Interventions Section¶

OID: 2.16.840.1.113883.10.20.21.2.3 Version: 2015-08-01 Badge: Specialized Section

Overview¶

The Interventions Section represents interventions - actions taken to maximize the prospects of achieving the goals of care for the patient, including removal of barriers to success. Interventions can be planned, ordered, or historical (already performed).

Interventions include actions that may be ongoing (such as maintenance medications and monitoring health status). This section documents both completed interventions and those that are planned for the future. Instructions may be nested within interventions and can include self-care instructions.

Template Details¶

Template ID: 2.16.840.1.113883.10.20.21.2.3
Extension: 2015-08-01
Conformance: MAY
Cardinality: 0..1 (Optional in documents)
LOINC Code: 62387-6 "Interventions Provided"

Protocol Requirements¶

InterventionProtocol (Completed Interventions)¶

from typing import Protocol, Optional
from datetime import datetime

class InterventionProtocol(Protocol):
    description: str                    # Description of the intervention
    status: str                        # Status (e.g., "completed", "active", "in-progress")
    effective_time: Optional[datetime] # When intervention was performed
    goal_reference_id: Optional[str]   # Reference to related goal

PlannedInterventionProtocol (Future Interventions)¶

class PlannedInterventionProtocol(Protocol):
    description: str                    # Description of planned intervention
    status: str                        # Status (typically "active" for planned)
    effective_time: Optional[datetime] # When intervention is planned
    goal_reference_id: Optional[str]   # Reference to related goal

Code Example¶

Completed Interventions¶

from ccdakit import InterventionsSection, CDAVersion
from datetime import datetime

# Define completed interventions
interventions = [
    {
        "description": "Patient education on diabetes self-management",
        "status": "completed",
        "effective_time": datetime(2025, 1, 15, 10, 30),
        "goal_reference_id": "goal-1"
    },
    {
        "description": "Home safety assessment completed",
        "status": "completed",
        "effective_time": datetime(2025, 1, 10, 14, 0),
        "goal_reference_id": None
    },
    {
        "description": "Smoking cessation counseling provided",
        "status": "completed",
        "effective_time": datetime(2025, 1, 12, 11, 15),
        "goal_reference_id": "goal-2"
    }
]

section = InterventionsSection(
    interventions=interventions,
    version=CDAVersion.R2_1
)

xml_element = section.build()

Planned Interventions¶

from ccdakit import InterventionsSection, CDAVersion
from datetime import datetime

# Define planned interventions
planned_interventions = [
    {
        "description": "Physical therapy evaluation scheduled",
        "status": "active",
        "effective_time": datetime(2025, 2, 1, 9, 0),
        "goal_reference_id": "goal-mobility"
    },
    {
        "description": "Nutritional counseling appointment",
        "status": "active",
        "effective_time": datetime(2025, 1, 25, 14, 30),
        "goal_reference_id": "goal-weight"
    }
]

section = InterventionsSection(
    planned_interventions=planned_interventions,
    version=CDAVersion.R2_1
)

xml_element = section.build()

Combined Completed and Planned Interventions¶

from ccdakit import InterventionsSection, CDAVersion
from datetime import datetime

# Both completed and planned interventions
interventions = [
    {
        "description": "Medication adherence counseling provided",
        "status": "completed",
        "effective_time": datetime(2025, 1, 18, 10, 0),
        "goal_reference_id": "goal-medication-adherence"
    },
    {
        "description": "Chronic pain management education completed",
        "status": "completed",
        "effective_time": datetime(2025, 1, 18, 10, 30),
        "goal_reference_id": "goal-pain-control"
    }
]

planned_interventions = [
    {
        "description": "Follow-up phone call for medication adherence",
        "status": "active",
        "effective_time": datetime(2025, 2, 1, 10, 0),
        "goal_reference_id": "goal-medication-adherence"
    },
    {
        "description": "Social work consult for transportation assistance",
        "status": "active",
        "effective_time": datetime(2025, 1, 22, 13, 0),
        "goal_reference_id": None
    }
]

section = InterventionsSection(
    interventions=interventions,
    planned_interventions=planned_interventions,
    version=CDAVersion.R2_1
)

xml_element = section.build()

