health-data-standards 3.6.1 → 3.7.0

data/templates/cat1/r4/_2.16.840.1.113883.10.20.24.3.135.cat1.erb

@@ -0,0 +1,75 @@
+<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" extension="2016-08-01"/>
+    <id root="<%= UUID.generate %>" />
+    <code code="CONC" codeSystem="2.16.840.1.113883.5.6" displayName="Concern" />
+    <% if entry.end_time %>
+    <statusCode code="completed" />
+    <% else %>
+    <statusCode code="active" />
+    <% end %>
+    <effectiveTime>
+      <low <%= value_or_null_flavor(entry.start_time) %> />
+      <high <%= value_or_null_flavor(entry.end_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/r4/_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" extension="2016-08-01"/>
+    <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>

data/templates/cat1/r4/_2.16.840.1.113883.10.20.24.3.140.cat1.erb

@@ -0,0 +1,39 @@
+<entry>
+  <act classCode="ACT" moodCode="EVN" <%== negation_indicator(entry) %>>
+    <!-- Immunization, Administered template -->
+    <templateId root="2.16.840.1.113883.10.20.24.3.140"/>
+    <id root="1.3.6.1.4.1.115" extension="<%= entry.id %>"/>
+    <code code="416118004" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Administration"/>
+    <statusCode code="completed"/>
+    <effectiveTime xsi:type="IVL_TS">
+      <low <%= value_or_null_flavor(entry.start_time) %>/>
+      <high <%= value_or_null_flavor(entry.end_time) %>/>
+    </effectiveTime>
+    <entryRelationship typeCode="COMP">
+      <substanceAdministration classCode="SBADM" moodCode="EVN">
+        <!-- Immunization Activity template -->
+        <templateId root="2.16.840.1.113883.10.20.22.4.52" extension="2014-06-09"/>
+        <id root="<%= UUID.generate %>"/>
+        <text><%= entry.description %></text>
+        <statusCode code="completed"/>
+        <effectiveTime xsi:type="IVL_TS">
+          <low <%= value_or_null_flavor(entry.start_time) %>/>
+          <high <%= value_or_null_flavor(entry.end_time) %>/>
+        </effectiveTime>
+        <%== render(:partial => 'medication_details', :locals => {:entry => entry, :route_oids=>field_oids["ROUTE"]}) %>
+        <consumable>
+          <manufacturedProduct classCode="MANU">
+            <!-- Immunization Information (consolidation) template -->
+            <templateId root="2.16.840.1.113883.10.20.22.4.54" extension="2014-06-09"/>
+            <id root="<%= UUID.generate %>"/>
+            <manufacturedMaterial>
+              <%== code_display(entry, 'value_set_map' => filtered_vs_map, 'preferred_code_sets' => ['CVX', 'RxNorm'], 'extra_content' => "sdtc:valueSet=\"#{value_set_oid}\"") %>
+              <lotNumberText>1</lotNumberText>
+            </manufacturedMaterial>
+          </manufacturedProduct>
+        </consumable>
+      </substanceAdministration>
+    </entryRelationship>
+    <%== render(:partial => 'reason', :locals => {:entry => entry,:reason_oids=>field_oids["REASON"]}) %>
+  </act>
+</entry>

data/templates/cat1/{_2.16.840.1.113883.10.20.24.3.59.cat1.erb → r4/_2.16.840.1.113883.10.20.24.3.144.cat1.erb}

