History of Infection

Section Code

LOINC: 56838-6 (History of Infectious Disease)

Description

The history of infection section is used to express any infections that the patient may have had prior to the current condition of the patient. It shall contain a narrative and problem concern entries describing each of the past infections.

CDA Level

Level 3 Only

Template IDs

Level / Spec

Template ID

Standards Reference

3 / IHE

1.3.6.1.4.1.19376.1.5.3.1.1.16.2.1.1.1

IHE PCC CDA Suppl: 6.3.3.2.37

Expected Entries / Sub-Sections

Entry

Template ID

Reference

Problem Concern Entry

1.3.6.1.4.1.19376.1.5.3.1.4.5.2

3.4.2.17

OpenSHR Implementation Notes

Data Model

Obs

Code File

CodedHistoryOfInfectionSectionProcessor.java

Additional Constraints

• None

Notes

Each problem concern entry contained within the history of infection sections should be related to past infections, and should exclude current infections.

Specification

<component typeCode="COMP" contextConductionInd="true">
<section classCode="DOCSECT" moodCode="EVN">
<!-- IHE PCC History of Infection -->
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.1.16.2.1.1.1"/>
<!-- Section Code -->
<code code="56838-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"
displayName="History of Infectious Disease"/>
<title language="en-US">History of Infection</title>
<!-- 1..1 Text as described in the general implementation notes -->
<text mediaType="text/x-hl7-text+xml">
...
</text>
<!-- 0..n Problem concern "act's identifying the past illnesses -->
<entry typeCode="COMP" contextConductionInd="true">
<act moodCode="EVN">
...
</act>
</entry>
</section>
</component>