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      <body>This section describes constraints that apply to the header for all documents within the scope of this implementation guide. Header constraints specific to each document type are described in the appropriate document-specific section below

Document Type Codes
CDA R2 states that LOINC is the preferred vocabulary for document type codes, which specify the type of document being exchanged (e.g., History and Physical). Each document type in this guide recommends a single preferred clinicalDocument/code, with further specification provided by author or performer, setting, or specialty</body>
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        <body>UNIMPLEMENTABLE</body>
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        <language>Analysis</language>
        <body>[DEPRECATED] The US Realm Clinical Document Date and Time datatype flavor records date and time information. If no time zone offset &#xD;
is provided, you can make no assumption about time, unless you have made a local exchange agreement.&#xD;
This data type uses the same rules as US Realm Date and Time (DTM.US.FIELDED),  but is used with the effectiveTime &#xD;
element.</body>
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        <body>UNIMPLEMENTABLE</body>
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        <language>Analysis</language>
        <body>The US Realm Clinical Document Date and Time datatype flavor records date and time information. If no time zone offset &#xD;
is provided, you can make no assumption about time, unless you have made a local exchange agreement.</body>
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        <body>typeId SHALL contain exactly one [1..1] @root=&quot;2.16.840.1.113883.1.3&quot;</body>
        <body>not self.typeId.oclIsUndefined() and self.typeId.root = '2.16.840.1.113883.1.3'</body>
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        <body>typeId SHALL contain exactly one [1..1] @extension=&quot;POCD_HD000040&quot;</body>
        <body>not self.typeId.oclIsUndefined() and self.typeId.extension = 'POCD_HD000040'</body>
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        <body>id SHALL be a globally unique identifier for the document</body>
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        <body>code SHALL specify the particular kind of document (e.g. History and Physical, Discharge Summary, Progress Note).</body>
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        <body>If setId is present versionNumber SHALL be present</body>
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        <body>If versionNumber is present setId SHALL be present</body>
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        <body>Signifies the document creation time, when the document first came into being. Where the CDA document is a transform from an original document in some other format, the ClinicalDocument.effectiveTime is the time the original document is created. The time when the transform occurred is not currently represented in CDA (CONF:9995)</body>
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      <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_GTn7wFe-EeOSS41gMnqXhA" value="*"/>
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      <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_KPgikCzHEeGMXrZ0DiQwGg" value="*"/>
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        <body>INLINE</body>
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              <language>Analysis</language>
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              <body>If sdtc:raceCode is present, then the patient SHALL contain [1..1] raceCode</body>
              <body>sDTCRaceCode->notEmpty() implies not raceCode.oclIsUndefined()</body>
            </specification>
          </ownedRule>
          <generalization xmi:id="_wfQ6oCylEeGMXrZ0DiQwGg">
            <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_mxsCMEALEd6wZe6nFLrjsw"/>
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          <ownedAttribute xmi:id="_7OrqsCylEeGMXrZ0DiQwGg" name="administrativeGenderCode" visibility="private" aggregation="composite">
            <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_Z1EGIDxaEd6JwqSGecoePg"/>
            <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_BYC0wEEiEeGdmoWy_aLP0Q" value="1"/>
            <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_BYC0wUEiEeGdmoWy_aLP0Q" value="1"/>
            <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_2wfzIEreEd6FXKclYGEDCw"/>
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          <ownedAttribute xmi:id="_7Os40CylEeGMXrZ0DiQwGg" name="birthTime" visibility="private" type="_nFdFAJ4wEeKLDuYB2cFreQ" aggregation="composite">
            <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_B1saEEEiEeGdmoWy_aLP0Q" value="1"/>
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            <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_5dgL8EreEd6FXKclYGEDCw"/>
          </ownedAttribute>
          <ownedAttribute xmi:id="_7Os41CylEeGMXrZ0DiQwGg" name="ethnicGroupCode" visibility="private" aggregation="composite">
            <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_Z1EGIDxaEd6JwqSGecoePg"/>
            <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_7Os41SylEeGMXrZ0DiQwGg" value="1"/>
            <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_7Os41iylEeGMXrZ0DiQwGg"/>
            <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_K0rTIErfEd6FXKclYGEDCw"/>
          </ownedAttribute>
          <ownedAttribute xmi:id="_7Otf4SylEeGMXrZ0DiQwGg" name="maritalStatusCode" visibility="private" aggregation="composite">
            <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_Z1EGIDxaEd6JwqSGecoePg"/>
            <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_UuyLcE4REeGug8Lotu3QeQ" value="1"/>
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            <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_9DbJwEreEd6FXKclYGEDCw"/>
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          <ownedAttribute xmi:id="_7OuG8SylEeGMXrZ0DiQwGg" name="name" visibility="private" type="_aSeEwPIYEeGu1M-cCXg0Dg" aggregation="composite">
            <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_WxU6MPC5EeKYpKTSzJdlwg" value="*"/>
            <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_WxU6MfC5EeKYpKTSzJdlwg" value="1"/>
            <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_QcivsEAMEd6wZe6nFLrjsw"/>
          </ownedAttribute>
          <ownedAttribute xmi:id="_7OuuACylEeGMXrZ0DiQwGg" name="raceCode" visibility="private" aggregation="composite">
            <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_Z1EGIDxaEd6JwqSGecoePg"/>
            <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_dZl_cE4REeGug8Lotu3QeQ" value="1"/>
            <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_dZl_cU4REeGug8Lotu3QeQ"/>
            <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_INfOcErfEd6FXKclYGEDCw"/>
          </ownedAttribute>
          <ownedAttribute xmi:id="_7OvVECylEeGMXrZ0DiQwGg" name="religiousAffiliationCode" visibility="private" aggregation="composite">
            <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_Z1EGIDxaEd6JwqSGecoePg"/>
            <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_gJPckE4REeGug8Lotu3QeQ" value="1"/>
            <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_gJPckU4REeGug8Lotu3QeQ"/>
            <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#__nV4AEreEd6FXKclYGEDCw"/>
          </ownedAttribute>
          <ownedAttribute xmi:id="_2jzBMCyrEeGMXrZ0DiQwGg" name="guardian" type="_-vjwcCylEeGMXrZ0DiQwGg" association="_2jzoQCyrEeGMXrZ0DiQwGg">
            <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_52SFoCyrEeGMXrZ0DiQwGg" value="*"/>
            <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_52SssCyrEeGMXrZ0DiQwGg"/>
          </ownedAttribute>
          <ownedAttribute xmi:id="_ypIF8CysEeGMXrZ0DiQwGg" name="birthplace" type="_NOxMACymEeGMXrZ0DiQwGg" association="_ypItASysEeGMXrZ0DiQwGg">
            <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_ypItACysEeGMXrZ0DiQwGg"/>
          </ownedAttribute>
          <ownedAttribute xmi:id="_GmM4YCytEeGMXrZ0DiQwGg" name="languageCommunication" type="_hrAmsCymEeGMXrZ0DiQwGg" association="_GmNfcCytEeGMXrZ0DiQwGg">
            <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_AbJD8PIkEeGu1M-cCXg0Dg" value="*"/>
            <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_AbJD8fIkEeGu1M-cCXg0Dg"/>
          </ownedAttribute>
          <ownedAttribute xmi:id="_d3LCgNBWEeGg9eE98HsYZw" name="sDTCRaceCode" visibility="private" aggregation="composite">
            <ownedComment xmi:id="_dsxL8KbDEeKAJ7JddNoP1Q">
              <body>Note: The sdtc:raceCode is only used to record additional values when the patient has indicated multiple races or additional race detail beyond the five categories required for Meaningful Use Stage 2. The prefix sdtc: SHALL be bound to the namespace &quot;urn:hl7-org:sdtc&quot;. The use of the namespace provides a necessary extension to CDA R2 for the use of the additional raceCode elements.</body>
            </ownedComment>
            <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_Z1EGIDxaEd6JwqSGecoePg"/>
            <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_d3LCgdBWEeGg9eE98HsYZw" value="*"/>
            <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_d3LCgtBWEeGg9eE98HsYZw"/>
          </ownedAttribute>
          <nestedClassifier xmi:type="uml:Class" xmi:id="_-vjwcCylEeGMXrZ0DiQwGg" name="Guardian">
            <ownedRule xmi:id="_2G-bEDp-EeOpivxgTh7oFg" name="CodeFromPersonalRelationshipOrResponsibleParty" constrainedElement="_-vjwcCylEeGMXrZ0DiQwGg">
              <specification xmi:type="uml:OpaqueExpression" xmi:id="_MXnLkDp_EeOpivxgTh7oFg">
                <language>Analysis</language>
                <language>OCL</language>
                <body>The guardian code, if present, SHALL be selected from ValueSet PersonalRelationshipRoleType 2.16.840.1.113883.1.11.19563 DYNAMIC or ValueSet Responsible Party 2.16.840.1.113883.1.11.19830 DYNAMIC</body>
                <body>(not code.oclIsUndefined()) and code.isNullFlavorUndefined() implies&#xD;
(code.oclIsKindOf(datatypes::CE) and &#xD;
let value : datatypes::CE = code.oclAsType(datatypes::CE) in &#xD;
value.codeSystem = '2.16.840.1.113883.5.111' and (value.code = 'ADOPT' or value.code = 'AUNT' or value.code = 'CHILD' or value.code = 'CHLDINLAW' or value.code = 'COUSN' or value.code = 'DOMPART' or value.code = 'FAMMEMB' or value.code = 'CHLDFOST' or value.code = 'GRNDCHILD' or value.code = 'GPARNT' or value.code = 'GRPRN' or value.code = 'GGRPRN' or value.code = 'HSIB' or value.code = 'MAUNT' or value.code = 'MCOUSN' or value.code = 'MGRPRN' or value.code = 'MGGRPRN' or value.code = 'MUNCLE' or value.code = 'NCHILD' or value.code = 'NPRN' or value.code = 'NSIB' or value.code = 'NBOR' or value.code = 'NIENEPH' or value.code = 'PRN' or value.code = 'PRNINLAW' or value.code = 'PAUNT' or value.code = 'PCOUSN' or value.code = 'PGRPRN' or value.code = 'PGGRPRN' or value.code = 'PUNCLE' or value.code = 'ROOM' or value.code = 'SIB' or value.code = 'SIBINLAW' or value.code = 'SIGOTHR' or value.code = 'SPS' or value.code = 'STEP' or value.code = 'STPPRN' or value.code = 'STPSIB' or value.code = 'UNCLE' or value.code = 'FRND' or value.code = 'RESPRSN' or value.code = 'EXCEST' or value.code = 'GUADLTM' or value.code = 'GUARD' or value.code = 'POWATT' or value.code = 'DPOWATT' or value.code = 'HPOWATT' or value.code = 'SPOWATT'))</body>
              </specification>
            </ownedRule>
            <generalization xmi:id="_-vjwcSylEeGMXrZ0DiQwGg">
              <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_liVJMEcIEd6besF9iFIJkQ"/>
            </generalization>
            <ownedAttribute xmi:id="_Cmzu0CymEeGMXrZ0DiQwGg" name="addr" visibility="private" type="_i4zXgPIPEeGu1M-cCXg0Dg" aggregation="composite">
              <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_Cmzu0SymEeGMXrZ0DiQwGg" value="*"/>
              <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_Cmzu0iymEeGMXrZ0DiQwGg"/>
              <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_r_LfgEo3Ed6c3qsAxlFHaQ"/>
            </ownedAttribute>
            <ownedAttribute xmi:id="_Cm0V4CymEeGMXrZ0DiQwGg" name="code" visibility="private" aggregation="composite">
              <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_Z1EGIDxaEd6JwqSGecoePg"/>
              <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_Cm0V4SymEeGMXrZ0DiQwGg" value="1"/>
              <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_Cm0V4iymEeGMXrZ0DiQwGg"/>
              <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_pgeocEo3Ed6c3qsAxlFHaQ"/>
            </ownedAttribute>
            <ownedAttribute xmi:id="_Cm088CymEeGMXrZ0DiQwGg" name="telecom" visibility="private" type="_TJgmcOxkEeG7k4bbVdXbXw" aggregation="composite">
              <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_Cm088SymEeGMXrZ0DiQwGg" value="*"/>
              <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_Cm088iymEeGMXrZ0DiQwGg"/>
              <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_vEd1cEo3Ed6c3qsAxlFHaQ"/>
            </ownedAttribute>
            <ownedAttribute xmi:id="_PFeT0OxlEeG7k4bbVdXbXw" name="guardianPerson" visibility="private" type="_Qh844OxlEeG7k4bbVdXbXw" aggregation="composite">
              <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_Zxa5IOxlEeG7k4bbVdXbXw" value="1"/>
              <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_Zxa5IexlEeG7k4bbVdXbXw" value="1"/>
              <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_sGovcUcjEd6besF9iFIJkQ"/>
              <association href="../consol.uml#_PFfh8OxlEeG7k4bbVdXbXw"/>
            </ownedAttribute>
            <nestedClassifier xmi:type="uml:Class" xmi:id="_TJgmcOxkEeG7k4bbVdXbXw" name="TEL">
              <generalization xmi:id="_TKoAwOxkEeG7k4bbVdXbXw">
                <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_22o_kD52Ed6cla2oXsPtlA"/>
              </generalization>
              <ownedAttribute xmi:id="_T-Xx4OxkEeG7k4bbVdXbXw" name="use" visibility="private">
                <type xmi:type="uml:Enumeration" href="../../../org.openhealthtools.mdht.uml.hl7.vocab/model/vocab.uml#__zFEA0DcEd6xYZuu1VKCVw"/>
                <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_d8C78OxkEeG7k4bbVdXbXw" value="1"/>
                <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_d8DjAOxkEeG7k4bbVdXbXw"/>
                <redefinedProperty href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_5iTUkD52Ed6cla2oXsPtlA"/>
              </ownedAttribute>
            </nestedClassifier>
            <nestedClassifier xmi:type="uml:Class" xmi:id="_Qh844OxlEeG7k4bbVdXbXw" name="Person">
              <ownedRule xmi:id="_gAUEUOxlEeG7k4bbVdXbXw" name="USRealmPatientName" constrainedElement="_Qh844OxlEeG7k4bbVdXbXw">
                <specification xmi:type="uml:OpaqueExpression" xmi:id="_nroxQOxlEeG7k4bbVdXbXw">
                  <language>Analysis</language>
                  <body>The content of name SHALL be a conformant US Realm Person Name (PTN.US.FIELDED) (2.16.840.1.113883.10.20.22.5.1.1)</body>
                </specification>
              </ownedRule>
              <generalization xmi:id="_Qh844exlEeG7k4bbVdXbXw">
                <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_Je2yMEcaEd6besF9iFIJkQ"/>
              </generalization>
              <ownedAttribute xmi:id="_RBsv8OxlEeG7k4bbVdXbXw" name="name" visibility="private" aggregation="composite">
                <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_3VD9wD5yEd6cla2oXsPtlA"/>
                <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_V-tcgOxlEeG7k4bbVdXbXw" value="*"/>
                <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_V-tcgexlEeG7k4bbVdXbXw" value="1"/>
                <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_L08A0ErgEd6FXKclYGEDCw"/>
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            </nestedClassifier>
          </nestedClassifier>
          <nestedClassifier xmi:type="uml:Class" xmi:id="_hrAmsCymEeGMXrZ0DiQwGg" name="LanguageCommunication">
            <generalization xmi:id="_hrAmsSymEeGMXrZ0DiQwGg">
              <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_cHD44EcZEd6besF9iFIJkQ"/>
            </generalization>
            <ownedAttribute xmi:id="_nLJ1gCymEeGMXrZ0DiQwGg" name="preferenceInd" visibility="private" aggregation="composite">
              <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_r1WssDxjEd6JwqSGecoePg"/>
              <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_nLJ1gSymEeGMXrZ0DiQwGg" value="1"/>
              <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_nLJ1giymEeGMXrZ0DiQwGg"/>
              <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_pFayMEo5Ed6c3qsAxlFHaQ"/>
            </ownedAttribute>
            <ownedAttribute xmi:id="_nLKckSymEeGMXrZ0DiQwGg" name="proficiencyLevelCode" visibility="private" aggregation="composite">
              <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_Z1EGIDxaEd6JwqSGecoePg"/>
              <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_3MYVIHK9EeGig5KF4CgPyw" value="1"/>
              <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_3MYVIXK9EeGig5KF4CgPyw"/>
              <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_mYRPcEo5Ed6c3qsAxlFHaQ"/>
            </ownedAttribute>
            <ownedAttribute xmi:id="_ZGMo0CytEeGMXrZ0DiQwGg" name="modeCode" visibility="private" aggregation="composite">
              <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_Z1EGIDxaEd6JwqSGecoePg"/>
              <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_ZGMo0SytEeGMXrZ0DiQwGg" value="1"/>
              <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_ZGMo0iytEeGMXrZ0DiQwGg"/>
              <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_g17BMEo5Ed6c3qsAxlFHaQ"/>
            </ownedAttribute>
            <ownedAttribute xmi:id="_DKwi4NBZEeG2b5vwscX4AA" name="languageCode" visibility="private" aggregation="composite">
              <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_iYn74D55Ed6cla2oXsPtlA"/>
              <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_KJ0mwNBZEeG2b5vwscX4AA" value="1"/>
              <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_KJ0mwdBZEeG2b5vwscX4AA" value="1"/>
            </ownedAttribute>
          </nestedClassifier>
          <nestedClassifier xmi:type="uml:Class" xmi:id="_NOxMACymEeGMXrZ0DiQwGg" name="Birthplace">
            <generalization xmi:id="_NOxMASymEeGMXrZ0DiQwGg">
              <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_Y18S8EcEEd6besF9iFIJkQ"/>
            </generalization>
            <ownedAttribute xmi:id="_5KzqQCysEeGMXrZ0DiQwGg" name="place" type="_TGgbcCymEeGMXrZ0DiQwGg" association="_5K0RUSysEeGMXrZ0DiQwGg">
              <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_z4ehkOxlEeG7k4bbVdXbXw" value="1"/>
              <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_z4ehkexlEeG7k4bbVdXbXw" value="1"/>
            </ownedAttribute>
            <nestedClassifier xmi:type="uml:Class" xmi:id="_TGgbcCymEeGMXrZ0DiQwGg" name="Place">
              <ownedRule xmi:id="_7XFBIOxlEeG7k4bbVdXbXw" name="HasState" constrainedElement="_TGgbcCymEeGMXrZ0DiQwGg">
                <specification xmi:type="uml:OpaqueExpression" xmi:id="__kVEsOxlEeG7k4bbVdXbXw">
                  <language>Analysis</language>
                  <body>If country is US, this addr SHALL contain exactly one [1..1] state, which SHALL be selected from ValueSet StateValueSet 2.16.840.1.113883.3.88.12.80.1 DYNAMIC</body>
                </specification>
              </ownedRule>
              <ownedRule xmi:id="_79bPcOxlEeG7k4bbVdXbXw" name="hasPostalCode" constrainedElement="_TGgbcCymEeGMXrZ0DiQwGg">
                <specification xmi:type="uml:OpaqueExpression" xmi:id="_B7izsOxmEeG7k4bbVdXbXw">
                  <language>Analysis</language>
                  <body>This addr MAY contain zero or one [0..1] postalCode, which SHALL be selected from ValueSet PostalCodeValueSet 2.16.840.1.113883.3.88.12.80.2 DYNAMIC</body>
                </specification>
              </ownedRule>
              <ownedRule xmi:id="_8kl9IOxlEeG7k4bbVdXbXw" name="hasCountryValue" constrainedElement="_TGgbcCymEeGMXrZ0DiQwGg">
                <specification xmi:type="uml:OpaqueExpression" xmi:id="_E8wh8OxmEeG7k4bbVdXbXw">
                  <language>Analysis</language>
                  <body>This addr SHOULD contain zero or one [0..1] country, which SHALL be selected from ValueSet CountryValueSet 2.16.840.1.113883.3.88.12.80.63 DYNAMIC</body>
                </specification>
              </ownedRule>
              <generalization xmi:id="_TGgbcSymEeGMXrZ0DiQwGg">
                <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_KY0gEEcaEd6besF9iFIJkQ"/>
              </generalization>
              <ownedAttribute xmi:id="_bs30UCymEeGMXrZ0DiQwGg" name="addr" visibility="private" aggregation="composite">
                <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_v0zRUD5yEd6cla2oXsPtlA"/>
                <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_2CY0YOxlEeG7k4bbVdXbXw" value="1"/>
                <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_2CZbcOxlEeG7k4bbVdXbXw" value="1"/>
                <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_sK2_QErgEd6FXKclYGEDCw"/>
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            </nestedClassifier>
          </nestedClassifier>
          <nestedClassifier xmi:type="uml:Class" xmi:id="_nFdFAJ4wEeKLDuYB2cFreQ" name="TS">
            <ownedRule xmi:id="_dqXccDVREeGIw7CntkyPQw" name="birthTimePreciseToYear" constrainedElement="_wfQTkCylEeGMXrZ0DiQwGg">
              <specification xmi:type="uml:OpaqueExpression" xmi:id="_sg6Z8DVREeGIw7CntkyPQw">
                <language>Analysis</language>
                <language>OCL</language>
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                <body>precise to day</body>
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              <body>The id SHOULD include zero or one [0..1] id where id/@root =&quot;2.16.840.1.113883.4.6&quot; National Provider Identifier (CONF:9996)</body>
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        <body>The componentOf element contains the encompassing encounter for this document. The encompassing encounter represents the setting of the clinical encounter during which the document act(s) or ServiceEvent occurred. &#xD;
&#xD;
&lt;p>&#xD;
 In order to represent providers associated with a specific encounter, they are recorded within the encompassingEncounter as participants.&#xD;
In a CCD the encompassingEncounter may be used when documenting a specific encounter and its participants. All relevant encounters in a CCD may be listed in the encounters section.&#xD;
&#xD;
&lt;/p></body>
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        <body>INLINE</body>
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            <type xmi:type="uml:Enumeration" href="../../../org.openhealthtools.mdht.uml.hl7.vocab/model/vocab.uml#__zFEA0DcEd6xYZuu1VKCVw"/>
            <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_ZKUhIPLtEeGoTuv6nvWAog" value="1"/>
            <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_ZKUhIfLtEeGoTuv6nvWAog"/>
            <redefinedProperty href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_5iTUkD52Ed6cla2oXsPtlA"/>
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        </nestedClassifier>
      </nestedClassifier>
    </nestedClassifier>
    <nestedClassifier xmi:type="uml:Class" xmi:id="_BArpECynEeGMXrZ0DiQwGg" name="DataEnterer">
      <ownedComment xmi:id="_LqavcCzJEeGMXrZ0DiQwGg">
        <body>The dataEnterer element represents the person who transferred the content, written or dictated by someone else, into the clinical document. The guiding rule of thumb is that an author provides the content found within the header or body of the document, subject to their own interpretation, and the dataEnterer adds that information to the electronic system. In other words, a dataEnterer transfers information from one source to another (e.g., transcription from paper form to electronic system).</body>
      </ownedComment>
      <ownedComment xmi:id="_piYdsCzJEeGMXrZ0DiQwGg">
        <body>INLINE</body>
      </ownedComment>
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        <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_twqZYEcEEd6besF9iFIJkQ"/>
      </generalization>
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        <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_UXCGAFjWEeGKdMKWzrgL_Q" value="1"/>
        <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_UXCGAVjWEeGKdMKWzrgL_Q" value="1"/>
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      <nestedClassifier xmi:type="uml:Class" xmi:id="_HOG0oCynEeGMXrZ0DiQwGg" name="AssignedEntity">
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            <language>Analysis</language>
            <language>OCL</language>
            <body>id SHOULD include zero or one [0..1] @root =&quot;2.16.840.1.113883.4.6&quot; National Provider Identifier</body>
            <body>self.id->exists( root='2.16.840.1.113883.4.6' )</body>
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        </ownedRule>
        <generalization xmi:id="_HOHbsCynEeGMXrZ0DiQwGg">
          <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_6qmVsEcDEd6besF9iFIJkQ"/>
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          <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_DBIXAEoeEd6c3qsAxlFHaQ"/>
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        <ownedAttribute xmi:id="_NIuY8CynEeGMXrZ0DiQwGg" name="code" visibility="private" aggregation="composite">
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        <ownedAttribute xmi:id="_NIvAACynEeGMXrZ0DiQwGg" name="id" visibility="private" aggregation="composite">
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        <ownedAttribute xmi:id="_NIvABCynEeGMXrZ0DiQwGg" name="telecom" visibility="private" type="_5dcVMPInEeGu1M-cCXg0Dg" aggregation="composite">
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          <association href="../consol.uml#_XaJ7QOxvEeG7k4bbVdXbXw"/>