@@ -3,19 +3,19 @@
  %>   
 <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"/>
+    <!-- Assessment Performed -->
+    <templateId root="2.16.840.1.113883.10.20.24.3.144" extension="2016-08-01" />
     <id root="1.3.6.1.4.1.115" extension="<%= entry.id %>"/>
-    <%== code_display(entry, 'value_set_map' => value_set_map, 'preferred_code_sets' => ['SNOMED-CT', 'ICD-9-CM', 'ICD-10-CM'], 'extra_content' => "sdtc:valueSet=\"#{value_set_oid}\"") %>
+    <%== code_display(entry, 'value_set_map' => filtered_vs_map,'preferred_code_sets' => ['*'], '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 => {:values => [value], :result_oids=>result_oids}) %>
+    <%== render(:partial => 'result_value', :locals => {:values => [value], :result_oids=>result_oids} ) %>
+    <%== render(:partial => 'reason', :locals => {:entry => entry, :reason_oids=>field_oids["REASON"]}) %>
   </observation>
 </entry>
 <% end %>

data/templates/cat1/r4/_2.16.840.1.113883.10.20.24.3.145.cat1.erb

@@ -0,0 +1,24 @@
+<entry>
+  <observation classCode="OBS" moodCode="INT" <%== negation_indicator(entry) %>>
+    <!-- Conforms to C-CDA R2.1 Planned Observation (V2) -->
+    <templateId root="2.16.840.1.113883.10.20.22.4.44" extension="2014-06-09" />
+    <!-- Assessment Recommended -->
+    <templateId root="2.16.840.1.113883.10.20.24.3.145" extension="2016-08-01"/>
+    <id root="1.3.6.1.4.1.115" extension="<%= entry.id %>"/>
+    <%== code_display(entry, 'value_set_map' => filtered_vs_map,'preferred_code_sets' => ['*'], 'extra_content' => "sdtc:valueSet=\"#{value_set_oid}\"") %>
+    <text><%= entry.description %></text>
+    <statusCode code="active"/>
+    <effectiveTime>
+      <low <%= value_or_null_flavor(entry.start_time) %>/>
+      <high <%= value_or_null_flavor(entry.end_time) %>/>
+    </effectiveTime>
+    <author>
+      <templateId root="2.16.840.1.113883.10.20.22.4.119"/>
+      <time <%= value_or_null_flavor(entry.as_point_in_time) %>/>
+      <assignedAuthor>
+        <id root="<%= UUID.generate %>"/>
+      </assignedAuthor>
+    </author>
+    <%== render(:partial => 'reason', :locals => {:entry => entry, :reason_oids=>field_oids["REASON"]}) %>
+  </observation>
+</entry>

data/templates/cat1/r4/_2.16.840.1.113883.10.20.24.3.17.cat1.erb

@@ -0,0 +1,23 @@
+<entry>
+  <observation classCode="OBS" moodCode="RQO" <%== negation_indicator(entry) %>>
+  <!-- Consolidated Plan of Care Activity Observation
+       templateId (Implied Template) -->
+  <templateId root="2.16.840.1.113883.10.20.22.4.44" extension="2014-06-09"/>
+  <!-- Diagnostic Study, Order template -->
+  <templateId root="2.16.840.1.113883.10.20.24.3.17" extension="2016-02-01"/>
+  <id root="1.3.6.1.4.1.115" extension="<%= entry.id %>"/>
+  <%== code_display(entry, 'value_set_map' => filtered_vs_map,'preferred_code_sets' => ['LOINC'], 'extra_content' => "sdtc:valueSet=\"#{value_set_oid}\"") %>
+  <text><%= entry.description %></text>
+  <statusCode code="active"/>
+
+  <!-- Attribute: datetime -->
+  <author>
+    <templateId root="2.16.840.1.113883.10.20.22.4.119"/>
+    <time <%= value_or_null_flavor(entry.as_point_in_time) %>/>
+    <assignedAuthor>
+      <id nullFlavor="NA" root="<%= UUID.generate %>"/>
+    </assignedAuthor>
+  </author>
+  <%== render(:partial => 'reason', :locals => {:entry => entry, :reason_oids=>field_oids["REASON"]}) %>
+</observation>
+</entry>

