[at0001]/items[at0048], code=at0048, itemType=ELEMENT, level=4, text=Outcome, description=Outcome of procedure performed., comment=Coding with a terminology is preferred, where possible., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-ACTION.procedure.v1]/description[at0001]/items[at0006], code=at0006, itemType=ELEMENT, level=4, text=Complication, description=Details about any complication arising from the procedure., comment=Use this data element to record simple terms or precoordinated complications. If the requirements for recording complication are more complex then use of a specific CLUSTER archetype within the 'Procedure detail' SLOT in this archetype is advised and this data element becomes redundant., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-ACTION.procedure.v1]/description[at0001]/items[at0066], code=at0066, itemType=ELEMENT, level=4, text=Scheduled date/time, description=The date and/or time on which the procedure is intended to be performed., comment=Only for use in association with the 'Procedure scheduled' pathway step., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-ACTION.procedure.v1]/description[at0001]/items[at0060], code=at0060, itemType=ELEMENT, level=4, text=Final end date/time, description=The date and/or time when the entire procedure, or the last component of a multicomponent procedure, was finished., comment=Only for use in association with the 'Procedure performed' pathway step, and in situations where the procedure is repeated on multiple occasions before being completed or there are multiple components to the whole procedure. This may be the same as the RM time attribute for the 'Procedure completed' pathway step., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-ACTION.procedure.v1]/description[at0001]/items[at0061], code=at0061, itemType=ELEMENT, level=4, text=Total duration, description=The total amount of time taken to complete the procedure, which may include time spent during the active phase of the procedure plus time during which the procedure was suspended., comment=Only for use in association with the 'Procedure completed' pathway steps., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DURATION, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-ACTION.procedure.v1]/description[at0001]/items[at0067], code=at0067, itemType=ELEMENT, level=4, text=Procedure type, description=The type of procedure., comment=This pragmatic data element may be used to support organisation within the user interface., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-ACTION.procedure.v1]/description[at0001]/items[at0005], code=at0005, itemType=ELEMENT, level=4, text=Comment, description=Additional narrative about the activity or care pathway step not captured in other fields., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-ACTION.procedure.v1]/protocol[at0053], code=at0053, itemType=UNSUPPORTEDTOPLEVELATTRIBUTE, level=3, text=Protocol, description=, comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=UNSUPPORTEDTOPLEVELATTRIBUTE, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-ACTION.procedure.v1]/protocol[at0053]/items[at0054], code=at0054, itemType=ELEMENT, level=4, text=Requestor order identifier, description=The local ID assigned to the order by the healthcare provider or organisation requesting the service., comment=This is equivalent to Placer Order Number in HL7 v2 specifications., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=
  •  Text
  •  Identifier
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.laser.v0]/items[openEHR-EHR-ACTION.procedure.v1]/protocol[at0053]/items[at0056], code=at0056, itemType=ELEMENT, level=4, text=Receiver order identifier, description=The ID assigned to the order by the healthcare provider or organisation receiving the request for service. This is also referred to as Filler Order Identifier., comment=This is equivalent to Filler Order Number in HL7 v2 specifications., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=
  •  Text
  •  Identifier
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0], code=at0000, itemType=SECTION, level=1, text=Ophthalmic surgical procedure, description=Describes any surgical procedure aimed at treating ophthalmic conditions., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=SECTION, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0], code=at0000.1, itemType=INSTRUCTION, level=2, text=Procedure request, description=Request for a procedure to be performed by a healthcare provider or agency., comment=For example equipment request.!, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=INSTRUCTION, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/activities[at0001], code=at0001, itemType=ACTIVITY, level=3, text=Request, description=Description of the requested service., comment=null, uncommonOntologyItems=null, occurencesFormal=1..*, occurencesText=Mandatory, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=ACTIVITY, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/activities[at0001]/description[at0009], code=at0009, itemType=UNSUPPORTEDTOPLEVELATTRIBUTE, level=4, text=Description, description=, comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=UNSUPPORTEDTOPLEVELATTRIBUTE, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/activities[at0001]/description[at0009]/items[at0121.1], code=at0121.1, itemType=ELEMENT, level=5, text=Procedure name, description=Identification of the procedure requested, by name., comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=termset: external, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/activities[at0001]/description[at0009]/items[at0148.1], code=at0148.1, itemType=ELEMENT, level=5, text=Procedure type, description=Category of procedure requested., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/activities[at0001]/description[at0009]/items[at0135], code=at0135, itemType=ELEMENT, level=5, text=Description, description=Narrative description of the service requested., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/activities[at0001]/description[at0009]/items[at0.150], code=at0.150, itemType=ELEMENT, level=5, text=Body site, description=Identification of the body site for the procedure., comment=Occurrences for this data element are unbounded to allow for clinical scenarios such as removing multiple skin lesions in different places, but where all of the other attributes are identical. Use this data element to record simple terms or precoordinated anatomical locations. If the requirements for recording the anatomical location are determined at run-time by the application or require more complex modelling such as relative locations then use the CLUSTER.anatomical_location or CLUSTER.relative_location within the 'Procedure detail' SLOT in this archetype. If the anatomical location is included in the 'Procedure name' via precoordinated codes, this data element becomes redundant., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/activities[at0001]/description[at0009]/items[at0062.1], code=at0062.1, itemType=ELEMENT, level=5, text=Indication, description=A short phrase describing the indication for the procedure., comment=May be narrative or a coded value set., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/activities[at0001]/description[at0009]/items[at0064.1], code=at0064.1, itemType=ELEMENT, level=5, text=Indication description, description=Narrative description about the indication for the procedure., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/activities[at0001]/description[at0009]/items[at0065.1], code=at0065.1, itemType=ELEMENT, level=5, text=Objective, description=Description of the objective of the procedure., comment=May be narrative or a coded value set., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/activities[at0001]/description[at0009]/items[at0068], code=at0068, itemType=ELEMENT, level=5, text=Urgency, description=Urgency of the request for service., comment=Specific definitions of emergency and urgent will vary between clinical contexts, clinical systems and the nature of the request itself, so have not be defined in this archetype. If explicit timing is required then the Service period should be clearly stated., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=
  •  Coded Text
    • Emergency  [The request requires immediate attention.]