        </ownedAttribute>
        <nestedClassifier xmi:type="uml:Class" xmi:id="_YHe7UOxvEeG7k4bbVdXbXw" name="Person">
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            <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_Je2yMEcaEd6besF9iFIJkQ"/>
          </generalization>
          <ownedAttribute xmi:id="_YggfUOxvEeG7k4bbVdXbXw" name="name" visibility="private" aggregation="composite">
            <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_3VD9wD5yEd6cla2oXsPtlA"/>
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        </nestedClassifier>
        <nestedClassifier xmi:type="uml:Class" xmi:id="_5dcVMPInEeGu1M-cCXg0Dg" name="TEL">
          <generalization xmi:id="_5ddjUPInEeGu1M-cCXg0Dg">
            <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_22o_kD52Ed6cla2oXsPtlA"/>
          </generalization>
          <ownedAttribute xmi:id="_8KE6kPInEeGu1M-cCXg0Dg" name="use" visibility="private">
            <type xmi:type="uml:Enumeration" href="../../../org.openhealthtools.mdht.uml.hl7.vocab/model/vocab.uml#__zFEA0DcEd6xYZuu1VKCVw"/>
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            <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_9pgF8PInEeGu1M-cCXg0Dg"/>
            <redefinedProperty href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_5iTUkD52Ed6cla2oXsPtlA"/>
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        </nestedClassifier>
      </nestedClassifier>
    </nestedClassifier>
    <nestedClassifier xmi:type="uml:Class" xmi:id="_lU63MCynEeGMXrZ0DiQwGg" name="Custodian">
      <ownedComment xmi:id="_ML1acCzJEeGMXrZ0DiQwGg">
        <body>The custodian element represents the organization that is in charge of maintaining the document. The custodian is the steward that is entrusted with the care of the document. Every CDA document has exactly one custodian. The custodian participation satisfies the CDA definition of Stewardship. Because CDA is an exchange standard and may not represent the original form of the authenticated document (e.g., CDA could include scanned copy of original), the custodian represents the steward of the original source document. The custodian may be the document originator, a health information exchange, or other responsible party.</body>
      </ownedComment>
      <ownedComment xmi:id="_wlNAMCzJEeGMXrZ0DiQwGg">
        <body>INLINE</body>
      </ownedComment>
      <generalization xmi:id="_lU7eQCynEeGMXrZ0DiQwGg">
        <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_mMYIkEcEEd6besF9iFIJkQ"/>
      </generalization>
      <ownedAttribute xmi:id="_XnGLkCzDEeGMXrZ0DiQwGg" name="assignedCustodian" type="_rk3yUCynEeGMXrZ0DiQwGg" association="_XnGLkizDEeGMXrZ0DiQwGg">
        <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_ZK3rcCzDEeGMXrZ0DiQwGg" value="1"/>
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      </ownedAttribute>
      <nestedClassifier xmi:type="uml:Class" xmi:id="_rk3yUCynEeGMXrZ0DiQwGg" name="AssignedCustodian">
        <generalization xmi:id="_rk3yUSynEeGMXrZ0DiQwGg">
          <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_1G6DoEcDEd6besF9iFIJkQ"/>
        </generalization>
        <ownedAttribute xmi:id="_yffKUCzDEeGMXrZ0DiQwGg" name="representedCustodianOrganization" type="_yEoEACynEeGMXrZ0DiQwGg" association="_yffxYSzDEeGMXrZ0DiQwGg">
          <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_yffxYCzDEeGMXrZ0DiQwGg"/>
        </ownedAttribute>
        <nestedClassifier xmi:type="uml:Class" xmi:id="_yEoEACynEeGMXrZ0DiQwGg" name="CustodianOrganization">
          <ownedRule xmi:id="__ERYsDVXEeGIw7CntkyPQw" name="hasNationalProviderIdentifier" constrainedElement="_6j680CytEeGMXrZ0DiQwGg">
            <specification xmi:type="uml:OpaqueExpression" xmi:id="__ERYsTVXEeGIw7CntkyPQw">
              <language>Analysis</language>
              <language>OCL</language>
              <body>The id SHOULD include zero or one [0..1] @root =&quot;2.16.840.1.113883.4.6&quot; National Provider Identifier (CONF:9996)</body>
              <body>self.id->exists( root='2.16.840.1.113883.4.6' )</body>
            </specification>
          </ownedRule>
          <generalization xmi:id="_yEoEASynEeGMXrZ0DiQwGg">
            <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_nNMFUEcEEd6besF9iFIJkQ"/>
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            <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_2ikp8EowEd6c3qsAxlFHaQ"/>
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          <ownedAttribute xmi:id="_2zSLgCynEeGMXrZ0DiQwGg" name="id" visibility="private" aggregation="composite">
            <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_culQ8DxaEd6JwqSGecoePg"/>
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            <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_BmgG4EowEd6c3qsAxlFHaQ"/>
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          <ownedAttribute xmi:id="_2zSykCynEeGMXrZ0DiQwGg" name="name" visibility="private" aggregation="composite">
            <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_yQ9xwD5yEd6cla2oXsPtlA"/>
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            <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_EqJeEEowEd6c3qsAxlFHaQ"/>
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          <ownedAttribute xmi:id="_2zSylCynEeGMXrZ0DiQwGg" name="telecom" visibility="private" type="_Z3dUAPIpEeGu1M-cCXg0Dg" aggregation="composite">
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              <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_22o_kD52Ed6cla2oXsPtlA"/>
            </generalization>
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              <type xmi:type="uml:Enumeration" href="../../../org.openhealthtools.mdht.uml.hl7.vocab/model/vocab.uml#__zFEA0DcEd6xYZuu1VKCVw"/>
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              <redefinedProperty href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_5iTUkD52Ed6cla2oXsPtlA"/>
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    <nestedClassifier xmi:type="uml:Class" xmi:id="_7nao4CynEeGMXrZ0DiQwGg" name="InformationRecipient">
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        <body>The informationRecipient element records the intended recipient of the information at the time the document is created. For example, in cases where the intended recipient of the document is the patient's health chart, set the receivedOrganization to be the scoping organization for that chart</body>
      </ownedComment>
      <ownedComment xmi:id="_0u29MCzJEeGMXrZ0DiQwGg">
        <body>INLINE</body>
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          <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_TWL5IEcZEd6besF9iFIJkQ"/>
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            <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_zjKW8EcZEd6besF9iFIJkQ"/>
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        </nestedClassifier>
        <nestedClassifier xmi:type="uml:Class" xmi:id="_HcPMsCymEeGMXrZ0DiQwGg" name="Person">
          <generalization xmi:id="_HcPzwCymEeGMXrZ0DiQwGg">
            <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_Je2yMEcaEd6besF9iFIJkQ"/>
          </generalization>
          <ownedAttribute xmi:id="_IfG-8CymEeGMXrZ0DiQwGg" name="name" visibility="private" aggregation="composite">
            <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_3VD9wD5yEd6cla2oXsPtlA"/>
            <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_TWuaACysEeGMXrZ0DiQwGg" value="*"/>
            <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_TWvBECysEeGMXrZ0DiQwGg" value="1"/>
            <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_L08A0ErgEd6FXKclYGEDCw"/>
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        </nestedClassifier>
      </nestedClassifier>
    </nestedClassifier>
    <nestedClassifier xmi:type="uml:Class" xmi:id="_TpC14CyoEeGMXrZ0DiQwGg" name="LegalAuthenticator">
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        <body>&lt;p>The legalAuthenticator identifies the single person legally responsible for the document and must be present if the document has been legally authenticated. (Note that per the following section, there may also be one or more document authenticators.) &lt;/p>

&lt;p>Based on local practice, clinical documents may be released before legal authentication. This implies that a clinical document that does not contain this element has not been legally authenticated.&lt;/p>

&lt;p>The act of legal authentication requires a certain privilege be granted to the legal authenticator depending upon local policy. All clinical documents have the potential for legal authentication, given the appropriate credentials.&lt;/p>

&lt;p>Local policies may choose to delegate the function of legal authentication to a device or system that generates the clinical document. In these cases, the legal authenticator is a person accepting responsibility for the document, not the generating device or system.&lt;/p>

&lt;p>Note that the legal authenticator, if present, must be a person.&lt;/p></body>
      </ownedComment>
      <ownedComment xmi:id="__MVosCzJEeGMXrZ0DiQwGg">
        <body>INLINE</body>
      </ownedComment>
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        <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_fcTWYEcZEd6besF9iFIJkQ"/>
      </generalization>
      <ownedAttribute xmi:id="_Zc4cwCyoEeGMXrZ0DiQwGg" name="time" visibility="private" aggregation="composite">
        <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_4ysYYD59Ed6cla2oXsPtlA"/>
        <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_weOy0Eo5Ed6c3qsAxlFHaQ"/>
      </ownedAttribute>
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        <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_iYn74D55Ed6cla2oXsPtlA"/>
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            <language>Analysis</language>
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            <body>The id MAY include zero or one [0..1] root =&quot;2.16.840.1.113883.4.6&quot; National Provider Identifier (CONF:9996)</body>
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        <nestedClassifier xmi:type="uml:Class" xmi:id="_6xk70OxvEeG7k4bbVdXbXw" name="Person">
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            <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_Je2yMEcaEd6besF9iFIJkQ"/>
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          <generalization xmi:id="_65URwPIxEeGu1M-cCXg0Dg">
            <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_22o_kD52Ed6cla2oXsPtlA"/>
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          <ownedAttribute xmi:id="_7OIEIPIxEeGu1M-cCXg0Dg" name="use" visibility="private">
            <type xmi:type="uml:Enumeration" href="../../../org.openhealthtools.mdht.uml.hl7.vocab/model/vocab.uml#__zFEA0DcEd6xYZuu1VKCVw"/>
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            <redefinedProperty href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_5iTUkD52Ed6cla2oXsPtlA"/>
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        <body>The authenticator identifies a participant or participants who attested to the accuracy of the information in the document.</body>
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      <ownedComment xmi:id="_HXynMCzKEeGMXrZ0DiQwGg">
        <body>INLINE</body>
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        <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_BkHyQEcEEd6besF9iFIJkQ"/>
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        <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_4ysYYD59Ed6cla2oXsPtlA"/>
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        <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_iYn74D55Ed6cla2oXsPtlA"/>
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            <language>OCL</language>
            <body>The id SHOULD include zero or one [0..1] root =&quot;2.16.840.1.113883.4.6&quot; National Provider Identifier (CONF:9996)</body>
            <body>self.id->exists( root='2.16.840.1.113883.4.6' )</body>
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          <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_6qmVsEcDEd6besF9iFIJkQ"/>
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            <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_Je2yMEcaEd6besF9iFIJkQ"/>
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            <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_22o_kD52Ed6cla2oXsPtlA"/>
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        <body>&lt;p>The informant element describes the source of the information in a medical document.&lt;/p>

&lt;p>Assigned health care providers may be a source of information when a document is created. (e.g., a nurse's aide who provides information about a recent significant health care event that occurred within an acute care facility.) In these cases, the assignedEntity element is used.&lt;/p>

&lt;p>When the informant is a personal relation, that informant is represented in the relatedEntity element.  The code element of the relatedEntity describes the relationship between the informant and the patient. The relationship between the informant and the patient  needs to be described to help the receiver of the clinical document understand the information in the document.&lt;/p></body>
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      <ownedComment xmi:id="_OmmzwCzJEeGMXrZ0DiQwGg">
        <body>INLINE</body>
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          <language>Analysis</language>
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      <ownedAttribute xmi:id="_z9sQkDCbEeGKv64oQf5fow" name="assignedEntity" type="_NmVGsCzCEeGMXrZ0DiQwGg" association="_z9s3oTCbEeGKv64oQf5fow">
        <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_z9s3oDCbEeGKv64oQf5fow"/>
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      <ownedAttribute xmi:id="_5sn0ADVWEeGIw7CntkyPQw" name="relatedEntity" type="_ou68wDVWEeGIw7CntkyPQw" association="_5sn0AjVWEeGIw7CntkyPQw">
        <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_5sn0ATVWEeGIw7CntkyPQw"/>
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            <language>Analysis</language>
            <language>OCL</language>
            <body>The id SHOULD include zero or one [0..1] id where id/@root =&quot;2.16.840.1.113883.4.6&quot; National Provider Identifier</body>
            <body>self.id->exists( root='2.16.840.1.113883.4.6' )</body>
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          <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_6qmVsEcDEd6besF9iFIJkQ"/>
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          <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_Z1EGIDxaEd6JwqSGecoePg"/>
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          <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_9JenIEodEd6c3qsAxlFHaQ"/>
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        <ownedAttribute xmi:id="_f4q_sOxvEeG7k4bbVdXbXw" name="assignedPerson" visibility="private" type="_gidjkOxvEeG7k4bbVdXbXw" aggregation="composite">
          <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_uM2VQPIoEeGu1M-cCXg0Dg" value="1"/>
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            <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_Je2yMEcaEd6besF9iFIJkQ"/>
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          <ownedAttribute xmi:id="_g5RhEOxvEeG7k4bbVdXbXw" name="name" visibility="private" aggregation="composite">
            <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_3VD9wD5yEd6cla2oXsPtlA"/>
            <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_3aTjUPIoEeGu1M-cCXg0Dg" value="*"/>
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            <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_L08A0ErgEd6FXKclYGEDCw"/>
          </ownedAttribute>
        </nestedClassifier>
      </nestedClassifier>
      <nestedClassifier xmi:type="uml:Class" xmi:id="_ou68wDVWEeGIw7CntkyPQw" name="RelatedEntity">
        <generalization xmi:id="_ou68wTVWEeGIw7CntkyPQw">
          <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_e-h_0EcaEd6besF9iFIJkQ"/>
        </generalization>
        <ownedAttribute xmi:id="_sVcXgDVWEeGIw7CntkyPQw" name="addr" visibility="private" type="_i4zXgPIPEeGu1M-cCXg0Dg" aggregation="composite">
          <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_sVcXgTVWEeGIw7CntkyPQw" value="*"/>
          <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_sVcXgjVWEeGIw7CntkyPQw"/>
          <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_JIRXgErmEd6FXKclYGEDCw"/>
        </ownedAttribute>
        <ownedAttribute xmi:id="_H_GbIDVXEeGIw7CntkyPQw" name="person" type="_gidjkOxvEeG7k4bbVdXbXw" association="_H_GbIjVXEeGIw7CntkyPQw">
          <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_H_GbITVXEeGIw7CntkyPQw"/>
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      </nestedClassifier>
    </nestedClassifier>
    <nestedClassifier xmi:type="uml:Class" xmi:id="_Zi4mACzHEeGMXrZ0DiQwGg" name="ParticipantSupport">
      <ownedComment xmi:id="_PhdScCzJEeGMXrZ0DiQwGg">
        <body>&lt;p>The participant element identifies other supporting participants, including parents, relatives, caregivers, insurance policyholders, guarantors, and other participants related in some way to the patient. &lt;/p>

&lt;p>A supporting person or organization is an individual or an organization with a relationship to the patient. A supporting person who is playing multiple roles would be recorded in multiple particpants (e.g., emergency contact and next-of-kin)&lt;/p></body>
      </ownedComment>
      <ownedComment xmi:id="_PhHewCzKEeGMXrZ0DiQwGg">
        <body>INLINE</body>
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      <ownedRule xmi:id="_CAPIoDVaEeGIw7CntkyPQw" name="associatedEntityHasAssociatedPersonOrScopingOrganization" constrainedElement="_Zi4mACzHEeGMXrZ0DiQwGg">
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          <language>Analysis</language>
          <language>OCL</language>
          <body>Such participants, if present, SHALL have an associatedPerson or scopingOrganization element under participant/associatedEntity.</body>
          <body>(not self.associatedEntity.associatedPerson.oclIsUndefined()) or (not self.associatedEntity.scopingOrganization.oclIsUndefined())</body>
        </specification>
      </ownedRule>
      <ownedRule xmi:id="_PAeEwDVaEeGIw7CntkyPQw" name="useINDRoleclassCodes" constrainedElement="_Zi4mACzHEeGMXrZ0DiQwGg">
        <specification xmi:type="uml:OpaqueExpression" xmi:id="_QbEagDVaEeGIw7CntkyPQw">
          <language>Analysis</language>
          <body>Unless otherwise specified by the document specific header constraints, when participant/@typeCode is IND, associatedEntity/@classCode SHALL be selected from ValueSet INDRoleclassCodes 2.16.840.1.113883.11.20.9.33 STATIC 2011-09-30.</body>
        </specification>
      </ownedRule>
      <generalization xmi:id="_Zi4mASzHEeGMXrZ0DiQwGg">
        <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_4_GbMEcZEd6besF9iFIJkQ"/>
      </generalization>
      <ownedAttribute xmi:id="_fvjjoCzHEeGMXrZ0DiQwGg" name="time" visibility="private" aggregation="composite">
        <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_QYeW4D5-Ed6cla2oXsPtlA"/>
        <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_fvjjoSzHEeGMXrZ0DiQwGg" value="1"/>
        <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_fvjjoizHEeGMXrZ0DiQwGg"/>
        <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_VDhXoErdEd6FXKclYGEDCw"/>
      </ownedAttribute>
    </nestedClassifier>
    <nestedClassifier xmi:type="uml:Class" xmi:id="_yamekCyoEeGMXrZ0DiQwGg" name="InFulfillmentOf">
      <ownedComment xmi:id="_QC0TECzJEeGMXrZ0DiQwGg">
        <body>The inFulfillmentOf element represents orders that are fulfilled by this document.</body>
      </ownedComment>
      <ownedComment xmi:id="_TxyCsCzKEeGMXrZ0DiQwGg">
        <body>INLINE</body>
      </ownedComment>
      <generalization xmi:id="_yamekSyoEeGMXrZ0DiQwGg">
        <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_Li14oEcZEd6besF9iFIJkQ"/>
      </generalization>
      <ownedAttribute xmi:id="_DYZrYCzIEeGMXrZ0DiQwGg" name="order" type="_24atsCyoEeGMXrZ0DiQwGg" association="_DYaScSzIEeGMXrZ0DiQwGg">
        <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_EfJRACzIEeGMXrZ0DiQwGg" value="1"/>
        <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_EfJRASzIEeGMXrZ0DiQwGg" value="1"/>
      </ownedAttribute>
      <nestedClassifier xmi:type="uml:Class" xmi:id="_24atsCyoEeGMXrZ0DiQwGg" name="Order">
        <generalization xmi:id="_24bUwCyoEeGMXrZ0DiQwGg">
          <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_vgekoEcZEd6besF9iFIJkQ"/>
        </generalization>
        <ownedAttribute xmi:id="_44iLUCyoEeGMXrZ0DiQwGg" name="id" visibility="private" aggregation="composite">
          <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_culQ8DxaEd6JwqSGecoePg"/>
          <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_44iLUSyoEeGMXrZ0DiQwGg" value="*"/>
          <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_44iLUiyoEeGMXrZ0DiQwGg" value="1"/>
          <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_XKImMEraEd6FXKclYGEDCw"/>
        </ownedAttribute>
      </nestedClassifier>
    </nestedClassifier>
    <nestedClassifier xmi:type="uml:Class" xmi:id="_2aslsOxwEeG7k4bbVdXbXw" name="DocumentationOf">
      <ownedComment xmi:id="_oh4VgPIzEeGu1M-cCXg0Dg">
        <body>A serviceEvent represents the main act, such as a colonoscopy or a cardiac stress study, being documented. In a continuity of care document, CCD, the serviceEvent is a provision of healthcare over a period of time. In a provision of healthcare serviceEvent, the care providers, PCP or other longitudinal providers, are recorded within the serviceEvent. If the document is about a single encounter, the providers associated can be recorded in the componentOf/encompassingEncounter.</body>
      </ownedComment>
      <ownedComment xmi:id="_xZnyQPIzEeGu1M-cCXg0Dg">
        <body>INLINE</body>
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      <generalization xmi:id="_2atMwOxwEeG7k4bbVdXbXw">
        <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_1fhigEcEEd6besF9iFIJkQ"/>
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      <ownedAttribute xmi:id="_23GN0OxwEeG7k4bbVdXbXw" name="serviceEvent" visibility="private" type="_7HSQoOxwEeG7k4bbVdXbXw" aggregation="composite">
        <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_23GN0exwEeG7k4bbVdXbXw" value="1"/>
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        <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_5Z6ewUoVEd6c3qsAxlFHaQ"/>
        <association href="../consol.uml#_23G04OxwEeG7k4bbVdXbXw"/>
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      <nestedClassifier xmi:type="uml:Class" xmi:id="_7HSQoOxwEeG7k4bbVdXbXw" name="ServiceEvent">
        <ownedRule xmi:id="_KuE-MPLmEeGHzIc9Q7dMxA" name="effectiveTimeLow" constrainedElement="_7HSQoOxwEeG7k4bbVdXbXw">
          <specification xmi:type="uml:OpaqueExpression" xmi:id="_Xgx0oPLmEeGHzIc9Q7dMxA">
            <language>Analysis</language>
            <language>OCL</language>
            <body>effectiveTime SHALL contain exactly one [1..1] low</body>
            <body>self.effectiveTime->forAll(not low.oclIsUndefined())</body>
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        <generalization xmi:id="_7HS3sOxwEeG7k4bbVdXbXw">
          <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_lriDUEcaEd6besF9iFIJkQ"/>
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        <ownedAttribute xmi:id="__z2GYOxwEeG7k4bbVdXbXw" name="effectiveTime" visibility="private" aggregation="composite">
          <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_QYeW4D5-Ed6cla2oXsPtlA"/>
          <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_dZqq8PIzEeGu1M-cCXg0Dg" value="1"/>
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          <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_OYDkMEroEd6FXKclYGEDCw"/>
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        <ownedAttribute xmi:id="_IT-UYOxxEeG7k4bbVdXbXw" name="performer" visibility="private" type="_Kb1YwOxxEeG7k4bbVdXbXw" aggregation="composite">
          <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_IT-UYexxEeG7k4bbVdXbXw" value="*"/>
          <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_IT-UYuxxEeG7k4bbVdXbXw"/>
          <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_6MIl4EoVEd6c3qsAxlFHaQ"/>
          <association href="../consol.uml#_IT_igOxxEeG7k4bbVdXbXw"/>
        </ownedAttribute>
        <nestedClassifier xmi:type="uml:Class" xmi:id="_Kb1YwOxxEeG7k4bbVdXbXw" name="Performer1">
          <generalization xmi:id="_Kb1YwexxEeG7k4bbVdXbXw">
            <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_FvF74EcaEd6besF9iFIJkQ"/>
          </generalization>
          <ownedAttribute xmi:id="_NMTVQOxxEeG7k4bbVdXbXw" name="functionCode" visibility="private" aggregation="composite">
            <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_Z1EGIDxaEd6JwqSGecoePg"/>
            <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_NMTVQexxEeG7k4bbVdXbXw" value="1"/>
            <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_NMTVQuxxEeG7k4bbVdXbXw"/>
            <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_xEWTMErfEd6FXKclYGEDCw"/>
          </ownedAttribute>
          <ownedAttribute xmi:id="_NMT8UOxxEeG7k4bbVdXbXw" name="assignedEntity" visibility="private" type="_YzQKQOxxEeG7k4bbVdXbXw" aggregation="composite">
            <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_NMT8UexxEeG7k4bbVdXbXw" value="1"/>
            <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_NMT8UuxxEeG7k4bbVdXbXw" value="1"/>
            <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_670WYUoVEd6c3qsAxlFHaQ"/>
            <association href="../consol.uml#_NMUjYOxxEeG7k4bbVdXbXw"/>
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          <ownedAttribute xmi:id="_wsF2ICeiEeKFA9nMp1YYPg" name="typeCode" visibility="private">
            <type xmi:type="uml:Enumeration" href="../../../org.openhealthtools.mdht.uml.hl7.vocab/model/vocab.uml#__zOqckDcEd6xYZuu1VKCVw"/>
            <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_3_p4cErfEd6FXKclYGEDCw"/>