data/templates/cat1/r4/_2.16.840.1.113883.10.20.24.3.18.cat1.erb

@@ -0,0 +1,25 @@
+<% vals = entry.values.empty? ? [nil] : entry.values 
+   vals.each do |value| 
+ %>   
+<entry>
+  <observation classCode="OBS" moodCode="EVN" <%== negation_indicator(entry) %>>
+    <!-- Consolidated Procedure Activity Observation templateId 
+       (Implied Template) -->
+    <templateId root="2.16.840.1.113883.10.20.22.4.13" extension="2014-06-09"/>
+    <!-- Diagnostic Study, Performed template -->
+    <templateId root="2.16.840.1.113883.10.20.24.3.18" extension="2016-02-01"/>
+    <id root="1.3.6.1.4.1.115" extension="<%= entry.id %>"/>
+    <%== code_display(entry,'value_set_map' => filtered_vs_map, 'preferred_code_sets' => ['*'], 'extra_content' => "sdtc:valueSet=\"#{value_set_oid}\"") %>
+    <text><%= entry.description %></text>
+    <statusCode code="completed"/>
+    <effectiveTime>
+      <!-- Attribute: Start Datetime -->
+      <low <%= value_or_null_flavor(entry.start_time) %>/>
+      <!-- Attribute: End Datetime -->
+      <high <%= value_or_null_flavor(entry.end_time) %>/>
+    </effectiveTime>
+    <%== render(:partial => 'result_value', :locals => {:values => [value], :result_oids=>result_oids}) %>
+    <%== render(:partial => 'reason', :locals => {:entry => entry, :reason_oids=>field_oids["REASON"]}) %>
+  </observation>
+</entry>
+<% end %>

data/templates/cat1/r4/_2.16.840.1.113883.10.20.24.3.2.cat1.erb

@@ -0,0 +1,29 @@
+<entry>
+  <act classCode="ACT" moodCode="EVN" <%== negation_indicator(entry) %>>
+    <!-- Communication from patient to provider -->
+    <templateId root="2.16.840.1.113883.10.20.24.3.2" extension="2016-02-01"/>
+    <id root="1.3.6.1.4.1.115" extension="<%= entry.id %>"/>  
+    <%== code_display(entry, 'value_set_map' => filtered_vs_map, 'preferred_code_sets' => ['*'], '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>
+    
+    <participant typeCode="AUT">
+      <participantRole classCode="PAT">
+        <code code="116154003" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Patient"/>
+      </participantRole>
+    </participant>
+
+    <participant typeCode="IRCP">
+      <participantRole classCode="ASSIGNED">
+        <code code="158965000" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Medical Practitioner"/>
+      </participantRole>
+    </participant>
+
+    <%== render(:partial => 'reason', :locals => {:entry => entry, :reason_oids=>field_oids["REASON"]}) %>
+
+  </act>
+</entry>

data/templates/cat1/r4/_2.16.840.1.113883.10.20.24.3.22.cat1.erb

@@ -0,0 +1,30 @@
+<entry>
+  <act classCode="ACT" moodCode="RQO" <%== negation_indicator(entry) %>>
+    <templateId root="2.16.840.1.113883.10.20.24.3.132"/>
+    <id root="<%= UUID.generate %>" />
+    <code code="ENC" codeSystem="2.16.840.1.113883.5.6" displayName="Encounter" codeSystemName="ActClass"/>
+    <entryRelationship typeCode="SUBJ">
+      <encounter classCode="ENC" moodCode="RQO">
+        <!--  Plan of Care Activity Encounter template -->
+        <templateId root="2.16.840.1.113883.10.20.22.4.40" extension="2014-06-09"/>
+        <!-- Encounter order template -->
+        <templateId root="2.16.840.1.113883.10.20.24.3.22" extension="2016-02-01"/>
+        <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', 'CPT', 'HCPCS', 'CDT'], 'value_set_map' => filtered_vs_map, 'extra_content' => "sdtc:valueSet=\"#{value_set_oid}\"") %>
+        <text><%= entry.description %></text>
+        <statusCode code="active"/>
+      
+        <!-- Attribute: datetime -->
+        <author>
+          <templateId root="2.16.840.1.113883.10.20.22.4.119"/>
+          <time <%= value_or_null_flavor(entry.start_time) %>/>
+          <assignedAuthor>
+            <id root="<%= UUID.generate %>"/>
+          </assignedAuthor>
+        </author>
+
+      </encounter>
+    </entryRelationship>
+    <%== render(:partial => 'reason', :locals => {:entry => entry, :reason_oids=>field_oids["REASON"], :r2_compatibility => r2_compatibility}) %>
+  </act>
+</entry>

