This afternoon, I'll be talking to the S&I Framework Public Health Reporting Initiative about CDA documents for use in a public health reporting context.
The goal of this initiative is to start with a common data set that makes up the core of all public health functions (e.g., patient demographics, facility and provider identification). Adding to that would be report specific content (e.g., ELR, Immunizations, Public Records, et cetera). And it might then be customized do deal with initiative or locale specific content. This is a pattern we've all seen before, and are re-executing upon today in S&I.
A key challenge for public health would be in developing its transition strategy if the CDA model for reporting were chosen. This is truly a new paradigm for reporting in public health. HL7 is currently executing a "Cross-Paradigm" exploration for immunizations, looking at services, V3 messages, documents, et cetera. While I haven't been following that project, it should help inform some of the work of this initiative.
A few years back IHE PCC created the Immunization Content profile. We demonstrated the ability of several systems to transform from V2 to CDA, and from CDA back to V2 through showcases at HIMSS and for Public Health. There's no good reason to replace what we have today with something that transforms from V2 to CDA and than back again. BUT, there are really good reasons to be able to use information in a summary of care record that is already being communicated to an HIE, to provide public health what it needs, or to reuse the transport and content standards that are being used elsewhere to enable public health functions.
I'd love it if public health used the same transports and content that EHRs are using to communicate with each other.