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          <nestedClassifier xmi:type="uml:Class" xmi:id="_YzQKQOxxEeG7k4bbVdXbXw" name="AssignedEntity">
            <ownedRule xmi:id="_jsztwOxxEeG7k4bbVdXbXw" name="hasNationalProviderIdentifier" constrainedElement="_6j680CytEeGMXrZ0DiQwGg">
              <specification xmi:type="uml:OpaqueExpression" xmi:id="_jsztwexxEeG7k4bbVdXbXw">
                <language>Analysis</language>
                <language>OCL</language>
                <body>The id SHOULD include zero or one [0..1]root =&quot;2.16.840.1.113883.4.6&quot; National Provider Identifier (CONF:9996)</body>
                <body>self.id->exists( root='2.16.840.1.113883.4.6' )</body>
              </specification>
            </ownedRule>
            <generalization xmi:id="_YzQxUOxxEeG7k4bbVdXbXw">
              <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_6qmVsEcDEd6besF9iFIJkQ"/>
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            <ownedAttribute xmi:id="_Zphq8OxxEeG7k4bbVdXbXw" name="code" visibility="private" aggregation="composite">
              <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_Z1EGIDxaEd6JwqSGecoePg"/>
              <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_Zphq8exxEeG7k4bbVdXbXw" value="1"/>
              <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_Zphq8uxxEeG7k4bbVdXbXw"/>
              <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_CDS1wEoeEd6c3qsAxlFHaQ"/>
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            <ownedAttribute xmi:id="_Zphq8-xxEeG7k4bbVdXbXw" name="id" visibility="private" aggregation="composite">
              <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_culQ8DxaEd6JwqSGecoePg"/>
              <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_Zphq9OxxEeG7k4bbVdXbXw" value="*"/>
              <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_Zphq9exxEeG7k4bbVdXbXw" value="1"/>
              <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_9JenIEodEd6c3qsAxlFHaQ"/>
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          </nestedClassifier>
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    </nestedClassifier>
    <nestedClassifier xmi:type="uml:Class" xmi:id="_i4zXgPIPEeGu1M-cCXg0Dg" name="USRealmAddress">
      <ownedComment xmi:id="_u_CwkPIPEeGu1M-cCXg0Dg">
        <body>Reusable &quot;address&quot; template, designed for use in US Realm CDA Header.</body>
      </ownedComment>
      <ownedRule xmi:id="_7BBfQPIQEeGu1M-cCXg0Dg" name="USRealmAddressStateCountry" constrainedElement="_i4zXgPIPEeGu1M-cCXg0Dg">
        <specification xmi:type="uml:OpaqueExpression" xmi:id="_j2h5IPIREeGu1M-cCXg0Dg">
          <language>Analysis</language>
          <body>State is required if the country is US. If country is not specified, its assumed to be US. If country is something other than US, the state MAY be present but MAY be bound to different vocabularies</body>
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      </ownedRule>
      <ownedRule xmi:id="_8-l_MPIQEeGu1M-cCXg0Dg" name="USRealmAddressPostal" constrainedElement="_7BBfQPIQEeGu1M-cCXg0Dg">
        <specification xmi:type="uml:OpaqueExpression" xmi:id="_fdgDYPIREeGu1M-cCXg0Dg">
          <language>Analysis</language>
          <body>PostalCode is required if the country is US. If country is not specified, its assumed to be US. If country is something other than US, the postalCode MAY be present but MAY be bound to different vocabularies</body>
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      <ownedRule xmi:id="_YrEtUPIREeGu1M-cCXg0Dg" name="mixedContentWhiteSpace" constrainedElement="_i4zXgPIPEeGu1M-cCXg0Dg">
        <specification xmi:type="uml:OpaqueExpression" xmi:id="_dwS6sPIREeGu1M-cCXg0Dg">
          <language>Analysis</language>
          <body>SHALL NOT have mixed content except for white space</body>
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      <ownedRule xmi:id="_ls2IQPIWEeGu1M-cCXg0Dg" name="USRealmAddressStreet" constrainedElement="_i4zXgPIPEeGu1M-cCXg0Dg">
        <specification xmi:type="uml:OpaqueExpression" xmi:id="_pval0PIWEeGu1M-cCXg0Dg">
          <language>Analysis</language>
          <language>OCL</language>
          <body>SHALL contain at least one and not more than 4 streetAddressLine</body>
          <body>self.isNullFlavorUndefined() implies ( self.streetAddressLine->size() >=1 and self.streetAddressLine->size() &lt;=4)</body>
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      <generalization xmi:id="_j0nfgPIPEeGu1M-cCXg0Dg">
        <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_v0zRUD5yEd6cla2oXsPtlA"/>
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      <ownedAttribute xmi:id="_qB12wPIPEeGu1M-cCXg0Dg" name="city" visibility="private" isOrdered="true" isDerived="true" aggregation="composite">
        <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_DHg4ID5zEd6cla2oXsPtlA"/>
        <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_uZbsoPIQEeGu1M-cCXg0Dg" value="1"/>
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        <redefinedProperty href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_XlrLED9HEd6uA6ElmbQH3Q"/>
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      <ownedAttribute xmi:id="_qB12w_IPEeGu1M-cCXg0Dg" name="country" visibility="private" isOrdered="true" isDerived="true" aggregation="composite">
        <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_DHg4ID5zEd6cla2oXsPtlA"/>
        <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_XymCoPIQEeGu1M-cCXg0Dg" value="1"/>
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        <redefinedProperty href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_Q-8j4D_lEd6wZe6nFLrjsw"/>
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      <ownedAttribute xmi:id="_qB12xvIPEeGu1M-cCXg0Dg" name="postalCode" visibility="private" isOrdered="true" isDerived="true" aggregation="composite">
        <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_DHg4ID5zEd6cla2oXsPtlA"/>
        <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_yRva8PIQEeGu1M-cCXg0Dg" value="1"/>
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        <redefinedProperty href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_wQKkED_lEd6wZe6nFLrjsw"/>
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      <ownedAttribute xmi:id="_qB12yfIPEeGu1M-cCXg0Dg" name="state" visibility="private" isOrdered="true" isDerived="true" aggregation="composite">
        <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_DHg4ID5zEd6cla2oXsPtlA"/>
        <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_DIvpwPIQEeGu1M-cCXg0Dg" value="1"/>
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        <redefinedProperty href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_UGUkgD_lEd6wZe6nFLrjsw"/>
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      <ownedAttribute xmi:id="_qB12zPIPEeGu1M-cCXg0Dg" name="streetAddressLine" visibility="private" isOrdered="true" isDerived="true" aggregation="composite">
        <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_DHg4ID5zEd6cla2oXsPtlA"/>
        <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_SUqKUPLAEeGFUPBL8qS7yQ" value="*"/>
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        <redefinedProperty href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_00o1ED9GEd6uA6ElmbQH3Q"/>
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      <ownedAttribute xmi:id="_qB12z_IPEeGu1M-cCXg0Dg" name="use" visibility="private">
        <type xmi:type="uml:Enumeration" href="../../../org.openhealthtools.mdht.uml.hl7.vocab/model/vocab.uml#__y7Gd0DcEd6xYZuu1VKCVw"/>
        <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_Ii0iAPeQEeGE6_g8dRyaRg" value="1"/>
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        <redefinedProperty href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_qe2q4D5zEd6cla2oXsPtlA"/>
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    </nestedClassifier>
    <nestedClassifier xmi:type="uml:Class" xmi:id="_aSeEwPIYEeGu1M-cCXg0Dg" name="USRealmPatientName">
      <ownedComment xmi:id="_J-c08PIeEeGu1M-cCXg0Dg">
        <body>The US Realm Patient Name datatype flavor is a set of reusable constraints that can be used for the patient or any other person. It requires a first (given) and last (family) name. If a patient or person has only one name part (e.g., patient with first name only) place the name part in the field required by the organization. Use the appropriate nullFlavor, &quot;Not Applicable&quot; (NA), in the other field.</body>
      </ownedComment>
      <ownedRule xmi:id="_4e-Q4PIeEeGu1M-cCXg0Dg" name="USRealmPatientNameMixedContent" constrainedElement="_2DNRcBSVEeGGzu7fmW9pXw">
        <ownedComment xmi:id="_4e-Q4fIeEeGu1M-cCXg0Dg">
          <body>QUERY</body>
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        <specification xmi:type="uml:OpaqueExpression" xmi:id="_4e-Q4vIeEeGu1M-cCXg0Dg">
          <language>Analysis</language>
          <language>OCL</language>
          <body>US Realm Patient Name SHALL NOT contain any mixed content other than whitespace</body>
          <body>getText(true)=''</body>
        </specification>
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      <generalization xmi:id="_bAS0EPIYEeGu1M-cCXg0Dg">
        <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_3VD9wD5yEd6cla2oXsPtlA"/>
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      <ownedAttribute xmi:id="_d9iBQPIYEeGu1M-cCXg0Dg" name="family" visibility="private" isOrdered="true" isDerived="true" aggregation="composite">
        <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_D7EcAD5zEd6cla2oXsPtlA"/>
        <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_so2XcPIeEeGu1M-cCXg0Dg" value="1"/>
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        <redefinedProperty href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_9IA_sD92Ed6NdqfHy-LGHg"/>
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        <redefinedProperty href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_AYLv8D93Ed6NdqfHy-LGHg"/>
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      <ownedAttribute xmi:id="_d9iBRvIYEeGu1M-cCXg0Dg" name="prefix" visibility="private" isOrdered="true" isDerived="true" aggregation="composite">
        <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_D7EcAD5zEd6cla2oXsPtlA"/>
        <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_d9iBR_IYEeGu1M-cCXg0Dg" value="*"/>
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        <redefinedProperty href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_Db1uMD93Ed6NdqfHy-LGHg"/>
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      <ownedAttribute xmi:id="_d9iBSfIYEeGu1M-cCXg0Dg" name="suffix" visibility="private" isOrdered="true" isDerived="true" aggregation="composite">
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        <redefinedProperty href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_EtgKYD93Ed6NdqfHy-LGHg"/>
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      <ownedAttribute xmi:id="_d9iBTPIYEeGu1M-cCXg0Dg" name="use" visibility="private">
        <type xmi:type="uml:Enumeration" href="../../../org.openhealthtools.mdht.uml.hl7.vocab/model/vocab.uml#__yoORUDcEd6xYZuu1VKCVw"/>
        <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_pC-c8PIeEeGu1M-cCXg0Dg" value="1"/>
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        <redefinedProperty href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_ruuXUD5zEd6cla2oXsPtlA"/>
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      <ownedComment xmi:id="_XVyLAPI1EeGu1M-cCXg0Dg">
        <body>The header can record information about the patient's consent.&#xD;
The type of consent (e.g., a consent to perform the related serviceEvent) is conveyed in consent/code. Consents in the header have been finalized (consent/statusCode must equal Completed) and should be on file. This specification does not address how 'Privacy Consent' is represented, but does not preclude the inclusion of 'Privacy Consent'.</body>
      </ownedComment>
      <ownedComment xmi:id="_bzFcwPI1EeGu1M-cCXg0Dg">
        <body>INLINE</body>
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        <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_JpCq8EcEEd6besF9iFIJkQ"/>
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      <ownedAttribute xmi:id="__Y_asPI0EeGu1M-cCXg0Dg" name="consent" visibility="private" type="_DHFdEPI1EeGu1M-cCXg0Dg" aggregation="composite">
        <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="__Y_asfI0EeGu1M-cCXg0Dg" value="1"/>
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      <nestedClassifier xmi:type="uml:Class" xmi:id="_DHFdEPI1EeGu1M-cCXg0Dg" name="Consent">
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          <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_fVPRoEcEEd6besF9iFIJkQ"/>
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        <ownedAttribute xmi:id="_FDNykPI1EeGu1M-cCXg0Dg" name="code" visibility="private" aggregation="composite">
          <ownedComment xmi:id="_MZuGEPI1EeGu1M-cCXg0Dg">
            <body>The type of consent (e.g., a consent to perform the related serviceEvent) is conveyed in consent/code (CONF:16796).</body>
          </ownedComment>
          <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_Z1EGIDxaEd6JwqSGecoePg"/>
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          <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_yR04YEouEd6c3qsAxlFHaQ"/>
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        <ownedAttribute xmi:id="_FDOZoPI1EeGu1M-cCXg0Dg" name="id" visibility="private" aggregation="composite">
          <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_culQ8DxaEd6JwqSGecoePg"/>
          <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_FDOZofI1EeGu1M-cCXg0Dg" value="*"/>
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          <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_vjoMwEouEd6c3qsAxlFHaQ"/>
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        <ownedAttribute xmi:id="_FDOZo_I1EeGu1M-cCXg0Dg" name="statusCode" visibility="private" aggregation="composite">
          <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_iYn74D55Ed6cla2oXsPtlA"/>
          <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_2qQ4QEouEd6c3qsAxlFHaQ"/>
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    <ownedComment xmi:id="_jQgdgCypEeGMXrZ0DiQwGg">
      <body>The recordTarget records the patient whose health information is described by the clinical document; it must contain at least one patientRole element.</body>
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    <ownedEnd xmi:id="_2D3_0RSVEeGGzu7fmW9pXw" type="_2DNRcBSVEeGGzu7fmW9pXw" association="_2D3_0BSVEeGGzu7fmW9pXw"/>
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  <uml:Association xmi:id="_2D0VeBSVEeGGzu7fmW9pXw" memberEnd="_2DNSDBSVEeGGzu7fmW9pXw _2D0VeRSVEeGGzu7fmW9pXw">
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    <ruleId>CONF:5252</ruleId>
    <ruleId>CONF:10036</ruleId>
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  <CDA:CodeSystemConstraint xmi:id="_2DTYEhSVEeGGzu7fmW9pXw" code="US" base_Property="_2DNR9BSVEeGGzu7fmW9pXw">
    <ruleId>CONF:16791</ruleId>
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    <ruleId>CONF:5361</ruleId>
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  <CDA:PropertyValidation xmi:id="_2DTYEBSVEeGGzu7fmW9pXw" base_Property="_2DNR7RSVEeGGzu7fmW9pXw">
    <ruleId>CONF:5363</ruleId>
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  <CDA:PropertyValidation xmi:id="_2DNSEBSVEeGGzu7fmW9pXw" base_Property="_2DNR5RSVEeGGzu7fmW9pXw">
    <ruleId>CONF:5253</ruleId>
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    <ruleId>CONF:5254</ruleId>
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  <CDA:PropertyValidation xmi:id="_2DNSERSVEeGGzu7fmW9pXw" base_Property="_2DNR6xSVEeGGzu7fmW9pXw">
    <ruleId>CONF:5256</ruleId>
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    <ownedAttribute xmi:id="_XBDRMDzHEeGMk58Mp9-wVA" name="chiefComplaintAndReasonForVisitSection" association="_XBDRMjzHEeGMk58Mp9-wVA">
      <type xmi:type="uml:Class" href="consol-other.uml#_oI7CQCsaEeGHF88-qhhUMA"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_XBDRMTzHEeGMk58Mp9-wVA"/>
    </ownedAttribute>
    <ownedAttribute xmi:id="_Zufu4DzHEeGMk58Mp9-wVA" name="chiefComplaintSection" association="_Zufu4jzHEeGMk58Mp9-wVA">
      <type xmi:type="uml:Class" href="consol-other.uml#_2PWQCBSVEeGGzu7fmW9pXw"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_Zufu4TzHEeGMk58Mp9-wVA"/>
    </ownedAttribute>
    <ownedAttribute xmi:id="_xJ2mEDzHEeGMk58Mp9-wVA" name="familyHistorySection" association="_xKAXETzHEeGMk58Mp9-wVA">
      <type xmi:type="uml:Class" href="consol-familyhistory.uml#_2IWQIxSVEeGGzu7fmW9pXw"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_xKAXEDzHEeGMk58Mp9-wVA"/>
    </ownedAttribute>
    <ownedAttribute xmi:id="_hcNMADzIEeGMk58Mp9-wVA" name="hospitalConsultationsSection" association="_hcNMAjzIEeGMk58Mp9-wVA">
      <type xmi:type="uml:Class" href="consol-other.uml#_eKFbUDVyEeGaW4kr-GbV8Q"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_hcNMATzIEeGMk58Mp9-wVA"/>
    </ownedAttribute>
    <ownedAttribute xmi:id="_64c84DzIEeGMk58Mp9-wVA" name="hospitalDischargeInstructionsSection" association="_64c84jzIEeGMk58Mp9-wVA">
      <type xmi:type="uml:Class" href="consol-discharge.uml#_lBergCUMEeGiOPpZVnfEJA"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_64c84TzIEeGMk58Mp9-wVA"/>
    </ownedAttribute>
    <ownedAttribute xmi:id="_JDyaMDzJEeGMk58Mp9-wVA" name="hospitalDischargePhysicalSection" association="_JDyaMjzJEeGMk58Mp9-wVA">
      <type xmi:type="uml:Class" href="consol-discharge.uml#_WikGsCUTEeGiOPpZVnfEJA"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_JDyaMTzJEeGMk58Mp9-wVA"/>
    </ownedAttribute>
    <ownedAttribute xmi:id="_N0z5MDzJEeGMk58Mp9-wVA" name="hospitalDischargeStudiesSummarySection" association="_N0z5MjzJEeGMk58Mp9-wVA">
      <type xmi:type="uml:Class" href="consol-discharge.uml#_38AXoCUTEeGiOPpZVnfEJA"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_N0z5MTzJEeGMk58Mp9-wVA"/>
    </ownedAttribute>
    <ownedAttribute xmi:id="_UcKAoDzJEeGMk58Mp9-wVA" name="immunizationsSectionEntriesOptional" association="_UcKAojzJEeGMk58Mp9-wVA">
      <type xmi:type="uml:Class" href="consol-immunizations.uml#_EuPloBVeEeGQCvUGzi1kDQ"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_UcKAoTzJEeGMk58Mp9-wVA"/>
    </ownedAttribute>
    <ownedAttribute xmi:id="_aeGU8DzJEeGMk58Mp9-wVA" name="problemSectionEntriesOptional" association="_aeGU8jzJEeGMk58Mp9-wVA">
      <type xmi:type="uml:Class" href="consol-problems.uml#_naxrkBVdEeGQCvUGzi1kDQ"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_aeGU8TzJEeGMk58Mp9-wVA"/>
    </ownedAttribute>
    <ownedAttribute xmi:id="_hj_ZkDzJEeGMk58Mp9-wVA" name="proceduresSectionEntriesOptional" association="_hj_ZkjzJEeGMk58Mp9-wVA">
      <type xmi:type="uml:Class" href="consol-procedures.uml#_s9Ig4BVdEeGQCvUGzi1kDQ"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_hj_ZkTzJEeGMk58Mp9-wVA"/>
    </ownedAttribute>
    <ownedAttribute xmi:id="_nJ6gQDzJEeGMk58Mp9-wVA" name="reasonForVisitSection" association="_nJ6gQjzJEeGMk58Mp9-wVA">
      <type xmi:type="uml:Class" href="consol-other.uml#_Nm64UCscEeGHF88-qhhUMA"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_nJ6gQTzJEeGMk58Mp9-wVA"/>
    </ownedAttribute>
    <ownedAttribute xmi:id="_rgQ1cDzJEeGMk58Mp9-wVA" name="reviewOfSystemsSection" association="_rgQ1cjzJEeGMk58Mp9-wVA">
      <type xmi:type="uml:Class" href="consol-exams.uml#_2RqkMBSVEeGGzu7fmW9pXw"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_rgQ1cTzJEeGMk58Mp9-wVA"/>
    </ownedAttribute>
    <ownedAttribute xmi:id="_yQsncDzJEeGMk58Mp9-wVA" name="socialHistorySection" association="_yQsncjzJEeGMk58Mp9-wVA">
      <type xmi:type="uml:Class" href="consol-socialhistory.uml#_2JKvgBSVEeGGzu7fmW9pXw"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_yQsncTzJEeGMk58Mp9-wVA"/>
    </ownedAttribute>
    <ownedAttribute xmi:id="_ezg64PLEEeGFUPBL8qS7yQ" name="allergiesSectionEntriesOptional" association="_eziJAPLEEeGFUPBL8qS7yQ">
      <type xmi:type="uml:Class" href="consol-allergies.uml#_bGzYgBVdEeGQCvUGzi1kDQ"/>
      <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_fxY4YPLEEeGFUPBL8qS7yQ" value="1"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_fxY4YfLEEeGFUPBL8qS7yQ" value="1"/>
    </ownedAttribute>
    <ownedAttribute xmi:id="_stQR4PLEEeGFUPBL8qS7yQ" name="vitalSignsSectionEntriesOptional" association="_stRgAPLEEeGFUPBL8qS7yQ">
      <type xmi:type="uml:Class" href="consol-vitalsigns.uml#_bRH8sBVeEeGQCvUGzi1kDQ"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_stQR4fLEEeGFUPBL8qS7yQ"/>
    </ownedAttribute>
    <nestedClassifier xmi:type="uml:Class" xmi:id="_7G6B4DzDEeGMk58Mp9-wVA" name="ComponentOf">
      <ownedComment xmi:id="_ceudYD0gEeGagp6xeAJzMA">
        <body>INLINE</body>
      </ownedComment>
      <generalization xmi:id="_DZY1cDzEEeGMk58Mp9-wVA">
        <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_NWHRoEAJEd6wZe6nFLrjsw"/>
      </generalization>
      <ownedAttribute xmi:id="_bylN4DzEEeGMk58Mp9-wVA" name="encompassingEncounter" type="_TeTqkDzEEeGMk58Mp9-wVA" association="_bylN4jzEEeGMk58Mp9-wVA">
        <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_erzdwDzEEeGMk58Mp9-wVA" value="1"/>
        <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_erzdwTzEEeGMk58Mp9-wVA" value="1"/>
      </ownedAttribute>
      <nestedClassifier xmi:type="uml:Class" xmi:id="_TeTqkDzEEeGMk58Mp9-wVA" name="EncompassingEncounter3">
        <ownedRule xmi:id="_8bTXEDzFEeGMk58Mp9-wVA" name="encompassingEncounterHasEffectiveTimeLow" constrainedElement="_TeTqkDzEEeGMk58Mp9-wVA">
          <specification xmi:type="uml:OpaqueExpression" xmi:id="__jugkDzFEeGMk58Mp9-wVA">
            <language>Analysis</language>
            <language>OCL</language>
            <body>This encompassingEncounter SHALL contain exactly one [1..1] effectiveTime/low</body>
            <body>not self.effectiveTime.low.oclIsUndefined()</body>
          </specification>
        </ownedRule>
        <ownedRule xmi:id="_Ejp-QDzGEeGMk58Mp9-wVA" name="encompassingEncounterHasEffectiveTimeHigh" constrainedElement="_TeTqkDzEEeGMk58Mp9-wVA">
          <specification xmi:type="uml:OpaqueExpression" xmi:id="_Ejp-QTzGEeGMk58Mp9-wVA">
            <language>Analysis</language>
            <language>OCL</language>
            <body>This encompassingEncounter SHALL contain exactly one [1..1] effectiveTime/high</body>
            <body>not self.effectiveTime.high.oclIsUndefined()</body>
          </specification>
        </ownedRule>
        <ownedRule xmi:id="_j2YAAF1FEeO84_IebRjYkg" name="dischargeDispositionCodeValueSet" constrainedElement="_TeTqkDzEEeGMk58Mp9-wVA">
          <specification xmi:type="uml:OpaqueExpression" xmi:id="_pKF8YF1FEeO84_IebRjYkg">
            <language>Analysis</language>
            <language>OCL</language>
            <body>dischargeDispositionCode SHOULD be selected from ValueSet NUBC UB-04 FL17-Patient Status 2.16.840.1.113883.6.301.5 STATIC</body>
            <body>dischargeDispositionCode.oclIsUndefined() or dischargeDispositionCode.isNullFlavorUndefined() implies let value : datatypes::CE = dischargeDispositionCode.oclAsType(datatypes::CE) in value.codeSystem &lt;> '2.16.840.1.113883.12.112' implies value.codeSystem = '2.16.840.1.113883.6.301.5' and not value.code.oclIsUndefined()</body>
          </specification>
        </ownedRule>
        <ownedRule xmi:id="_lGT94F1FEeO84_IebRjYkg" name="dischargeDispositionCodeCodeSystem" constrainedElement="_TeTqkDzEEeGMk58Mp9-wVA">
          <specification xmi:type="uml:OpaqueExpression" xmi:id="_CM0aAF1GEeO84_IebRjYkg">
            <language>Analysis</language>
            <language>OCL</language>
            <body>dischargeDispositionCode, if access to NUBC is unavailable, MAY be selected from CodeSystem 2.16.840.1.113883.12.112 HL7 Discharge Disposition</body>
            <body>dischargeDispositionCode.oclIsUndefined() or dischargeDispositionCode.isNullFlavorUndefined() implies let value : datatypes::CE = dischargeDispositionCode.oclAsType(datatypes::CE) in value.codeSystem &lt;> '2.16.840.1.113883.6.301.5' implies value.codeSystem = '2.16.840.1.113883.12.112' and not value.code.oclIsUndefined()</body>
          </specification>
        </ownedRule>
        <generalization xmi:id="_liV3wDzEEeGMk58Mp9-wVA">
          <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_j5JZsEAJEd6wZe6nFLrjsw"/>
        </generalization>
        <ownedAttribute xmi:id="_tzLskDzEEeGMk58Mp9-wVA" name="dischargeDispositionCode" visibility="private" aggregation="composite">
          <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_Z1EGIDxaEd6JwqSGecoePg"/>
          <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_k-ih8HT9EeGB7fSw5LjeyA" value="1"/>
          <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_k-ih8XT9EeGB7fSw5LjeyA" value="1"/>
          <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_wOswwEozEd6c3qsAxlFHaQ"/>
        </ownedAttribute>
        <ownedAttribute xmi:id="_tzLskzzEEeGMk58Mp9-wVA" name="effectiveTime" visibility="private" aggregation="composite">
          <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_QYeW4D5-Ed6cla2oXsPtlA"/>
          <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_sKO1wEozEd6c3qsAxlFHaQ"/>
        </ownedAttribute>
        <ownedAttribute xmi:id="_wxzkYDzFEeGMk58Mp9-wVA" name="responsibleParty" type="_cALIgDzFEeGMk58Mp9-wVA" association="_wxzkYjzFEeGMk58Mp9-wVA">
          <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_wxzkYTzFEeGMk58Mp9-wVA"/>
        </ownedAttribute>
        <ownedAttribute xmi:id="_zQf0YDzFEeGMk58Mp9-wVA" name="encounterParticipant" type="_dTBQcDzFEeGMk58Mp9-wVA" association="_zQf0YjzFEeGMk58Mp9-wVA">
          <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_zQf0YTzFEeGMk58Mp9-wVA"/>
        </ownedAttribute>
        <nestedClassifier xmi:type="uml:Class" xmi:id="_cALIgDzFEeGMk58Mp9-wVA" name="ResponsibleParty">
          <ownedRule xmi:id="_cALIgTzFEeGMk58Mp9-wVA" name="assignedEntityHasPersonOrOrganization" constrainedElement="_cALIgDzFEeGMk58Mp9-wVA">
            <specification xmi:type="uml:OpaqueExpression" xmi:id="_cALIgjzFEeGMk58Mp9-wVA">
              <language>Analysis</language>
              <language>OCL</language>
              <body>The responsibleParty element, if present, SHALL contain an assignedEntity element which SHALL contain an assignedPerson element, a representedOrganization element, or both.</body>
