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Act.moodCode

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2.2.3

The Act.moodCode is a structural code which is defined as "a code distinguishing whether an Act is conceived of as a factual statement or in some other manner as a command, possibility, goal, etc". Its values are drawn from the HL7 ActMood vocabulary table.

We need to consider what the analogous V2 constructs are here. This likely is already documented somewhere, at least partially. RH

2.2.3.1

The values specified in the ActMood vocabulary partially overlap with SNOMED CT representations of [ 408729009 | finding context ] and [ 408730004 | procedure context ].


  • SNOMED CT [ 408729009 | finding context ]:
    • Represents an assertion that the [ 246090004 | associated finding ] is: present, absent, a goal, a risk or an expectation.
    • May also represent an assertion that the presence or absence of a finding is unknown, possible or probable.
    • Applies to:
      • any SNOMED CT expression that represents a [ <<404684003 | clinical finding ].
      • any SNOMED CT expression that represents either a [ <<71388002 | procedure ] or an [ <<363787002 | observable entity ] provided that the expression is combined with a relevant result or value.
    • Is relevant to instances of HL7 Observation classes expressed in "event", "goal", "expectation" and "risk" moods.
  • SNOMED CT [ 408730004 | procedure context ]
    • Represents an assertion that the [ 363589002 | associated procedure ] is: "requested", "planned", "started", "done", "cancelled", "not done", "not to be done" or one of several more specific [ <<408730004 | procedure context ] values.
    • May also represent an assertion that it is not known whether the procedure has been done.
    • Applies to any SNOMED CT expression that represents a [ <<71388002 | procedure ] (except where that expression is combined with a relevant result value).
    • Is relevant to:
      • instances of various HL7 Act classes including Procedure, SubstanceAdministration and Supply.
      • instances of the HL7 Observation class except in "intent" moods (including "request" and other subtype of "intent").
2.2.3.2

The following rules ensure validation and consistent interpretation of particular combinations of moodCode and SNOMED CT context. They also specify the context a particular moodCode value applies to a SNOMED CT expression that does not include an explicit representations of context.


  1. The moodCode SHALL be present in all Act class instances [[[4]]]
  2. If the code attribute of an instance of the Observation class, with a moodCode that is neither "intent" (INT) nor a subtype of "intent", is populated with a SNOMED CT expression, this expression MAY include an explicit representation of [ 408729009 | finding context ].
  4. If the value attribute of an instance of the Observation class is populated with a SNOMED CT expression, this expression MAY include an explicit representation of [ 408729009 | finding context ].
  6. If the code attribute of an instance of any Act class (except Observations included in points 2 or 3 above) is populated with a SNOMED CT expression, this expression MAY include an explicit representation of [ 408730004 | procedure context ].
  8. If a SNOMED CT expression includes an explicit statement of context this SHALL be validated by the rules stated above and SHALL be interpreted as a restatement or refinement of the meaning specified by the moodCode. The meaning of the SNOMED CT context SHALL NOT be interpreted as an independent compounding semantic modifier.

For example
moodCode="RQO" and code=[ 408730004 | procedure context | = 385644000 | requested ]
This means "requested". It does not mean a "request to request".


moodCode="INT" and code=[ 408730004 | procedure context | = 385650005 | organised ]
This means "organized". It does not mean an "intention to organize".


moodCode="INT" and value=[ 408729009 | finding context | = 410518001 | goal ]
This is an error. It does not mean an "intention to set a goal".

HL7 Act.moodCode mapping to default context for SNOMED CT findings shows the mapping from moodCode to the default [ 408729009 | finding context ] for concepts that are subtypes of [ 404684003 | clinical finding ]. HL7 Act.moodCode mapping to default context for SNOMED CT procedures shows the mapping from moodCode to default [ 408730004 | procedure context ] for concepts that are subtypes of [ <<71388002 | procedure ].


HL7 Act.moodCode constraints on explicit context for SNOMED CT findings shows the [ 408729009 | finding context ] validation constraints for SNOMED CT expressions based on the moodCode of the containing Act class instance. HL7 Act.moodCode constraints on explicit context for SNOMED CT procedures shows the [ 408730004 | procedure context ] validation constraints for SNOMED CT expressions based on the moodCode of the containing Act class instance.


