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WE Care Assessment(C-CDA2.1).xml
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WE Care Assessment(C-CDA2.1).xml
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<section>
<!-- An assessment should be included in the section where it is appropriate in clinical context -->
<!-- Other asssessments may go into other sections. Depression screening is clinically appropriate for Mental Status -->
<templateId root="2.16.840.1.113883.10.20.22.2.17"/>
<templateId root="2.16.840.1.113883.10.20.22.2.17" extension="2015-08-01"/>
<code code="29762-2" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"
displayName="Social History"/>
<title>Social History</title>
<text>
<table>
<thead>
<tr>
<th>Date</th>
<th>Assessment</th>
<th>Value</th>
</tr>
</thead>
<tbody>
<!-- Note that WE Care doesn't include total score, detailed responses shown below -->
<tr>
<td ID="assessment" colspan="5">WE Care Survey</td>
</tr>
<!-- WE CARE Questions -->
<tr ID="assessment1">
<td>06/22/2015</td>
<td>WE CARE Question: Do you have a high school degree?</td>
<td>No</td>
</tr>
<tr ID="assessment2">
<td>06/22/2015</td>
<td>WE CARE Question: If no, would you like help to get a GED?</td>
<td>Yes</td>
</tr>
<tr ID="assessment3">
<td>06/22/2015</td>
<td>WE CARE Question: Do you have a job?</td>
<td>Yes</td>
</tr>
<tr ID="assessment4">
<td>06/22/2015</td>
<td>WE CARE Question: If no, would you like help with finding employment and or
job training?</td>
<td>Maybe Later</td>
</tr>
<!-- How do we code no answer. FHIR NLM LHC Omits -->
<tr ID="assessment5">
<td>06/22/2015</td>
<td>WE CARE Question: Do you need daycare for your child?</td>
<td>Yes</td>
</tr>
<tr ID="assessment6">
<td>06/22/2015</td>
<td>WE CARE Question: If yes, would you like help finding it?</td>
<td>Yes</td>
</tr>
<tr ID="assessment7">
<td>06/22/2015</td>
<td>WE CARE Question: Do you think you are at risk of becoming homeless?</td>
<td>Yes</td>
</tr>
<tr ID="assessment8">
<td>06/22/2015</td>
<td>WE CARE Question: If yes, would you like help with this?</td>
<td>No</td>
</tr>
<tr ID="assessment9">
<td>06/22/2015</td>
<td>WE CARE Question: If yes, is this an emergency?</td>
<td>No</td>
</tr>
<tr ID="assessment10">
<td>06/22/2015</td>
<td>WE CARE Question: Do you always have enough food for your family?</td>
<td>No</td>
</tr>
<tr ID="assessment11">
<td>06/22/2015</td>
<td>WE CARE Question: If no, would you like help with this?</td>
<td>Yes</td>
</tr>
<tr ID="assessment12">
<td>06/22/2015</td>
<td>WE CARE Question: If yes, do you need food for tonight?</td>
<td>Yes</td>
</tr>
<tr ID="assessment13">
<td>06/22/2015</td>
<td>WE CARE Question: Do you have trouble paying your heating bill and or
electricity bill?</td>
<td>Yes</td>
</tr>
<tr ID="assessment14">
<td>06/22/2015</td>
<td>WE CARE Question: If yes, would you like help with this?</td>
<td>Yes</td>
</tr>
<tr ID="assessment15">
<td>06/22/2015</td>
<td>WE CARE Question: If yes, are you at risk of having your utilities shut off
in the next week?</td>
<td>No</td>
</tr>
</tbody>
</table>
</text>
<entry typeCode="DRIV">
<observation classCode="OBS" moodCode="EVN">
<!-- Assessment Scale Observation -->
<templateId root="2.16.840.1.113883.10.20.22.4.69" extension="2022-06-01"/>
<id root="48a7c8f7-30d6-4173-b3c4-4ad4abcfdb1a"/>
<code code="96447-8" displayName="WE CARE Survey" codeSystem="2.16.840.1.113883.6.1"
codeSystemName="LOINC"/>
<text>
<reference value="#assessment"/>
</text>
<statusCode code="completed"/>
<effectiveTime value="20150622"/>
<!-- Note that the value attribute is required in an assessment scale observation. Since LOINC organizes this information -->
<!-- Where the total score is part of the panel, that total score code is shown through entryRelationship to supporting observation -->
<!-- The WE CARE scale does NOT have a total score so a numeric INT is inappropriate -->
<value xsi:type="CD" nullFlavor="NA"/>
<entryRelationship typeCode="COMP">
<observation classCode="OBS" moodCode="EVN">
<!-- Assessment Scale Supporting Observation -->
<templateId root="2.16.840.1.113883.10.20.22.4.86" extension="2015-08-01"/>
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<text>
<reference value="#assessment1"/>
</text>
<statusCode code="completed"/>
<effectiveTime value="20150622"/>
<!-- xsi:type could be CD or CO - CO Indicates to receiver that these values can be put in an ordered list -->
<value xsi:type="CO" code="LA32-8" displayName="No"
codeSystem="2.16.840.1.113883.6.1"/>
</observation>
</entryRelationship>
<!-- The total score may be adequate for some use cases, although detail components can be sent as shown below as warranted by use case -->
<entryRelationship typeCode="COMP">
<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.86" extension="2015-08-01"/>
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<text>
<reference value="#assessment2"/>
</text>
<statusCode code="completed"/>
<effectiveTime value="20150622"/>
<!-- xsi:type could be CD or CO - CO Indicates to receiver that these values can be put in an ordered list -->
<value xsi:type="CO" code="LA33-6" displayName="Yes"
codeSystem="2.16.840.1.113883.6.1"/>
</observation>
</entryRelationship>
<entryRelationship typeCode="COMP">
<observation classCode="OBS" moodCode="EVN">
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<code code="96444-5" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
<text>
<reference value="#assessment3"/>
</text>
<statusCode code="completed"/>
<effectiveTime value="20150622"/>
<!-- xsi:type could be CD or CO - CO Indicates to receiver that these values can be put in an ordered list -->
<value xsi:type="CO" code="LA33-6" displayName="Yes"