              <body>not self.assignedEntity.assignedPerson.oclIsUndefined() or not self.assignedEntity.representedOrganization->isEmpty()</body>
            </specification>
          </ownedRule>
          <generalization xmi:id="_cALIgzzFEeGMk58Mp9-wVA">
            <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_hfdrgEcaEd6besF9iFIJkQ"/>
          </generalization>
          <ownedAttribute xmi:id="_0PA-kD0nEeGsYqsxu3WrRA" name="assignedEntity" association="_0PA-kj0nEeGsYqsxu3WrRA">
            <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_6qmVsEcDEd6besF9iFIJkQ"/>
            <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_Xtcf0PKzEeGFUPBL8qS7yQ" value="*"/>
            <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_Xtcf0fKzEeGFUPBL8qS7yQ" value="1"/>
          </ownedAttribute>
        </nestedClassifier>
        <nestedClassifier xmi:type="uml:Class" xmi:id="_dTBQcDzFEeGMk58Mp9-wVA" name="EncounterParticipant">
          <ownedRule xmi:id="_dTBQcTzFEeGMk58Mp9-wVA" name="assignedEntityHasPersonOrOrganization" constrainedElement="_tUQLcDswEeGvzMYhXuqAEA">
            <specification xmi:type="uml:OpaqueExpression" xmi:id="_dTBQcjzFEeGMk58Mp9-wVA">
              <language>Analysis</language>
              <language>OCL</language>
              <body>The responsibleParty element, if present, SHALL contain an assignedEntity element which SHALL contain an assignedPerson element, a representedOrganization element, or both.</body>
              <body>not self.assignedEntity.assignedPerson.oclIsUndefined() or not self.assignedEntity.representedOrganization->isEmpty()</body>
            </specification>
          </ownedRule>
          <generalization xmi:id="_dTBQczzFEeGMk58Mp9-wVA">
            <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_5t1WAEcEEd6besF9iFIJkQ"/>
          </generalization>
          <ownedAttribute xmi:id="_4gASoD0nEeGsYqsxu3WrRA" name="assignedEntity" association="_4gASoj0nEeGsYqsxu3WrRA">
            <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_6qmVsEcDEd6besF9iFIJkQ"/>
            <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_dI3msPKzEeGFUPBL8qS7yQ" value="*"/>
            <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_dI3msfKzEeGFUPBL8qS7yQ" value="1"/>
          </ownedAttribute>
        </nestedClassifier>
      </nestedClassifier>
    </nestedClassifier>
  </uml:Class>
  <uml:Association xmi:id="_2UnxyxSVEeGGzu7fmW9pXw" memberEnd="_2UnxlhSVEeGGzu7fmW9pXw _2UnxzBSVEeGGzu7fmW9pXw">
    <ownedEnd xmi:id="_2UnxzBSVEeGGzu7fmW9pXw" type="_2UnxkRSVEeGGzu7fmW9pXw" association="_2UnxyxSVEeGGzu7fmW9pXw"/>
  </uml:Association>
  <uml:Association xmi:id="_2UnxzhSVEeGGzu7fmW9pXw" memberEnd="_2UnxmRSVEeGGzu7fmW9pXw _2UnxzxSVEeGGzu7fmW9pXw">
    <ownedEnd xmi:id="_2UnxzxSVEeGGzu7fmW9pXw" type="_2UnxkRSVEeGGzu7fmW9pXw" association="_2UnxzhSVEeGGzu7fmW9pXw"/>
  </uml:Association>
  <uml:Association xmi:id="_2Unx1xSVEeGGzu7fmW9pXw" memberEnd="_2UnxoRSVEeGGzu7fmW9pXw _2Ut4MBSVEeGGzu7fmW9pXw">
    <ownedEnd xmi:id="_2Ut4MBSVEeGGzu7fmW9pXw" type="_2UnxkRSVEeGGzu7fmW9pXw" association="_2Unx1xSVEeGGzu7fmW9pXw"/>
  </uml:Association>
  <uml:Association xmi:id="_2Ut4MhSVEeGGzu7fmW9pXw" memberEnd="_2UnxpBSVEeGGzu7fmW9pXw _2Ut4MxSVEeGGzu7fmW9pXw">
    <ownedEnd xmi:id="_2Ut4MxSVEeGGzu7fmW9pXw" type="_2UnxkRSVEeGGzu7fmW9pXw" association="_2Ut4MhSVEeGGzu7fmW9pXw"/>
  </uml:Association>
  <uml:Association xmi:id="_2Ut4NRSVEeGGzu7fmW9pXw" memberEnd="_2UnxphSVEeGGzu7fmW9pXw _2Ut4NhSVEeGGzu7fmW9pXw">
    <ownedEnd xmi:id="_2Ut4NhSVEeGGzu7fmW9pXw" type="_2UnxkRSVEeGGzu7fmW9pXw" association="_2Ut4NRSVEeGGzu7fmW9pXw"/>
  </uml:Association>
  <uml:Association xmi:id="_2Ut4OxSVEeGGzu7fmW9pXw" memberEnd="_2UnxqxSVEeGGzu7fmW9pXw _2Ut4PBSVEeGGzu7fmW9pXw">
    <ownedEnd xmi:id="_2Ut4PBSVEeGGzu7fmW9pXw" type="_2UnxkRSVEeGGzu7fmW9pXw" association="_2Ut4OxSVEeGGzu7fmW9pXw"/>
  </uml:Association>
  <uml:Association xmi:id="_2Ut4PhSVEeGGzu7fmW9pXw" memberEnd="_2UnxrRSVEeGGzu7fmW9pXw _2Ut4PxSVEeGGzu7fmW9pXw">
    <ownedEnd xmi:id="_2Ut4PxSVEeGGzu7fmW9pXw" type="_2UnxkRSVEeGGzu7fmW9pXw" association="_2Ut4PhSVEeGGzu7fmW9pXw"/>
  </uml:Association>
  <uml:Association xmi:id="_2Ut4QRSVEeGGzu7fmW9pXw" memberEnd="_2UnxsBSVEeGGzu7fmW9pXw _2Ut4QhSVEeGGzu7fmW9pXw">
    <ownedEnd xmi:id="_2Ut4QhSVEeGGzu7fmW9pXw" type="_2UnxkRSVEeGGzu7fmW9pXw" association="_2Ut4QRSVEeGGzu7fmW9pXw"/>
  </uml:Association>
  <uml:Association xmi:id="_2Uz-0BSVEeGGzu7fmW9pXw" memberEnd="_2UnxuBSVEeGGzu7fmW9pXw _2Uz-0RSVEeGGzu7fmW9pXw">
    <ownedEnd xmi:id="_2Uz-0RSVEeGGzu7fmW9pXw" type="_2UnxkRSVEeGGzu7fmW9pXw" association="_2Uz-0BSVEeGGzu7fmW9pXw"/>
  </uml:Association>
  <uml:Association xmi:id="_2Uz-0xSVEeGGzu7fmW9pXw" memberEnd="_2UnxuxSVEeGGzu7fmW9pXw _2Uz-1BSVEeGGzu7fmW9pXw">
    <ownedEnd xmi:id="_2Uz-1BSVEeGGzu7fmW9pXw" type="_2UnxkRSVEeGGzu7fmW9pXw" association="_2Uz-0xSVEeGGzu7fmW9pXw"/>
  </uml:Association>
  <CDA:CDATemplate xmi:id="_2UnxxhSVEeGGzu7fmW9pXw" base_Class="_2UnxkRSVEeGGzu7fmW9pXw" templateId="2.16.840.1.113883.10.20.22.1.8">
    <ruleId>CONF:8375</ruleId>
    <ruleId>CONF:10043</ruleId>
  </CDA:CDATemplate>
  <CDA:AssociationValidation xmi:id="_2UnxzRSVEeGGzu7fmW9pXw" severity="INFO" base_Association="_2UnxyxSVEeGGzu7fmW9pXw">
    <ruleId>CONF:10111</ruleId>
  </CDA:AssociationValidation>
  <CDA:AssociationValidation xmi:id="_2Unx0BSVEeGGzu7fmW9pXw" base_Association="_2UnxzhSVEeGGzu7fmW9pXw">
    <ruleId>CONF:9928</ruleId>
  </CDA:AssociationValidation>
  <CDA:AssociationValidation xmi:id="_2Ut4MRSVEeGGzu7fmW9pXw" base_Association="_2Unx1xSVEeGGzu7fmW9pXw">
    <ruleId>CONF:9546</ruleId>
  </CDA:AssociationValidation>
  <CDA:AssociationValidation xmi:id="_2Ut4NBSVEeGGzu7fmW9pXw" severity="INFO" base_Association="_2Ut4MhSVEeGGzu7fmW9pXw">
    <ruleId>CONF:9558</ruleId>
  </CDA:AssociationValidation>
  <CDA:AssociationValidation xmi:id="_2Ut4NxSVEeGGzu7fmW9pXw" base_Association="_2Ut4NRSVEeGGzu7fmW9pXw">
    <ruleId>CONF:9548</ruleId>
  </CDA:AssociationValidation>
  <CDA:AssociationValidation xmi:id="_2Ut4PRSVEeGGzu7fmW9pXw" severity="INFO" base_Association="_2Ut4OxSVEeGGzu7fmW9pXw">
    <ruleId>CONF:9562</ruleId>
  </CDA:AssociationValidation>
  <CDA:AssociationValidation xmi:id="_2Ut4QBSVEeGGzu7fmW9pXw" severity="INFO" base_Association="_2Ut4PhSVEeGGzu7fmW9pXw">
    <ruleId>CONF:9566</ruleId>
  </CDA:AssociationValidation>
  <CDA:AssociationValidation xmi:id="_2Ut4QxSVEeGGzu7fmW9pXw" base_Association="_2Ut4QRSVEeGGzu7fmW9pXw">
    <ruleId>CONF:9544</ruleId>
  </CDA:AssociationValidation>
  <CDA:AssociationValidation xmi:id="_2Uz-0hSVEeGGzu7fmW9pXw" base_Association="_2Uz-0BSVEeGGzu7fmW9pXw">
    <ruleId>CONF:9550</ruleId>
  </CDA:AssociationValidation>
  <CDA:AssociationValidation xmi:id="_2Uz-1RSVEeGGzu7fmW9pXw" severity="INFO" base_Association="_2Uz-0xSVEeGGzu7fmW9pXw">
    <ruleId>CONF:9564</ruleId>
  </CDA:AssociationValidation>
  <uml:Class xmi:id="_2IJb0BSVEeGGzu7fmW9pXw" name="ContinuityOfCareDocument">
    <ownedComment xmi:id="_2IJb0RSVEeGGzu7fmW9pXw" annotatedElement="_2IJb0BSVEeGGzu7fmW9pXw">
      <body>This section, Continuity of Care Document (CCD) Release 1.1, describes CDA constraints  in accordance with Stage 1 Meaningful Use. The CCD requirements in this guide supersede CCD Release 1; in the near future, this guide could supersede HITSP C32 .&#xD;
&#xD;
The CCD is a core data set of the most relevant administrative, demographic, and clinical information facts about a patient's healthcare, covering one or more healthcare encounters. It provides a means for one healthcare practitioner, system, or setting to aggregate all of the pertinent data about a patient and forward it to another practitioner, system, or setting to support the continuity of care. The primary use case for the CCD is to provide a snapshot in time containing the pertinent clinical, demographic, and administrative data for a specific patient . More specific use cases, such as a Discharge Summary or Progress Note, are available as alternative documents in this guide.</body>
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            <body>UNIMPLEMENTABLE</body>
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            <language>OCL</language>
            <body>If assignedAuthor has an associated representedOrganization with no assignedPerson or assignedAuthoringDevice, then the value for &quot;ClinicalDocument/author/assignedAuthor/id/@NullFlavor&quot; SHALL be &quot;NA&quot; &quot;Not applicable&quot; 2.16.840.1.113883.5.1008 NullFlavor STATIC.</body>
            <body>(not self.representedOrganization.oclIsUndefined() and self.assignedPerson.oclIsUndefined() and self.assignedAuthoringDevice.oclIsUndefined()) implies self.id->exists(id | not id.isNullFlavorUndefined() and id.nullFlavor = vocab::NullFlavor::NA)</body>
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    <ruleId>CONF:10038</ruleId>
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      <body>An unstructured document is a document which is used when the patient record is captured in an unstructured format that is encapsulated within an image file or as unstructured text in an electronic file such as a word processing or Portable Document Format (PDF) document. &#xD;
There is a need to raise the level of interoperability for these documents to provide full access to the longitudinal patient record across a continuum of care. Until this gap is addressed, image and multi-media files will continue to be a portion of the patient record that remains difficult to access and share with all participants in a patient's care. The Unstructured Document type addresses this gap by providing consistent guidance on the use of CDA for such documents.&#xD;
An Unstructured Document (UD) document type can (1) include unstructured content, such as a graphic, directly in a text element with a mediaType attribute, or (2) reference a single document file, such as a word-processing document, using a text/reference element.&#xD;
For guidance on how to handle multiple files, on the selection of media types for this IG, and on the identification of external files, see the subsections which follow the constraints below.&#xD;
IHE's XDS-SD (Cross-Transaction Specifications and Content Specifications, Scanned Documents Module) profile addresses a similar, more restricted use case, specifically for scanned documents or documents electronically created from existing text sources, and limits content to PDF-A or text. This Unstructured Documents implementation guide is applicable not only for scanned documents in non-PDF formats, but also for clinical documents produced through word processing applications, etc. &#xD;
For conformance with both specifications, please review the appendix on XDS-SD and US Realm Clinical Document Header Comparison and ensure that your documents at a minimum conform to all the SHALL constraints from either specification .</body>
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        <body>The recordTarget element records the patient or patients whose health information is recorded in the Unstructured Documents instance. The following constraint is an addition to those in the US Realm Clinical Document Header.</body>
      </ownedComment>
      <ownedComment xmi:id="_JAIrwEBXEeGXKr6TcG1UOQ">
        <body>INLINE</body>
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        <body>INLINE</body>
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            <language>Analysis</language>
            <language>OCL</language>
            <body>The text element SHALL either contain a reference element with a value attribute, or have a representation attribute with the value of B64, a mediaType attribute, and contain the media content.</body>
            <body>not self.text.reference.value.oclIsUndefined() xor ( self.text.representation = 'B64'  and (not self.text.mediaType.oclIsUndefined()) and (not self.text.oclIsUndefined()))</body>
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            <language>OCL</language>
            <body>The value of @mediaType, if present, SHALL be drawn from the value set 2.16.840.1.113883.11.20.7.1 SupportedFileFormats STATIC 20100512.</body>
            <body>not self.text.mediaType.oclIsUndefined()  implies (self.text.mediaType = 'application/msword' or self.text.mediaType = 'application/pdf' or self.text.mediaType = 'text/plain' or self.text.mediaType = 'text/rtf' or self.text.mediaType = 'text/html' or self.text.mediaType = 'image/gif' or self.text.mediaType = 'image/tiff' or self.text.mediaType = 'image/jpeg' or self.text.mediaType = 'image/png')</body>
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    <ruleId>CONF:5264</ruleId>
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    <ruleId>CONF:5266</ruleId>
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    <ruleId>CONF:5441</ruleId>
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    <ruleId>iv.</ruleId>
    <ruleId>CONF:5519</ruleId>
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    <ruleId>CONF:5607</ruleId>
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      <body>For the purpose of this Implementation Guide, a consultation visit is defined by the evaluation and management guidelines for a consultation established by the Centers for Medicare and Medicaid Services (CMS). According to those guidelines, a Consultation Note must be generated as a result of a physician or nonphysician practitioner's (NPP) request for an opinion or advice from another physician or NPP. Consultations must involve face-to-face time with the patient or fall under guidelines for telemedicine visits. &#xD;
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        <body>The Consultation Note limits document type codes to those codes listed in the Consultation Note LOINC Document Codes table (invalid codes are listed in a separate table). Implementation may use translation elements to specify a local code that is equivalent to a document type (see the Consultation Note translation of local code figure).&#xD;
The Consultation Note recommends use of a single document type code, 11488-4 &quot;Consultation Note&quot;, with further specification provided by author or performer, setting, or specialty. The specialized codes in the Consultation Note LOINC Document Codes table are pre-coordinated with the practice setting or the training or professional level of the author. Use of these codes is not recommended, as this duplicates information that may be present in the header. When pre-coordinated codes are used, any coded values describing the author or performer of the service act or the practice setting must be consistent with the LOINC document type. For example, a Cardiology Consultation Note would not be authored by an Obstetrician.</body>
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  <CDA:AssociationValidation xmi:id="_oGY1UD-XEeGvOdejHZ7dYg" severity="INFO" base_Association="_qCP6gj-WEeGvOdejHZ7dYg">
    <ruleId>CONF:9817</ruleId>
  </CDA:AssociationValidation>
  <CDA:AssociationValidation xmi:id="_okg7wD-XEeGvOdejHZ7dYg" severity="INFO" base_Association="_r_TdED-WEeGvOdejHZ7dYg">
    <ruleId>CONF:9819</ruleId>
  </CDA:AssociationValidation>
  <CDA:AssociationValidation xmi:id="_pEjtwD-XEeGvOdejHZ7dYg" severity="INFO" base_Association="_t4nvID-WEeGvOdejHZ7dYg">
    <ruleId>CONF:9821</ruleId>
  </CDA:AssociationValidation>
  <CDA:AssociationValidation xmi:id="_pfQswD-XEeGvOdejHZ7dYg" severity="INFO" base_Association="_v_RSkj-WEeGvOdejHZ7dYg">
    <ruleId>CONF:9823</ruleId>
  </CDA:AssociationValidation>
  <CDA:AssociationValidation xmi:id="_qFGkwD-XEeGvOdejHZ7dYg" severity="INFO" base_Association="_ydBucD-WEeGvOdejHZ7dYg">
    <ruleId>CONF:9825</ruleId>
  </CDA:AssociationValidation>
  <CDA:AssociationValidation xmi:id="_sTd5wD-XEeGvOdejHZ7dYg" severity="INFO" base_Association="_0qXIsj-WEeGvOdejHZ7dYg">
    <ruleId>CONF:9827</ruleId>
  </CDA:AssociationValidation>
  <CDA:AssociationValidation xmi:id="_qzQrQD-XEeGvOdejHZ7dYg" severity="INFO" base_Association="_2inDwD-WEeGvOdejHZ7dYg">
    <ruleId>CONF:9829</ruleId>
  </CDA:AssociationValidation>
  <CDA:AssociationValidation xmi:id="_sww5wD-XEeGvOdejHZ7dYg" severity="INFO" base_Association="_4MImUj-WEeGvOdejHZ7dYg">
    <ruleId>CONF:9831</ruleId>
  </CDA:AssociationValidation>
  <CDA:AssociationValidation xmi:id="_tOSjQD-XEeGvOdejHZ7dYg" severity="INFO" base_Association="_5_sOoD-WEeGvOdejHZ7dYg">
    <ruleId>CONF:9833</ruleId>
  </CDA:AssociationValidation>
  <CDA:AssociationValidation xmi:id="_t2MQwD-XEeGvOdejHZ7dYg" severity="INFO" base_Association="_8abLsj-WEeGvOdejHZ7dYg">
    <ruleId>CONF:9835</ruleId>
  </CDA:AssociationValidation>
  <CDA:AssociationValidation xmi:id="_udGfwD-XEeGvOdejHZ7dYg" severity="INFO" base_Association="_-sRSgD-WEeGvOdejHZ7dYg">
    <ruleId>CONF:9837</ruleId>
  </CDA:AssociationValidation>
  <CDA:AssociationValidation xmi:id="_u5BmwD-XEeGvOdejHZ7dYg" severity="INFO" base_Association="_Ai8gQD-XEeGvOdejHZ7dYg">
    <ruleId>CONF:9839</ruleId>
  </CDA:AssociationValidation>
  <CDA:AssociationValidation xmi:id="_vlu7wD-XEeGvOdejHZ7dYg" severity="INFO" base_Association="_DZkvIT-XEeGvOdejHZ7dYg">
    <ruleId>CONF:9841</ruleId>
  </CDA:AssociationValidation>
  <CDA:AssociationValidation xmi:id="_wEyPQD-XEeGvOdejHZ7dYg" severity="INFO" base_Association="_GXB-wD-XEeGvOdejHZ7dYg">
    <ruleId>CONF:9843</ruleId>
  </CDA:AssociationValidation>
  <CDA:AssociationValidation xmi:id="_wcqjwD-XEeGvOdejHZ7dYg" severity="INFO" base_Association="_JNfOgT-XEeGvOdejHZ7dYg">
    <ruleId>CONF:9845</ruleId>
  </CDA:AssociationValidation>
  <CDA:AssociationValidation xmi:id="_w9jDQD-XEeGvOdejHZ7dYg" severity="INFO" base_Association="_KwZLsD-XEeGvOdejHZ7dYg">
    <ruleId>CONF:9847</ruleId>
  </CDA:AssociationValidation>
  <CDA:AssociationValidation xmi:id="_xX3nwD-XEeGvOdejHZ7dYg" severity="INFO" base_Association="_NopyQj-XEeGvOdejHZ7dYg">
    <ruleId>CONF:9849</ruleId>
  </CDA:AssociationValidation>
  <uml:Association xmi:id="_0WBKAT-OEeGvOdejHZ7dYg" memberEnd="_0WAi8D-OEeGvOdejHZ7dYg _0WBKAj-OEeGvOdejHZ7dYg">
    <ownedEnd xmi:id="_0WBKAj-OEeGvOdejHZ7dYg" type="_5JnTkD7YEeGvOdejHZ7dYg" association="_0WBKAT-OEeGvOdejHZ7dYg"/>
  </uml:Association>
  <uml:Association xmi:id="_2cq4AT-PEeGvOdejHZ7dYg" memberEnd="_2cqQ8D-PEeGvOdejHZ7dYg _2cq4Aj-PEeGvOdejHZ7dYg">
    <ownedEnd xmi:id="_2cq4Aj-PEeGvOdejHZ7dYg" type="_6-yFcD7YEeGvOdejHZ7dYg" association="_2cq4AT-PEeGvOdejHZ7dYg"/>
  </uml:Association>
  <uml:Association xmi:id="_644koT-PEeGvOdejHZ7dYg" memberEnd="_6439kD-PEeGvOdejHZ7dYg _644koj-PEeGvOdejHZ7dYg">
    <ownedEnd xmi:id="_644koj-PEeGvOdejHZ7dYg" type="_IVODYD-PEeGvOdejHZ7dYg" association="_644koT-PEeGvOdejHZ7dYg"/>
  </uml:Association>
  <uml:Association xmi:id="_6l3FgD-QEeGvOdejHZ7dYg" memberEnd="_6l2ecD-QEeGvOdejHZ7dYg _6l3FgT-QEeGvOdejHZ7dYg">
    <ownedEnd xmi:id="_6l3FgT-QEeGvOdejHZ7dYg" type="_6-yFcD7YEeGvOdejHZ7dYg" association="_6l3FgD-QEeGvOdejHZ7dYg"/>
  </uml:Association>
  <CDA:ConstraintValidation xmi:id="_QFc28D-6EeGtTIIxHid14Q" base_Constraint="_NBpHsD-6EeGtTIIxHid14Q">
    <ruleId>CONF:9643</ruleId>
  </CDA:ConstraintValidation>
  <CDA:ConstraintValidation xmi:id="_Qex88D-6EeGtTIIxHid14Q" base_Constraint="_Ot-tsD-6EeGtTIIxHid14Q">
    <ruleId>CONF:10064</ruleId>
  </CDA:ConstraintValidation>
  <uml:Class xmi:id="_UBzvED_LEeGXieeKs7NJjA" name="ProgressNote">
    <ownedComment xmi:id="_m480MD_LEeGXieeKs7NJjA">
      <body>A Progress Note documents a patient's clinical status during a hospitalization or outpatient visit; thus, it is associated with an encounter.&#xD;
Taber's  medical dictionary defines a Progress Note as &quot;An ongoing record of a patient's illness and treatment. Physicians, nurses, consultants, and therapists record their notes concerning the progress or lack of progress made by the patient between the time of the previous note and the most recent note.&quot; &#xD;
Mosby's  medical dictionary defines a Progress Note as &quot;Notes made by a nurse, physician, social worker, physical therapist, and other health care professionals that describe the patient's condition and the treatment given or planned.&quot;&#xD;
A Progress Note is not a re-evaluation note. A Progress Note is not intended to be a Progress Report for Medicare. Medicare B Section 1833(e) defines the requirements of a Medicare Progress Report.</body>
    </ownedComment>
    <ownedRule xmi:id="_iu5zoD_hEeGysvimLgYv4A" name="hasAnAssementAndPlanSectionOrIndividualAssementAndPlanSections" constrainedElement="_-Qa60D1jEeG3tde5scYNWA">
      <specification xmi:type="uml:OpaqueExpression" xmi:id="_iu5zoT_hEeGysvimLgYv4A">
        <language>Analysis</language>
        <language>OCL</language>
        <body>SHALL include an Assessment and Plan Section, or an Assessment Section and a Plan Section</body>
        <body>(self.getAllSections()->one(section : cda::Section | not section.oclIsUndefined() and section.oclIsKindOf(consol::PlanOfCareSection)) and  self.getAllSections()->one(section : cda::Section | not section.oclIsUndefined() and section.oclIsKindOf(consol::AssessmentSection))) xor self.getAllSections()->one(section : cda::Section | not section.oclIsUndefined() and section.oclIsKindOf(consol::AssessmentAndPlanSection))</body>
      </specification>
    </ownedRule>
    <ownedRule xmi:id="_lKUtMD_hEeGysvimLgYv4A" name="doesNotHaveIndividualAssementAndPlanSectionsWhenAssementAndPlanSectionPresent" constrainedElement="_-Qa60D1jEeG3tde5scYNWA">
      <specification xmi:type="uml:OpaqueExpression" xmi:id="_lKUtMT_hEeGysvimLgYv4A">
        <language>Analysis</language>
        <language>OCL</language>
        <body>SHALL NOT include an Assessment/Plan Section when an Assessment Section and a Plan of Care Section are present</body>
        <body>(self.getAllSections()->one(section : cda::Section | not section.oclIsUndefined() and section.oclIsKindOf(consol::PlanOfCareSection)) or  self.getAllSections()->one(section : cda::Section | not section.oclIsUndefined() and section.oclIsKindOf(consol::AssessmentSection))) xor self.getAllSections()->one(section : cda::Section | not section.oclIsUndefined() and section.oclIsKindOf(consol::AssessmentAndPlanSection))</body>
      </specification>
    </ownedRule>
    <generalization xmi:id="_UCQbAD_LEeGXieeKs7NJjA" general="_2DNRcBSVEeGGzu7fmW9pXw"/>
    <ownedAttribute xmi:id="_X72iwD_LEeGXieeKs7NJjA" name="code" visibility="private" aggregation="composite" redefinedProperty="_2DNR5RSVEeGGzu7fmW9pXw">
      <ownedComment xmi:id="_pChhED_REeGXieeKs7NJjA">
        <body>The Progress Note limits document type codes to those codes listed in the Progress Note LOINC Document Codes, as of publication of this implementation guide. This is a dynamic value set meaning that these codes may be added to or deprecated by LOINC. The table lists all codes that have the scale DOC (document) and a 'component' referring to &quot;subsequent evaluation notes&quot;. &#xD;
&#xD;
The Progress Note recommends use of a single document type code, 11506-3 &quot;Subsequent evaluation note&quot;, using post-coordination for author or performer, setting, or specialty. Some of the LOINC codes in the Progress Note LOINC Document Codes table are pre-coordinated with the practice setting or the training or professional level of the author. Use of pre-coordinated codes is not recommended because of potential conflict with other information in the header.  When these pre-coordinated codes are used, any coded values describing the author or performer of the service act or the practice setting must be consistent with the LOINC document type. Note: The LOINC display name &quot;Subsequent evaluation note&quot; is equivalent to Progress Note.</body>
      </ownedComment>
      <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_Z1EGIDxaEd6JwqSGecoePg"/>
      <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_X72iwT_LEeGXieeKs7NJjA" value="1"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_X72iwj_LEeGXieeKs7NJjA" value="1"/>
    </ownedAttribute>
    <ownedAttribute xmi:id="_O246oD_REeGXieeKs7NJjA" name="documentationOf" type="_aemW4D_MEeGXieeKs7NJjA" association="_O246oj_REeGXieeKs7NJjA">
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_O246oT_REeGXieeKs7NJjA"/>
    </ownedAttribute>
    <ownedAttribute xmi:id="_R2OZkD_REeGXieeKs7NJjA" name="componentOf" type="_xFWhUD_MEeGXieeKs7NJjA" association="_R2OZkj_REeGXieeKs7NJjA">
      <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_nhniMPK-EeGFUPBL8qS7yQ" value="1"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_nhoJQPK-EeGFUPBL8qS7yQ" value="1"/>
    </ownedAttribute>
    <ownedAttribute xmi:id="_AERwAD_TEeGXieeKs7NJjA" name="assessmentSection" association="_AERwAj_TEeGXieeKs7NJjA">
      <type xmi:type="uml:Class" href="consol-other.uml#_W8pI4DszEeGvzMYhXuqAEA"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_AERwAT_TEeGXieeKs7NJjA"/>
    </ownedAttribute>
    <ownedAttribute xmi:id="_DmxmYD_TEeGXieeKs7NJjA" name="planOfCareSection" association="_DmxmYj_TEeGXieeKs7NJjA">
      <type xmi:type="uml:Class" href="consol-planofcare.uml#_2NP-QxSVEeGGzu7fmW9pXw"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_DmxmYT_TEeGXieeKs7NJjA"/>
    </ownedAttribute>
    <ownedAttribute xmi:id="_FNS4QD_TEeGXieeKs7NJjA" name="assessmentAndPlanSection" association="_FNS4Qj_TEeGXieeKs7NJjA">
      <type xmi:type="uml:Class" href="consol-other.uml#_2Rwq0BSVEeGGzu7fmW9pXw"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_FNS4QT_TEeGXieeKs7NJjA"/>
    </ownedAttribute>
    <ownedAttribute xmi:id="_Jrs9QD_TEeGXieeKs7NJjA" name="allergiesSectionEntriesOptional" association="_Jrs9Qj_TEeGXieeKs7NJjA">
      <type xmi:type="uml:Class" href="consol-allergies.uml#_bGzYgBVdEeGQCvUGzi1kDQ"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_Jrs9QT_TEeGXieeKs7NJjA"/>
    </ownedAttribute>
    <ownedAttribute xmi:id="_L2R-cD_TEeGXieeKs7NJjA" name="chiefComplaintSection" association="_L2R-cj_TEeGXieeKs7NJjA">
      <type xmi:type="uml:Class" href="consol-other.uml#_2PWQCBSVEeGGzu7fmW9pXw"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_L2R-cT_TEeGXieeKs7NJjA"/>
    </ownedAttribute>
    <ownedAttribute xmi:id="_Q7kdQD_TEeGXieeKs7NJjA" name="interventionsSection" association="_Q7kdQj_TEeGXieeKs7NJjA">
      <type xmi:type="uml:Class" href="consol-other.uml#_hqzJADVyEeGaW4kr-GbV8Q"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_Q7kdQT_TEeGXieeKs7NJjA"/>
    </ownedAttribute>
    <ownedAttribute xmi:id="_WVlO4D_TEeGXieeKs7NJjA" name="medicationsSectionEntriesOptional" association="_WVlO4j_TEeGXieeKs7NJjA">
      <type xmi:type="uml:Class" href="consol-medications.uml#_iAoXEBVdEeGQCvUGzi1kDQ"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_WVlO4T_TEeGXieeKs7NJjA"/>
    </ownedAttribute>
    <ownedAttribute xmi:id="_YYjzQD_TEeGXieeKs7NJjA" name="objectiveSection" association="_YYjzQj_TEeGXieeKs7NJjA">
