John Halamka's "Genius of the AND" post seemingly reversed a half-decade of progress in the CCR/CDA debate, but unblocked a political log-jam that we can now see has led to a market choice towards CDA. That simple idea, "why not both", came back to me again while discussing the current challenges with content for the ABBI project with Doug Fridsma. I espoused the viewpoint that Consolidated CDA was the mandated format that all providers will have to use, and that I didn't want to see dumbed down ASCII or PDF in downloads. And so he did as he has to me several times, asked a simple question which changed my viewpoint. "Why Not Both?"
And then John Moehrke jumped in. No reason at all. You can negotiate it. In fact, hData, MHD and FHIR all support query parameters that let you ask for what you want.
And I know that their are transforms from the provider mandated Consolidated CDA format to text/html, text/plain (via Corey Spears excellent Blue Button Stylesheet efforts), and from text/html to application/pdf, and also from text/xml to application/json (and potentially from Consolidated CDA to FHIR).
So, my thinking is that my ABBI PULL Implementation will support content negotiations. That data sources will either locate content in the requested format, or transform content in other formats to the requested format.
It should be pretty easy to ensure that the appropriate content negotiation parameter exists in the protocol.
Meanwhile, back at the ranch, John Moehrke, Grahame Grieve and Gerald Beuchelt are out their aligning MHD, FHIR and hData across IHE, HL7 and OMG. No S&I Framework project is necessary. That may in fact be the greatest success of S&I, is the fear that if we do not do it, they'll decide to come along and do it for us.
So, I expected to have an MHD implementation for the IHE Connectathon, and will be using the same code for the HL7 FHIR Connectathon, perhaps with a bit different transforms. And when we are done, we'll be able to pick and choose. And Gerald has offered to be a sounding board. I think I'm psyched.
I love it when a plan comes together.