health-data-standards 2.2.1 → 3.0.3

data/templates/cat1/_2.16.840.1.113883.10.20.24.3.51.cat1.erb

@@ -0,0 +1,13 @@
+<entry>
+  <!-- Clinical Trial Participant -->
+  <observation classCode="OBS" moodCode="EVN">
+    <templateId root="2.16.840.1.113883.10.20.24.3.51"/>
+    <id root="<%= UUID.generate %>"/>
+    <code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
+    <statusCode code="active"/>
+    <effectiveTime>
+      <low value="20100101"/> <!-- Currently hardcoded to January 1, 2010 -->
+    </effectiveTime>
+    <value code="428024001" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="clinical trial participant" xsi:type="CD"/>
+  </observation>
+</entry>

data/templates/cat1/_2.16.840.1.113883.10.20.24.3.54.cat1.erb

@@ -0,0 +1,16 @@
+<entry>
+  <!-- Patient characteristic expired -->
+  <observation classCode="OBS" moodCode="EVN">
+    <!-- Consolidation Deceased Observation templateId -->
+    <templateId root="2.16.840.1.113883.10.20.22.4.79"/>
+    <!-- Patient Characteristic Expired -->
+    <templateId root="2.16.840.1.113883.10.20.24.3.54"/>
+    <id root="<%= UUID.generate %>"/>
+    <code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4" codeSystemName="HL7ActCode"/>
+    <statusCode code="completed"/>
+    <effectiveTime>
+      <low <%= value_or_null_flavor(entry.start_time) %>/>
+    </effectiveTime>
+    <value code="419099009" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Dead" sdtc:valueSet="2.16.840.1.113883.3.666.5.539" xsi:type="CD"/>
+  </observation>
+</entry>

data/templates/cat1/_2.16.840.1.113883.10.20.24.3.55.cat1.erb

@@ -0,0 +1,10 @@
+<entry>
+  <!-- Patient Characteristic Payer -->
+  <observation classCode="OBS" moodCode="EVN">
+    <templateId root="2.16.840.1.113883.10.20.24.3.55"/>
+    <id root="1.3.6.1.4.1.115" extension="<%= entry.id %>"/>
+    <code code="48768-6" codeSystemName="LOINC" displayName="Payment source"/> 
+    <statusCode code="completed"/>
+    <%== code_display(entry, 'tag_name' => 'value', 'extra_content' => "xsi:type=\"CD\" sdtc:valueSet=\"2.16.840.1.114222.4.11.3591\"") %>
+  </observation>            
+</entry>

data/templates/cat1/_2.16.840.1.113883.10.20.24.3.57.cat1.erb

@@ -0,0 +1,19 @@
+<entry>
+  <!-- Physical Exam Finding -->
+  <observation classCode="OBS" moodCode="EVN">
+    <!--  Result observation template -->
+    <templateId root="2.16.840.1.113883.10.20.22.4.2"/>
+    <!-- Physical Exam, Finding template -->
+    <templateId root="2.16.840.1.113883.10.20.24.3.57"/>
+    <id root="1.3.6.1.4.1.115" extension="<%= entry.id %>"/>
+    <%== code_display(entry, 'preferred_code_sets' => ['LOINC', 'SNOMED-CT'], 'extra_content' => "sdtc:valueSet=\"#{value_set_oid}\"") %>    
+
+    <statusCode code="completed"/>
+
+    <effectiveTime>
+      <low <%= value_or_null_flavor(entry.start_time) %>/>
+      <high <%= value_or_null_flavor(entry.end_time) %>/>
+    </effectiveTime>
+    <%== render(:partial => 'result_value', :locals => {:entry => entry}) %>
+  </observation>
+</entry>