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</observation>
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<entryRelationship typeCode="COMP">
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<text>
<reference value="#assessment4"/>
</text>
<statusCode code="completed"/>
<effectiveTime value="20150622"/>
<!-- xsi:type could be CD or CO - CO Indicates to receiver that these values can be put in an ordered list -->
<value xsi:type="CO" code="LA31439-5" displayName="Maybe Later"
codeSystem="2.16.840.1.113883.6.1"/>
</observation>
</entryRelationship>
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<text>
<reference value="#assessment5"/>
</text>
<statusCode code="completed"/>
<effectiveTime value="20150622"/>
<!-- xsi:type could be CD or CO - CO Indicates to receiver that these values can be put in an ordered list -->
<value xsi:type="CO" code="LA33-6" displayName="Yes"
codeSystem="2.16.840.1.113883.6.1"/>
</observation>
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<entryRelationship typeCode="COMP">
<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.86" extension="2015-08-01"/>
<id root="b24d5a2c-48d6-46a0-bd92-1c901e577cc3"/>
<code code="96433-8" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
<text>
<reference value="#assessment6"/>
</text>
<statusCode code="completed"/>
<effectiveTime value="20150622"/>
<!-- xsi:type could be CD or CO - CO Indicates to receiver that these values can be put in an ordered list -->
<value xsi:type="CO" code="LA33-6" displayName="Yes"
codeSystem="2.16.840.1.113883.6.1"/>
</observation>
</entryRelationship>
<entryRelationship typeCode="COMP">
<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.86" extension="2015-08-01"/>
<id root="c67c51ea-4928-449d-b6c0-0f85b1975e07"/>
<code code="96441-1" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
<text>
<reference value="#assessment7"/>
</text>
<statusCode code="completed"/>
<effectiveTime value="20150622"/>
<!-- xsi:type could be CD or CO - CO Indicates to receiver that these values can be put in an ordered list -->
<value xsi:type="CO" code="LA33-6" displayName="Yes"
codeSystem="2.16.840.1.113883.6.1"/>
</observation>
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<entryRelationship typeCode="COMP">
<observation classCode="OBS" moodCode="EVN">
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<code code="96440-3" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
<text>
<reference value="#assessment8"/>
</text>
<statusCode code="completed"/>
<effectiveTime value="20150622"/>
<!-- xsi:type could be CD or CO - CO Indicates to receiver that these values can be put in an ordered list -->
<value xsi:type="CO" code="LA32-8" displayName="No"
codeSystem="2.16.840.1.113883.6.1"/>
</observation>
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<entryRelationship typeCode="COMP">
<observation classCode="OBS" moodCode="EVN">
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<text>
<reference value="#assessment9"/>
</text>
<statusCode code="completed"/>
<effectiveTime value="20150622"/>
<!-- xsi:type could be CD or CO - CO Indicates to receiver that these values can be put in an ordered list -->
<value xsi:type="CO" code="LA32-8" displayName="No"
codeSystem="2.16.840.1.113883.6.1"/>
</observation>
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<entryRelationship typeCode="COMP">
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<text>
<reference value="#assessment10"/>
</text>
<statusCode code="completed"/>
<effectiveTime value="20150622"/>
<!-- xsi:type could be CD or CO - CO Indicates to receiver that these values can be put in an ordered list -->
<value xsi:type="CO" code="LA32-8" displayName="No"
codeSystem="2.16.840.1.113883.6.1"/>
</observation>
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<entryRelationship typeCode="COMP">
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<code code="96438-7" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
<text>
<reference value="#assessment11"/>
</text>
<statusCode code="completed"/>
<effectiveTime value="20150622"/>
<!-- xsi:type could be CD or CO - CO Indicates to receiver that these values can be put in an ordered list -->
<value xsi:type="CO" code="LA33-6" displayName="Yes"
codeSystem="2.16.840.1.113883.6.1"/>
</observation>
</entryRelationship>
<entryRelationship typeCode="COMP">
<observation classCode="OBS" moodCode="EVN">
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<text>
<reference value="#assessment12"/>
</text>
<statusCode code="completed"/>
<effectiveTime value="20150622"/>
<!-- xsi:type could be CD or CO - CO Indicates to receiver that these values can be put in an ordered list -->
<value xsi:type="CO" code="LA33-6" displayName="Yes"
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<text>
<reference value="#assessment13"/>
</text>
<statusCode code="completed"/>
<effectiveTime value="20150622"/>
<!-- xsi:type could be CD or CO - CO Indicates to receiver that these values can be put in an ordered list -->
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</text>
<statusCode code="completed"/>
<effectiveTime value="20150622"/>
<!-- xsi:type could be CD or CO - CO Indicates to receiver that these values can be put in an ordered list -->
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</observation>
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</text>
<statusCode code="completed"/>
<effectiveTime value="20150622"/>
<!-- xsi:type could be CD or CO - CO Indicates to receiver that these values can be put in an ordered list -->
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</observation>
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</observation>
</entry>
</section>