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COCT_MT470002CA
Consent Event basic

Derived from RMIM: _ and HMD: _
 
ConsentEvent
[Constraint: "

One and only one of author2 (Consenter) and author1 (Provider) must be specified.

"]

Design Comments:

Information pertaining to a patient's agreement/acceptance to have his/her clinical information electronically stored and shared.

UsageNotes:

The keywords will not be passed from prescriber to dispenser by the DIS.

Rationale:

Provides authorization to record and/or view patient information.

Indicates the consent or keyword used to authorize access or update, including a reason for access; May also be used to override access restriction to the information ('break the glass') on a message by message basis. May be required on a Prescription Request to indicate a keyword for DUR processing.

classCode [1..1] (M)
Act (CS) {CNE:C:ActClass:CONS, fixed value= "CONS"}
moodCode [1..1] (M)
Act (CS) {CNE:C:ActMood:EVN, fixed value= "EVN"}
id [0..1]
Act (II.BUS)

Design Comments:

A unique identifier for a specific consent for a patient.

Rationale:

Provides a traceable audit link between a physical consent form and its electronic record

Mapping:

Authorization.formNumber

code [1..1] (M)
Act (CV) {CNE:C:ActCode:INFA, fixed value= "INFA"}

Mapping:

Authorization.dataType

effectiveTime [0..1]
Act (IVL<TS.FULLDATE>)

Design Comments:

Indicates the time that the consent will expire. 'Low' is effective time and 'High' is end time.

Rationale:

Most consents are not open-ended, to ensure the patient retains a level of control.

Mapping:

Authorization.endTime (high)

reasonCode [0..1]
Act (CV) {CNE:D:ActConsentInformationAccessOverrideReason}

Constraint:

If author1 (provider) is specified, reason code must be specified.

Design Comments:

Indicates a reason for overriding a patient's consent rules.

Rationale:

Important for audit purposes

Mapping:

Authorization.reason (mnemonic)

Mapping:

Authorization.comment (original text)

subject1 [1..1] (Subject)

Design Comments:

The patient's record the consent is associated with.

Rationale:

Essential for knowing what patient the consent is for, and therefore mandatory.

author1 [0..1] (Author)

Design Comments:

Indicates that the consent was provided by the patient or representative.

Rationale:

Consent can be provided by the patient or representative or the provider.

Mapping:

Authorization.Person

Mapping:

Authorization.signatory(PT)

author2 [0..1] (Author2)

Design Comments:

Indicates that information access was approved by a provider rather than a patient. I.e. This is an override rather than an actual consent, and is used for the purposes of 'breaking the glass' only.

Rationale:

Clinical circumstances may demand that a patient's information be accessed without consent to ensure patient safety.

Mapping:

Authorization.signatory(PROV)

subject2 [1..1] (Subject2)
 
Subject

Design Comments:

The patient's record the consent is associated with.

Rationale:

Essential for knowing what patient the consent is for, and therefore mandatory.

typeCode [1..1] (M)
Participation (CS) {CNE:C:ParticipationType:SBJ, fixed value= "SBJ"}
contextControlCode [1..1] (M)
Participation (CS) {CNE:C:ContextControl:OP, fixed value= "OP"}
patient [1..1] (R_PatientPersonIdentified-confirmable)
 
Author

Design Comments:

Indicates that the consent was provided by the patient or representative.

Rationale:

Consent can be provided by the patient or representative or the provider.

Mapping:

Authorization.Person

Mapping:

Authorization.signatory(PT)

typeCode [1..1] (M)
Participation (CS) {CNE:C:ParticipationType:AUT, fixed value= "AUT"}
contextControlCode [1..1] (M)
Participation (CS) {CNE:C:ContextControl:OP, fixed value= "OP"}
modeCode [0..1]
Participation (CV) {CNE:V:x_PhysicalVerbalParticipationMode}

Design Comments:

Indicates whether the patient's consent is written or verbal.