      <type xmi:type="uml:Class" href="consol-other.uml#_rNJpADVyEeGaW4kr-GbV8Q"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_YYjzQT_TEeGXieeKs7NJjA"/>
    </ownedAttribute>
    <ownedAttribute xmi:id="_cy7s0D_TEeGXieeKs7NJjA" name="physicalExamSection" association="_cy7s0j_TEeGXieeKs7NJjA">
      <type xmi:type="uml:Class" href="consol-exams.uml#_2Pxt0hSVEeGGzu7fmW9pXw"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_cy7s0T_TEeGXieeKs7NJjA"/>
    </ownedAttribute>
    <ownedAttribute xmi:id="_fVXNUD_TEeGXieeKs7NJjA" name="problemSectionEntriesOptional" association="_fVXNUj_TEeGXieeKs7NJjA">
      <type xmi:type="uml:Class" href="consol-problems.uml#_naxrkBVdEeGQCvUGzi1kDQ"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_fVXNUT_TEeGXieeKs7NJjA"/>
    </ownedAttribute>
    <ownedAttribute xmi:id="_ib_nED_TEeGXieeKs7NJjA" name="resultsSectionEntriesOptional" association="_ib_nEj_TEeGXieeKs7NJjA">
      <type xmi:type="uml:Class" href="consol-results.uml#_xGqiEBVdEeGQCvUGzi1kDQ"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_ib_nET_TEeGXieeKs7NJjA"/>
    </ownedAttribute>
    <ownedAttribute xmi:id="_kps0wD_TEeGXieeKs7NJjA" name="reviewOfSystemsSection" association="_kps0wj_TEeGXieeKs7NJjA">
      <type xmi:type="uml:Class" href="consol-exams.uml#_2RqkMBSVEeGGzu7fmW9pXw"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_kps0wT_TEeGXieeKs7NJjA"/>
    </ownedAttribute>
    <ownedAttribute xmi:id="_mj5QkD_TEeGXieeKs7NJjA" name="subjectiveSection" association="_mkCagD_TEeGXieeKs7NJjA">
      <type xmi:type="uml:Class" href="consol-other.uml#_iy8nYDVzEeGaW4kr-GbV8Q"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_mj5QkT_TEeGXieeKs7NJjA"/>
    </ownedAttribute>
    <ownedAttribute xmi:id="_oWB8kD_TEeGXieeKs7NJjA" name="vitalSignsSectionEntriesOptional" association="_oWB8kj_TEeGXieeKs7NJjA">
      <type xmi:type="uml:Class" href="consol-vitalsigns.uml#_bRH8sBVeEeGQCvUGzi1kDQ"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_oWB8kT_TEeGXieeKs7NJjA"/>
    </ownedAttribute>
    <ownedAttribute xmi:id="_j6RBAPK-EeGFUPBL8qS7yQ" name="instructionsSection" association="_j6SPIPK-EeGFUPBL8qS7yQ">
      <type xmi:type="uml:Class" href="consol-other.uml#_4qKukEE1EeGdmoWy_aLP0Q"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_j6RBAfK-EeGFUPBL8qS7yQ"/>
    </ownedAttribute>
    <nestedClassifier xmi:type="uml:Class" xmi:id="_aemW4D_MEeGXieeKs7NJjA" name="DocumentationOf">
      <ownedComment xmi:id="_RZWooD_XEeGnev0fONNFyw">
        <body>INLINE</body>
      </ownedComment>
      <generalization xmi:id="_jl-yID_MEeGXieeKs7NJjA">
        <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_1fhigEcEEd6besF9iFIJkQ"/>
      </generalization>
      <ownedAttribute xmi:id="_CR-nkD_cEeGnev0fONNFyw" name="serviceEvent2" type="_sfqx0D_bEeGnev0fONNFyw" association="_CR-nkj_cEeGnev0fONNFyw">
        <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_wG9c0PK9EeGFUPBL8qS7yQ" value="1"/>
        <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_wG9c0fK9EeGFUPBL8qS7yQ" value="1"/>
      </ownedAttribute>
      <nestedClassifier xmi:type="uml:Class" xmi:id="_sfqx0D_bEeGnev0fONNFyw" name="ServiceEvent2">
        <ownedRule xmi:id="_9PpxYPK9EeGFUPBL8qS7yQ" name="effectiveTimeLow" constrainedElement="_sfqx0D_bEeGnev0fONNFyw">
          <specification xmi:type="uml:OpaqueExpression" xmi:id="_BZn3cPK-EeGFUPBL8qS7yQ">
            <language>Analysis</language>
            <language>OCL</language>
            <body>The serviceEvent/effectiveTime element SHOULD be present with effectiveTime/low element</body>
            <body>self.effectiveTime->forAll(not low.oclIsUndefined())</body>
          </specification>
        </ownedRule>
        <ownedRule xmi:id="_9tVL4PK9EeGFUPBL8qS7yQ" name="effectiveTimeHigh" constrainedElement="_sfqx0D_bEeGnev0fONNFyw">
          <specification xmi:type="uml:OpaqueExpression" xmi:id="_DIRKkPK-EeGFUPBL8qS7yQ">
            <language>Analysis</language>
            <language>OCL</language>
            <body>If a width element is not present, the serviceEvent SHALL include effectiveTime/</body>
            <body>self.effectiveTime->forAll(width.oclIsUndefined() implies not high.oclIsUndefined())</body>
          </specification>
        </ownedRule>
        <ownedRule xmi:id="_0IhrUGd2EeO8u4bjJ5HCCg" name="preciseToTheDay" constrainedElement="_sfqx0D_bEeGnev0fONNFyw">
          <specification xmi:type="uml:OpaqueExpression" xmi:id="_0IhrUWd2EeO8u4bjJ5HCCg">
            <language>OCL</language>
            <language>Analysis</language>
            <body>(not self.effectiveTime.low.value.oclIsUndefined() implies self.effectiveTime.low.value.size() >= 8) and (not self.effectiveTime.high.value.oclIsUndefined() implies self.effectiveTime.high.value.size() >= 8)</body>
            <body>The content of effectiveTime conforms to US Realm Date and Time (DT.US.FIELDED) (2.16.840.1.113883.10.20.22.5.4). SHALL be precise to the day</body>
          </specification>
        </ownedRule>
        <ownedRule xmi:id="_1sibwGd2EeO8u4bjJ5HCCg" name="preciseToTheMinute" constrainedElement="_sfqx0D_bEeGnev0fONNFyw">
          <specification xmi:type="uml:OpaqueExpression" xmi:id="_1sibwWd2EeO8u4bjJ5HCCg">
            <language>OCL</language>
            <language>Analysis</language>
            <body>(not self.effectiveTime.low.value.oclIsUndefined() implies self.effectiveTime.low.value.size() >= 12) and (not self.effectiveTime.high.value.oclIsUndefined() implies self.effectiveTime.high.value.size() >= 12)</body>
            <body>The content of effectiveTime conforms to US Realm Date and Time (DT.US.FIELDED) (2.16.840.1.113883.10.20.22.5.4). SHOULD be precise to the minute</body>
          </specification>
        </ownedRule>
        <ownedRule xmi:id="_265sUGd2EeO8u4bjJ5HCCg" name="preciseToTheSecond" constrainedElement="_sfqx0D_bEeGnev0fONNFyw">
          <specification xmi:type="uml:OpaqueExpression" xmi:id="_265sUWd2EeO8u4bjJ5HCCg">
            <language>OCL</language>
            <language>Analysis</language>
            <body>(not self.effectiveTime.low.value.oclIsUndefined() implies self.effectiveTime.low.value.size() >= 14) and (not self.effectiveTime.high.value.oclIsUndefined() implies self.effectiveTime.high.value.size() >= 14)</body>
            <body>The content of effectiveTime conforms to US Realm Date and Time (DT.US.FIELDED) (2.16.840.1.113883.10.20.22.5.4). MAY be precise to the second</body>
          </specification>
        </ownedRule>
        <ownedRule xmi:id="_4PDb0Gd2EeO8u4bjJ5HCCg" name="ifMorePreciseThanDayIncludeTimeZoneOffset" constrainedElement="_sfqx0D_bEeGnev0fONNFyw">
          <specification xmi:type="uml:OpaqueExpression" xmi:id="_4PDb0Wd2EeO8u4bjJ5HCCg">
            <language>OCL</language>
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            <body>(not self.effectiveTime.low.value.oclIsUndefined() and self.effectiveTime.low.value.size() > 8 implies self.effectiveTime.low.value.size() >= 15) and (not self.effectiveTime.high.value.oclIsUndefined() and self.effectiveTime.high.value.size() > 8 implies self.effectiveTime.high.value.size() >= 15)</body>
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            <body>The content of effectiveTime conforms to US Realm Date and Time (DT.US.FIELDED) (2.16.840.1.113883.10.20.22.5.4). SHALL be precise to the day</body>
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            <body>The content of effectiveTime conforms to US Realm Date and Time (DT.US.FIELDED) (2.16.840.1.113883.10.20.22.5.4). SHOULD be precise to the minute</body>
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            <body>The content of effectiveTime conforms to US Realm Date and Time (DT.US.FIELDED) (2.16.840.1.113883.10.20.22.5.4). MAY be precise to the second</body>
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            <body>The content of effectiveTime conforms to US Realm Date and Time (DT.US.FIELDED) (2.16.840.1.113883.10.20.22.5.4). If more precise than day, SHOULD include time-zone offset</body>
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        <body>Given that DIR documents may be transformed from established collections of imaging reports already stored with their own type codes, there is no static set of Document Type codes. The set of LOINC codes listed in the DIR LOINC Document Type Codes table may be extended by additions to LOINC and supplemented by local codes as translations.&#xD;
The DIR document recommends use of a single document type code, 18748-4 &quot;Diagnostic Imaging Report&quot;, with further specification provided by author or performer, setting, or specialty. Some of these codes in the DIR LOINC Document Type Codes table are pre-coordinated with either the imaging modality, body part examined, or specific imaging method such as the view.  Use of these codes is not recommended, as this duplicates information potentially present with the header. When pre-coordinated codes are used, any coded values describing the author or performer of the service act or the practice setting must be consistent with the LOINC document type. This table is drawn from LOINC Version 2.36, June 30, 2011, and consists of codes whose scale is DOC and that refer to reports for diagnostic imaging procedures.</body>
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        <body>If participant is present, the assignedEntity/assignedPerson element SHALL be present and SHALL represent the physician requesting the imaging procedure (the referring physician AssociatedEntity that is the target of ClincalDocument/participant@typeCode=REF).</body>
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      <ownedComment xmi:id="_7I_5APLgEeGHzIc9Q7dMxA">
        <body>INLINE</body>
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          <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_8OcHAEcDEd6besF9iFIJkQ"/>
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        <body>An inFulfillmentOf element represents the Placer Order that is either a group of orders (modeled as PlacerGroup in the Placer Order RMIM of the Orders &amp; Observations domain) or a single order item (modeled as ObservationRequest in the same RMIM).  This optionality reflects two major approaches to the grouping of procedures as implemented in the installed base of imaging information systems.  These approaches differ in their handling of grouped procedures and how they are mapped to identifiers in the Digital Imaging and Communications in Medicine (DICOM) image and structured reporting data.  The example of a CT examination covering chest, abdomen, and pelvis will be used in the discussion below.&#xD;
In the IHE Scheduled Workflow model, the Chest CT, Abdomen CT, and Pelvis CT each represent a Requested Procedure, and all three procedures are grouped under a single Filler Order.  The Filler Order number maps directly to the DICOM Accession Number in the DICOM imaging and report data.&#xD;
A widely deployed alternative approach maps the requested procedure identifiers directly to the DICOM Accession Number.  The Requested Procedure ID in such implementations may or may not be different from the Accession Number, but is of little identifying importance because there is only one Requested Procedure per Accession Number.  There is no identifier that formally connects the requested procedures ordered in this group.&#xD;
In both cases, inFulfillmentOf/order/id is mapped to the DICOM Accession Number in the imaging data.</body>
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        <body>Each documentationOf/serviceEvent indicates an imaging procedure that the provider describes and interprets in the content of the DIR. The main activity being described by this document is the interpretation of the imaging procedure. This is shown by setting the value of the @classCode attribute of the serviceEvent element to ACT, and indicating the duration over which care was provided in the effectiveTime element. Within each documentationOf element, there is one serviceEvent element. This event is the unit imaging procedure corresponding to a billable item. The type of imaging procedure may be further described in the serviceEvent/code element.  This guide makes no specific recommendations about the vocabulary to use for describing this event.&#xD;
 &#xD;
In IHE Scheduled Workflow environments, one serviceEvent/id element contains the DICOM Study Instance UID from the Modality Worklist, and the second serviceEvent/id element contains the DICOM Requested Procedure ID from the Modality Worklist. These two ids are in a single serviceEvent.&#xD;
The effectiveTime for the serviceEvent covers the duration of the imaging procedure being reported. This event should have one or more performers, which may participate at the same or different periods of time.</body>
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&#xD;
OIDs SHALL be no more than 64 characters in length..</body>
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            <language>OCL</language>
            <language>Analysis</language>
            <body>not self.effectiveTime.value.oclIsUndefined() implies self.effectiveTime.value.size() >= 12</body>
            <body>The content of effectiveTime conforms to US Realm Date and Time (DT.US.FIELDED) (2.16.840.1.113883.10.20.22.5.4). SHOULD be precise to the minute</body>
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        </ownedRule>
        <ownedRule xmi:id="_DftyYGdkEeO8u4bjJ5HCCg" name="preciseToTheSecond" constrainedElement="_lxDCoEVKEeGAh_iQGJvI5w">
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            <language>OCL</language>
            <language>Analysis</language>
            <body>not self.effectiveTime.value.oclIsUndefined() implies self.effectiveTime.value.size() >= 14</body>
            <body>The content of effectiveTime conforms to US Realm Date and Time (DT.US.FIELDED) (2.16.840.1.113883.10.20.22.5.4). MAY be precise to the second</body>
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            <language>Analysis</language>
            <body>not self.effectiveTime.value.oclIsUndefined() and self.effectiveTime.value.size() > 8 implies self.effectiveTime.value.size() >= 15</body>
            <body>The content of effectiveTime conforms to US Realm Date and Time (DT.US.FIELDED) (2.16.840.1.113883.10.20.22.5.4). If more precise than day, SHOULD include time-zone offset</body>
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          <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_j5JZsEAJEd6wZe6nFLrjsw"/>
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          <ownedComment xmi:id="__KaUIEb2EeGp67IkyTw1fg">
            <body>In the case of transformed DICOM SR documents, an appropriate null flavor MAY be used if the id is unavailable.</body>
          </ownedComment>
          <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_culQ8DxaEd6JwqSGecoePg"/>
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          <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_kfYp8EozEd6c3qsAxlFHaQ"/>
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        <ownedAttribute xmi:id="_v99YEEb2EeGp67IkyTw1fg" name="physicianofRecordParticipant">
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          <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_HfEbMUrXEeGJpZWiuxRVIw"/>
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            <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_hfdrgEcaEd6besF9iFIJkQ"/>
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          <ownedAttribute xmi:id="_dTg1sEb3EeGp67IkyTw1fg" name="assignedEntity" type="_ftDAQEb0EeGp67IkyTw1fg">
            <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_dF8yYPKvEeGFUPBL8qS7yQ" value="1"/>
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                <language>OCL</language>
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    <ruleId>CONF:14834</ruleId>
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    <ruleId>CONF:8430</ruleId>
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    <ruleId>CONF:8435</ruleId>
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      <body>CARE PLAN FRAMEWORK&#xD;
A Care Plan is a consensus-driven dynamic plan that represents all of a patient's and Care Team Members' prioritized concerns, goals, and planned interventions. It serves as a blueprint shared by all Care Team Members, including the patient, to guide the Care Team Members (including Patients, their caregivers, providers and patient's care. A Care Plan integrates multiple interventions proposed by multiple providers and disciplines for multiple conditions.&#xD;
A Care Plan represents one or more Plan(s) of Care and serves to reconcile and resolve conflicts between the various Plans of Care developed for a specific patient by different providers. While both a plan of care and a care plan include the patient's life goals and require Care Team Members (including patients) to prioritize goals and interventions, the reconciliation process becomes more complex as the number of plans of care increases. The Care Plan also serves to enable longitudinal coordination of care.&#xD;
The CDA Care Plan represents an instance of this dynamic Care Plan at a point in time. The CDA document itself is NOT dynamic.&#xD;
Key differentiators between a Care Plan CDA and CCD (another &quot;snapshot in time&quot; document):&#xD;
•  Requires relationships between various acts:&#xD;
        o  Health Concerns&#xD;
        o  Problems&#xD;
        o  Interventions&#xD;
        o  Goals&#xD;
        o  Outcomes&#xD;
•  Provides the ability to identify patient and provider priorities with each act&#xD;
•  Provides a header participant to indicate occurrences of Care Plan review&#xD;
Please see: Appendix E in Volume 1 of this guide to view Care Plan Relationship Diagrams and story board.</body>
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    <nestedClassifier xmi:type="uml:Class" xmi:id="_fgKZEJ8BEeOr4eM3k36wAg" name="ParticipantCaregiver">
      <ownedComment xmi:id="_lUehEJ8BEeOr4eM3k36wAg">
        <body>INLINE</body>
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      <ownedComment xmi:id="_msxJsJ8BEeOr4eM3k36wAg">
        <body>participant&#xD;
This participant identifies individuals who support the patient such as a relative or caregiver.</body>
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          <generalization xmi:id="_15oOEJ8EEeOr4eM3k36wAg">
            <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_Je2yMEcaEd6besF9iFIJkQ"/>
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            <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_L08A0ErgEd6FXKclYGEDCw"/>
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    </nestedClassifier>
    <nestedClassifier xmi:type="uml:Class" xmi:id="_LbFScJ8HEeOr4eM3k36wAg" name="DocumentationOf">
      <ownedComment xmi:id="_N-0agJ8HEeOr4eM3k36wAg">
        <body>INLINE</body>
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      <generalization xmi:id="_LbHHoJ8HEeOr4eM3k36wAg">
        <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_1fhigEcEEd6besF9iFIJkQ"/>
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      <ownedAttribute xmi:id="_gR2tAJ8HEeOr4eM3k36wAg" name="serviceEvent" type="_ojYeUJ8HEeOr4eM3k36wAg" association="_gR37IJ8HEeOr4eM3k36wAg">
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        <ownedComment xmi:id="_z6PB0J8HEeOr4eM3k36wAg">
          <body>serviceEvent&#xD;
The serviceEvent describes the provision of healthcare over a period of time.  The duration over which care was provided is indicated in serviceEvent/effectiveTime. Additional data from outside this duration may also be included if it is relevant to care provided during that time range (e.g. reviewed during the stated time range).</body>
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        <ownedAttribute xmi:id="_COQc4J8PEeOr4eM3k36wAg" name="performer1" type="_mSfqsJ8QEeOr4eM3k36wAg" association="_CORrAJ8PEeOr4eM3k36wAg">
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            <body>performer&#xD;
The performer(s) represents the healthcare providers involved in the current or historical care of the patient.The patient's key healthcare providers would be listed here which would include the primary physician and any active consulting physicians, therapists, counselors, and care team members.</body>
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          <ownedAttribute xmi:id="_AsGbsJ8REeOr4eM3k36wAg" name="assignedEntity" type="_gOCYcJ8REeOr4eM3k36wAg" association="_AsHp0J8REeOr4eM3k36wAg">
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            <ownedAttribute xmi:id="_imp1oJ8REeOr4eM3k36wAg" name="code" visibility="private" aggregation="composite">
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        <body>INLINE</body>
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      <ownedComment xmi:id="_bFKvQJ8TEeOr4eM3k36wAg">
        <body>relatedDocument&#xD;
The Care Plan is continually evolving and dynamic. The Care Plan CDA instance is NOT dynamic. Each time a Care Plan CDA is generated it represents a snapshot in time of the Care Plan at that moment. Whenever a care provider or patient generates a Care Plan, it should be noted through relatedDocument whether the current Care Plan replaces or appends another Care Plan. The relatedDocumentTypeCode indicates whether the current document is an addendum to the ParentDocument (APND (append)) or the current document is a replacement of the ParentDocument (RPLC (replace)).</body>
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      <generalization xmi:id="_MHLF8J8TEeOr4eM3k36wAg">
        <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_d3mM8EcaEd6besF9iFIJkQ"/>
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        <body>INLINE</body>
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        <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_NWHRoEAJEd6wZe6nFLrjsw"/>
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    <ruleId>CONF:28742</ruleId>
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    <ruleId>CONF:28748</ruleId>
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    <ruleId>CONF:28746</ruleId>
    <ruleId>CONF:28747</ruleId>
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  <CDA:AssociationValidation xmi:id="_4_MTQJ50EeOr4eM3k36wAg" severity="WARNING" base_Association="_2aBAwJ50EeOr4eM3k36wAg">
    <ruleId>CONF:31993</ruleId>
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  <uml:Association xmi:id="_StfLgJ53EeOr4eM3k36wAg" memberEnd="_Std9YJ53EeOr4eM3k36wAg _StfLgZ53EeOr4eM3k36wAg">
    <ownedEnd xmi:id="_StfLgZ53EeOr4eM3k36wAg" type="_fneAkJ51EeOr4eM3k36wAg" association="_StfLgJ53EeOr4eM3k36wAg"/>
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    <ruleId>CONF:31994</ruleId>
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    <ruleId>CONF:31997</ruleId>
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    <ruleId>CONF:32003</ruleId>
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    <ruleId>CONF:31914</ruleId>
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    <ruleId>CONF:31915</ruleId>
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    <ruleId>CONF:31917</ruleId>
    <ruleId>CONF:31918</ruleId>
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    <ruleId>CONF:31677</ruleId>
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    <ruleId>CONF:31678</ruleId>
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    <ruleId>CONF:31679</ruleId>
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    <ruleId>CONF:31682</ruleId>
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    <reference href="../../../org.openhealthtools.mdht.uml.term.models/model/CodeSystems.uml#_ya6aMCWsEd-iTYfpNb4PkQ"/>
    <ruleId>CONF:31680</ruleId>
    <ruleId>CONF:31681</ruleId>
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    <ruleId>CONF:31683</ruleId>
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    <ruleId>CONF:31686</ruleId>
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    <ruleId>CONF:31684</ruleId>
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    <reference href="../consol-vocab.uml#_x4P9YZ6CEeOr4eM3k36wAg"/>
    <ruleId>CONF:31685</ruleId>
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    <ruleId>CONF:31895</ruleId>
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    <ruleId>CONF:31896</ruleId>
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    <ruleId>CONF:31897</ruleId>
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    <reference href="../consol-vocab.uml#_4m1G4EFaEeGFqszUdHc61Q"/>
    <ruleId>CONF:31898</ruleId>
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    <ruleId>CONF:31899</ruleId>
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    <ruleId>CONF:31900</ruleId>
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    <ownedEnd xmi:id="__jk48Z8GEeOr4eM3k36wAg" type="_2jWfwJ5wEeOr4eM3k36wAg" association="__jk48J8GEeOr4eM3k36wAg"/>
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    <ruleId>CONF:31901</ruleId>
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    <ruleId>CONF:31902</ruleId>
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  <CDA:PropertyValidation xmi:id="_BocBwJ8JEeOr4eM3k36wAg" base_Property="_rDKTcJ8HEeOr4eM3k36wAg">
    <ruleId>CONF:31903</ruleId>
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    <ruleId>CONF:31904</ruleId>
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    <ownedEnd xmi:id="_CORrAZ8PEeOr4eM3k36wAg" type="_ojYeUJ8HEeOr4eM3k36wAg" association="_CORrAJ8PEeOr4eM3k36wAg"/>
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  <CDA:AssociationValidation xmi:id="_EcDKIJ8PEeOr4eM3k36wAg" base_Association="_CORrAJ8PEeOr4eM3k36wAg">
    <ruleId>CONF:31905</ruleId>
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  <CDA:PropertyValidation xmi:id="_4eFRYJ8QEeOr4eM3k36wAg" base_Property="_o45sQJ8QEeOr4eM3k36wAg">
    <ruleId>CONF:31906</ruleId>
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    <ownedEnd xmi:id="_AsIQ4J8REeOr4eM3k36wAg" type="_mSfqsJ8QEeOr4eM3k36wAg" association="_AsHp0J8REeOr4eM3k36wAg"/>
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  <CDA:AssociationValidation xmi:id="_BmwtIJ8REeOr4eM3k36wAg" severity="WARNING" base_Association="_AsHp0J8REeOr4eM3k36wAg">
    <ruleId>CONF:31907</ruleId>
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    <ruleId>CONF:31908</ruleId>
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    <ruleId>CONF:31909</ruleId>
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    <ruleId>CONF:29893</ruleId>