data/templates/cat1/_2.16.840.1.113883.10.20.24.3.59.cat1.erb

@@ -0,0 +1,17 @@
+<entry>
+  <observation classCode="OBS" moodCode="EVN" <%== negation_indicator(entry) %>>
+    <!-- Procedure Activity Procedure (Consolidation) template -->
+    <templateId root="2.16.840.1.113883.10.20.22.4.13"/>
+    <!-- Physical Exam, Performed template -->
+    <templateId root="2.16.840.1.113883.10.20.24.3.59"/>
+    <id root="1.3.6.1.4.1.115" extension="<%= entry.id %>"/>
+    <%== code_display(entry, 'preferred_code_sets' => ['SNOMED-CT', 'ICD-9-CM', 'ICD-10-CM'], 'extra_content' => "sdtc:valueSet=\"#{value_set_oid}\"") %>
+    <text><%= entry.description %></text>
+    <statusCode code="completed"/>
+    <effectiveTime>
+      <low <%= value_or_null_flavor(entry.start_time) %>/>
+      <high <%= value_or_null_flavor(entry.end_time) %>/>
+    </effectiveTime>
+    <%== render(:partial => 'result_value', :locals => {:entry => entry}) %>
+  </observation>
+</entry>

data/templates/cat1/_2.16.840.1.113883.10.20.24.3.62.cat1.erb

@@ -0,0 +1,36 @@
+<entry>
+  <observation classCode="OBS" moodCode="EVN">
+    <templateId root="2.16.840.1.113883.10.20.24.3.62"/>
+    <templateId root="2.16.840.1.113883.10.20.24.3.104"/>
+    <id root="1.3.6.1.4.1.115" extension="<%= entry.id %>"/>
+    <code code="ASSERTION" 
+          codeSystem="2.16.840.1.113883.5.4"
+          codeSystemName="ActCode"
+          displayName="Assertion"/>  
+    <statusCode code="completed"/>
+    <effectiveTime>
+      <low value="<%= entry.start_time %>"/>
+    </effectiveTime>
+    <value xsi:type="CD"
+           code="102460003"
+           codeSystem="2.16.840.1.113883.6.96"
+           codeSystemName="SNOMED CT"
+           displayName="Decreased tolerance"/>
+    <entryRelationship typeCode="CAUS" inversionInd="true">
+      <procedure classCode="PROC" moodCode="EVN">
+        <!--  Procedure performed template -->
+        <templateId root="2.16.840.1.113883.10.20.24.3.64"/>
+        <!-- Procedure Activity Procedure-->
+        <templateId root="2.16.840.1.113883.10.20.22.4.14"/>
+        <id root="1.3.6.1.4.1.115" extension="<%= entry.id %>"/>
+        <%== code_display(entry, 'preferred_code_sets' => ['LOINC', 'SNOMED-CT', 'CPT'], 'extra_content' => "sdtc:valueSet=\"#{value_set_oid}\"") %>
+        <text><%= entry.description %></text>
+        <statusCode code="completed"/>
+        <effectiveTime>
+          <low <%= value_or_null_flavor(entry.start_time) %>/>
+          <high <%= value_or_null_flavor(entry.end_time) %>/>
+        </effectiveTime>
+      </procedure>
+    </entryRelationship>
+  </observation>
+</entry>

data/templates/cat1/_2.16.840.1.113883.10.20.24.3.63.cat1.erb

@@ -0,0 +1,23 @@
+<entry>
+  <procedure classCode="PROC" moodCode="RQO" <%== negation_indicator(entry) %>>
+    <!-- Consolidated Plan of Care Activity Procedure TemplateId (Implied Template) -->
+    <templateId root="2.16.840.1.113883.10.20.22.4.41"/> 
+    <!-- QRDA Procedure, Order TemplateId --> 
+    <templateId root="2.16.840.1.113883.10.20.24.3.63"/> 
+    <id root="1.3.6.1.4.1.115" extension="<%= entry.id %>"/>
+    <%== code_display(entry, 'preferred_code_sets' => ['LOINC', 'SNOMED-CT', 'ICD-9-PCS', 'ICD-10-PCS'], 'extra_content' => "sdtc:valueSet=\"#{value_set_oid}\"") %>
+    <text><%= entry.description %></text>
+    <statusCode code="new"/>
+    <!-- Attribute: method--> 
+    <methodCode nullFlavor="UNK"/>
+    
+    <!-- Attribute: datetime --> 
+    <author>
+      <time <%= value_or_null_flavor(entry.start_time) %>/> 
+      <assignedAuthor>
+        <id nullFlavor="NA"/>
+      </assignedAuthor>
+    </author>
+    <%== render(:partial => 'reason', :locals => {:entry => entry}) %>
+  </procedure>
+</entry>