Rationale:

Verbal consents may trigger a higher level of auditing.

signatureText [0..1]
Participation (ST)

Design Comments:

Indicates the keyword appropriate to the action being performed by the message.

Rationale:

Allows providers who know the keyword to access information protected by patient keywords.

personalRelationship [1..1] (R_RelatedPersonInformational)
 
Author2

Design Comments:

Indicates that information access was approved by a provider rather than a patient. I.e. This is an override rather than an actual consent, and is used for the purposes of 'breaking the glass' only.

Rationale:

Clinical circumstances may demand that a patient's information be accessed without consent to ensure patient safety.

Mapping:

Authorization.signatory(PROV)

typeCode [1..1] (M)
Participation (CS) {CNE:C:ParticipationType:AUT, fixed value= "AUT"}
contextControlCode [1..1] (M)
Participation (CS) {CNE:C:ContextControl:OP, fixed value= "OP"}
assignedEntity [1..1] (R_AssignedPersonIdentified-confirmable)
 
Subject2
typeCode [1..1] (M)
ActRelationship (CS) {CNE:C:ActRelationshipType:SUBJ, fixed value= "SUBJ"}
contextControlCode [1..1] (M)
ActRelationship (CS) {CNE:C:ContextControl:AN, fixed value= "AN"}
contextConductionInd [1..1] (M)
ActRelationship (BL){fixed value= "true"}
informDefinition [1..1] (InformDefinition)

Design Comments:

Defines the types of information permission is being granted to access.

Rationale:

Allows discrete control over different types of information.

 
InformDefinition

Design Comments:

Defines the types of information permission is being granted to access.

Rationale:

Allows discrete control over different types of information.

classCode [1..1] (M)
Act (CS) {CNE:C:ActClass:INFRM, fixed value= "INFRM"}
moodCode [1..1] (M)
Act (CS) {CNE:C:ActMood:DEF, fixed value= "DEF"}
receiver [1..1] (Receiver)

Design Comments:

Identifies the beneficiary of the consent as being a Provider or Service Location.

Rationale:

Indicates who is receiving consent to view information.

This participation is marked as "populated" as receiver must be specified when keyword is involved.

subject [1..10] (Subject3)
 
Receiver

Design Comments:

Identifies the beneficiary of the consent as being a Provider or Service Location.

Rationale:

Indicates who is receiving consent to view information.

This participation is marked as "populated" as receiver must be specified when keyword is involved.

typeCode [1..1] (M)
ManagedParticipation (CS) {CNE:C:ParticipationType:RCV, fixed value= "RCV"}
contextControlCode [1..1] (M)
ManagedParticipation (CS) {CNE:C:ContextControl:OP, fixed value= "OP"}
recipient [1..1] (Recipient)
 
Recipient
choice of R_AssignedPersonIdentified-confirmable
          or R_ServiceDeliveryLocationContact
 
Subject3
typeCode [1..1] (M)
ActRelationship (CS) {CNE:C:ActRelationshipType:SUBJ, fixed value= "SUBJ"}
contextControlCode [1..1] (M)
ActRelationship (CS) {CNE:C:ContextControl:AN, fixed value= "AN"}
contextConductionInd [1..1] (M)
ActRelationship (BL){fixed value= "false"}
actDefinition [1..1] (ActDefinition)
 
ActDefinition
classCode [1..1] (M)
Act (CS) {CNE:C:ActClass:ACT, fixed value= "ACT"}
moodCode [1..1] (M)
Act (CS) {CNE:C:ActMood:DEF, fixed value= "DEF"}
code [1..1] (M)
Act (CV) {CNE:D:ActInformationAccessCode}

Design Comments:

The type of patient information that can be accessed or modified.

Rationale:

Different consents (or even keywords) may be needed to access different types of patient information (e.g. demographics, medications, allergies, lab results). Understanding the type of information the consent applies to is critical, and therefore the attribute is mandatory.