    • Urgent  [The request requires prioritised attention.]
    • Routine  [The request does not require prioritised scheduling.]
  •  Text
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/activities[at0001]/description[at0009]/items[at0040], code=at0040, itemType=ELEMENT, level=5, text=Service due, description=The date/time, or acceptable interval of date/time, for provision of the service., comment=In practice, clinicians will often think in terms of ordering services as approximate timing, for example: review in 3 months, 6 months or 12 months. As clinical systems need more exact parameters to operate on, this '3 months' will usually be converted to an exact date 3 months from the date of recording and stored using this data element., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/activities[at0001]/description[at0009]/items[at0145], code=at0145, itemType=ELEMENT, level=5, text=Service period start, description=The date/time that marks the beginning of the valid period of time for delivery of this service., comment=This date/time is the equivalent to the earliest possible date for service delivery. For example: sometimes a certain amount of time must pass before a service can be performed, for example some procedures can only be performed once the patient has stopped taking medications for a specific amount of time., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/activities[at0001]/description[at0009]/items[at0144], code=at0144, itemType=ELEMENT, level=5, text=Service period expiry, description=The date/time that marks the conclusion of the valid period of time for delivery of this service., comment=This date/time is the equivalent to the latest possible date for service delivery or to the date of expiry for this request. For example: a service may be required to be completed before another event, such as scheduled surgery., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/protocol[at0008], code=at0008, itemType=UNSUPPORTEDTOPLEVELATTRIBUTE, level=3, text=Protocol, description=, comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=UNSUPPORTEDTOPLEVELATTRIBUTE, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/protocol[at0008]/items[at0010], code=at0010, itemType=ELEMENT, level=4, text=Requestor Identifier, description=The local ID assigned to the order by the healthcare provider or organisation requesting the service. This is also referred to as Placer Order Identifier., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/protocol[at0008]/items[at0011], code=at0011, itemType=ELEMENT, level=4, text=Receiver identifier, description=The ID assigned to the order by the healthcare provider or organisation receiving the request for service. This is also referred to as Filler Order Identifier., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0]/items[openEHR-EHR-INSTRUCTION.request-procedure.v0]/protocol[at0008]/items[at0127], code=at0127, itemType=ELEMENT, level=4, text=Request status, description=The status of the request for service as indicated by the requester. Status is used to denote whether this is the initial request, or a follow-up request to change or provide supplementary information., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0]/items[openEHR-EHR-ACTION.procedure.v1], code=at0000, itemType=ACTION, level=2, text=Procedure, description=A clinical activity carried out for screening, investigative, diagnostic, curative, therapeutic, evaluative or palliative purposes., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=ACTION, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0]/items[openEHR-EHR-ACTION.procedure.v1]/description[at0001], code=at0001, itemType=UNSUPPORTEDTOPLEVELATTRIBUTE, level=3, text=Description, description=, comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=UNSUPPORTEDTOPLEVELATTRIBUTE, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0]/items[openEHR-EHR-ACTION.procedure.v1]/description[at0001]/items[at0002], code=at0002, itemType=ELEMENT, level=4, text=Procedure name, description=Identification of the procedure by name., comment=Coding of the specific procedure with a terminology is preferred, where possible., uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=termset: external, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0]/items[openEHR-EHR-ACTION.procedure.v1]/description[at0001]/items[at0049], code=at0049, itemType=ELEMENT, level=4, text=Description, description=Narrative description about the procedure, as appropriate for the pathway step., comment=For example: description about the performance and findings from the the procedure, the aborted attempt or the cancellation of the procedure., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0]/items[openEHR-EHR-ACTION.procedure.v1]/description[at0001]/items[at0065], code=at0065, itemType=ELEMENT, level=4, text=Method, description=Identification of specific method or technique for the procedure., comment=Use this data element to record simple terms or a narrative description. If the requirements for recording the method require more complex modelling then this can be represented by additional archetypes within the 'Procedure detail' SLOT in this archetype. If the method is included in the 'Procedure name' via precoordinated codes, this data element becomes redundant., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0]/items[openEHR-EHR-ACTION.procedure.v1]/description[at0001]/items[at0058], code=at0058, itemType=ELEMENT, level=4, text=Urgency, description=Urgency