data/templates/cat1/r4/_2.16.840.1.113883.10.20.24.3.23.cat1.erb

@@ -0,0 +1,116 @@
+<entry>
+  <act classCode="ACT" moodCode="EVN" <%== negation_indicator(entry) %>>
+    <!--Encounter performed Act -->
+    <templateId root="2.16.840.1.113883.10.20.24.3.133"/>
+    <id root="<%= UUID.generate %>" />
+    <code code="ENC" codeSystem="2.16.840.1.113883.5.6" displayName="Encounter" codeSystemName="ActClass"/>
+    <entryRelationship typeCode="SUBJ">
+      <encounter classCode="ENC" moodCode="EVN">
+        <!--  Encounter activities template -->
+        <templateId root="2.16.840.1.113883.10.20.22.4.49" extension="2015-08-01"/> 
+        <!-- Encounter performed template -->
+        <templateId root="2.16.840.1.113883.10.20.24.3.23" extension="2016-02-01"/>
+        <id root="1.3.6.1.4.1.115" extension="<%= entry.id %>"/>
+        <%== code_display(entry, 'value_set_map' => filtered_vs_map, 'preferred_code_sets' => ['*'], 'extra_content' => "sdtc:valueSet=\"#{value_set_oid}\"") %>
+        <text><%= entry.description %></text>
+        <statusCode code="completed"/>
+        <effectiveTime>
+          <!-- We try to look for the admit/discharge times on the encounter if they are
+               there. If not, we fall back to the typical start/end date. -->
+          <low <%= value_or_null_flavor(entry.admit_time || entry.start_time) %>/>
+          <high <%= value_or_null_flavor(entry.discharge_time || entry.end_time) %>/>
+        </effectiveTime>
+        <% if entry.discharge_disposition.present?
+          vset = oid_for_code(entry.discharge_disposition,field_oids["DISCHARGE_STATUS"], entry.record["bundle_id"])
+          if vset %>  
+            <sdtc:dischargeDispositionCode code="<%= entry.discharge_disposition['code'] %>" 
+                codeSystem="<%= HealthDataStandards::Util::CodeSystemHelper.oid_for_code_system(entry.discharge_disposition['codeSystem'] || entry.discharge_disposition['code_system']) %>" sdtc:valueSet="<%= vset %>"/>
+          <% end %>
+        <% end -%>
+
+        <% if entry.respond_to?(:facility) && entry.facility.present? -%>
+        <participant typeCode="LOC">
+          <!-- Facility Location template -->
+          <templateId root="2.16.840.1.113883.10.20.24.3.100"/>
+          <time>
+            <!-- Attribute: facility location arrival datetime -->
+            <low <%= value_or_null_flavor(entry.facility.start_time) %>/>
+            <!-- Attribute: facility location departure datetime -->
+            <high <%= value_or_null_flavor(entry.facility.end_time) %>/>
+          </time>
+          <participantRole classCode="SDLOC">
+            <% if entry.facility.code.present? -%>
+              <% vset = oid_for_code(entry.facility.code,field_oids["FACILITY_LOCATION"],entry.record["bundle_id"]) %>
+              <% if vset %>
+                <code code="<%= entry.facility.code['code'] %>" 
+                  codeSystem="<%= HealthDataStandards::Util::CodeSystemHelper.oid_for_code_system(entry.facility.code['codeSystem'] || entry.facility.code['code_system']) %>" sdtc:valueSet="<%= vset %>"/>
+              <% else %>
+                <code nullFlavor="UNK"/>
+              <% end %>
+            <% else -%>
+            <code nullFlavor="UNK"/>
+            <% end -%>
+            <% if entry.facility.addresses.present? -%>
+            <addr>
+              <streetAddressLine><%= entry.facility.addresses.first.street %></streetAddressLine>
