Clinical Statements
The article Clinical act statements, provides an overview of the clinical statements that form the “core” of a CDA document.

Clinical statements are contained within entry elements, which in turn are contained within section elements, which in turn comprise the structured CDA Body, located in the XML path: ClinicalDocument/component/structuredBody.

Clinical statements begin with an XML element of: act, encounter, procedure, observation, substanceAdministration, supply, or organizer.

“Organizer” Clinical Statements
The clinical act statement element named organizer is a bit different than the others. It is used to represent clinical acts that, by their nature, have multiple component parts.

The component parts of the organizer act are each represented within a sub-element of organizer named component.

The component sub-element of organizer is an act relationship element.

More than Just a List of Acts
It’s tempting to think of the organizer element only as a “list” mechanism for other acts. That is indeed its primary purpose, but it’s also important to note that the organizer element represents an independent clinical act in and of itself.

The organizer act has the same common sub-elements and attributes as other acts (although there are some differences relative to most other clinical act statements, see below, later in this article, for additional information). Refer to the article What goes inside a clinical statement XML entry?, for an overview of some of the sub-elements and attributes that all clinical act statements have in common.

So, for example, the organizer act has its own statusCode, effectiveTime, and similar sub-elements. It can have its own participations sub-elements (refer to the article Participation elements, for additional information) and act relationship elements that link it to other acts.

While the attributes and sub-elements of the the organizer act are separate from those of the acts contained in the component sub-elements of that organizer act, they do need to be logically and clinically consistent.

entryRelationship Is Not Used with organizer
Although the organizer act can be related to other acts via act relationship elements, it can’t be the “source” of an entryRelationship element (refer to the article The entryRelationship element for an explanation of the “source” and “target” of an entryRelationship element). That is because it is intended that the component element, not the entryRelationship be use to capture the “related acts” of the organizer element.

The act relationship elements reference and preconditon may be used inside of an organizer element, alongside its component act relationship elements.

Nested Organizer Acts
It’s permissible to nest one organizer act inside the component sub-element of another organizer act.

moodCode and classCode Values for Act Statements
The moodCode attribute (refer to the article The moodCode attribute for additional information) of the organizer element takes only the “EVN” value indicating an actual, transpired event.

The classCode attribute (refer to the article The classCode attribute for additional information) of the organizer element can take one of two values:

  • “BATTERY” – Used when the contents of the organizer are a group of related clinical acts (typically, observations) in a flat list, as would be the case in a battery of tests.
  • “CLUSTER” – Used for more complex organizer constructs with nested organizer

The negationInd attribute is not available with the organizer element.

Other CDA PRO Know Articles Referenced In This Article