health-data-standards 3.6.1 → 3.7.0

data/templates/c32/_medical_equipment.c32.erb

@@ -23,7 +23,7 @@
             <addr/>
             <telecom/>
             <playingDevice>
-              <%== code_display(entry, {:preferred_code_sets => ['SNOMED-CT']}) %>
+              <%== code_display(entry, {'preferred_code_sets' => ['SNOMED-CT']}) %>
             </playingDevice>
             <% if entry.manufacturer %>
             <scopingEntity>

data/templates/c32/_vital_signs.c32.erb

@@ -28,7 +28,7 @@
             <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.13" assigningAuthorityName="IHE PCC"/>
             <!-- Result observation template -->
             <id root="<%= UUID.generate %>"/>
-            <%== code_display(entry, {'preferred_code_sets' => ['LOINC','SNOMED']}) %>
+            <%== code_display(entry, {'preferred_code_sets' => ['LOINC','SNOMED-CT']}) %>
             <text>
               <reference value="vitals-desc-<%= i %>"/>
             </text>

data/templates/cat1/{_2.16.840.1.113883.10.20.22.4.85.cat1.erb → r2/_2.16.840.1.113883.10.20.22.4.85.cat1.erb}

@@ -13,7 +13,7 @@
     </effectiveTime>
     <%== code_display(entry, 'preferred_code_sets' => ['SNOMED-CT'],
                          'tag_name' => 'value',
-                         'value_set_map' => value_set_map,
+                         'value_set_map' => filtered_vs_map,
                          'extra_content' => "xsi:type=\"CD\" sdtc:valueSet=\"#{value_set_oid}\"") %>
   </observation>
 </entry>

data/templates/cat1/{_2.16.840.1.113883.10.20.24.3.1.cat1.erb → r2/_2.16.840.1.113883.10.20.24.3.1.cat1.erb}

@@ -1,10 +1,10 @@
 <entry>
   <observation classCode="OBS" moodCode="GOL">
     <!-- 2.16.840.1.113883.10.20.22.4.44 Plan of Care Activity Observation -->
-    <templateId root="2.16.840.1.113883.10.20.22.4.44"/>
-    <templateId root="2.16.840.1.113883.10.20.24.3.1"/>
+    <templateId root="2.16.840.1.113883.10.20.22.4.44" <% if !r2_compatibility %>extension="2014-06-09"<%end%>/>
+    <templateId root="2.16.840.1.113883.10.20.24.3.1" <% if !r2_compatibility %>extension="2014-12-01"<%end%>/>
     <id root="1.3.6.1.4.1.115" extension="<%= entry.id %>"/>
-    <%== code_display(entry,'value_set_map' => value_set_map, 'extra_content' => "sdtc:valueSet=\"#{value_set_oid}\"") %>
+    <%== code_display(entry,'value_set_map' => filtered_vs_map, 'extra_content' => "sdtc:valueSet=\"#{value_set_oid}\"") %>
     <text><%= entry.description %></text>
     <statusCode code="active"/>
     <effectiveTime>

data/templates/cat1/{_2.16.840.1.113883.10.20.24.3.101.cat1.erb → r2/_2.16.840.1.113883.10.20.24.3.101.cat1.erb}

@@ -1,6 +1,6 @@
 <entry>
   <observation classCode="OBS" moodCode="EVN">
-    <templateId root="2.16.840.1.113883.10.20.24.3.101"/>
+    <templateId root="2.16.840.1.113883.10.20.24.3.101" <% if !r2_compatibility %>extension="2014-12-01"<%end%>/>
     <id root="1.3.6.1.4.1.115" extension="<%= entry.id %>"/>
     <code code="57036006" 
           codeSystem="2.16.840.1.113883.6.96" 

data/templates/cat1/{_2.16.840.1.113883.10.20.24.3.103.cat1.erb → r2/_2.16.840.1.113883.10.20.24.3.103.cat1.erb}

