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12.3.2 PRB - problem detail segment

The problem detail segment contains the data necessary to add, update, correct, and delete the problems of a given individual.

Figure 12-3. PRB attributes

SEQ

LEN

DT

OPT

RP/#

TBL#

ITEM #

ELEMENT NAME

1

2

ID

R


0287

00816

Action Code

2

26

TS

R



00817

Action Date/Time

3

80

CE

R



00838

Problem ID

4

60

EI

R



00839

Problem Instance ID

5

60

EI

O



00840

Episode of Care ID

6

60

NM

O



00841

Master Problem List Number

7

26

TS

O



00842

Problem Established Date/Time

8

26

TS

O



00843

Anticipated Problem Resolution Date/Time

9

26

TS

O



00844

Actual Problem Resolution Date/Time

10

80

CE

O



00845

Problem Classification

11

80

CE

O

Y


00846

Problem Management Discipline

12

80

CE

O



00847

Problem Persistence

13

80

CE

O



00848

Problem Confirmation Status

14

80

CE

O



00849

Problem Life Cycle Status

15

26

TS

O



00850

Problem Life Cycle Status Date/Time

16

26

TS

O



00851

Problem Date of Onset

17

80

ST

O



00852

Problem Onset Text

18

80

CE

O



00853

Problem Ranking

19

60

CE

O



00854

Certainty of Problem

20

5

NM

O


00855

Probability of Problem (0-1)

21

80

CE

O



00856

Individual Awareness of Problem

22

80

CE

O



00857

Problem Prognosis

23

80

CE

O



00858

Individual Awareness of Prognosis

24

200

ST

O



00859

Family/Significant Other Awareness of Problem/Prognosis

25

80

CE

O



00823

Security/Sensitivity

The business and/or application must assume the responsibility for maintaining knowledge about data ownership, versioning, and/or audit trail control (for purposes of data integrity). It is also their responsibility to represent the appropriate version of that data.

12.3.2.0 PRB field definitions

12.3.2.1 Action code (ID) 00816

Definition: This field contains the intent of the message. Refer to HL7 table 0287 - Action code for valid values.

12.3.2.2 Action date/time (TS) 00817

Definition: This field contains the date/time that the operation represented by the action code was performed.

12.3.2.3 Problem ID (CE) 00838

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (ST)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (ST)>

Definition: This field identifies the problem.

12.3.2.4 Problem instance ID (EI) 00839

Components: <entity identifier (ST)> ^ <assigning authority (HD)>

Definition: This field contains the identifier assigned by an initiating system to an instance of a problem.

Note: It is required that this value remain unique over time.

12.3.2.5 Episode of care ID (EI) 00840

Components: <entity identifier (ST)> ^ <assigning authority (HD)>

Definition: This field uniquely identifies the episode of care to which this problem applies. (See note under "Ongoing issues."

Note: It is expected that this field be unique over time.

12.3.2.6 Master problem list number (NM) 00841

Definition: This field prioritizes this problem on a master list that is maintained for the individual.

12.3.2.7 Problem established date/time (TS) 00842

Definition: This field contains the date/time when the corresponding problem was initially identified by the care giver.

12.3.2.8 Anticipated problem resolution date/time (TS) 00843

Definition: This field contains the estimated date/time for resolving the stated problem.

12.3.2.9 Actual problem resolution date/time (TS) 00844

Definition: This field contains the date/time that the problem was actually resolved.

12.3.2.10 Problem classification (CE) 00845

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (ST)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (ST)>

Definition: This field indicates the kind of problem. This field can be used to categorize problems so that they may be managed and viewed independently within different applications (e.g., Admission, Final, Post-Operative, Pre-Operative, Outpatient, Discharge, etc.).

12.3.2.11 Problem management discipline (CE) 00846

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (ST)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (ST)>

Definition: This field indicates the category of caregiver with responsibility for managing this specific problem (e.g.,Care Team, Nursing, Medicine, Respiratory Therapy, Occupational Therapy, Dietary etc.). This is a repeating field to allow identification of all disciplines who may have the responsibility for this problem.

12.3.2.12 Problem persistence (CE) 00847

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (ST)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (ST)>

Definition: This field contains the perseverance of a problem (e.g., acute, chronic, etc.).

12.3.2.13 Problem confirmation status (CE) 00848

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (ST)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (ST)>

Definition: This field contains the verification status of a problem (e.g., confirmed, differential, provisional, rule-out, etc.).

12.3.2.14 Problem life cycle status (CE) 00849

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (ST)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (ST)>

Definition: This field contains the current status of the problem at this particular date/time (e.g., active, active-improving, active-stable, active-worsening, inactive, resolved, etc.).

12.3.2.15 Problem life cycle status date/time (TS) 00850

Definition: This field indicates the effective date/time of the current problem life cycle status.

12.3.2.16 Problem date of onset (TS) 00851

Definition: This field contains the date/time when the problem began.

12.3.2.17 Problem onset text (ST) 00852

Definition: This field allows for a textual representation of the time when the problem began.

12.3.2.18 Problem ranking (CE) 00853

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (ST)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (ST)>

Definition: This field contains a user-defined prioritization of a problem (e.g., numeric ranking, or the use of words such as "primary," "secondary," etc.).

12.3.2.19 Certainty of problem (CE) 00854

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (ST)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (ST)>

Definition: This field contains a qualitative representation of the certainty of a problem (e.g., HI - high, LO - low, ME - medium, etc.).

12.3.2.20 Probability of problem ( NM) 00855

Definition: This field contains a quantitative or numeric representation of the certainty that the problem exists for this patient. This field has a valid range of 0 to 1. For example, a health care provider may be 75% (.75) sure that the problem has been correctly identified.

Note: We have provided for two different representations of the certainty of the problem due to varying representations in applications.

12.3.2.21 Individual awareness of problem (CE) 00856

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (ST)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (ST)>

Definition: This field contains the individual’s comprehension of the problem (e.g., Full, Marginal, Partial, etc.).

12.3.2.22 Problem prognosis (CE) 00857

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (ST)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (ST)>

Definition: This field contains the prognosis for the individual’s problem (e.g., good, poor, etc.).

12.3.2.23 Individual awareness of prognosis (CE) 00858

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (ST)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (ST)>

Definition: This field contains the individual’s comprehension of the prognosis for the problem (e.g., full, marginal, partial, etc.).

12.3.2.24 Family/significant other awareness of problem/prognosis (ST) 00859

Definition: This field indicates the individual’s family or significant other’s comprehension of the actual problem/prognosis.

12.3.2.25 Security/sensitivity (CE) 00823

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (ST)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (ST)>

Definition: This field contains information about the level of security and/or sensitivity surrounding the problem (e.g., highly sensitive, not sensitive, sensitive, etc.).

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