data/templates/cat1/_2.16.840.1.113883.10.20.24.3.64.cat1.erb

@@ -0,0 +1,29 @@
+<entry>
+  <procedure classCode="PROC" moodCode="EVN" <%== negation_indicator(entry) %>>
+    <!--  Procedure performed template -->
+    <templateId root="2.16.840.1.113883.10.20.24.3.64"/>
+    <!-- Procedure Activity Procedure-->
+    <templateId root="2.16.840.1.113883.10.20.22.4.14"/>
+    <id root="1.3.6.1.4.1.115" extension="<%= entry.id %>"/>
+    <%== code_display(entry, 'preferred_code_sets' => ['LOINC', 'SNOMED-CT', 'CPT', 'ICD-9-PCS', 'ICD-10-PCS'], 'extra_content' => "sdtc:valueSet=\"#{value_set_oid}\"") %>
+    <text><%= entry.description %></text>
+    <statusCode code="completed"/>
+    <effectiveTime>
+      <low <%= value_or_null_flavor(entry.start_time) %>/>
+      <high <%= value_or_null_flavor(entry.end_time) %>/>
+    </effectiveTime>
+    <%== render(:partial => 'reason', :locals => {:entry => entry}) %>
+    <% if entry.respond_to?(:incision_time) && entry.incision_time.present? -%>
+    <entryRelationship typeCode="REFR">
+      <procedure classCode="PROC" moodCode="EVN">
+        <templateId root="2.16.840.1.113883.10.20.24.3.89"/>
+        <code code="34896006" 
+              codeSystem="2.16.840.1.113883.6.96"
+              codeSystemName="SNOMED CT" 
+              displayName="incision"/>
+              <effectiveTime <%= value_or_null_flavor(entry.incision_time) %>/>
+      </procedure>
+    </entryRelationship>
+    <% end -%>
+  </procedure>
+</entry>

data/templates/cat1/_2.16.840.1.113883.10.20.24.3.66.cat1.erb

@@ -0,0 +1,34 @@
+<entry>
+  <procedure classCode="PROC" moodCode="EVN">
+    <!-- Consolidated Procedure Activity Procedure TemplateId 
+         (Implied Template) -->
+    <templateId root="2.16.840.1.113883.10.20.22.4.14"/>
+    <!-- QRDA Procedure, Result TemplateId -->
+    <templateId root="2.16.840.1.113883.10.20.24.3.66"/>
+    <id root="1.3.6.1.4.1.115" extension="<%= entry.id %>"/>
+    <%== code_display(entry, 'preferred_code_sets' => ['LOINC', 'SNOMED-CT', 'CPT'], 'extra_content' => "sdtc:valueSet=\"#{value_set_oid}\"") %>
+    <text><%= entry.description %></text>
+    <statusCode code="completed"/>
+    <effectiveTime>
+      <low <%= value_or_null_flavor(entry.start_time) %>/>
+      <high <%= value_or_null_flavor(entry.end_time) %>/>
+    </effectiveTime>
+    <% if entry.respond_to?(:ordinality_code) && entry.ordinality_code.present? -%>
+    <!-- Attribute: ordinality -->
+    <priorityCode code="<%= entry.ordinality_code['code'] %>" codeSystem="<%= entry.ordinality_code['code'] %>"/>
+    <% end -%>
+    <entryRelationship typeCode="REFR">
+      <observation classCode="OBS" moodCode="EVN">
+        <!-- Result Observation template (consolidation) -->
+        <templateId root="2.16.840.1.113883.10.20.22.4.2"/>
+        <!-- Result template -->
+        <templateId root="2.16.840.1.113883.10.20.24.3.87"/>
+        <id root="<%= UUID.generate %>"/>
+        <%== code_display(entry, 'preferred_code_sets' => ['LOINC', 'SNOMED-CT', 'CPT'], 'extra_content' => "sdtc:valueSet=\"#{value_set_oid}\"") %>
+        <statusCode code="completed"/>
+        <effectiveTime <%= value_or_null_flavor(entry.start_time) %>/>
+        <%== render(:partial => 'result_value', :locals => {:entry => entry}) %>
+      </observation>
+    </entryRelationship>
+  </procedure>
+</entry>