@@ -4,10 +4,14 @@
     <id root="1.3.6.1.4.1.115" extension="<%= entry.id %>"/>
     <code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4" />
     <statusCode code="completed" />
-    <effectiveTime <%= value_or_null_flavor(entry.start_time) %>/>
-    <%== code_display(entry, 'preferred_code_sets' => ['SNOMED-CT'],
-                             'tag_name' => 'value','value_set_map' => value_set_map,
+    <effectiveTime>
+      <!-- Attribute: Start Datetime -->
+      <low <%= value_or_null_flavor(entry.start_time) %>/>
+      <!-- Attribute: Stop Datetime -->
+      <high <%= value_or_null_flavor(entry.end_time) %>/>
+    </effectiveTime>
+    <%== code_display(entry, 'preferred_code_sets' => ['*'],
+                             'tag_name' => 'value','value_set_map' => filtered_vs_map,
                              'extra_content' => "xsi:type=\"CD\" sdtc:valueSet=\"#{value_set_oid}\"") %>
-    <text><%= entry.description %></text>
   </observation>
-</entry>
+</entry>

data/templates/cat1/{_2.16.840.1.113883.10.20.24.3.105.cat1.erb → r2/_2.16.840.1.113883.10.20.24.3.105.cat1.erb}

@@ -1,7 +1,7 @@
 <entry>
-  <act classCode="ACT" moodCode="EVN">
+  <act classCode="ACT" moodCode="EVN" <%== negation_indicator(entry) %>>
     <!-- Discharge Medication Entry -->
-    <templateId root="2.16.840.1.113883.10.20.24.3.105"/>
+    <templateId root="2.16.840.1.113883.10.20.24.3.105"<% if !r2_compatibility %>extension="2014-12-01"<%end%>/>
     <id root="1.3.6.1.4.1.115" extension="<%= entry.id %>"/>
     <code code="10183-2"
           codeSystem="2.16.840.1.113883.6.1" 
@@ -12,7 +12,7 @@
       <low <%= value_or_null_flavor(entry.start_time) %>/>
     </effectiveTime>
     <entryRelationship typeCode="SUBJ">
-      <substanceAdministration moodCode="EVN" classCode="SBADM">
+      <substanceAdministration moodCode="EVN" classCode="SBADM" <%== negation_indicator(entry) %>>
         <!-- Medication Activity (consolidation) template -->
         <templateId root="2.16.840.1.113883.10.20.22.4.16"/> 
         <!-- Medication, Active template -->
@@ -25,18 +25,25 @@
             <low <%= value_or_null_flavor(entry.start_time) %>/>
             <high <%= value_or_null_flavor(entry.end_time) %>/>
         </effectiveTime>
-        
+        <% if entry.administrationTiming.present?
+          period = entry.administrationTiming['period'] %>
+          <effectiveTime xsi:type="PIVL_TS" institutionSpecified="true" operator="A">
+            <period value="<%= period['value']%>" unit="<%= period['unit']%>"/>
+          </effectiveTime>
+        <% end %>
         <% if entry.route.present? -%>
         <!-- Attribute: route -->
-        <routeCode code="<%= entry.route['code'] %>" codeSystem="<%= HealthDataStandards::Util::CodeSystemHelper.oid_for_code_system(entry.route['code_system']) %>"/>
+          <% vset = oid_for_code(entry.route.code,field_oids["ROUTE"]) %>
+          <% if vset %>
+            <routeCode code="<%= entry.route['code'] %>" codeSystem="<%= HealthDataStandards::Util::CodeSystemHelper.oid_for_code_system(entry.route['code_system']) %>" sdtc:valueSet="<%= vset %>"/>
+          <% end %>
         <% end -%>
         
         <!-- Attribute: dose -->
         <% if entry.dose.present? -%>
-        <doseQuantity value="<%= entry.dose['value']%>"/>
+          <doseQuantity value="<%= entry.dose['value']%>"/>
         <% end -%>
 