Comprehensive Care Coordination Example¶

from ccdakit import InterventionsSection, CDAVersion
from datetime import datetime

# Complex care coordination interventions
interventions = [
    {
        "description": "Care coordination meeting with primary care provider",
        "status": "completed",
        "effective_time": datetime(2025, 1, 15, 14, 0),
        "goal_reference_id": None
    },
    {
        "description": "Medical equipment evaluation and ordering (walker)",
        "status": "completed",
        "effective_time": datetime(2025, 1, 16, 11, 0),
        "goal_reference_id": "goal-mobility"
    },
    {
        "description": "Referral to diabetes educator",
        "status": "completed",
        "effective_time": datetime(2025, 1, 15, 15, 30),
        "goal_reference_id": "goal-diabetes-control"
    }
]

planned_interventions = [
    {
        "description": "Home health nursing assessment scheduled",
        "status": "active",
        "effective_time": datetime(2025, 1, 25, 10, 0),
        "goal_reference_id": None
    },
    {
        "description": "Caregiver training on wound care",
        "status": "active",
        "effective_time": datetime(2025, 1, 23, 14, 0),
        "goal_reference_id": "goal-wound-healing"
    }
]

section = InterventionsSection(
    interventions=interventions,
    planned_interventions=planned_interventions,
    version=CDAVersion.R2_1
)

xml_element = section.build()

Official Reference¶

HL7 C-CDA Interventions Section Specification

Best Practices¶

Link to Goals: Always reference related health goals when interventions are goal-directed to show care coordination.
Be Specific: Describe interventions in detail so other providers understand exactly what was done.
Document Outcomes: When possible, note the outcome or effectiveness of completed interventions.
Include All Disciplines: Document interventions from all care team members (nursing, PT, OT, social work, pharmacy, etc.).
Track Planned Items: Use planned interventions to document future actions that are part of the care plan.
Timestamp Accurately: Include specific dates and times for both completed and planned interventions.
Update Status: Keep intervention status current as they progress from planned to in-progress to completed.
Address Barriers: Document interventions specifically aimed at removing barriers to care (transportation, finances, health literacy).
Self-Care Instructions: Include patient education and self-care instructions as interventions.
Care Coordination: Document care coordination activities and referrals to other providers or services.

Common Intervention Types¶

Patient Education¶

Disease-specific education (diabetes, heart failure, COPD)
Medication management education
Lifestyle modification counseling
Symptom management instruction
Self-monitoring techniques

Care Coordination¶

Referrals to specialists
Home health arrangements
Medical equipment ordering
Care transition planning
Follow-up appointment scheduling

Behavioral Health¶

Smoking cessation counseling
Alcohol and substance abuse counseling
Mental health counseling
Stress management techniques
Sleep hygiene education

Nutritional Support¶

Dietary counseling
Meal planning assistance
Nutritional supplements
Enteral/parenteral nutrition management

Rehabilitation Services¶

Physical therapy
Occupational therapy
Speech therapy
Cardiac rehabilitation
Pulmonary rehabilitation

Financial assistance programs
Transportation arrangements
Housing assistance
Community resource connection
Caregiver support services

Barrier Removal¶

Health literacy interventions
Language interpretation services
Transportation assistance
Financial counseling
Medication affordability programs

Status Values¶

active: Intervention is ongoing or planned
completed: Intervention has been finished
in-progress: Intervention is currently being performed
suspended: Intervention temporarily on hold
cancelled: Planned intervention was cancelled
aborted: Intervention started but not completed

Linking Interventions to Goals¶

When interventions are tied to specific health goals, use the goal_reference_id field to create the link:

# Example showing intervention-goal relationship
interventions = [
    {
        "description": "Daily walking program initiated",
        "status": "active",
        "effective_time": datetime(2025, 1, 15),
        "goal_reference_id": "goal-increase-activity"  # Links to mobility goal
    }
]

This creates a clear connection between the action taken (intervention) and the desired outcome (goal), demonstrating coordinated, goal-directed care.