“As disparate SDOs (HL7, IHE, HITSP, etc.) developed CDA IGs, multiple approaches for documenting template requirements began to diverge threatening interoperability…”
IG = Implementation Guide
So my wild guess is they created a new artifact with the same problems the current artifacts have, like the need for an IG, instead of doing a little research and find a better solution like using archetypes to model and “consolidate” CDA templates.
Does anyone know more about CCDA? Do you think this is a good area of work for openEHR in the US? I mean, maybe we (as a community) can propose an openEHR-based solution or make some kind of statement, for documental consolidation than having another implementation guide + CDA templates.
Dear sir,
let me share a litttle thought of mine about this CCDA thing
dating back to 2000, CDA is created and used in some places in USA and in 2005 it is evoved to Release 2, in that time ,there is not only one CDA for the clinical document representation in USA,for some continuity of care and specially for patient transfer between different facilities there is a standard named CCR, after some kinds of fighting,they all agreed to use CDA as the basic format or model to solve the continuity of care problem ,which became the most widely used across the whole world CCD(Continuity of Care Document) in 2007,in this CCD they defined different kinds of templates for vital signs and chief complaint and so on.after then IHE,HITSP and HL7 they create a bunch of other IG for different use cases, for example public health section .these all existing IGs contain a number of templates(section level and entry level ) inherit the constraints defined in the original CCD standards and inconsistency between these templates bring them a new level interoperability problem.in order to solve this mess they came to the idea to create a unified template library based on these efforts these SDO and agency have done.
at last I want to say maybe CDA is not that widely used across the world,openEHR is definitely less.
There is some work going on t odo mappings between openEHR and C-CDA
as part of the EU SemanticHealthNet project but I suspect C-CDA has
little future, to be rapidly replaced by FHIR,
I think this recent tweet is relevant - The #argonaut project, CCDA on fhir at #HL7WGM pic.twitter.com/NoRgffPHHk
Ian
Dr Ian McNicoll
office +44 (0)1536 414 994
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ian.mcnicoll@oceaninformatics.com
Clinical Modelling Consultant, Ocean Informatics, UK
Director openEHR Foundation www.openehr.org/knowledge
Honorary Senior Research Associate, CHIME, UCL
SCIMP Working Group, NHS Scotland
BCS Primary Health Care www.phcsg.org
technically speaking, the main problem with CDA is its lack of easy computability. Like other message-based ‘models’, A CDA template is a manually defined model of some content, expressed directly in a concrete implementation format, namely a specific kind of document XSD, which imposes all kinds of RIM-originated features. It also lacks any equivalent of the archetype /template separation, i.e. re-usable components, as well as any easy way to semantically query data based on it, other than devising ad hoc Xpath-based queries. In openEHR - far from perfect itself as we know - I believe we have achieved some useful architectural principles, namely:
technically speaking, the main problem with CDA is its lack of easy computability. Like other message-based ‘models’, A CDA template is a manually defined model of some content, expressed directly in a concrete implementation format, namely a specific kind of document XSD, which imposes all kinds of RIM-originated features. It also lacks any equivalent of the archetype /template separation, i.e. re-usable components, as well as any easy way to semantically query data based on it, other than devising ad hoc Xpath-based queries. In openEHR - far from perfect itself as we know - I believe we have achieved some useful architectural principles, namely:
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