Yesterday, Dave Carlson presented on how the Model Driven Health Tools will be used to generate the guide being produced by the CDA Consolidation project. It was like someone turned on the way-back machine for me. Before I entered the field of Healthcare (a decade ago now), I used to work for a company (now defunct) that produced technical documentation tools working with SGML and XML.
These days there is an OASIS XML-based standard for designing, writing, managing, and publishing many kinds of information in print and on the Web: The Darwin Information Typing Architecture or DITA. The DITA standard has several open source implementations, including DITA-OT, which MDHT is using as an output format for the model.
DITA can be readily transformed to standard formats like XHTML and PDF, or proprietary formats like RTF, or other output combinations like JavaDoc, Eclipse Help, et cetera, using a common set of inputs.
Dave is using ANT, another Java based open source component to support the documentation build process.
There's plenty of content uses in the CDA Consolidation project that needs to be created manually. This is incorporated into the documentation using topic maps to build the "Table of Contents" of the guide. Getting this content from an editor into DITA format would clearly be a concern. However, most word processors these days generate XML output, often in a standard format like OpenDocument or DocBook, or at least in a well documented proprietary variants of a standard format . It's pretty easy to write XML transforms from these formats to DITA to capture the necessary documentation structure, so that editors can continue to use their favorite word processes. There are also commercial products that support editing of DITA directly.
There's plenty of proprietary solutions that support complex documentation development applications, many of them using DITA these days as well. What the MDHT and CDA Consolidation projects have done has been to develop tools which could support standards developers using open source tools, generating very high quality output.
It's all still very much a work in progress, but as I think about next generation publishing tools, I'm hoping that HL7, IHE, DICOM and other standards organizations consider the MDHT tools as a very strong starting point. Who knows, maybe there will even be a GIT integration someday that will make one of my IHE colleagues happy.