News around the HL7 CDA

The CDA Consolidation project reached a major milestone today as the Structured Documents Workgroup voted to approve the ballot reconciliation for posting.  This reconciliation addressed over 500 comments since the HL7 Working Group meeting in May, just less than two months ago.  That's a major amount of work.  There's still quite a bit left to do, and another ballot forthcoming that could result in a similar volume of work.  Even so, congratulations are in order.

As part of that, one of the things we finally resolved was how to deal with how to say that the patient is on no medications, or that it is unknown if the patient is taking any medications.  We based that off of work that I reported on here in the last couple of days.  We did make one minor modification which I will correct on those pages tomorrow.  In stating that it is unknown whether a patient is on medications, I incorrectly stated that the medication is unknown, as Grahame Grieve pointed out comments two days ago.  We fixed that by replacing that unknown with a general code indicating "medication" (and the same would be true for allergies and problems).

We also developed a more clear statement around the requirements for locations of entries in a section.  The Consolidation guide requires "direct" containment of the required acts within the section, whereas previous guides required them to be in the section or in any subordinate section.  That was clarified, and we further agreed that while they must be contained within an entry contained directly within the section, we did not require them to be immediately within that entry.  The rationale for this is to support enhancements such as those found in the IHE Reconciliation profile which I've discussed previously.

A couple of days ago the ONC Transitions of Care Project developed its initial ecosystem consensus statement recommending CDA Release 2 as the standard to use to convey information necessary for Transitions of Care.  That consensus statement has yet to be finalized (it should be by next week), but I'm hopeful that it will go forward pretty much as stated (There are a few things I want to review, and one suggestion that might be contentious).

Finally, there are several things happening at the same time that should enable closer cooperation between IHE and HL7 on the development of IHE profiles.  The "Activities with other SDOs" report that I give on Sunday at the HL7 WGM as the HL7 assigned liason to IHE will still occur.  A new initiative will probably happen at the next HL7 that will help HL7 and its partners like IHE to develop goals and objectives around those collaborations.  I look forward to that discussion.