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    <reference href="../consol-vocab.uml#_pucs0J8TEeOr4eM3k36wAg"/>
    <ruleId>CONF:31889</ruleId>
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    <ruleId>CONF:29894</ruleId>
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    <ruleId>CONF:28755</ruleId>
    <ruleId>CONF:28756</ruleId>
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    <ruleId>CONF:28761</ruleId>
    <ruleId>CONF:28762</ruleId>
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    <ruleId>CONF:29596</ruleId>
    <ruleId>CONF:29597</ruleId>
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    <ruleId>CONF:31044</ruleId>
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  <uml:Class xmi:id="_itRPkKAEEeOQs7VC4HptuQ" name="ReferralNote">
    <ownedComment xmi:id="_3p_hIKAEEeOQs7VC4HptuQ">
      <body>This document communicates pertinent patient information to the consulting provider from a referring provider. The information in this document includes the reason for the referral and additional medical information that would augment care delivery. &#xD;
Examples of referral situations are when a patient is referred from a family physician to a cardiologist for follow up for a cardiac condition or a when patient is sent by a primary care provider to an emergency department.</body>
    </ownedComment>
    <ownedRule xmi:id="_Y-s94KAXEeOQs7VC4HptuQ" name="hasAnAssementAndPlanSecV2OrAssementSecAndPlanOfTreatmentSecV2" constrainedElement="_itRPkKAEEeOQs7VC4HptuQ">
      <specification xmi:type="uml:OpaqueExpression" xmi:id="_3CkaIKAXEeOQs7VC4HptuQ">
        <language>Analysis</language>
        <body>SHALL include an Assessment and Plan Section (V2) (templateId: 2.16.840.1.113883.10.20.22.2.9.2) OR an Assessment Section (templateId: 2.16.840.1.113883.10.20.22.2.8) and a Plan of Treatment Section (V2) (templateId: 2.16.840.1.113883.10.20.22.2.10.2)</body>
      </specification>
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      <specification xmi:type="uml:OpaqueExpression" xmi:id="_Dun2AKAYEeOQs7VC4HptuQ">
        <language>Analysis</language>
        <body>SHALL NOT include an Assessment and Plan Section (V2) (templateId: 2.16.840.1.113883.10.20.22.2.9.2) when an Assessment Section (templateId: 2.16.840.1.113883.10.20.22.2.8) and a Plan of Treatment Section (V2) (templateId: 2.16.840.1.113883.10.20.22.2.10.2) are present</body>
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    <ownedAttribute xmi:id="_x7GrsKAEEeOQs7VC4HptuQ" name="code" visibility="private" aggregation="composite" redefinedProperty="_2DNR5RSVEeGGzu7fmW9pXw">
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        <body>The Referral note recommends use of the document type code 57113-1 &quot;Referral Note&quot;, with further specification provided by author or performer, setting, or specialty. When pre-coordinated codes are used, any coded values describing the author or performer of the service act or the practice setting must be consistent with the LOINC document type. For example, an Obstetrics and Gynecology Referral note would not be authored by a Pediatric Cardiologist.</body>
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      <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_Z1EGIDxaEd6JwqSGecoePg"/>
      <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_x7GrsaAEEeOQs7VC4HptuQ" value="1"/>
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    <ownedAttribute xmi:id="_x7KWEKAEEeOQs7VC4HptuQ" name="title" visibility="private" aggregation="composite" redefinedProperty="_2DNR9xSVEeGGzu7fmW9pXw">
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    </ownedAttribute>
    <ownedAttribute xmi:id="_kakXgKAHEeOQs7VC4HptuQ" name="informationRecipient" type="_vPn1gKAHEeOQs7VC4HptuQ" association="_kalloKAHEeOQs7VC4HptuQ">
      <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_mVbhsKAHEeOQs7VC4HptuQ" value="1"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_mVbhsaAHEeOQs7VC4HptuQ" value="1"/>
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    <ownedAttribute xmi:id="_YWyDQKAMEeOQs7VC4HptuQ" name="participantCaregiver" type="_nwIL0KAMEeOQs7VC4HptuQ" association="_YWz4cKAMEeOQs7VC4HptuQ">
      <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_YWyqUaAMEeOQs7VC4HptuQ" value="*"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_YWyqUKAMEeOQs7VC4HptuQ"/>
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    <ownedAttribute xmi:id="_4AG6EKAPEeOQs7VC4HptuQ" name="participantCallbackContact" type="_P2_2sKAQEeOQs7VC4HptuQ" association="_4AIvQKAPEeOQs7VC4HptuQ">
      <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_4AHhIaAPEeOQs7VC4HptuQ" value="*"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_4AHhIKAPEeOQs7VC4HptuQ"/>
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    <ownedAttribute xmi:id="_6MiYkKATEeOQs7VC4HptuQ" name="chiefComplaintSection" association="_6MjmsKATEeOQs7VC4HptuQ">
      <type xmi:type="uml:Class" href="consol-other.uml#_2PWQCBSVEeGGzu7fmW9pXw"/>
      <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_6Mi_oaATEeOQs7VC4HptuQ" value="*"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_6Mi_oKATEeOQs7VC4HptuQ"/>
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    <ownedAttribute xmi:id="_qwN_EKAUEeOQs7VC4HptuQ" name="chiefComplaintAndReasonForVisitSection" association="_qwPNMKAUEeOQs7VC4HptuQ">
      <type xmi:type="uml:Class" href="consol-other.uml#_oI7CQCsaEeGHF88-qhhUMA"/>
      <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_ynVsUKAUEeOQs7VC4HptuQ" value="1"/>
      <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_ynWTYKAUEeOQs7VC4HptuQ" value="1"/>
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    <nestedClassifier xmi:type="uml:Class" xmi:id="_vPn1gKAHEeOQs7VC4HptuQ" name="InformationRecipient">
      <ownedComment xmi:id="_yQNRoKAHEeOQs7VC4HptuQ">
        <body>INLINE</body>
      </ownedComment>
      <ownedComment xmi:id="_5Z4DAKAHEeOQs7VC4HptuQ">
        <body>informationRecipient&#xD;
The information recipient represents the intended recipient of the referral note.</body>
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        <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_I5t6QEcZEd6besF9iFIJkQ"/>
      </generalization>
      <ownedAttribute xmi:id="_--ce0KAHEeOQs7VC4HptuQ" name="intendedRecipient" type="_HFAWQKAIEeOQs7VC4HptuQ" association="_--ds8KAHEeOQs7VC4HptuQ">
        <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_AdeBkKAIEeOQs7VC4HptuQ" value="1"/>
        <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_AdeBkaAIEeOQs7VC4HptuQ" value="1"/>
      </ownedAttribute>
      <nestedClassifier xmi:type="uml:Class" xmi:id="_HFAWQKAIEeOQs7VC4HptuQ" name="IntendedRecipient">
        <generalization xmi:id="_HFAWQaAIEeOQs7VC4HptuQ">
          <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_TWL5IEcZEd6besF9iFIJkQ"/>
        </generalization>
        <ownedAttribute xmi:id="_Ma6D8KAIEeOQs7VC4HptuQ" name="addr" visibility="private" aggregation="composite">
          <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_v0zRUD5yEd6cla2oXsPtlA"/>
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          <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_CwF2EEo5Ed6c3qsAxlFHaQ"/>
        </ownedAttribute>
        <ownedAttribute xmi:id="_Ma6rAKAIEeOQs7VC4HptuQ" name="telecom" visibility="private" aggregation="composite">
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          <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_FNTfYEo5Ed6c3qsAxlFHaQ"/>
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          <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_sN4w0KuiEeOhqMhzpJF7Fw" value="1"/>
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        <nestedClassifier xmi:type="uml:Class" xmi:id="_otNC4KujEeOhqMhzpJF7Fw" name="Person">
          <generalization xmi:id="_otNC4aujEeOhqMhzpJF7Fw">
            <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_Je2yMEcaEd6besF9iFIJkQ"/>
          </generalization>
          <ownedAttribute xmi:id="_pYusIKujEeOhqMhzpJF7Fw" name="name" visibility="private" type="_Kj1mIKukEeOhqMhzpJF7Fw" aggregation="composite">
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            <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_L08A0ErgEd6FXKclYGEDCw"/>
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          <nestedClassifier xmi:type="uml:Class" xmi:id="_Kj1mIKukEeOhqMhzpJF7Fw" name="PN">
            <generalization xmi:id="_Kj1mIaukEeOhqMhzpJF7Fw">
              <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_3VD9wD5yEd6cla2oXsPtlA"/>
            </generalization>
            <ownedAttribute xmi:id="_L1gCUKukEeOhqMhzpJF7Fw" name="family" visibility="private" isOrdered="true" isDerived="true" aggregation="composite">
              <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_D7EcAD5zEd6cla2oXsPtlA"/>
              <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_RqL9wKukEeOhqMhzpJF7Fw" value="1"/>
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              <redefinedProperty href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_9IA_sD92Ed6NdqfHy-LGHg"/>
            </ownedAttribute>
            <ownedAttribute xmi:id="_L1gpYKukEeOhqMhzpJF7Fw" name="given" visibility="private" isOrdered="true" isDerived="true" aggregation="composite">
              <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_D7EcAD5zEd6cla2oXsPtlA"/>
              <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_SRspsKukEeOhqMhzpJF7Fw" value="1"/>
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              <redefinedProperty href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_AYLv8D93Ed6NdqfHy-LGHg"/>
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    </nestedClassifier>
    <nestedClassifier xmi:type="uml:Class" xmi:id="_nwIL0KAMEeOQs7VC4HptuQ" name="ParticipantCaregiver">
      <ownedComment xmi:id="_tn3bQKAMEeOQs7VC4HptuQ">
        <body>INLINE</body>
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      <ownedComment xmi:id="_uxq78KAMEeOQs7VC4HptuQ">
        <body>participant&#xD;
The Participants (support) identifies participants who support the patient such as a relative or caregiver.</body>
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      <ownedRule xmi:id="_3bOkwKCmEeOcydnWCT-HhA" name="nullFlavorValueAndTerminology" constrainedElement="_pqQ9QKAMEeOQs7VC4HptuQ">
        <specification xmi:type="uml:OpaqueExpression" xmi:id="_G1Qp0KCnEeOcydnWCT-HhA">
          <language>Analysis</language>
          <body>@nullFlavor SHALL=&quot;IND&quot; Indirect (CodeSystem: HL7ParticipationType 2.16.840.1.113883.5.90)</body>
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      <generalization xmi:id="_nwIy4KAMEeOQs7VC4HptuQ">
        <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_4_GbMEcZEd6besF9iFIJkQ"/>
      </generalization>
      <ownedAttribute xmi:id="_pqQ9QKAMEeOQs7VC4HptuQ" name="nullFlavor" visibility="private">
        <type xmi:type="uml:Enumeration" href="../../../org.openhealthtools.mdht.uml.hl7.vocab/model/vocab.uml#__yyDSUDcEd6xYZuu1VKCVw"/>
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        <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_fSVT4ExwEd6h-an5IXo-DA"/>
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      <ownedAttribute xmi:id="_XdNsEKAOEeOQs7VC4HptuQ" name="associatedEntity" type="_fky3MKAOEeOQs7VC4HptuQ" association="_XdPhQKAOEeOQs7VC4HptuQ">
        <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_ZqNvIKAOEeOQs7VC4HptuQ" value="1"/>
        <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_ZqO9QKAOEeOQs7VC4HptuQ" value="1"/>
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      <nestedClassifier xmi:type="uml:Class" xmi:id="_fky3MKAOEeOQs7VC4HptuQ" name="AssociatedEntity">
        <generalization xmi:id="_fkzeQKAOEeOQs7VC4HptuQ">
          <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_8OcHAEcDEd6besF9iFIJkQ"/>
        </generalization>
        <ownedAttribute xmi:id="_go70wKAOEeOQs7VC4HptuQ" name="classCode" visibility="private">
          <type xmi:type="uml:Enumeration" href="../../../org.openhealthtools.mdht.uml.hl7.vocab/model/vocab.uml#__zE3C0DcEd6xYZuu1VKCVw"/>
        </ownedAttribute>
        <ownedAttribute xmi:id="_A7QsoKAPEeOQs7VC4HptuQ" name="associatedPerson" type="_NeSvYKAPEeOQs7VC4HptuQ" association="_A7R6wKAPEeOQs7VC4HptuQ">
          <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_EzrvsKAPEeOQs7VC4HptuQ" value="1"/>
          <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_EzsWwKAPEeOQs7VC4HptuQ" value="1"/>
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        <nestedClassifier xmi:type="uml:Class" xmi:id="_NeSvYKAPEeOQs7VC4HptuQ" name="AssociatedPerson">
          <generalization xmi:id="_NeTWcKAPEeOQs7VC4HptuQ">
            <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_Je2yMEcaEd6besF9iFIJkQ"/>
          </generalization>
          <ownedAttribute xmi:id="_OFEbgKAPEeOQs7VC4HptuQ" name="name" visibility="private" aggregation="composite">
            <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_3VD9wD5yEd6cla2oXsPtlA"/>
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            <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_L08A0ErgEd6FXKclYGEDCw"/>
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    <nestedClassifier xmi:type="uml:Class" xmi:id="_P2_2sKAQEeOQs7VC4HptuQ" name="ParticipantCallbackContact">
      <ownedComment xmi:id="_VJHQkKAQEeOQs7VC4HptuQ">
        <body>INLINE</body>
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        <body>participant&#xD;
The participants (contact) represent the clinician to contact for questions about the referral summary.  This may represent the clinician who made the referral or the referral nurse.&#xD;
This participant represents the clinician to contact for questions about the referral note.  This call back contact individual may be a different person than the individual(s) identified in the author or legalAuthenticator participant.</body>
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        <specification xmi:type="uml:OpaqueExpression" xmi:id="_K2NA4KAREeOQs7VC4HptuQ">
          <language>Analysis</language>
          <body>The Associated Entity/@classCode SHALL=&quot;ASSIGNED&quot; assigned entity (CodeSystem: RoleClass 2.16.840.1.113883.5.110)</body>
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        <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_4_GbMEcZEd6besF9iFIJkQ"/>
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        <type xmi:type="uml:Enumeration" href="../../../org.openhealthtools.mdht.uml.hl7.vocab/model/vocab.uml#__y7BekDcEd6xYZuu1VKCVw"/>
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          <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_8OcHAEcDEd6besF9iFIJkQ"/>
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        <ownedAttribute xmi:id="__ZB9gKAREeOQs7VC4HptuQ" name="id" visibility="private" aggregation="composite">
          <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_culQ8DxaEd6JwqSGecoePg"/>
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          <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_8KBf0EoeEd6c3qsAxlFHaQ"/>
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        <ownedAttribute xmi:id="__ZBWcKAREeOQs7VC4HptuQ" name="addr" visibility="private" aggregation="composite">
          <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_v0zRUD5yEd6cla2oXsPtlA"/>
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          <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_-czawEoeEd6c3qsAxlFHaQ"/>
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        <ownedAttribute xmi:id="__ZCkkKAREeOQs7VC4HptuQ" name="telecom" visibility="private" aggregation="composite">
          <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_22o_kD52Ed6cla2oXsPtlA"/>
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          <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#__ZTfQEoeEd6c3qsAxlFHaQ"/>
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          <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_zjKW8EcZEd6besF9iFIJkQ"/>
          <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_BSRhoKATEeOQs7VC4HptuQ" value="1"/>
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Standardization of information used in this form will promote interoperability; create information suitable for reuse in quality measurement, public health, research, and for reimbursement.</body>
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        <body>The Transfer Summary recommends use of the document type code 18761-7 &quot;Provider Unspecified Transfer Summary&quot;, with further specification provided by author or performer, setting, or specialty. When pre-coordinated codes are used, any coded values describing the author or performer of the service act or the practice setting must be consistent with the LOINC document type. For example, an Obstetrics and Gynecology Transfer Summary note would not be authored by a Pediatric Cardiologist.</body>
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        <body>INLINE</body>
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        <type xmi:type="uml:PrimitiveType" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_RpDqMDrsEeCN26jpCPaoAw"/>
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        <body>INLINE</body>
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        <body>participant&#xD;
This participant identifies individuals who support the patient such as a relative or caregiver.</body>
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        <body>INLINE</body>
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        <body>participant&#xD;
This participant represents the clinician to contact for questions about the transfer summary.  This call back contact individual may be a different person than the individual(s) identified in the author or legalAuthenticator participant.</body>
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        <ownedAttribute xmi:id="_0t-oo6DYEeOPqKnBFQcY_A" name="telecom" visibility="private" aggregation="composite">
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        <body>INLINE</body>
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          <body>serviceEvent&#xD;
The serviceEvent in a Transfer Note contains the representation of providers who are wholly or partially responsible for the safety and well-being of a subject of care.</body>
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        <generalization xmi:id="_NPQbUKWVEeOPqKnBFQcY_A">
          <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_lriDUEcaEd6besF9iFIJkQ"/>
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        <ownedAttribute xmi:id="_OsJQFKWVEeOPqKnBFQcY_A" name="effectiveTime" visibility="private" aggregation="composite">
          <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_QYeW4D5-Ed6cla2oXsPtlA"/>
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        <ownedAttribute xmi:id="_xxHOsKWVEeOPqKnBFQcY_A" name="performer1" type="_-EJGkKWVEeOPqKnBFQcY_A" association="_xxIc0KWVEeOPqKnBFQcY_A">
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            <body>performer&#xD;
The performer(s) represents the healthcare providers involved in the current or historical care of the patient.The patient's key healthcare providers would be listed here which would include the primary physician and any active consulting physicians, therapists, counselors, and care team members.</body>
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            <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_FvF74EcaEd6besF9iFIJkQ"/>
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    <ruleId>CONF:28241</ruleId>
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  <CDA:AssociationValidation xmi:id="_uLkZoKDaEeOPqKnBFQcY_A" base_Association="_njkK4KDaEeOPqKnBFQcY_A">
    <ruleId>CONF:31632</ruleId>
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    <ruleId>CONF:31633</ruleId>
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  <CDA:AssociationValidation xmi:id="_GsKakKDbEeOPqKnBFQcY_A" severity="INFO" base_Association="_EXd0EKDbEeOPqKnBFQcY_A">
    <ruleId>CONF:31634</ruleId>
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    <ownedEnd xmi:id="_EePuIKWUEeOPqKnBFQcY_A" type="_mgnrsKDQEeOPqKnBFQcY_A" association="_EePHEKWUEeOPqKnBFQcY_A"/>
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    <ruleId>CONF:31574</ruleId>
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    <ruleId>CONF:31576</ruleId>
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    <ruleId>CONF:31577</ruleId>
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    <ruleId>CONF:31578</ruleId>
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        <body>INLINE</body>
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      <ownedComment xmi:id="_hP7_EKk9EeOTwZftO6CV5g">
        <body>recordTarget&#xD;
The recordTarget records the patient whose health information is described by the clinical document; each recordTarget must contain at least one patientRole element. If the document receiver is interested in setting up a translator for the encounter with the patient, the receiver of the document will have to infer the need for a translator, based upon the language skills identified for the patient, the patients language of preference and the predominant language used by the organization receiving the CDA.&#xD;
The patient MAY include 0..] guardian(s). When that role is present, it SHOULD include a code element. The guardian/code element encodes the relationship between the person in the role of guardian and the patient.&#xD;
Does the patient/guardian role refer to legal guardian?  &#xD;
HL7 Vocabulary simply describes guardian as a relationship to a ward.  This need not be a formal legal relationship. &#xD;
If legal guardian exists for the patient, should it be included or only if they are &quot;present&quot; for the generation of the PGD? &#xD;
When a guardian relationship exists for the patient, it may be represented, regardless of who is present at the time the document is generated. &#xD;
Examples for the use of the patient/guardian role:&#xD;
A child's parent MAY be represented in the guardian role.  In this case, the guardian/code element would encode the personal relationship of &quot;mother&quot; for the child's mom or &quot;father&quot; for the child's dad.&#xD;
An elderly person's child MAY be represented in the guardian role. In this case, the guardian/code element would encode the personal relationship of &quot;daughter&quot; or &quot;son&quot;, or if a legal relationship existed, the relationship of &quot;legal guardian&quot; could be encoded.</body>
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      <nestedClassifier xmi:type="uml:Class" xmi:id="_zjgdEKk9EeOTwZftO6CV5g" name="PatientRole">
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        <ownedAttribute xmi:id="_LVPy8KlJEeOTwZftO6CV5g" name="patient" type="_lQMSAKlJEeOTwZftO6CV5g" association="_LVRBEKlJEeOTwZftO6CV5g">
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          <ownedComment xmi:id="_nfNdkKllEeO4L-NdFOGFPw">
            <body>If present, this organization represents the provider organization where the person is claiming to be a patient.&#xD;
Note: If present, this organization represents the provider organization where the person is claiming to be a patient.</body>
          </ownedComment>
          <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_zjKW8EcZEd6besF9iFIJkQ"/>
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            <body>The combination of the @root and @extension attributes record the person's identity in a secure, trusted, and unique way.</body>
          </ownedComment>
          <generalization xmi:id="_NIX-cKk-EeOTwZftO6CV5g">
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        <nestedClassifier xmi:type="uml:Class" xmi:id="_lQMSAKlJEeOTwZftO6CV5g" name="Patient">
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            <ownedAttribute xmi:id="_sGMrEKlKEeOTwZftO6CV5g" name="code" visibility="private" aggregation="composite">
              <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_Z1EGIDxaEd6JwqSGecoePg"/>
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              <generalization xmi:id="_Jd5aUKlKEeOTwZftO6CV5g">
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            </nestedClassifier>
          </nestedClassifier>
          <nestedClassifier xmi:type="uml:Class" xmi:id="_l_etAKlhEeO4L-NdFOGFPw" name="LanguageCommunication">
            <ownedRule xmi:id="_OqdccKljEeO4L-NdFOGFPw" name="ifMoreThanOneLangComm" constrainedElement="_l_etAKlhEeO4L-NdFOGFPw">
              <specification xmi:type="uml:OpaqueExpression" xmi:id="_VGnAgKljEeO4L-NdFOGFPw">
                <language>Analysis</language>
                <body>If more than one languageCommunication is present, only one languageCommunication element SHALL have a preferenceInd with a value of 1</body>
              </specification>
            </ownedRule>
            <generalization xmi:id="_l_fUEKlhEeO4L-NdFOGFPw">
              <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_cHD44EcZEd6besF9iFIJkQ"/>
            </generalization>
            <ownedAttribute xmi:id="_nt1FMKlhEeO4L-NdFOGFPw" name="preferenceInd" visibility="private" aggregation="composite">
              <ownedComment xmi:id="_xMR8oKlhEeO4L-NdFOGFPw">
                <body>Note: Indicates a preference for information about care delivery and treatments be communicated (or translated if needed) into this language.</body>
              </ownedComment>
              <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_r1WssDxjEd6JwqSGecoePg"/>
              <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_nt1FMalhEeO4L-NdFOGFPw" value="1"/>
              <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_nt1FMqlhEeO4L-NdFOGFPw"/>
              <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_pFayMEo5Ed6c3qsAxlFHaQ"/>
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          </nestedClassifier>
        </nestedClassifier>
      </nestedClassifier>
    </nestedClassifier>
    <nestedClassifier xmi:type="uml:Class" xmi:id="_VlzWkKlmEeO4L-NdFOGFPw" name="Author">
      <ownedComment xmi:id="_YYij8KlmEeO4L-NdFOGFPw">
        <body>INLINE</body>
      </ownedComment>
      <ownedComment xmi:id="_aKzLwKlmEeO4L-NdFOGFPw">
        <body>author&#xD;
The author element represents the creator of the clinical document.  The author may be a device, or a person. The person is the patient or the patient's advocate.</body>
