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Tuesday, July 7, 2015

How Good it your CCDA Validator

I'm presently evaluating the HL7 C-CDA DSTU 2.1 update.  I'm doing it by way of updating the DSTU 2.0 sample files to conform to DSTU 2.1.  Along the way I've been testing my samples against both the 2.1 specification, and the 1.1 specification which it is to be backwards compatible with.

I have various validation tools for 1.1.  There's the Schematron produced by Trifolia, the TTT testing tool used for Meaningful Use, and the SITE Tool, as well as Josh Mandel's SMART CCDA Scorecard, and if I dug around hard enough, I could probably also find an Art Decor based validator.

Each one of these provides overlapping results.  Some are more up to date that others with HL7 Errata.  I'm still finding bugs with each of these so far.

One of the challenges that we have as an industry is that there is no single authority on what is a valid CCDA.  It should be HL7, but since ONC oversees the Certification program, and NIST develops the tools for that program, we have three different validators with slightly different ideas about what is a valid CCDA 1.1 document.

The validators are of varying quality with respect to how they work.  The Schematron-based tools are my favorite, simply because those tools are the most transparent about what they are testing.  None of the validation tools does a great job of taking me back to the source of truth used, although I can readily go from Conformance identifier back to the related specification.

I guess I'm spoiled by some of the W3C validators I've used, which link me directly to the conformance requirements in the standard.  Until we get an HTML version of CCDA, we won't be seeing that.  But hopefully that can be something that is produced sooner rather than later.