-
         <% if entry.product_form.present? -%>
         <administrationUnitCode code="<%= entry.product_form['code'] %>" codeSystem="<%= entry.product_form['codeSystem'] %>"/>
         <% end -%>
@@ -44,17 +51,18 @@
         <consumable>
           <manufacturedProduct classCode="MANU">
             <!-- Medication Information (consolidation) template --> 
-            <templateId root="2.16.840.1.113883.10.20.22.4.23"/>
+            <templateId root="2.16.840.1.113883.10.20.22.4.23" <% if !r2_compatibility %>extension="2014-06-09"<%end%>/>
             <id root="<%= UUID.generate %>"/>
             <manufacturedMaterial>
-              <%== code_display(entry,'preferred_code_sets' => ['RxNorm'],'value_set_map' => value_set_map, 'extra_content' => "sdtc:valueSet=\"#{value_set_oid}\"") %>
+              <%== code_display(entry,'preferred_code_sets' => ['RxNorm'],'value_set_map' => filtered_vs_map, 'extra_content' => "sdtc:valueSet=\"#{value_set_oid}\"") %>
             </manufacturedMaterial>
             <manufacturerOrganization>
               <name>Medication Factory Inc.</name>
             </manufacturerOrganization>
           </manufacturedProduct>
         </consumable>
+        <%== render(:partial => 'reason', :locals => {:entry => entry, :reason_oids=>field_oids["REASON"], :r2_compatibility => r2_compatibility}) %>
       </substanceAdministration>
     </entryRelationship>
   </act>
-</entry>
+</entry>

data/templates/cat1/r2/_2.16.840.1.113883.10.20.24.3.11.cat1.erb

@@ -0,0 +1,88 @@
+<% if !r2_compatibility %>
+<entry> 
+  <act classCode="ACT" moodCode="EVN">
+  <!-- Conforms to C-CDA Problem Concern Act (V2) -->
+  <templateId root="2.16.840.1.113883.10.20.22.4.3" extension="2014-06-09" />
+  <!-- Diagnosis Active Concern Act -->
+  <templateId root="2.16.840.1.113883.10.20.24.3.121" extension="2014-12-01" />
+  <id root="<%= UUID.generate %>" />
+  <code code="CONC" codeSystem="2.16.840.1.113883.5.6" displayName="Concern" />
+  <!-- The statusCode represents whether this is an active (active),       inactive (suspended) or resolved (completed) diagnosis -->    
+  <statusCode code="active" />
+  <effectiveTime>
+      <!-- Attribute: admission datetime -->
+      <low <%= value_or_null_flavor(entry.start_time) %>/>
+      <!-- Attribute: discharge datetime -->
+      <high <%= value_or_null_flavor(entry.end_time) %>/>
+    </effectiveTime>
+  <entryRelationship typeCode="SUBJ">
+<% else %>
+<entry>
+<% end %>
+  <observation classCode="OBS" moodCode="EVN">
+    <!--  Problem observation template -->
+    <templateId root="2.16.840.1.113883.10.20.22.4.4" <% if !r2_compatibility %>extension="2014-06-09"<%end%>/>
+    <!--  Diagnosis active template -->
+    <templateId root="2.16.840.1.113883.10.20.24.3.11" <% if !r2_compatibility %>extension="2014-12-01"<%end%>/>
+    <id root="1.3.6.1.4.1.115" extension="<%= entry.id %>"/>
+    <% if !r2_compatibility %>
+    <code code="29308-4" displayName="diagnosis" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
+    <% else %>
+    <code code="282291009" displayName="diagnosis" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED-CT"/>
+    <% end %>
+    <text><%= entry.description %></text>
+    <statusCode code="completed"/>
+    <effectiveTime>
+      <!-- Attribute: admission datetime -->
+      <low <%= value_or_null_flavor(entry.start_time) %>/>
+      <!-- Attribute: discharge datetime -->
+      <high <%= value_or_null_flavor(entry.end_time) %>/>
+    </effectiveTime>
+    <%== render(:partial => 'ordinality', :locals => {:entry => entry, :ordinality_oids=>field_oids["ORDINAL"]}) %>
+    <%== code_display(entry, {'tag_name' => 'value', 'value_set_map' => filtered_vs_map,'preferred_code_sets' => ['LOINC', 'SNOMED-CT', 'ICD-9-CM', 'ICD-10-CM'],
+                                                    'extra_content' => "xsi:type=\"CD\" sdtc:valueSet=\"#{value_set_oid}\"", 'laterality' => entry.laterality}) %>
+    <% if r2_compatibility %>
+    <entryRelationship typeCode="REFR">
+      <observation classCode="OBS" moodCode="EVN">
+        <!-- Problem Status (consolidation) template -->
+        <templateId root="2.16.840.1.113883.10.20.22.4.6" extension="2014-06-09"/>
+        <!-- Problem Status, Active template -->
+        <templateId root="2.16.840.1.113883.10.20.24.3.94" extension="2015-04-06"/>
+        <id root="<%= UUID.generate %>"/>  
+        <code code="33999-4" 
+          codeSystem="2.16.840.1.113883.6.1"
+          codeSystemName="LOINC" 
+          displayName="status"/>
+        <statusCode code="completed"/>
+        <value xsi:type="CD" code="55561003" 
+           displayName="active"
+           codeSystem="2.16.840.1.113883.6.96" 
+           codeSystemName="SNOMED CT"/>
+      </observation>
+    </entryRelationship>
+    <% end %>
+    <% if entry.severity %>
+    <entryRelationship typeCode="REFR">
+       <observation classCode="OBS" moodCode="EVN">
+          <templateId root="2.16.840.1.113883.10.20.22.4.8" <% if !r2_compatibility %>extension="2014-06-09"<%end%>/>
+          <code code="SEV" 
+                codeSystem="2.16.840.1.113883.5.4"/>
+           <statusCode code="completed"/>
+           <value xsi:type="CD"
+                code="<%= entry.severity['code'] %>"
+                codeSystem="<%= HealthDataStandards::Util::CodeSystemHelper.oid_for_code_system(entry.severity['codeSystem'] || entry.severity['code_system']) %>"
+              <% if entry.severity.has_key?('title') -%>
+                displayName="<%=entry.severity['title']%>"
+              <% end -%>
+                sdtc:valueSet="<%= oid_for_code(entry.severity,field_oids["SEVERITY"] || [], entry.record["bundle_id"]) %>"
+            />
+       </observation>
+
+    </entryRelationship>
+   <% end %> 
+  </observation>
+<% if !r2_compatibility %>
+    </entryRelationship>
+  </act>
+<% end %>
+</entry>