data/templates/cat1/_2.16.840.1.113883.10.20.24.3.69.cat1.erb

@@ -0,0 +1,23 @@
+<entry>
+  <observation classCode="OBS" moodCode="EVN" <%== negation_indicator(entry) %>>
+    <!-- Consolidation Assessment Scale Observation templateId -->
+    <templateId root="2.16.840.1.113883.10.20.22.4.69"/>
+    <!-- Risk Category Assessment -->
+    <templateId root="2.16.840.1.113883.10.20.24.3.69"/>
+    <id root="1.3.6.1.4.1.115" extension="<%= entry.id %>"/>
+    <%== code_display(entry, 'preferred_code_sets' => ['LOINC', 'SNOMED-CT'], 'extra_content' => "sdtc:valueSet=\"#{value_set_oid}\"") %>
+    <statusCode code="completed"/>
+
+    <effectiveTime>
+      <low <%= value_or_null_flavor(entry.start_time) %>/>
+    </effectiveTime>
+
+    <% ev = entry.values.first
+       if ev.present? && ev.respond_to?(:scalar) -%>
+    <value xsi:type="INT" value="<%= ev.scalar %>"/>
+    <% else -%>
+    <value nullFlavor="UNK"/>
+    <% end -%>
+    <%== render(:partial => 'reason', :locals => {:entry => entry}) %>
+  </observation>
+</entry>

data/templates/cat1/_2.16.840.1.113883.10.20.24.3.7.cat1.erb

@@ -0,0 +1,30 @@
+<entry>
+  <procedure classCode="PROC" moodCode="EVN" <%== negation_indicator(entry) %>>
+    <!-- Procedure Activity Procedure -->
+    <templateId root="2.16.840.1.113883.10.20.22.4.14"/>
+    <!-- Device Applied -->
+    <templateId root="2.16.840.1.113883.10.20.24.3.7"/>
+    <id root="1.3.6.1.4.1.115" extension="<%= entry.id %>"/>
+    <code code="360030002" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="application of device"/>
+    <text>Device, Applied</text>
+    <statusCode code="completed"/>
+    
+    <effectiveTime>
+      <low <%= value_or_null_flavor(entry.start_time) %>/>
+      <high <%= value_or_null_flavor(entry.removal_time || entry.end_time) %>/>
+    </effectiveTime>
+    
+    <% if entry.respond_to?(:anatomical_structure) && entry.anatomical_structure.present? -%>
+    <targetSiteCode code="<%= entry.anatomical_structure['code'] %>" 
+                    codeSystem="<%= HealthDataStandards::Util::CodeSystemHelper.oid_for_code_system(entry.anatomical_structure['codeSystem']) %>"/>
+    <% end -%>
+    <participant typeCode="DEV">
+      <participantRole classCode="MANU">
+        <playingDevice classCode="DEV">
+          <%== code_display(entry, 'preferred_code_sets' => ['LOINC', 'SNOMED-CT', 'ICD-9-PCS', 'ICD-10-PCS', 'CPT'], 'extra_content' => "sdtc:valueSet=\"#{value_set_oid}\"") %>
+        </playingDevice>
+      </participantRole>
+    </participant>
+    <%== render(:partial => 'reason', :locals => {:entry => entry}) %>
+  </procedure>
+</entry>

data/templates/cat1/_2.16.840.1.113883.10.20.24.3.76.cat1.erb

@@ -0,0 +1,32 @@
+<entry>
+  <observation classCode="OBS" moodCode="EVN">
+    <!--  Problem observation template -->
+    <templateId root="2.16.840.1.113883.10.20.22.4.4"/>
+    <!-- Symptom, active template -->
+    <templateId root="2.16.840.1.113883.10.20.24.3.76"/>  
+    <id root="1.3.6.1.4.1.115" extension="<%= entry.id %>"/>
+    <code code="418799008" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Symptom"/>
+    <text><%= entry.description %></text>
+    <statusCode code="completed"/> 
+    <%== code_display(entry, 'preferred_code_sets' => ['SNOMED-CT'], 'tag_name' => 'value', 'extra_content' => "xsi:type=\"CD\" sdtc:valueSet=\"#{value_set_oid}\"") %>
+    
+    <effectiveTime>
+      <low <%= value_or_null_flavor(entry.start_time) %>/>
+      <high <%= value_or_null_flavor(entry.end_time) %>/>
+    </effectiveTime>
+    
+    <!-- Status -->
+    <entryRelationship typeCode="REFR">
+      <observation classCode="OBS" moodCode="EVN">
+        <!-- Problem Status (consolidation) template -->
+        <templateId root="2.16.840.1.113883.10.20.22.4.6"/>
+        <!-- Problem Status, Active template -->
+        <templateId root="2.16.840.1.113883.10.20.24.3.94"/>
+        <id root="<%= UUID.generate %>"/>  
+        <code code="33999-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="status"/>
+        <statusCode code="completed"/>
+        <value code="55561003" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="active" xsi:type="CD"/>
+      </observation>
+    </entryRelationship>
+  </observation>
+</entry>