      </ownedComment>
      <generalization xmi:id="_Vlz9oKlmEeO4L-NdFOGFPw">
        <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_ChEisEcEEd6besF9iFIJkQ"/>
      </generalization>
      <ownedAttribute xmi:id="_qKrv4KlmEeO4L-NdFOGFPw" name="assignedAuthor" type="_wcg6UKlmEeO4L-NdFOGFPw" association="_qKtlEKlmEeO4L-NdFOGFPw">
        <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_t3s0MKlmEeO4L-NdFOGFPw" value="1"/>
        <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_t3s0MalmEeO4L-NdFOGFPw" value="1"/>
      </ownedAttribute>
      <nestedClassifier xmi:type="uml:Class" xmi:id="_wcg6UKlmEeO4L-NdFOGFPw" name="AssignedAuthor">
        <generalization xmi:id="_wchhYKlmEeO4L-NdFOGFPw">
          <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_z2vcQEcDEd6besF9iFIJkQ"/>
        </generalization>
        <ownedAttribute xmi:id="_zsyYQKlmEeO4L-NdFOGFPw" name="id" visibility="private" type="__Wat0KlmEeO4L-NdFOGFPw" aggregation="composite">
          <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_zsyYQalmEeO4L-NdFOGFPw" value="*"/>
          <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_zsyYQqlmEeO4L-NdFOGFPw" value="1"/>
          <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_IccloEodEd6c3qsAxlFHaQ"/>
        </ownedAttribute>
        <ownedAttribute xmi:id="_zsxxMKlmEeO4L-NdFOGFPw" name="code" visibility="private" type="_lC1aYKloEeO4L-NdFOGFPw" aggregation="composite">
          <ownedComment xmi:id="_Pi9N4KlnEeO4L-NdFOGFPw">
            <body>When the author is a person who is not acting in the role of a clinician, this code encodes the personal or legal relationship between author and the patient.</body>
          </ownedComment>
          <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_Toe40KlnEeO4L-NdFOGFPw" value="1"/>
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          <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_LGBP8EodEd6c3qsAxlFHaQ"/>
        </ownedAttribute>
        <nestedClassifier xmi:type="uml:Class" xmi:id="__Wat0KlmEeO4L-NdFOGFPw" name="II">
          <ownedComment xmi:id="_JbbO8KlnEeO4L-NdFOGFPw">
            <body>The combination of the @root and @extension attributes record the person's identity in a secure, trusted, and unique way.</body>
          </ownedComment>
          <generalization xmi:id="__Wat0almEeO4L-NdFOGFPw">
            <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_culQ8DxaEd6JwqSGecoePg"/>
          </generalization>
          <ownedAttribute xmi:id="__2HhkKlmEeO4L-NdFOGFPw" name="root" visibility="private">
            <type xmi:type="uml:PrimitiveType" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_RpDqMDrsEeCN26jpCPaoAw"/>
            <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="__2HhkalmEeO4L-NdFOGFPw" value="1"/>
            <lowerValue xmi:type="uml:LiteralInteger" xmi:id="__2HhkqlmEeO4L-NdFOGFPw"/>
            <redefinedProperty href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_hVUykDxaEd6JwqSGecoePg"/>
          </ownedAttribute>
        </nestedClassifier>
        <nestedClassifier xmi:type="uml:Class" xmi:id="_lC1aYKloEeO4L-NdFOGFPw" name="CE">
          <ownedRule xmi:id="_6jDakKloEeO4L-NdFOGFPw" name="codeSystemAndTerminology" constrainedElement="_lC1aYKloEeO4L-NdFOGFPw">
            <specification xmi:type="uml:OpaqueExpression" xmi:id="_RmPpYKlpEeO4L-NdFOGFPw">
              <language>Analysis</language>
              <body>The code/@code SHOULD be selected from ValueSet Personal And Legal Relationship Role Type 2.16.840.1.113883.11.20.12.1</body>
            </specification>
          </ownedRule>
          <generalization xmi:id="_lC2BcKloEeO4L-NdFOGFPw">
            <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_Z1EGIDxaEd6JwqSGecoePg"/>
          </generalization>
          <ownedAttribute xmi:id="_sY3z0KloEeO4L-NdFOGFPw" name="code" visibility="private">
            <type xmi:type="uml:PrimitiveType" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_WswmEETbEeC_V4iAGO_Ujg"/>
            <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_y2QG8KloEeO4L-NdFOGFPw" value="1"/>
            <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_y2QG8aloEeO4L-NdFOGFPw" value="1"/>
            <redefinedProperty href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_XcVvsDxkEd6JwqSGecoePg"/>
          </ownedAttribute>
        </nestedClassifier>
      </nestedClassifier>
    </nestedClassifier>
    <nestedClassifier xmi:type="uml:Class" xmi:id="_iLNloKlrEeO4L-NdFOGFPw" name="DataEnterer">
      <ownedComment xmi:id="_kfR6AKlrEeO4L-NdFOGFPw">
        <body>INLINE</body>
      </ownedComment>
      <ownedComment xmi:id="_lcHVsKlrEeO4L-NdFOGFPw">
        <body>dataEnterer&#xD;
The dataEnterer element represents the person who transferred the content, written or dictated by someone else, into the clinical document. The guiding rule of thumb is that an author provides the content found within the header or body of the document, subject to their own interpretation, and the dataEnterer adds that information to the electronic system. In other words, a dataEnterer transfers information from one source to another (e.g., transcription from paper form to electronic system). If the DataEnterer is missing, this role is assumed to be played by the Author.</body>
      </ownedComment>
      <generalization xmi:id="_iLNloalrEeO4L-NdFOGFPw">
        <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_twqZYEcEEd6besF9iFIJkQ"/>
      </generalization>
      <ownedAttribute xmi:id="_0yaKQKlrEeO4L-NdFOGFPw" name="assignedEntity" type="_ARVEoKlsEeO4L-NdFOGFPw" association="_0yb_cKlrEeO4L-NdFOGFPw">
        <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_2IfzcKlrEeO4L-NdFOGFPw" value="1"/>
        <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_2IfzcalrEeO4L-NdFOGFPw" value="1"/>
      </ownedAttribute>
      <nestedClassifier xmi:type="uml:Class" xmi:id="_ARVEoKlsEeO4L-NdFOGFPw" name="AssignedEntity">
        <generalization xmi:id="_ARVrsKlsEeO4L-NdFOGFPw">
          <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_6qmVsEcDEd6besF9iFIJkQ"/>
        </generalization>
        <ownedAttribute xmi:id="_BP93IKlsEeO4L-NdFOGFPw" name="code" visibility="private" aggregation="composite">
          <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_Z1EGIDxaEd6JwqSGecoePg"/>
          <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_BP93IalsEeO4L-NdFOGFPw" value="1"/>
          <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_BP93IqlsEeO4L-NdFOGFPw"/>
          <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_CDS1wEoeEd6c3qsAxlFHaQ"/>
        </ownedAttribute>
      </nestedClassifier>
    </nestedClassifier>
    <nestedClassifier xmi:type="uml:Class" xmi:id="_jpSbQKltEeO4L-NdFOGFPw" name="Informant">
      <ownedComment xmi:id="_nJaTEKltEeO4L-NdFOGFPw">
        <body>INLINE</body>
      </ownedComment>
      <ownedComment xmi:id="_onc-YKltEeO4L-NdFOGFPw">
        <body>informant&#xD;
The informant element describes the source of the information in a medical document.&#xD;
&#xD;
Assigned health care providers may be a source of information when a document is created. (e.g., a nurse's aide who provides information about a recent significant health care event that occurred within an acute care facility.) In these cases, the assignedEntity element is used.&#xD;
&#xD;
When the informant is a personal relation, that informant is represented in the relatedEntity element, even if the personal relation is medical professional.  The code element of the relatedEntity describes the relationship between the informant and the patient. The relationship between the informant and the patient  needs to be described to help the receiver of the clinical document understand the information in the document.</body>
      </ownedComment>
      <generalization xmi:id="_jpTpYKltEeO4L-NdFOGFPw">
        <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_GUBDUEcZEd6besF9iFIJkQ"/>
      </generalization>
      <ownedAttribute xmi:id="_x5r-wKltEeO4L-NdFOGFPw" name="relatedEntity" type="__9G2MKltEeO4L-NdFOGFPw" association="_x5tz8KltEeO4L-NdFOGFPw">
        <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_z5kL0KltEeO4L-NdFOGFPw" value="1"/>
        <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_z5ky4KltEeO4L-NdFOGFPw" value="1"/>
      </ownedAttribute>
      <nestedClassifier xmi:type="uml:Class" xmi:id="__9G2MKltEeO4L-NdFOGFPw" name="RelatedEntity">
        <ownedComment xmi:id="_Bc6cEKluEeO4L-NdFOGFPw">
          <body>Note: Each informant can be either an assignedEntity (a clinician serving the patient) OR a relatedEntity (a person with a personal or legal relationship with the patient).</body>
        </ownedComment>
        <generalization xmi:id="__9HdQKltEeO4L-NdFOGFPw">
          <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_e-h_0EcaEd6besF9iFIJkQ"/>
        </generalization>
        <ownedAttribute xmi:id="_Abai0KluEeO4L-NdFOGFPw" name="code" visibility="private" aggregation="composite">
          <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_Z1EGIDxaEd6JwqSGecoePg"/>
          <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_Abai0aluEeO4L-NdFOGFPw" value="1"/>
          <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_Abai0qluEeO4L-NdFOGFPw"/>
          <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_FfqSEErmEd6FXKclYGEDCw"/>
        </ownedAttribute>
      </nestedClassifier>
    </nestedClassifier>
    <nestedClassifier xmi:type="uml:Class" xmi:id="_aXueYKlvEeO4L-NdFOGFPw" name="Custodian">
      <ownedComment xmi:id="_cZ2uMKlvEeO4L-NdFOGFPw">
        <body>INLINE</body>
      </ownedComment>
      <ownedComment xmi:id="_df_24KlvEeO4L-NdFOGFPw">
        <body>custodian&#xD;
The custodian element represents the organization or person that is in charge of maintaining the document. The custodian is the steward that is entrusted with the care of the document. Every CDA document has exactly one custodian. The custodian participation satisfies the CDA definition of Stewardship. Because CDA is an exchange standard and may not represent the original form of the authenticated document (e.g., CDA could include scanned copy of original), the custodian represents the steward of the original source document. The custodian may be the document originator, a health information exchange, or other responsible party. Also, the custodian may be the patient or an organization acting on behalf of the patient, such as a PHR organization.</body>
      </ownedComment>
      <generalization xmi:id="_aXvFcKlvEeO4L-NdFOGFPw">
        <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_mMYIkEcEEd6besF9iFIJkQ"/>
      </generalization>
      <ownedAttribute xmi:id="_kqAmgKlvEeO4L-NdFOGFPw" name="assignedCustodian" type="_wry9YKlvEeO4L-NdFOGFPw" association="_kqB0oKlvEeO4L-NdFOGFPw">
        <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_nA6zgKlvEeO4L-NdFOGFPw" value="1"/>
        <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_nA7akKlvEeO4L-NdFOGFPw" value="1"/>
      </ownedAttribute>
      <nestedClassifier xmi:type="uml:Class" xmi:id="_wry9YKlvEeO4L-NdFOGFPw" name="AssignedCustodian">
        <generalization xmi:id="_wrzkcKlvEeO4L-NdFOGFPw">
          <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_1G6DoEcDEd6besF9iFIJkQ"/>
        </generalization>
        <ownedAttribute xmi:id="_WERPsKlwEeO4L-NdFOGFPw" name="representedCustodianOrganization" type="_o9IzIKlwEeO4L-NdFOGFPw" association="_WETE4KlwEeO4L-NdFOGFPw">
          <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_aLEF8KlwEeO4L-NdFOGFPw" value="1"/>
          <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_aLEF8alwEeO4L-NdFOGFPw" value="1"/>
        </ownedAttribute>
        <nestedClassifier xmi:type="uml:Class" xmi:id="_o9IzIKlwEeO4L-NdFOGFPw" name="RepresentedCustodianOrganization">
          <ownedComment xmi:id="_zJzbcKlwEeO4L-NdFOGFPw">
            <body>The representedCustodianOrganization may be the person when the document is not maintained by an organization.</body>
          </ownedComment>
          <generalization xmi:id="_o9JaMKlwEeO4L-NdFOGFPw">
            <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_nNMFUEcEEd6besF9iFIJkQ"/>
          </generalization>
          <ownedAttribute xmi:id="_tQ6VcKlwEeO4L-NdFOGFPw" name="id" visibility="private" type="_QOy0oKlxEeO4L-NdFOGFPw" aggregation="composite">
            <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_EBWAUKlxEeO4L-NdFOGFPw" value="*"/>
            <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_EBWAUalxEeO4L-NdFOGFPw" value="1"/>
            <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_BmgG4EowEd6c3qsAxlFHaQ"/>
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          <nestedClassifier xmi:type="uml:Class" xmi:id="_QOy0oKlxEeO4L-NdFOGFPw" name="II">
            <ownedComment xmi:id="_YwlPgKlxEeO4L-NdFOGFPw">
              <body>The combined @root and @extension attributes record the custodian organization's identity in a secure, trusted, and unique way.</body>
            </ownedComment>
            <generalization xmi:id="_QO0CwKlxEeO4L-NdFOGFPw">
              <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_culQ8DxaEd6JwqSGecoePg"/>
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            <ownedAttribute xmi:id="_Qs5s8KlxEeO4L-NdFOGFPw" name="root" visibility="private">
              <type xmi:type="uml:PrimitiveType" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_RpDqMDrsEeCN26jpCPaoAw"/>
              <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_Usd50KlxEeO4L-NdFOGFPw" value="1"/>
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              <redefinedProperty href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_hVUykDxaEd6JwqSGecoePg"/>
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        </nestedClassifier>
      </nestedClassifier>
    </nestedClassifier>
    <nestedClassifier xmi:type="uml:Class" xmi:id="_dKD-8Kl2EeO4L-NdFOGFPw" name="InformationRecipient">
      <ownedComment xmi:id="_ferF4Kl2EeO4L-NdFOGFPw">
        <body>INLINE</body>
      </ownedComment>
      <ownedComment xmi:id="_h5gJkKl2EeO4L-NdFOGFPw">
        <body>informationRecipient&#xD;
The informationRecipient element records the intended recipient of the information at the time the document is created. For example, in cases where the intended recipient of the document is the patient's health chart, set the receivedOrganization to be the scoping organization for that chart.</body>
      </ownedComment>
      <generalization xmi:id="_dKEmAKl2EeO4L-NdFOGFPw">
        <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_I5t6QEcZEd6besF9iFIJkQ"/>
      </generalization>
      <ownedAttribute xmi:id="_mH3ncKl2EeO4L-NdFOGFPw" name="intendedRecipient" type="_uYcWgKl2EeO4L-NdFOGFPw" association="_mH5coKl2EeO4L-NdFOGFPw">
        <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_ni2-wKl2EeO4L-NdFOGFPw" value="1"/>
        <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_ni3l0Kl2EeO4L-NdFOGFPw" value="1"/>
      </ownedAttribute>
      <nestedClassifier xmi:type="uml:Class" xmi:id="_uYcWgKl2EeO4L-NdFOGFPw" name="IntendedRecipient">
        <generalization xmi:id="_uYc9kKl2EeO4L-NdFOGFPw">
          <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_TWL5IEcZEd6besF9iFIJkQ"/>
        </generalization>
        <ownedAttribute xmi:id="_vOlUUKl2EeO4L-NdFOGFPw" name="id" visibility="private" type="_EYRD0Kl3EeO4L-NdFOGFPw" aggregation="composite">
          <ownedComment xmi:id="_-XAE8Kl2EeO4L-NdFOGFPw">
            <body>The combined @root and @extension attributes to record the information recipient's identity in a secure, trusted, and unique way.</body>
          </ownedComment>
          <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_vOlUUal2EeO4L-NdFOGFPw" value="*"/>
          <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_vOlUUql2EeO4L-NdFOGFPw"/>
          <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#__7V2gEo4Ed6c3qsAxlFHaQ"/>
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        <nestedClassifier xmi:type="uml:Class" xmi:id="_EYRD0Kl3EeO4L-NdFOGFPw" name="II">
          <ownedComment xmi:id="_S3GE4Kl3EeO4L-NdFOGFPw">
            <body>For a provider, the id/@root =&quot;2.16.840.1.113883.4.6&quot; indicates the National Provider Identifier where id/@extension is the NPI number for the provider.&#xD;
The ids MAY reference the id of a person or organization entity specified elsewhere in the document.</body>
          </ownedComment>
          <generalization xmi:id="_EYSR8Kl3EeO4L-NdFOGFPw">
            <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_culQ8DxaEd6JwqSGecoePg"/>
          </generalization>
          <ownedAttribute xmi:id="_FGXf8Kl3EeO4L-NdFOGFPw" name="root" visibility="private">
            <type xmi:type="uml:PrimitiveType" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_RpDqMDrsEeCN26jpCPaoAw"/>
            <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_FGXf8al3EeO4L-NdFOGFPw" value="1"/>
            <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_FGXf8ql3EeO4L-NdFOGFPw"/>
            <redefinedProperty href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_hVUykDxaEd6JwqSGecoePg"/>
          </ownedAttribute>
        </nestedClassifier>
      </nestedClassifier>
    </nestedClassifier>
    <nestedClassifier xmi:type="uml:Class" xmi:id="_3qgiUKl3EeO4L-NdFOGFPw" name="LegalAuthenticator">
      <ownedComment xmi:id="_6M6NoKl3EeO4L-NdFOGFPw">
        <body>INLINE</body>
      </ownedComment>
      <ownedComment xmi:id="_7SFtAKl3EeO4L-NdFOGFPw">
        <body>legalAuthenticator&#xD;
In a patient authored document, the legalAuthenticator identifies the single person legally responsible for the document and must be present if the document has been legally authenticated. (Note that per the following section, there may also be one or more document authenticators.) &#xD;
Based on local practice, patient authored documents may be provided without legal authentication. This implies that a patient authored document that does not contain this element has not been legally authenticated.&#xD;
The act of legal authentication requires a certain privilege be granted to the legal authenticator depending upon local policy. All patient documents have the potential for legal authentication, given the appropriate legal authority.&#xD;
Local policies MAY choose to delegate the function of legal authentication to a device or system that generates the document. In these cases, the legal authenticator is the person accepting responsibility for the document, not the generating device or system.&#xD;
Note that the legal authenticator, if present, must be a person.</body>
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      <generalization xmi:id="_3qhJYKl3EeO4L-NdFOGFPw">
        <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_fcTWYEcZEd6besF9iFIJkQ"/>
      </generalization>
      <ownedAttribute xmi:id="_D5UokKl4EeO4L-NdFOGFPw" name="assignedEntity" type="_L8M54Kl4EeO4L-NdFOGFPw" association="_D5VPoKl4EeO4L-NdFOGFPw">
        <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_Fy2WAKl4EeO4L-NdFOGFPw" value="1"/>
        <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_Fy2WAal4EeO4L-NdFOGFPw" value="1"/>
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      <nestedClassifier xmi:type="uml:Class" xmi:id="_L8M54Kl4EeO4L-NdFOGFPw" name="AssignedEntity">
        <generalization xmi:id="_L8OIAKl4EeO4L-NdFOGFPw">
          <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_6qmVsEcDEd6besF9iFIJkQ"/>
        </generalization>
        <ownedAttribute xmi:id="_NYPaEKl4EeO4L-NdFOGFPw" name="id" visibility="private" aggregation="composite">
          <ownedComment xmi:id="_c4TOoKl4EeO4L-NdFOGFPw">
            <body>The combined @root and @extension  attributes to record the information recipient's identity in a secure, trusted, and unique way.</body>
          </ownedComment>
          <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_culQ8DxaEd6JwqSGecoePg"/>
          <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_NYPaEal4EeO4L-NdFOGFPw" value="*"/>
          <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_NYPaEql4EeO4L-NdFOGFPw" value="1"/>
          <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_9JenIEodEd6c3qsAxlFHaQ"/>
        </ownedAttribute>
        <ownedAttribute xmi:id="_NYOzAKl4EeO4L-NdFOGFPw" name="code" visibility="private" type="_j8secKl4EeO4L-NdFOGFPw" aggregation="composite">
          <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_NYOzAal4EeO4L-NdFOGFPw" value="1"/>
          <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_NYOzAql4EeO4L-NdFOGFPw"/>
          <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_CDS1wEoeEd6c3qsAxlFHaQ"/>
        </ownedAttribute>
        <nestedClassifier xmi:type="uml:Class" xmi:id="_j8secKl4EeO4L-NdFOGFPw" name="CE">
          <ownedRule xmi:id="_w1FGIKl4EeO4L-NdFOGFPw" name="codeSystemAndTerminology" constrainedElement="_j8secKl4EeO4L-NdFOGFPw">
            <specification xmi:type="uml:OpaqueExpression" xmi:id="_2vi5cKl4EeO4L-NdFOGFPw">
              <language>Analysis</language>
              <body>The code/@code SHOULD be selected from ValueSet Personal And Legal Relationship Role Type 2.16.840.1.113883.11.20.12.1</body>
            </specification>
          </ownedRule>
          <generalization xmi:id="_j8tFgKl4EeO4L-NdFOGFPw">
            <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_Z1EGIDxaEd6JwqSGecoePg"/>
          </generalization>
          <ownedAttribute xmi:id="_oCUQAKl4EeO4L-NdFOGFPw" name="code" visibility="private">
            <type xmi:type="uml:PrimitiveType" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_WswmEETbEeC_V4iAGO_Ujg"/>
            <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_oCUQAal4EeO4L-NdFOGFPw" value="1"/>
            <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_oCUQAql4EeO4L-NdFOGFPw"/>
            <redefinedProperty href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_XcVvsDxkEd6JwqSGecoePg"/>
          </ownedAttribute>
        </nestedClassifier>
      </nestedClassifier>
    </nestedClassifier>
    <nestedClassifier xmi:type="uml:Class" xmi:id="_TN57AKl6EeO4L-NdFOGFPw" name="Authenticator">
      <ownedComment xmi:id="_VKXAoKl6EeO4L-NdFOGFPw">
        <body>INLINE</body>
      </ownedComment>
      <ownedComment xmi:id="_WkcZAKl6EeO4L-NdFOGFPw">
        <body>authenticator</body>
      </ownedComment>
      <generalization xmi:id="_TN6iEKl6EeO4L-NdFOGFPw">
        <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_BkHyQEcEEd6besF9iFIJkQ"/>
      </generalization>
      <ownedAttribute xmi:id="_a_ox8Kl6EeO4L-NdFOGFPw" name="assignedEntity" type="_0u7aoKl6EeO4L-NdFOGFPw" association="_a_qnIKl6EeO4L-NdFOGFPw">
        <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_cGdQEKl6EeO4L-NdFOGFPw" value="1"/>
        <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_cGd3IKl6EeO4L-NdFOGFPw" value="1"/>
      </ownedAttribute>
      <nestedClassifier xmi:type="uml:Class" xmi:id="_0u7aoKl6EeO4L-NdFOGFPw" name="AssignedEntity">
        <generalization xmi:id="_0u8owKl6EeO4L-NdFOGFPw">
          <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_6qmVsEcDEd6besF9iFIJkQ"/>
        </generalization>
        <ownedAttribute xmi:id="_2K3NI6l6EeO4L-NdFOGFPw" name="id" visibility="private" aggregation="composite">
          <ownedComment xmi:id="_CT-UAKl7EeO4L-NdFOGFPw">
            <body>The combined @root and @extension  attributes to record the authenticator's identity in a secure, trusted, and unique way.</body>
          </ownedComment>
          <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_culQ8DxaEd6JwqSGecoePg"/>
          <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_2K3NJKl6EeO4L-NdFOGFPw" value="*"/>
          <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_2K3NJal6EeO4L-NdFOGFPw" value="1"/>
          <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_9JenIEodEd6c3qsAxlFHaQ"/>
        </ownedAttribute>
        <ownedAttribute xmi:id="_2K3NIKl6EeO4L-NdFOGFPw" name="code" visibility="private" aggregation="composite">
          <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_Z1EGIDxaEd6JwqSGecoePg"/>
          <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_2K3NIal6EeO4L-NdFOGFPw" value="1"/>
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          <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_CDS1wEoeEd6c3qsAxlFHaQ"/>
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      </nestedClassifier>
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    <nestedClassifier xmi:type="uml:Class" xmi:id="_Q7gEAKn9EeO4L-NdFOGFPw" name="Participant">
      <ownedComment xmi:id="_UIGi4Kn9EeO4L-NdFOGFPw">
        <body>INLINE</body>
      </ownedComment>
      <ownedComment xmi:id="_d3c9EKn9EeO4L-NdFOGFPw">
        <body>participant&#xD;
The participant element identifies other supporting participants, including parents, relatives, caregivers, insurance policyholders, guarantors, and other participants related in some way to the patient. &#xD;
A supporting person or organization is an individual or an organization with a relationship to the patient. A supporting person who is playing multiple roles would be recorded in multiple participants (e.g., emergency contact and next-of-kin)</body>
      </ownedComment>
      <ownedRule xmi:id="_0B3UUKn-EeO4L-NdFOGFPw" name="ifTypeCodeINDThenAEClassCodeFromINDRoleclassCodes" constrainedElement="_Q7gEAKn9EeO4L-NdFOGFPw">
        <specification xmi:type="uml:OpaqueExpression" xmi:id="_OUy1kKn_EeO4L-NdFOGFPw">
          <language>Analysis</language>
          <body>Unless otherwise specified by the document specific header constraints, when participant/@typeCode is IND, associatedEntity/@classCode SHALL be selected from ValueSet 2.16.840.1.113883.11.20.9.33 INDRoleclassCodes STATIC 2011-09-30</body>
        </specification>
      </ownedRule>
      <generalization xmi:id="_Q7grEKn9EeO4L-NdFOGFPw">
        <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_4_GbMEcZEd6besF9iFIJkQ"/>
      </generalization>
      <ownedAttribute xmi:id="_SMoUsKn9EeO4L-NdFOGFPw" name="typeCode" visibility="private">
        <type xmi:type="uml:Enumeration" href="../../../org.openhealthtools.mdht.uml.hl7.vocab/model/vocab.uml#__y7BekDcEd6xYZuu1VKCVw"/>
        <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_bmsJsErdEd6FXKclYGEDCw"/>
      </ownedAttribute>
      <ownedAttribute xmi:id="_v-uEcKn9EeO4L-NdFOGFPw" name="associatedEntity" type="_A-NEYKn-EeO4L-NdFOGFPw" association="_v-v5oKn9EeO4L-NdFOGFPw">
        <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_9rqVkKn9EeO4L-NdFOGFPw" value="1"/>