data/templates/cat1/r2/_2.16.840.1.113883.10.20.24.3.12.cat1.erb

@@ -0,0 +1,50 @@
+<entry typeCode="DRIV">
+  <organizer moodCode="EVN" classCode="CLUSTER">
+    <templateId root="2.16.840.1.113883.10.20.22.4.45" <% if !r2_compatibility %>extension="2014-06-09"<%end%>/>
+    <!--    Family history organizer template   -->
+    <templateId root="2.16.840.1.113883.10.20.24.3.12" <% if !r2_compatibility %>extension="2014-12-01"<%end%>/>
+    <statusCode code="completed"/>
+    <effectiveTime>
+      <low <%= value_or_null_flavor(entry.start_time) %>/>
+      <high <%= value_or_null_flavor(entry.end_time) %>/>
+    </effectiveTime>
+    <!-- The subject is currently hardcoded to father -->
+    <subject>
+      <relatedSubject classCode="PRS">
+        <code code="FTH" displayName="Father" 
+              codeSystemName="HL7RoleCode" 
+              codeSystem="2.16.840.1.113883.5.111">
+          <translation code="9947008" 
+                displayName="Biological father" 
+                codeSystemName="SNOMED CT" 
+                codeSystem="2.16.840.1.113883.6.96"/>
+        </code>
+        <subject>
+          <administrativeGenderCode 
+               code="M" codeSystem="2.16.840.1.113883.5.1"
+               codeSystemName="HL7AdministrativeGender" 
+               displayName="Male"/>
+            <birthTime value="1912"/>
+        </subject>
+      </relatedSubject>
+    </subject>
+    <component>
+      <observation classCode="OBS" moodCode="EVN">
+        <templateId root="2.16.840.1.113883.10.20.22.4.46" <% if !r2_compatibility %>extension="2014-06-09"<%end%>/>
+        <id root="1.3.6.1.4.1.115" extension="<%= entry.id %>"/>
+        <code code="55607006" displayName="Problem" 
+              codeSystemName="SNOMED CT" 
+              codeSystem="2.16.840.1.113883.6.96"/>
+        <statusCode code="completed"/>
+        <effectiveTime>
+          <low <%= value_or_null_flavor(entry.start_time) %>/>
+          <high <%= value_or_null_flavor(entry.end_time) %>/>
+        </effectiveTime>
+        <%== code_display(entry, 'value_set_map' => filtered_vs_map,'preferred_code_sets' => ['SNOMED-CT'],
+                         'tag_name' => 'value',
+                         'extra_content' => "xsi:type=\"CD\" sdtc:valueSet=\"#{value_set_oid}\"") %>
+        <text><%= entry.description %></text>
+      </observation>
+    </component>
+  </organizer>
+</entry>

