DICOM PS3.20 2019a - Imaging Reports using HL7 Clinical Document Architecture

9.8.11 Recommendation

Template ID

1.2.840.10008.9.12

Name

Recommendation

Effective Date

2015/03/24

Version Label

DICOM-20150324

Status

Active

Description

This section provides a separate section to describe the study interpreter's recommendations for follow-up studies or procedures.

Classification

CDA Section Level

Relationships

Included in 9.6 Impression

Context

parent node

Open/Closed

Open

Revision History

DICOM-20150324: Initial version

Business Name

Nest Level

Element/​Attribute

Card

Elem/Attr Conf

Data Type

Value Conf

Value

Subsidiary Template

Recommendation

section

>

template​Id

1..1

SHALL

II

>@

@root

1..1

SHALL

UID

SHALL

1.2.840.10008.9.12

>

id

1..*

SHALL

II

>

code

1..1

SHALL

CD

SHALL

(18783-1, LOINC, "Study recommendation")

Title

>

title

0..1

MAY

ST

Text

>

text

0..1

SHALL

ED

Content[*]

>>

content

0..*

SHALL

ST

[See 9.8.11.1 text/content]

*

>>@

@ID

1..1

SHALL

XML ID

Guideline​Ref

>>>

link​Html

0..1

MAY

ST

Guideline​URI

>>>@

@href

1..1

SHALL

URI

>

entry

0..*

SHOULD

Followup​Procedure[*]

>>

procedure

1..1

SHALL

>>@

@classCode

1..1

SHALL

CS

SHALL

PROC

>>@

@moodCode

1..1

SHALL

CS

SHALL

PRP

Procedure​Code

>>>

code

1..1

SHALL

CD

Concept​Domain Recommended Follow-up

When

>>>

effective​Time

1..1

SHOULD

IVL <TS>

>>>

text

1..1

SHALL

ED

Ref

>>>>

reference

1..1

SHALL

URL (XML IDREF)

# content​Ref

9.8.11.1 text/content

Each documented recommendation SHALL be included as narrative in a content element, labeled with an XML ID (see Section 9.1.1.1 <content> Markup and Links From Entries). The content element NEED NOT be top level markup within the section/text element; it MAY be wrapped in another allowed narrative block markup, such as paragraph, list/item, or table/row/cell.

If the recommendation is based on a clinical guideline, a reference to that guideline MAY be included in a linkHtml element.

Each recommendation SHOULD have a corresponding structured entry.

Example 9.8.11-1. Radiology recommendation section example

<section classCode="DOCSECT" moodCode="EVN">
    <templateId root="1.2.840.10008.9.12" />
    <id root="1.2.840.10213.2.62.7044779.114265201"/>
    <code code="18783-1" codeSystem="2.16.840.1.113883.6.1"
        codeSystemName="LOINC" displayName="Study Recommendation"/>
    <title>Radiology Recommendation</title>
    <text>
        <content ID="rec01">Biopsy should be considered. Follow-up at 3 month interval.
        </content>
        <linkHtml href="http://pubs.rsna.org/doi/abs/10.1148/radiol.2372041887"/>
    </text>
    <entry>
        <procedure ID="RadRec1" classCode="PROC" moodCode="PRP"/>
        <!-- local coding scheme -->
        <code code="9191919" codeSystem="2.16.840.1.56789.6.1"
            codeSystemName="My Hospital Coding System"
            displayName="3 month follow-up"/>
        <text><reference value="#rec01"/></text>
        <effectiveTime value="20141213"/>
    </entry>
</section>

DICOM PS3.20 2019a - Imaging Reports using HL7 Clinical Document Architecture