+              <city><%= entry.facility.addresses.first.city %></city>
+              <state><%= entry.facility.addresses.first.state %></state>
+              <postalCode><%= entry.facility.addresses.first.zip %></postalCode>
+              <country><%= entry.facility.addresses.first.country %></country>
+            </addr>
+            <% end -%>
+            <telecom nullFlavor="UNK"/>
+            <playingEntity classCode="PLC">
+              <name><%= entry.facility.name %></name>
+            </playingEntity>
+          </participantRole>
+        </participant>
+        <% end -%>
+        <% if entry.reason.present? -%>
+          <%== render(:partial => 'reason', :locals => {:entry => entry,:reason_oids=>field_oids["REASON"]}) %>
+        <% end -%>
+        <% if entry.principalDiagnosis 
+          value_set = oid_for_code(entry.principal_diagnosis.preferred_code, field_oids["PRINCIPAL_DIAGNOSIS"], entry.record["bundle_id"])
+          if value_set %>
+            <entryRelationship typeCode="REFR">
+                <observation classCode="OBS" moodCode="EVN">
+                  <code code="8319008" codeSystem="2.16.840.1.113883.6.96" displayName="Principal Diagnosis" codeSystemName="SNOMED CT"/>
+                  <%== code_display(entry.principal_diagnosis, 'tag_name' => 'value', 'preferred_code_sets' => ['SNOMED-CT', 'ICD-9-CM', 'ICD-10-CM', 'CPT'], 'extra_content' => "xsi:type=\"CD\" sdtc:valueSet=\"#{value_set}\"") %>
+                </observation>
+            </entryRelationship>
+          <% end %>
+        <% end -%>
+        <% if entry.diagnosis
+          value_set = oid_for_code(entry.diagnosis.preferred_code, field_oids["DIAGNOSIS"], entry.record["bundle_id"])
+          if value_set %>
+            <entryRelationship typeCode="REFR">
+                <act classCode="ACT" moodCode="EVN">
+                  <templateId root="2.16.840.1.113883.10.20.22.4.80" extension="2015-08-01"/>
+                  <code code="29308-4" codeSystem="2.16.840.1.113883.6.1" displayName="Diagnosis" codeSystemName="LOINC"/>
+                  <entryRelationship typeCode="SUBJ">
+                    <observation classCode="OBS" moodCode="EVN">
+                      <!--  Problem observation template -->
+                      <templateId root="2.16.840.1.113883.10.20.22.4.4" extension="2015-08-01"/>
+                      <id root="1.3.6.1.4.1.115" extension="<%= UUID.generate %>"/>
+                      <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: admission datetime -->
+                        <low <%= value_or_null_flavor(entry.start_time) %>/>
+                        <!-- Attribute: discharge datetime -->
+                        <high <%= value_or_null_flavor(entry.end_time) %>/>
+                      </effectiveTime>
+                      <%== code_display(entry.diagnosis, 'tag_name' => 'value', 'preferred_code_sets' => ['SNOMED-CT', 'ICD-9-CM', 'ICD-10-CM', 'CPT'], 'extra_content' => "xsi:type=\"CD\" sdtc:valueSet=\"#{value_set}\"") %>
+                    </observation>
+                  </entryRelationship>
+                </act>
+            </entryRelationship>
+          <% end %>
+        <% end -%>
+      </encounter>
+    </entryRelationship>
+    <%== render(:partial => 'reason', :locals => {:entry => entry, :reason_oids=>field_oids["REASON"], :r2_compatibility => r2_compatibility}) %>
+  </act>
+</entry>