data/templates/cat1/r2/_2.16.840.1.113883.10.20.24.3.13.cat1.erb

@@ -0,0 +1,54 @@
+<entry>
+  <act classCode="ACT" moodCode="EVN">
+    <!-- Conforms to C-CDA Problem Concern Act (V2) -->
+    <templateId root="2.16.840.1.113883.10.20.22.4.3" extension="2014-06-09" />
+    <!-- Diagnosis Resolved Concern Act -->
+    <templateId root="2.16.840.1.113883.10.20.24.3.123" extension="2014-12-01" />
+    <id root="<%= UUID.generate %>"/>
+    <code code="CONC" codeSystem="2.16.840.1.113883.5.6" displayName="Concern" />
+    <statusCode code="suspended" />
+    <effectiveTime>
+      <!-- Attribute: Start Datetime -->
+      <low <%= value_or_null_flavor(entry.start_time) %>/>
+      <!-- Attribute: Stop Datetime -->
+      <high <%= value_or_null_flavor(entry.end_time) %>/>
+    </effectiveTime>
+    <entryRelationship typeCode="SUBJ">
+  <observation classCode="OBS" moodCode="EVN">
+  <!--  Problem observation template -->
+  <templateId root="2.16.840.1.113883.10.20.22.4.4" <% if !r2_compatibility %>extension="2014-06-09"<%end%>/>
+  <!-- Diagnosis, inactive template -->
+  <templateId root="2.16.840.1.113883.10.20.24.3.13" <% if !r2_compatibility %>extension="2014-12-01"<%end%>/>
+  <id root="1.3.6.1.4.1.115" extension="<%= entry.id %>"/>
+  <code code="29308-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="diagnosis"/>
+  
+  <statusCode code="completed"/>
+
+  <effectiveTime>
+    <!-- Attribute: Start Datetime -->
+    <low <%= value_or_null_flavor(entry.start_time) %>/>
+    <!-- Attribute: Stop Datetime -->
+    <high <%= value_or_null_flavor(entry.end_time) %>/>
+  </effectiveTime>
+  <%== render(:partial => 'ordinality', :locals => {:entry => entry, :ordinality_oids=>field_oids["ORDINAL"]}) %>
+
+  <%== code_display(entry, 'value_set_map' => filtered_vs_map,'tag_name' => 'value', 'preferred_code_sets' => ['SNOMED-CT', 'ICD-9-CM', 'ICD-10-CM', 'LOINC'], 'extra_content' => "xsi:type=\"CD\" sdtc:valueSet=\"#{value_set_oid}\"") %>
+  <% if r2_compatibility %>
+  <!-- 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, Inactive template -->
+      <templateId root="2.16.840.1.113883.10.20.24.3.95"/>
+      <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="73425007" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="inactive" xsi:type="CD"/>
+    </observation>
+  </entryRelationship>
+  <% end %>
+  </observation>
+  </entryRelationship>
+  </act>
+</entry>