In these tables the symbol "<<" preceding a value indicates that either the value or any subtype of the value is permitted.


The context values in these tables are based on the following assumptions about other attributes in the same Act class instance:If any these assumption do not apply then refer to the referenced sections for further information.


  • the HL7 negationInd is omitted from the Act class instance (see Act.negationInd)
  • the HL7 uncertaintyCode is omitted from the Act class instance (see Act.uncertaintyCode)
  • the HL7 statusCode in the Act class instance has a value that does not influence the context (see Act.statusCode)
HL7 Act.moodCode mapping to default context for SNOMED CT findings
moodCode Mood Name Finding context
EVN Event known present ] 
                                            GOL
Goal goal ] 
                                            RSK
Risk at risk ] 
                                            EXPEC
Expectation expectation ]
HL7 Act.moodCode constraints on explicit context for SNOMED CT findings
moodCode Mood name Finding context
EVN Event known |)

OR

                                            (<<261665006 | unknown |)]
                                         

                                            GOL
Goal goal ] 
                                            RSK
Risk at risk ] 
                                            EXPEC
Expectation expectation ]
HL7 Act.moodCode mapping to default context for SNOMED CT procedures
moodCode Mood name Procedure context
EVN Event done )

OR
(values dependent of Act.statusCode - see note )]

INT Intent pre-starting action status ]
RQO Request requested ]
PRP Proposal to be done ]
PRMS Promise accepted ]
ARQ Appointment request requested ]
APT Appointment scheduled ]

Note: For more information on statusCode dependent values see HL7 statusCode impact of defaults and constraints applicable to procedure context for Acts in "event" mood

HL7 Act.moodCode constraints on explicit context for SNOMED CT procedures
moodCode Mood name Procedure context
EVN Event post-starting action status)

OR
[[]](values dependent of Act.statusCode - see note ) ]

INT Intent pre-starting action status ]
RQO Request requested ]
PRP Proposal being organized |)

OR
(<< 385643006 | to be done |) ]

PRMS Promise being organized ]
ARQ Appointment request requested ]
APT Appointment being organized ]

For more information on statusCode dependent values see HL7 statusCode impact of defaults and constraints applicable to procedure context for Acts in "event" mood


HL7 MoodCodes that have no direct relationship to finding or procedure context lists Act.moodCodes that have no direct relationship to SNOMED CT context attributes. While no constraints are specified for these moodCodes, some combinations may be irrational or open to misinterpretation. Therefore, caution should be used when combining these moodCodes with explicit representations of SNOMED CT context.


HL7 MoodCodes that have no direct relationship to finding or procedure context
moodCode Name
DEF Definition
SLOT Resource slot
EVN.CRT Event criterion
OPT Option
2.2.3.3

The Act.moodCode is a mandatory component all HL7 Act classes. Therefore this HL7 representation is required irrespective of whether SNOMED CT context representations are used.


SNOMED CT [ 408729009 | finding context ] and [ 408730004 | procedure context ] value hierarchies include more specific meanings than those associated with the Act.moodCode. Therefore, the SNOMED CT representation cannot be prohibited without resulting in loss of information.


For example, Act.moodCode cannot be used to express various:


  • SNOMED CT [ 408730004 | procedure context ] values, including [ 410536001 | contraindicated ] and [ 385661002 | considered and not done ].
  • SNOMED CT [ 408729009 | finding context ] values, including [ 410596003 | likely outcome ] and [410605003 | confirmed present ].

The SNOMED CT context model permits default context values to be applied, based on the surrounding information model. Therefore, inclusion of SNOMED CT context can be specified as optional, provided there are explicit rules (such as those in HL7 Act.moodCode mapping to default context for SNOMED CT findings and HL7 Act.moodCode mapping to default context for SNOMED CT procedures) for deriving default context values from the moodCode and, where relevant, from other HL7 Act class attributes.


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