data/templates/cat1/_measures.cat1.erb

@@ -0,0 +1,66 @@
+      <component>
+        <section>
+          <!-- 
+            *****************************************************************
+            Measure Section
+            *****************************************************************
+          -->
+          <!-- This is the templateId for Measure Section -->
+          <templateId root="2.16.840.1.113883.10.20.24.2.2"/>
+          <!-- This is the templateId for Measure Section QDM -->
+          <templateId root="2.16.840.1.113883.10.20.24.2.3"/>
+          <!-- This is the LOINC code for "Measure document". This stays the same for all measure section required by QRDA standard -->
+          <code code="55186-1" codeSystem="2.16.840.1.113883.6.1"/>
+          <title>Measure Section</title>
+          <text>
+            <table border="1" width="100%">
+              <thead>
+                <tr>
+                  <th>eMeasure Title</th>
+                  <th>Version neutral identifier</th>
+                  <th>eMeasure Version Number</th>
+                  <th>NQF eMeasure Number</th>
+                  <th>Version specific identifier</th>
+                </tr>
+              </thead>
+              <tbody>
+                <% measures.each do |measure| -%>
+                <tr>
+                  <td><%= measure.title %></td>
+                  <td><%= measure.hqmf_set_id %></td>
+                  <td><%= measure.hqmf_version_number %></td>
+                  <td><%= measure.id %></td>
+                  <td><%= measure.hqmf_id %></td>
+                  <td></td>
+                </tr>
+                <% end -%>
+              </tbody>
+            </table>
+          </text>
+          <!-- 1..* Organizers, each containing a reference to an eMeasure -->
+          <% measures.each do |measure| -%>
+          <entry>
+            <organizer classCode="CLUSTER" moodCode="EVN">
+              <!-- This is the templateId for Measure Reference -->
+              <templateId root="2.16.840.1.113883.10.20.24.3.98"/>
+              <!-- This is the templateId for eMeasure Reference QDM -->
+              <templateId root="2.16.840.1.113883.10.20.24.3.97"/>
+              <statusCode code="completed"/>
+              <!-- Containing isBranch external references -->
+              <reference typeCode="REFR">
+                <externalDocument classCode="DOC" moodCode="EVN">
+                  <!-- SHALL: This is the version specific identifier for eMeasure: QualityMeasureDocument/id it is a GUID-->
+                  <id root="<%= measure.hqmf_id %>"/>
+                  <!-- SHOULD This is the title of the eMeasure -->
+                  <text><%= measure.title %></text>
+                  <!-- SHOULD: setId is the eMeasure version neutral id  -->
+                  <setId root="<%= measure.hqmf_set_id %>"/>
+                  <!-- This is the sequential eMeasure Version number -->
+                  <versionNumber value="<%= measure.hqmf_version_number %>"/>                  
+                </externalDocument>
+              </reference>
+            </organizer>
+          </entry>
+          <% end -%>
+        </section>
+      </component>

data/templates/cat1/_medication_details.cat1.erb

@@ -0,0 +1,9 @@
+<% if entry.route.present? -%>
+<!-- Attribute: route -->
+<routeCode code="<%= entry.route['code'] %>" codeSystem="<%= entry.route['codeSystem'] %>"/>
+<% end -%>
+
+<!-- Attribute: dose -->
+<% if entry.dose.present? -%>
+<doseQuantity value="<%= entry.dose['value']%>"/>
+<% end -%>