data/templates/cat1/r2/_2.16.840.1.113883.10.20.24.3.135.cat1.erb

@@ -0,0 +1,70 @@
+<entry>
+  <act classCode="ACT" moodCode="EVN">
+    <!-- Conforms to C-CDA 2.1 Problem Concern Act (V3) -->
+    <templateId root="2.16.840.1.113883.10.20.22.4.3" extension="2015-08-01" />
+    <!-- Diagnosis Concern Act -->
+    <templateId root="2.16.840.1.113883.10.20.24.3.137" />
+    <id root="<%= UUID.generate %>" />
+    <code code="CONC" codeSystem="2.16.840.1.113883.5.6" displayName="Concern" />
+    <statusCode code="active" />
+    <effectiveTime>
+      <low <%= value_or_null_flavor(entry.start_time) %> />
+    </effectiveTime>
+    <entryRelationship typeCode="SUBJ">
+      <observation classCode="OBS" moodCode="EVN">
+        <!-- Conforms to C-CDA R2.1 Problem Observation (V3) -->
+        <templateId root="2.16.840.1.113883.10.20.22.4.4" extension="2015-08-01" />
+        <!-- Diagnosis template -->
+        <templateId root="2.16.840.1.113883.10.20.24.3.135" />
+        <id root="1.3.6.1.4.1.115" extension="<%= entry.id %>" />
+        <code code="29308-4" codeSystem="2.16.840.1.113883.6.1">
+          <translation code="282291009" codeSystem="2.16.840.1.113883.6.96"/>
+        </code>
+        <statusCode code="completed" />
+        <effectiveTime>
+          <!-- Attribute: onset datetime -->
+          <low <%= value_or_null_flavor(entry.start_time) %> />
+          <!-- Attribute: abatement datetime -->
+          <high <%= value_or_null_flavor(entry.end_time) %> />
+        </effectiveTime>
+        <%== code_display(entry, 'tag_name' => 'value', 'value_set_map' => filtered_vs_map, 'preferred_code_sets' => ['LOINC', 'SNOMED-CT', 'ICD-9-CM', 'ICD-10-CM'],
+                                 'extra_content' => "xsi:type=\"CD\" sdtc:valueSet=\"#{value_set_oid}\"") %>
+        <% if entry.laterality -%>
+          <targetSiteCode code="<%= entry.laterality['code'] %>"
+                          codeSystem="<%= HealthDataStandards::Util::CodeSystemHelper.oid_for_code_system(entry.laterality['codeSystem'] || entry.laterality['code_system']) %>"
+                          <% if entry.laterality.has_key?('title') -%>
+                            displayName="<%=entry.laterality['title']%>"
+                          <% end -%>
+                          sdtc:valueSet="<%= oid_for_code(entry.severity,field_oids["LATERALITY"] || [], entry.record["bundle_id"]) %>"
+          />
+        <% end -%>
+        <% if entry.anatomical_location -%>
+          <targetSiteCode code="<%= entry.anatomical_location['code'] %>"
+                          codeSystem="<%= HealthDataStandards::Util::CodeSystemHelper.oid_for_code_system(entry.anatomical_location['codeSystem'] || entry.anatomical_location['code_system']) %>"
+                          <% if entry.anatomical_location.has_key?('title') -%>
+                            displayName="<%=entry.anatomical_location['title']%>"
+                          <% end -%>
+                          sdtc:valueSet="<%= oid_for_code(entry.anatomical_location,field_oids["ANATOMICAL_LOCATION_SITE"] || [], entry.record["bundle_id"]) %>"
+          />
+        <% end -%>
+        <% if entry.severity -%>
+          <entryRelationship typeCode="REFR">
+            <observation classCode="OBS" moodCode="EVN">
+              <templateId root="2.16.840.1.113883.10.20.22.4.8" extension="2014-06-09" />
+              <code code="SEV" codeSystem="2.16.840.1.113883.5.4" />
+              <statusCode code="completed" />
+              <value xsi:type="CD"
+                     code="<%= entry.severity['code'] %>"
+                     codeSystem="<%= HealthDataStandards::Util::CodeSystemHelper.oid_for_code_system(entry.severity['codeSystem'] || entry.severity['code_system']) %>"
+                     <% if entry.severity.has_key?('title') -%>
+                       displayName="<%=entry.severity['title']%>"
+                     <% end -%>
+                     sdtc:valueSet="<%= oid_for_code(entry.severity,field_oids["SEVERITY"] || [], entry.record["bundle_id"]) %>"
+              />
+            </observation>
+          </entryRelationship>
+        <% end -%>
+      </observation>
+    </entryRelationship>
+  </act>
+</entry>

