EffectiveTime represents the creation time of the document.If the CDA document is a transformation from an original document in some other format, the ClinicalDocument.effectiveTime is the time the original document has been created. The time when the transformation occurred is not currently represented in CDA.
It shall have the format yyyyMMddHHmmss[+/-]HHmm

The confidentiality code is a required contextual component of CDA and expresses the level of confidentiality assigned to the entire document. Unless any use case contradicts the following option, the ClinicalDocument/confidentialityCode will be given the constant value “Normal”.

Note:

The value for the confidentialityCode will be set at the creation time of the document and is for information only. It does not automatically apply security constraints. The rules related to the visibility and access of documents are executed on application level and therefore rely on the implementation of the applications who visualize or provide the document content.

Identifier of the author of this document, more than one identifier can be provided. For health professionals the hpdID (root OID = 1.3.182.4.1) from the HPD shall be provided. Additionally, if known, the code prestataire from CNS (UCM) with OID 1.3.182.4.6 may be provided.  Identifiers shall be provided as specified in chapter:   2.2.2 and following the specification of the II data type in chapter: 2.2

When a patient authors a document e.g. his national identifier (root  OID = 1.3.182.4.4) or the DSPPID (root OID = 1.3.182.2.4.2) can be used. 

If the author is a device, then the id of the device inside the institution shall be given.

Warning: If isMandatory=true, minimumMultiplicity shall be greater than 0.

Set of identifiers to identify the informationRecipient uniquely (Person as health professional). The use of the eHealthID as identification scheme is preferred.

Code to classify the type of participant e.g. “REF” for referrer.  Possible values shall be from value set:

Functional role of the participant e.g. “ADMPHYS” for the admitting physician, related to the patient´s treatment documented in this document instance

Specifies the type of the associated person e.g. “PROV” for healthcare provider.

Code for defining the role or the associatedEntity finer grained. Element is optional, if given the values shall be taken from the value sets as described in the table above, see Table 72 : Different participants as AssociatedEntity.

Code of the service event. The codes which can be used here are related to the specific CDA specification for the document type or medical domain e.g. laboratory and radiology domain. 

Value of the time (interval) when the act (service event) was executed. If the effectiveTime should be used to describe a point in time, the low and high attribute should have the same value.

The id must be the identifier of the parentDocument. The other parameters of the parentDocument like e.g. setId and versionNumber can be gained when retrieving this parent document. Putting values for attributes of this document creates redundancy, therefore they are omitted. 

Could be used e.g. to identify the document containing the signed consent of the patient.