data/templates/cat1/_ordinality.cat1.erb

@@ -0,0 +1,4 @@
+<% if entry.respond_to?(:ordinality) && entry.ordinality.present? -%>
+<priorityCode  code="<%= entry.ordinality['code'] %>" 
+              codeSystem="<%= HealthDataStandards::Util::CodeSystemHelper.oid_for_code_system(entry.ordinality['codeSystem'] || entry.ordinality['code_system']) %>"/>
+<% end -%>

data/templates/cat1/_patient_data.cat1.erb

@@ -0,0 +1,14 @@
+      <component>
+        <section>
+          <!-- This is the templateId for Patient Data section -->
+          <templateId root="2.16.840.1.113883.10.20.17.2.4"/>
+          <!-- This is the templateId for Patient Data QDM section -->
+          <templateId root="2.16.840.1.113883.10.20.24.2.1"/>
+          <code code="55188-7" codeSystem="2.16.840.1.113883.6.1"/>
+          <title>Patient Data</title>
+          <text>
+
+          </text>
+          <%== render_patient_data(patient, measures) %>
+        </section>
+      </component>

data/templates/cat1/_reason.cat1.erb

@@ -0,0 +1,16 @@
+<% if entry.negation_reason.present? -%>
+<entryRelationship typeCode="RSON">
+  <observation classCode="OBS" moodCode="EVN">
+    <templateId root="2.16.840.1.113883.10.20.24.3.88"/>  
+    <code code="410666004" 
+          codeSystem="2.16.840.1.113883.6.96"
+          displayName="reason" 
+          codeSystemName="SNOMED CT"/>
+    <statusCode code="completed"/>
+    <effectiveTime <%= value_or_null_flavor(entry.start_time) %>/>
+    <value xsi:type="CD" 
+         code="<%= entry.negation_reason['code'] %>" 
+         codeSystem="<%= HealthDataStandards::Util::CodeSystemHelper.oid_for_code_system(entry.negation_reason['codeSystem'] || entry.negation_reason['code_system']) %>"/>
+  </observation>
+</entryRelationship>
+<% end -%>

data/templates/cat1/_record_target.cat1.erb

@@ -0,0 +1,39 @@
+  <recordTarget>
+    <patientRole>
+      <id root="Cypress" extension="<%= patient.id %>"/>
+      <!-- Fake Medicare HIC number -->
+      <id extension="12345" root="2.16.840.1.113883.4.572"/>
+      <addr use="HP">
+        <streetAddressLine>202 Burlington Rd.</streetAddressLine>
+        <city>Bedford</city>
+        <state>MA</state>
+        <postalCode>01730</postalCode>
+        <country>US</country>
+      </addr>
+      <telecom use="WP" value="tel:+1-781-271-3000"/>
+      <patient>
+        <name>
+          <given><%= patient.first %></given>
+          <family><%= patient.last %></family>
+        </name>
+        <administrativeGenderCode code="<%= patient.gender %>" codeSystem="2.16.840.1.113883.5.1" codeSystemName="HL7 AdministrativeGender"/>
+        <birthTime value="<%= Time.at(patient.birthdate).utc.to_formatted_s(:number) %>"/>
+        <% if (patient.race) %>
+          <raceCode code="<%= patient.race['code'] %>" <% if patient.race['name']%>displayName="<%= patient.race['name'] %>"<% end %> codeSystemName="CDC Race and Ethnicity" codeSystem="2.16.840.1.113883.6.238"/>
+        <% end %>
+        <% if (patient.race) %>
+          <ethnicGroupCode code="<%= patient.ethnicity['code'] %>" <% if patient.ethnicity['name']%>displayName="<%= patient.ethnicity['name'] %>"<% end %> codeSystemName="CDC Race and Ethnicity" codeSystem="2.16.840.1.113883.6.238"/>
+        <% end %>
+        <%
+          languages = patient.languages 
+          languages = ["en-US"] if languages.nil? or languages.empty?
+          languages.each do |language|%>
+          <languageCommunication>
+            <templateId root="2.16.840.1.113883.3.88.11.83.2" assigningAuthorityName="HITSP/C83"/>
+            <templateId root="1.3.6.1.4.1.19376.1.5.3.1.2.1" assigningAuthorityName="IHE/PCC"/>
+            <languageCode code="<%= language %>"/>
+          </languageCommunication>
+        <% end %>
+      </patient>
+    </patientRole>
+  </recordTarget>