of the procedure., comment=Coding with a terminology is preferred, where possible., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0]/items[openEHR-EHR-ACTION.procedure.v1]/description[at0001]/items[at0063], code=at0063, itemType=ELEMENT, level=4, text=Body site, description=Identification of the body site for the procedure., comment=Occurrences for this data element are unbounded to allow for clinical scenarios such as removing multiple skin lesions in different places, but where all of the other attributes are identical. Use this data element to record simple terms or precoordinated anatomical locations. If the requirements for recording the anatomical location are determined at run-time by the application or require more complex modelling such as relative locations then use the CLUSTER.anatomical_location or CLUSTER.relative_location within the 'Procedure detail' SLOT in this archetype. If the anatomical location is included in the 'Procedure name' via precoordinated codes, this data element becomes redundant., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0]/items[openEHR-EHR-ACTION.procedure.v1]/description[at0001]/items[at0048], code=at0048, itemType=ELEMENT, level=4, text=Outcome, description=Outcome of procedure performed., comment=Coding with a terminology is preferred, where possible., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0]/items[openEHR-EHR-ACTION.procedure.v1]/description[at0001]/items[at0006], code=at0006, itemType=ELEMENT, level=4, text=Complication, description=Details about any complication arising from the procedure., comment=Use this data element to record simple terms or precoordinated complications. If the requirements for recording complication are more complex then use of a specific CLUSTER archetype within the 'Procedure detail' SLOT in this archetype is advised and this data element becomes redundant., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0]/items[openEHR-EHR-ACTION.procedure.v1]/description[at0001]/items[at0066], code=at0066, itemType=ELEMENT, level=4, text=Scheduled date/time, description=The date and/or time on which the procedure is intended to be performed., comment=Only for use in association with the 'Procedure scheduled' pathway step., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0]/items[openEHR-EHR-ACTION.procedure.v1]/description[at0001]/items[at0060], code=at0060, itemType=ELEMENT, level=4, text=Final end date/time, description=The date and/or time when the entire procedure, or the last component of a multicomponent procedure, was finished., comment=Only for use in association with the 'Procedure performed' pathway step, and in situations where the procedure is repeated on multiple occasions before being completed or there are multiple components to the whole procedure. This may be the same as the RM time attribute for the 'Procedure completed' pathway step., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0]/items[openEHR-EHR-ACTION.procedure.v1]/description[at0001]/items[at0061], code=at0061, itemType=ELEMENT, level=4, text=Total duration, description=The total amount of time taken to complete the procedure, which may include time spent during the active phase of the procedure plus time during which the procedure was suspended., comment=Only for use in association with the 'Procedure completed' pathway steps., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DURATION, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0]/items[openEHR-EHR-ACTION.procedure.v1]/description[at0001]/items[at0067], code=at0067, itemType=ELEMENT, level=4, text=Procedure type, description=The type of procedure., comment=This pragmatic data element may be used to support organisation within the user interface., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0]/items[openEHR-EHR-ACTION.procedure.v1]/description[at0001]/items[at0005], code=at0005, itemType=ELEMENT, level=4, text=Comment, description=Additional narrative about the activity or care pathway step not captured in other fields., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0]/items[openEHR-EHR-ACTION.procedure.v1]/protocol[at0053], code=at0053, itemType=UNSUPPORTEDTOPLEVELATTRIBUTE, level=3, text=Protocol, description=, comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=UNSUPPORTEDTOPLEVELATTRIBUTE, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0]/items[openEHR-EHR-ACTION.procedure.v1]/protocol[at0053]/items[at0054], code=at0054, itemType=ELEMENT, level=4, text=Requestor order identifier, description=The local ID assigned to the order by the healthcare provider or organisation requesting the service., comment=This is equivalent to Placer Order Number in HL7 v2 specifications., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=
  •  Text
  •  Identifier
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.progress_note.v1]/content[openEHR-EHR-SECTION.surgery_procedure.v0]/items[openEHR-EHR-ACTION.procedure.v1]/protocol[at0053]/items[at0056], code=at0056, itemType=ELEMENT, level=4, text=Receiver order identifier, description=The ID assigned to the order by the healthcare provider or organisation receiving the request for service. This is also referred to as Filler Order Identifier., comment=This is equivalent to Filler Order Number in HL7 v2 specifications., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=
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, extendedValues=null]], templateType=normal]