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      <nestedClassifier xmi:type="uml:Class" xmi:id="_A-NEYKn-EeO4L-NdFOGFPw" name="AssociatedEntity">
        <generalization xmi:id="_A-OSgKn-EeO4L-NdFOGFPw">
          <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_8OcHAEcDEd6besF9iFIJkQ"/>
        </generalization>
        <ownedAttribute xmi:id="_BdoLUKn-EeO4L-NdFOGFPw" name="code" visibility="private" aggregation="composite">
          <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_Z1EGIDxaEd6JwqSGecoePg"/>
          <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_BdoLUan-EeO4L-NdFOGFPw" value="1"/>
          <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_BdoLUqn-EeO4L-NdFOGFPw"/>
          <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_9XNrsEoeEd6c3qsAxlFHaQ"/>
        </ownedAttribute>
      </nestedClassifier>
    </nestedClassifier>
    <nestedClassifier xmi:type="uml:Class" xmi:id="_jQUX0KoAEeO4L-NdFOGFPw" name="InFulfillmentOf">
      <ownedComment xmi:id="_lYHKwKoAEeO4L-NdFOGFPw">
        <body>INLINE</body>
      </ownedComment>
      <ownedComment xmi:id="_mWs58KoAEeO4L-NdFOGFPw">
        <body>inFulfillmentOf</body>
      </ownedComment>
      <generalization xmi:id="_jQVl8KoAEeO4L-NdFOGFPw">
        <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_Li14oEcZEd6besF9iFIJkQ"/>
      </generalization>
      <ownedAttribute xmi:id="_q5kBIKoAEeO4L-NdFOGFPw" name="order" type="_KAD_EKoBEeO4L-NdFOGFPw" association="_q5l2UKoAEeO4L-NdFOGFPw">
        <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_t54XgKoAEeO4L-NdFOGFPw" value="1"/>
        <lowerValue xmi:type="uml:LiteralInteger" xmi:id="_t56MsKoAEeO4L-NdFOGFPw" value="1"/>
      </ownedAttribute>
      <nestedClassifier xmi:type="uml:Class" xmi:id="_KAD_EKoBEeO4L-NdFOGFPw" name="Order">
        <generalization xmi:id="_KAFNMKoBEeO4L-NdFOGFPw">
          <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_vgekoEcZEd6besF9iFIJkQ"/>
        </generalization>
        <ownedAttribute xmi:id="_KSmgkKoBEeO4L-NdFOGFPw" name="id" visibility="private" aggregation="composite">
          <ownedComment xmi:id="_a1RBoKoBEeO4L-NdFOGFPw">
            <body>A scheduled appointment or service event in a practice management system may be represented using this id element.</body>
          </ownedComment>
          <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_culQ8DxaEd6JwqSGecoePg"/>
          <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_KSmgkaoBEeO4L-NdFOGFPw" value="*"/>
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          <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_XKImMEraEd6FXKclYGEDCw"/>
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      </nestedClassifier>
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    <nestedClassifier xmi:type="uml:Class" xmi:id="_0f1s8KoCEeO4L-NdFOGFPw" name="DocumentationOf">
      <ownedComment xmi:id="_4hsY0KoCEeO4L-NdFOGFPw">
        <body>INLINE</body>
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      <generalization xmi:id="_0f2UAKoCEeO4L-NdFOGFPw">
        <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_1fhigEcEEd6besF9iFIJkQ"/>
      </generalization>
      <ownedAttribute xmi:id="_8FAukKoCEeO4L-NdFOGFPw" name="serviceEvent" type="_ECzrkKoDEeO4L-NdFOGFPw" association="_8FB8sKoCEeO4L-NdFOGFPw">
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      <nestedClassifier xmi:type="uml:Class" xmi:id="_ECzrkKoDEeO4L-NdFOGFPw" name="ServiceEvent">
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          <body>serviceEvent</body>
        </ownedComment>
        <generalization xmi:id="_EC05sKoDEeO4L-NdFOGFPw">
          <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_lriDUEcaEd6besF9iFIJkQ"/>
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          <ownedComment xmi:id="_qNyY4KoDEeO4L-NdFOGFPw">
            <body>The code should be selected from a value set established by the document-level template for a specific type of Patient Generated Document.</body>
          </ownedComment>
          <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_Z1EGIDxaEd6JwqSGecoePg"/>
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          <upperValue xmi:type="uml:LiteralUnlimitedNatural" xmi:id="_YkqwoaoEEeO4L-NdFOGFPw" value="*"/>
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        <nestedClassifier xmi:type="uml:Class" xmi:id="_qTzr4KoEEeO4L-NdFOGFPw" name="Performer">
          <ownedComment xmi:id="_0OH_8KoEEeO4L-NdFOGFPw">
            <body>performer&#xD;
serviceEvent/performer represents the healthcare providers, allied health professionals or other individuals involved in the current or pertinent historical care of the patient during the time span covered by the document.</body>
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          <generalization xmi:id="_qT06AKoEEeO4L-NdFOGFPw">
            <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_FvF74EcaEd6besF9iFIJkQ"/>
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              <body>The functionCode SHALL be selected from value set ParticipationType 2.16.840.1.113883.1.11.10901&#xD;
When indicating the performer was the primary care physician the functionCode shall be =&quot;PCP&quot;</body>
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            <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_Z1EGIDxaEd6JwqSGecoePg"/>
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          <nestedClassifier xmi:type="uml:Class" xmi:id="_81NVEKoFEeO4L-NdFOGFPw" name="AssignedEntity">
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              <general xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_6qmVsEcDEd6besF9iFIJkQ"/>
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            <ownedAttribute xmi:id="_-x8Hg6oFEeO4L-NdFOGFPw" name="id" visibility="private" aggregation="composite">
              <ownedComment xmi:id="_GDtE8KoGEeO4L-NdFOGFPw">
                <body>The combined @root and @extension attributes record the performer's identity in a secure, trusted, and unique way.</body>
              </ownedComment>
              <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_culQ8DxaEd6JwqSGecoePg"/>
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              <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_9JenIEodEd6c3qsAxlFHaQ"/>
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              <ownedComment xmi:id="_cfD3sKoGEeO4L-NdFOGFPw">
                <body>If the assignedEntity is an individual, the code SHOULD be selected from value set PersonalandLegalRelationshipRoleType value set</body>
              </ownedComment>
              <type xmi:type="uml:Class" href="../../../org.openhealthtools.mdht.uml.hl7.datatypes/model/datatypes.uml#_Z1EGIDxaEd6JwqSGecoePg"/>
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              <redefinedProperty href="../../../org.openhealthtools.mdht.uml.cda/model/cda.uml#_CDS1wEoeEd6c3qsAxlFHaQ"/>
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        </nestedClassifier>
      </nestedClassifier>
    </nestedClassifier>
  </uml:Class>
  <CDA:CDATemplate xmi:id="_wTVxcKi8EeOTwZftO6CV5g" base_Class="_OA1xkKi8EeOTwZftO6CV5g" templateId="2.16.840.1.113883.10.20.29.1">
    <ruleId>CONF:28458</ruleId>
    <ruleId>CONF:28459</ruleId>
  </CDA:CDATemplate>
  <CDA:ConformsTo xmi:id="__XcCwKi8EeOTwZftO6CV5g" base_Generalization="_OA2_sKi8EeOTwZftO6CV5g"/>
  <uml:Association xmi:id="_JSJwQKk9EeOTwZftO6CV5g" memberEnd="_JSH7EKk9EeOTwZftO6CV5g _JSKXUKk9EeOTwZftO6CV5g">
    <ownedEnd xmi:id="_JSKXUKk9EeOTwZftO6CV5g" type="_OA1xkKi8EeOTwZftO6CV5g" association="_JSJwQKk9EeOTwZftO6CV5g"/>
  </uml:Association>
  <CDA:AssociationValidation xmi:id="_MMR_EKk9EeOTwZftO6CV5g" base_Association="_JSJwQKk9EeOTwZftO6CV5g">
    <ruleId>CONF:28460</ruleId>
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  <CDA:AssociationValidation xmi:id="_sChX4Kk9EeOTwZftO6CV5g" base_Association="_rO_pMKk9EeOTwZftO6CV5g">
    <ruleId>CONF:28461</ruleId>
  </CDA:AssociationValidation>
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    <ruleId>CONF:28462</ruleId>
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    <ruleId>CONF:28464</ruleId>
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    <ruleId>CONF:28463</ruleId>
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  <CDA:AssociationValidation xmi:id="_NbH6UKlJEeOTwZftO6CV5g" base_Association="_LVRBEKlJEeOTwZftO6CV5g">
    <ruleId>CONF:28465</ruleId>
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  <CDA:AssociationValidation xmi:id="_sP2y0KlJEeOTwZftO6CV5g" severity="INFO" base_Association="_qbR20KlJEeOTwZftO6CV5g">
    <ruleId>CONF:28469</ruleId>
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    <ruleId>CONF:28470</ruleId>
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    <ruleId>CONF:28471</ruleId>
  </CDA:PropertyValidation>
  <CDA:PropertyValidation xmi:id="_jz42oKlKEeOTwZftO6CV5g" severity="WARNING" base_Property="_Lk2fwKlKEeOTwZftO6CV5g">
    <ruleId>CONF:28472</ruleId>
  </CDA:PropertyValidation>
  <CDA:PropertyValidation xmi:id="_tCAMAKlKEeOTwZftO6CV5g" severity="WARNING" base_Property="_sGMrEKlKEeOTwZftO6CV5g"/>
  <CDA:ValueSetConstraint xmi:id="_xheoAKlKEeOTwZftO6CV5g" base_Property="_sGMrEKlKEeOTwZftO6CV5g">
    <reference href="../consol-vocab.uml#_x4P9YZ6CEeOr4eM3k36wAg"/>
    <ruleId>CONF:28473</ruleId>
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  <uml:Association xmi:id="_avto8KlhEeO4L-NdFOGFPw" memberEnd="_avlGEKlhEeO4L-NdFOGFPw _avto8alhEeO4L-NdFOGFPw">
    <ownedEnd xmi:id="_avto8alhEeO4L-NdFOGFPw" type="_lQMSAKlJEeOTwZftO6CV5g" association="_avto8KlhEeO4L-NdFOGFPw"/>
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  <CDA:AssociationValidation xmi:id="_cHpFMKlhEeO4L-NdFOGFPw" severity="WARNING" base_Association="_avto8KlhEeO4L-NdFOGFPw">
    <ruleId>CONF:28474</ruleId>
  </CDA:AssociationValidation>
  <CDA:PropertyValidation xmi:id="_pIK8QKlhEeO4L-NdFOGFPw" severity="INFO" base_Property="_nt1FMKlhEeO4L-NdFOGFPw">
    <ruleId>CONF:28475</ruleId>
  </CDA:PropertyValidation>
  <CDA:ConstraintValidation xmi:id="_QdcdAKljEeO4L-NdFOGFPw" base_Constraint="_OqdccKljEeO4L-NdFOGFPw"/>
  <uml:Association xmi:id="_8cXCYKlkEeO4L-NdFOGFPw" memberEnd="_8cVNMKlkEeO4L-NdFOGFPw _8cXCYalkEeO4L-NdFOGFPw">
    <ownedEnd xmi:id="_8cXCYalkEeO4L-NdFOGFPw" type="_zjgdEKk9EeOTwZftO6CV5g" association="_8cXCYKlkEeO4L-NdFOGFPw"/>
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  <CDA:AssociationValidation xmi:id="_CmXGgKllEeO4L-NdFOGFPw" severity="INFO" base_Association="_8cXCYKlkEeO4L-NdFOGFPw">
    <ruleId>CONF:28476</ruleId>
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  <uml:Association xmi:id="_NI2_cKlmEeO4L-NdFOGFPw" memberEnd="_NI1KQKlmEeO4L-NdFOGFPw _NI2_calmEeO4L-NdFOGFPw">
    <ownedEnd xmi:id="_NI2_calmEeO4L-NdFOGFPw" type="_OA1xkKi8EeOTwZftO6CV5g" association="_NI2_cKlmEeO4L-NdFOGFPw"/>
  </uml:Association>
  <CDA:AssociationValidation xmi:id="_NsaYcKlmEeO4L-NdFOGFPw" base_Association="_NI2_cKlmEeO4L-NdFOGFPw">
    <ruleId>CONF:28477</ruleId>
  </CDA:AssociationValidation>
  <uml:Association xmi:id="_qKtlEKlmEeO4L-NdFOGFPw" memberEnd="_qKrv4KlmEeO4L-NdFOGFPw _qKtlEalmEeO4L-NdFOGFPw">
    <ownedEnd xmi:id="_qKtlEalmEeO4L-NdFOGFPw" type="_VlzWkKlmEeO4L-NdFOGFPw" association="_qKtlEKlmEeO4L-NdFOGFPw"/>
  </uml:Association>
  <CDA:AssociationValidation xmi:id="_scy8cKlmEeO4L-NdFOGFPw" base_Association="_qKtlEKlmEeO4L-NdFOGFPw">
    <ruleId>CONF:28478</ruleId>
  </CDA:AssociationValidation>
  <CDA:PropertyValidation xmi:id="_35r2gKlmEeO4L-NdFOGFPw" base_Property="_zsyYQKlmEeO4L-NdFOGFPw">
    <ruleId>CONF:28479</ruleId>
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  <CDA:PropertyValidation xmi:id="_By-P0KlnEeO4L-NdFOGFPw" severity="WARNING" base_Property="__2HhkKlmEeO4L-NdFOGFPw">
    <ruleId>CONF:28480</ruleId>
  </CDA:PropertyValidation>
  <CDA:PropertyValidation xmi:id="_S6oUUKlnEeO4L-NdFOGFPw" base_Property="_zsxxMKlmEeO4L-NdFOGFPw">
    <ruleId>CONF:28481</ruleId>
  </CDA:PropertyValidation>
  <CDA:PropertyValidation xmi:id="_xp8r4KloEeO4L-NdFOGFPw" base_Property="_sY3z0KloEeO4L-NdFOGFPw">
    <ruleId>CONF:28676</ruleId>
  </CDA:PropertyValidation>
  <CDA:ConstraintValidation xmi:id="_7aQvYKloEeO4L-NdFOGFPw" severity="WARNING" base_Constraint="_6jDakKloEeO4L-NdFOGFPw">
    <ruleId>CONF:28676</ruleId>
  </CDA:ConstraintValidation>
  <uml:Association xmi:id="_WhMOgKlrEeO4L-NdFOGFPw" memberEnd="_WhLAYKlrEeO4L-NdFOGFPw _WhMOgalrEeO4L-NdFOGFPw">
    <ownedEnd xmi:id="_WhMOgalrEeO4L-NdFOGFPw" type="_OA1xkKi8EeOTwZftO6CV5g" association="_WhMOgKlrEeO4L-NdFOGFPw"/>
  </uml:Association>
  <CDA:AssociationValidation xmi:id="_YUJZ4KlrEeO4L-NdFOGFPw" severity="INFO" base_Association="_WhMOgKlrEeO4L-NdFOGFPw">
    <ruleId>CONF:28678</ruleId>
  </CDA:AssociationValidation>
  <uml:Association xmi:id="_0yb_cKlrEeO4L-NdFOGFPw" memberEnd="_0yaKQKlrEeO4L-NdFOGFPw _0yb_calrEeO4L-NdFOGFPw">
    <ownedEnd xmi:id="_0yb_calrEeO4L-NdFOGFPw" type="_iLNloKlrEeO4L-NdFOGFPw" association="_0yb_cKlrEeO4L-NdFOGFPw"/>
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  <CDA:AssociationValidation xmi:id="_1TgFIKlrEeO4L-NdFOGFPw" base_Association="_0yb_cKlrEeO4L-NdFOGFPw">
    <ruleId>CONF:28679</ruleId>
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  <CDA:PropertyValidation xmi:id="_CrjEUKlsEeO4L-NdFOGFPw" severity="INFO" base_Property="_BP93IKlsEeO4L-NdFOGFPw"/>
  <CDA:ValueSetConstraint xmi:id="_DrQ04KlsEeO4L-NdFOGFPw" base_Property="_BP93IKlsEeO4L-NdFOGFPw" severity="WARNING">
    <reference href="../consol-vocab.uml#_x4P9YZ6CEeOr4eM3k36wAg"/>
    <ruleId>CONF:28680</ruleId>
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    <ownedEnd xmi:id="_Gf1_4altEeO4L-NdFOGFPw" type="_OA1xkKi8EeOTwZftO6CV5g" association="_Gf1_4KltEeO4L-NdFOGFPw"/>
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  <CDA:AssociationValidation xmi:id="_NYFDAKltEeO4L-NdFOGFPw" severity="INFO" base_Association="_Gf1_4KltEeO4L-NdFOGFPw">
    <ruleId>CONF:28681</ruleId>
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    <ownedEnd xmi:id="_x5tz8altEeO4L-NdFOGFPw" type="_jpSbQKltEeO4L-NdFOGFPw" association="_x5tz8KltEeO4L-NdFOGFPw"/>
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  <CDA:AssociationValidation xmi:id="_yobUEKltEeO4L-NdFOGFPw" base_Association="_x5tz8KltEeO4L-NdFOGFPw">
    <ruleId>CONF:28682</ruleId>
  </CDA:AssociationValidation>
  <CDA:PropertyValidation xmi:id="_Kz2WQKluEeO4L-NdFOGFPw" severity="INFO" base_Property="_Abai0KluEeO4L-NdFOGFPw">
    <ruleId>CONF:28683</ruleId>
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  <CDA:ValueSetConstraint xmi:id="_OdG78KluEeO4L-NdFOGFPw" base_Property="_Abai0KluEeO4L-NdFOGFPw" severity="WARNING">
    <reference href="../consol-vocab.uml#_x4P9YZ6CEeOr4eM3k36wAg"/>
    <ruleId>CONF:28684</ruleId>
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    <ownedEnd xmi:id="_MoEQcKlvEeO4L-NdFOGFPw" type="_OA1xkKi8EeOTwZftO6CV5g" association="_MoDpYKlvEeO4L-NdFOGFPw"/>
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  <CDA:AssociationValidation xmi:id="_NN0B0KlvEeO4L-NdFOGFPw" base_Association="_MoDpYKlvEeO4L-NdFOGFPw">
    <ruleId>CONF:28685</ruleId>
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    <ownedEnd xmi:id="_kqCbsKlvEeO4L-NdFOGFPw" type="_aXueYKlvEeO4L-NdFOGFPw" association="_kqB0oKlvEeO4L-NdFOGFPw"/>
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  <CDA:AssociationValidation xmi:id="_lOsA4KlvEeO4L-NdFOGFPw" base_Association="_kqB0oKlvEeO4L-NdFOGFPw">
    <ruleId>CONF:28686</ruleId>
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  <uml:Association xmi:id="_WETE4KlwEeO4L-NdFOGFPw" memberEnd="_WERPsKlwEeO4L-NdFOGFPw _WETE4alwEeO4L-NdFOGFPw">
    <ownedEnd xmi:id="_WETE4alwEeO4L-NdFOGFPw" type="_wry9YKlvEeO4L-NdFOGFPw" association="_WETE4KlwEeO4L-NdFOGFPw"/>
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  <CDA:AssociationValidation xmi:id="_XfKgYKlwEeO4L-NdFOGFPw" base_Association="_WETE4KlwEeO4L-NdFOGFPw">
    <ruleId>CONF:28687</ruleId>
  </CDA:AssociationValidation>
  <CDA:PropertyValidation xmi:id="_4P2vQKlwEeO4L-NdFOGFPw" base_Property="_tQ6VcKlwEeO4L-NdFOGFPw">
    <ruleId>CONF:28688</ruleId>
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  <CDA:PropertyValidation xmi:id="_TpnVsKlxEeO4L-NdFOGFPw" base_Property="_Qs5s8KlxEeO4L-NdFOGFPw">
    <ruleId>CONF:28689</ruleId>
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    <ownedEnd xmi:id="_W0EtQal2EeO4L-NdFOGFPw" type="_OA1xkKi8EeOTwZftO6CV5g" association="_W0EtQKl2EeO4L-NdFOGFPw"/>
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  <CDA:AssociationValidation xmi:id="_XbiV4Kl2EeO4L-NdFOGFPw" severity="INFO" base_Association="_W0EtQKl2EeO4L-NdFOGFPw">
    <ruleId>CONF:28690</ruleId>
  </CDA:AssociationValidation>
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    <ownedEnd xmi:id="_mH6DsKl2EeO4L-NdFOGFPw" type="_dKD-8Kl2EeO4L-NdFOGFPw" association="_mH5coKl2EeO4L-NdFOGFPw"/>
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  <CDA:AssociationValidation xmi:id="_m3Fd4Kl2EeO4L-NdFOGFPw" base_Association="_mH5coKl2EeO4L-NdFOGFPw">
    <ruleId>CONF:28691</ruleId>
  </CDA:AssociationValidation>
  <CDA:PropertyValidation xmi:id="_wKAawKl2EeO4L-NdFOGFPw" severity="WARNING" base_Property="_vOlUUKl2EeO4L-NdFOGFPw">
    <ruleId>CONF:28692</ruleId>
  </CDA:PropertyValidation>
  <CDA:PropertyValidation xmi:id="_GE5kwKl3EeO4L-NdFOGFPw" severity="WARNING" base_Property="_FGXf8Kl3EeO4L-NdFOGFPw">
    <ruleId>CONF:28693</ruleId>
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  <uml:Association xmi:id="_vJu0EKl3EeO4L-NdFOGFPw" memberEnd="_vJs-4Kl3EeO4L-NdFOGFPw _vJu0Eal3EeO4L-NdFOGFPw">
    <ownedEnd xmi:id="_vJu0Eal3EeO4L-NdFOGFPw" type="_OA1xkKi8EeOTwZftO6CV5g" association="_vJu0EKl3EeO4L-NdFOGFPw"/>
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  <CDA:AssociationValidation xmi:id="_vrT3IKl3EeO4L-NdFOGFPw" severity="INFO" base_Association="_vJu0EKl3EeO4L-NdFOGFPw">
    <ruleId>CONF:28694</ruleId>
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    <ownedEnd xmi:id="_D5V2sKl4EeO4L-NdFOGFPw" type="_3qgiUKl3EeO4L-NdFOGFPw" association="_D5VPoKl4EeO4L-NdFOGFPw"/>
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  <CDA:AssociationValidation xmi:id="_E1QsYKl4EeO4L-NdFOGFPw" base_Association="_D5VPoKl4EeO4L-NdFOGFPw">
    <ruleId>CONF:28695</ruleId>
  </CDA:AssociationValidation>
  <CDA:PropertyValidation xmi:id="_RmT9AKl4EeO4L-NdFOGFPw" base_Property="_NYPaEKl4EeO4L-NdFOGFPw">
    <ruleId>CONF:28696</ruleId>
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  <CDA:PropertyValidation xmi:id="_VwA9UKl4EeO4L-NdFOGFPw" severity="INFO" base_Property="_NYOzAKl4EeO4L-NdFOGFPw">
    <ruleId>CONF:28697</ruleId>
  </CDA:PropertyValidation>
  <CDA:PropertyValidation xmi:id="_pakcYKl4EeO4L-NdFOGFPw" severity="INFO" base_Property="_oCUQAKl4EeO4L-NdFOGFPw">
    <ruleId>CONF:28698</ruleId>
  </CDA:PropertyValidation>
  <CDA:ConstraintValidation xmi:id="_xbCS4Kl4EeO4L-NdFOGFPw" severity="WARNING" base_Constraint="_w1FGIKl4EeO4L-NdFOGFPw">
    <ruleId>CONF:28698</ruleId>
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  <uml:Association xmi:id="_NZaM0Kl6EeO4L-NdFOGFPw" memberEnd="_NZYXoKl6EeO4L-NdFOGFPw _NZaM0al6EeO4L-NdFOGFPw">
    <ownedEnd xmi:id="_NZaM0al6EeO4L-NdFOGFPw" type="_OA1xkKi8EeOTwZftO6CV5g" association="_NZaM0Kl6EeO4L-NdFOGFPw"/>
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  <CDA:AssociationValidation xmi:id="_OfbZsKl6EeO4L-NdFOGFPw" severity="INFO" base_Association="_NZaM0Kl6EeO4L-NdFOGFPw">
    <ruleId>CONF:28699</ruleId>
  </CDA:AssociationValidation>
  <uml:Association xmi:id="_a_qnIKl6EeO4L-NdFOGFPw" memberEnd="_a_ox8Kl6EeO4L-NdFOGFPw _a_rOMKl6EeO4L-NdFOGFPw">
    <ownedEnd xmi:id="_a_rOMKl6EeO4L-NdFOGFPw" type="_TN57AKl6EeO4L-NdFOGFPw" association="_a_qnIKl6EeO4L-NdFOGFPw"/>
  </uml:Association>
  <CDA:AssociationValidation xmi:id="_cXadMKl6EeO4L-NdFOGFPw" base_Association="_a_qnIKl6EeO4L-NdFOGFPw">
    <ruleId>CONF:28700</ruleId>
  </CDA:AssociationValidation>
  <CDA:PropertyValidation xmi:id="_4c4TEKl6EeO4L-NdFOGFPw" base_Property="_2K3NI6l6EeO4L-NdFOGFPw">
    <ruleId>CONF:28701</ruleId>
  </CDA:PropertyValidation>
  <CDA:PropertyValidation xmi:id="_50qlYKl6EeO4L-NdFOGFPw" severity="WARNING" base_Property="_2K3NIKl6EeO4L-NdFOGFPw"/>
  <CDA:ValueSetConstraint xmi:id="_GupIgKl7EeO4L-NdFOGFPw" base_Property="_2K3NIKl6EeO4L-NdFOGFPw" severity="WARNING">
    <reference href="../consol-vocab.uml#_x4P9YZ6CEeOr4eM3k36wAg"/>
    <ruleId>CONF:28702</ruleId>
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  <uml:Association xmi:id="_4E7zEKn8EeO4L-NdFOGFPw" memberEnd="_4E5W0Kn8EeO4L-NdFOGFPw _4E7zEan8EeO4L-NdFOGFPw">
    <ownedEnd xmi:id="_4E7zEan8EeO4L-NdFOGFPw" type="_OA1xkKi8EeOTwZftO6CV5g" association="_4E7zEKn8EeO4L-NdFOGFPw"/>
  </uml:Association>
  <CDA:AssociationValidation xmi:id="_6Hrt8Kn8EeO4L-NdFOGFPw" severity="INFO" base_Association="_4E7zEKn8EeO4L-NdFOGFPw">
    <ruleId>CONF:28703</ruleId>
  </CDA:AssociationValidation>
  <CDA:PropertyValidation xmi:id="_jJISEKn9EeO4L-NdFOGFPw" base_Property="_SMoUsKn9EeO4L-NdFOGFPw">
    <ruleId>CONF:28704</ruleId>
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  <uml:Association xmi:id="_v-v5oKn9EeO4L-NdFOGFPw" memberEnd="_v-uEcKn9EeO4L-NdFOGFPw _v-v5oan9EeO4L-NdFOGFPw">
    <ownedEnd xmi:id="_v-v5oan9EeO4L-NdFOGFPw" type="_Q7gEAKn9EeO4L-NdFOGFPw" association="_v-v5oKn9EeO4L-NdFOGFPw"/>
  </uml:Association>
  <CDA:AssociationValidation xmi:id="_6MAX0Kn9EeO4L-NdFOGFPw" base_Association="_v-v5oKn9EeO4L-NdFOGFPw">
    <ruleId>CONF:28705</ruleId>
  </CDA:AssociationValidation>
  <CDA:PropertyValidation xmi:id="_DXJRsKn-EeO4L-NdFOGFPw" severity="WARNING" base_Property="_BdoLUKn-EeO4L-NdFOGFPw"/>
  <CDA:ValueSetConstraint xmi:id="_IySEsKn-EeO4L-NdFOGFPw" base_Property="_BdoLUKn-EeO4L-NdFOGFPw" severity="WARNING">
    <reference href="../consol-vocab.uml#_x4P9YZ6CEeOr4eM3k36wAg"/>
    <ruleId>CONF:28706</ruleId>
  </CDA:ValueSetConstraint>
  <CDA:ConstraintValidation xmi:id="_O2OHoKn_EeO4L-NdFOGFPw" base_Constraint="_0B3UUKn-EeO4L-NdFOGFPw"/>
  <uml:Association xmi:id="_cT2U8KoAEeO4L-NdFOGFPw" memberEnd="_cT0fwKoAEeO4L-NdFOGFPw _cT2U8aoAEeO4L-NdFOGFPw">
    <ownedEnd xmi:id="_cT2U8aoAEeO4L-NdFOGFPw" type="_OA1xkKi8EeOTwZftO6CV5g" association="_cT2U8KoAEeO4L-NdFOGFPw"/>
  </uml:Association>
  <CDA:AssociationValidation xmi:id="_c_ZMUKoAEeO4L-NdFOGFPw" severity="INFO" base_Association="_cT2U8KoAEeO4L-NdFOGFPw">
    <ruleId>CONF:28707</ruleId>
  </CDA:AssociationValidation>
  <uml:Association xmi:id="_q5l2UKoAEeO4L-NdFOGFPw" memberEnd="_q5kBIKoAEeO4L-NdFOGFPw _q5l2UaoAEeO4L-NdFOGFPw">
    <ownedEnd xmi:id="_q5l2UaoAEeO4L-NdFOGFPw" type="_jQUX0KoAEeO4L-NdFOGFPw" association="_q5l2UKoAEeO4L-NdFOGFPw"/>
  </uml:Association>
  <CDA:AssociationValidation xmi:id="_s_6poKoAEeO4L-NdFOGFPw" base_Association="_q5l2UKoAEeO4L-NdFOGFPw">
    <ruleId>CONF:28708</ruleId>
  </CDA:AssociationValidation>
  <CDA:PropertyValidation xmi:id="_MNZZUKoBEeO4L-NdFOGFPw" base_Property="_KSmgkKoBEeO4L-NdFOGFPw">
    <ruleId>CONF:28709</ruleId>
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  <uml:Association xmi:id="_tpA_EKoCEeO4L-NdFOGFPw" memberEnd="_to_J4KoCEeO4L-NdFOGFPw _tpBmIKoCEeO4L-NdFOGFPw">
    <ownedEnd xmi:id="_tpBmIKoCEeO4L-NdFOGFPw" type="_OA1xkKi8EeOTwZftO6CV5g" association="_tpA_EKoCEeO4L-NdFOGFPw"/>
  </uml:Association>
  <CDA:AssociationValidation xmi:id="_uX7TgKoCEeO4L-NdFOGFPw" severity="INFO" base_Association="_tpA_EKoCEeO4L-NdFOGFPw">
    <ruleId>CONF:28710</ruleId>
  </CDA:AssociationValidation>
  <uml:Association xmi:id="_8FB8sKoCEeO4L-NdFOGFPw" memberEnd="_8FAukKoCEeO4L-NdFOGFPw _8FCjwKoCEeO4L-NdFOGFPw">
    <ownedEnd xmi:id="_8FCjwKoCEeO4L-NdFOGFPw" type="_0f1s8KoCEeO4L-NdFOGFPw" association="_8FB8sKoCEeO4L-NdFOGFPw"/>
  </uml:Association>
  <CDA:AssociationValidation xmi:id="_8_tcQKoCEeO4L-NdFOGFPw" base_Association="_8FB8sKoCEeO4L-NdFOGFPw">
    <ruleId>CONF:28711</ruleId>
  </CDA:AssociationValidation>
  <CDA:PropertyValidation xmi:id="_F5CNYKoDEeO4L-NdFOGFPw" severity="WARNING" base_Property="_ElQ4YKoDEeO4L-NdFOGFPw">
    <ruleId>CONF:28712</ruleId>
  </CDA:PropertyValidation>
  <uml:Association xmi:id="_Ykr-wKoEEeO4L-NdFOGFPw" memberEnd="_YkqJkKoEEeO4L-NdFOGFPw _Ykr-waoEEeO4L-NdFOGFPw">
    <ownedEnd xmi:id="_Ykr-waoEEeO4L-NdFOGFPw" type="_ECzrkKoDEeO4L-NdFOGFPw" association="_Ykr-wKoEEeO4L-NdFOGFPw"/>
  </uml:Association>
  <CDA:AssociationValidation xmi:id="_bSS0gKoEEeO4L-NdFOGFPw" severity="WARNING" base_Association="_Ykr-wKoEEeO4L-NdFOGFPw">
    <ruleId>CONF:28713</ruleId>
  </CDA:AssociationValidation>
  <CDA:PropertyValidation xmi:id="_tcTG0KoEEeO4L-NdFOGFPw" severity="INFO" base_Property="_ruikgKoEEeO4L-NdFOGFPw"/>
  <uml:Association xmi:id="_w8PjAKoFEeO4L-NdFOGFPw" memberEnd="_w8Nt0KoFEeO4L-NdFOGFPw _w8PjAaoFEeO4L-NdFOGFPw">
    <ownedEnd xmi:id="_w8PjAaoFEeO4L-NdFOGFPw" type="_qTzr4KoEEeO4L-NdFOGFPw" association="_w8PjAKoFEeO4L-NdFOGFPw"/>
  </uml:Association>
  <CDA:AssociationValidation xmi:id="_xscQ4KoFEeO4L-NdFOGFPw" base_Association="_w8PjAKoFEeO4L-NdFOGFPw">
    <ruleId>CONF:28715</ruleId>
  </CDA:AssociationValidation>
  <CDA:PropertyValidation xmi:id="_Bdw0kKoGEeO4L-NdFOGFPw" base_Property="_-x8Hg6oFEeO4L-NdFOGFPw">
    <ruleId>CONF:28716</ruleId>
  </CDA:PropertyValidation>
  <CDA:PropertyValidation xmi:id="_PXchMKoGEeO4L-NdFOGFPw" severity="INFO" base_Property="_-x8HgKoFEeO4L-NdFOGFPw"/>
  <CDA:ValueSetConstraint xmi:id="_Ri1asKoGEeO4L-NdFOGFPw" base_Property="_-x8HgKoFEeO4L-NdFOGFPw" severity="WARNING">
    <reference href="../consol-vocab.uml#_x4P9YZ6CEeOr4eM3k36wAg"/>
    <ruleId>CONF:28718</ruleId>
  </CDA:ValueSetConstraint>
  <CDA:ValueSetConstraint xmi:id="_uJKakKoJEeO4L-NdFOGFPw" base_Property="_ruikgKoEEeO4L-NdFOGFPw">
    <reference href="../consol-vocab.uml#_uGfWgKoIEeO4L-NdFOGFPw"/>
    <ruleId>CONF:28714</ruleId>
  </CDA:ValueSetConstraint>
  <uml:Association xmi:id="_9SceAKuiEeOhqMhzpJF7Fw" memberEnd="_9SaBwKuiEeOhqMhzpJF7Fw _9SceAauiEeOhqMhzpJF7Fw">
    <ownedEnd xmi:id="_9SceAauiEeOhqMhzpJF7Fw" type="_HFAWQKAIEeOQs7VC4HptuQ" association="_9SceAKuiEeOhqMhzpJF7Fw"/>
  </uml:Association>
  <CDA:AssociationValidation xmi:id="_OZgsoKujEeOhqMhzpJF7Fw" base_Association="_9SceAKuiEeOhqMhzpJF7Fw">
    <ruleId>CONF:31593</ruleId>
  </CDA:AssociationValidation>
  <CDA:PropertyValidation xmi:id="_sYWe8KujEeOhqMhzpJF7Fw" base_Property="_pYusIKujEeOhqMhzpJF7Fw">
    <ruleId>CONF:31594</ruleId>
  </CDA:PropertyValidation>
  <CDA:PropertyValidation xmi:id="_Q7XI4KukEeOhqMhzpJF7Fw" base_Property="_L1gCUKukEeOhqMhzpJF7Fw">
    <ruleId>CONF:31595</ruleId>
  </CDA:PropertyValidation>
  <CDA:PropertyValidation xmi:id="_SlxcQKukEeOhqMhzpJF7Fw" base_Property="_L1gpYKukEeOhqMhzpJF7Fw">
    <ruleId>CONF:31596</ruleId>
  </CDA:PropertyValidation>
</xmi:XMI>