data/templates/cat1/r2/_2.16.840.1.113883.10.20.24.3.136.cat1.erb

@@ -0,0 +1,52 @@
+<entry>
+  <act classCode="ACT" moodCode="EVN">
+    <!-- Conforms to C-CDA 2.1 Problem Concern Act (V3) -->
+    <templateId root="2.16.840.1.113883.10.20.22.4.3" extension="2015-08-01" />
+    <!-- Symptom Concern Act -->
+    <templateId root="2.16.840.1.113883.10.20.24.3.138" />
+    <id root="<%= UUID.generate %>" />
+    <code code="CONC" codeSystem="2.16.840.1.113883.5.6" displayName="Concern" />
+    <statusCode code="active" />
+    <effectiveTime>
+      <low <%= value_or_null_flavor(entry.start_time) %> />
+    </effectiveTime>
+    <entryRelationship typeCode="SUBJ">
+      <observation classCode="OBS" moodCode="EVN">
+        <!-- Conforms to C-CDA R2.1 Problem Observation (V3) -->
+        <templateId root="2.16.840.1.113883.10.20.22.4.4" extension="2015-08-01" />
+        <!-- Symptom template -->
+        <templateId root="2.16.840.1.113883.10.20.24.3.136" />
+        <id root="1.3.6.1.4.1.115" extension="<%= entry.id %>" />
+        <code code="75325-1" codeSystem="2.16.840.1.113883.6.1">
+          <translation code="418799008" codeSystem="2.16.840.1.113883.6.96"/>
+        </code>
+        <statusCode code="completed" />
+        <effectiveTime>
+          <!-- Attribute: onset datetime -->
+          <low <%= value_or_null_flavor(entry.start_time) %> />
+          <!-- Attribute: abatement datetime -->
+          <high <%= value_or_null_flavor(entry.end_time) %> />
+        </effectiveTime>
+        <%== code_display(entry, 'tag_name' => 'value', 'value_set_map' => filtered_vs_map, 'preferred_code_sets' => ['LOINC', 'SNOMED-CT', 'ICD-9-CM', 'ICD-10-CM'],
+                                 'extra_content' => "xsi:type=\"CD\" sdtc:valueSet=\"#{value_set_oid}\"") %>
+        <% if entry.severity -%>
+          <entryRelationship typeCode="REFR">
+            <observation classCode="OBS" moodCode="EVN">
+              <templateId root="2.16.840.1.113883.10.20.22.4.8" extension="2014-06-09" />
+              <code code="SEV" codeSystem="2.16.840.1.113883.5.4" />
+              <statusCode code="completed" />
+              <value xsi:type="CD"
+                     code="<%= entry.severity['code'] %>"
+                     codeSystem="<%= HealthDataStandards::Util::CodeSystemHelper.oid_for_code_system(entry.severity['codeSystem'] || entry.severity['code_system']) %>"
+                     <% if entry.severity.has_key?('title') -%>
+                       displayName="<%=entry.severity['title']%>"
+                     <% end -%>
+                     sdtc:valueSet="<%= oid_for_code(entry.severity,field_oids["SEVERITY"] || [], entry.record["bundle_id"]) %>"
+              />
+            </observation>
+          </entryRelationship>
+        <% end -%>
+      </observation>
+    </entryRelationship>
+  </act>
+</entry>