by dr Kai Heitmann
On August 16, HL7 International started the ballot on the HL7 CDA® R2 Implementation Guide: International Patient Summary, Edition 2.
The CDA Implementation Guide is still considered a valuable specification. Several countries, e.g. in Europe, have started early with CDA infrastructures and despite of the common movement to FHIR, this specification helps to align and migrate on a conceptual level to what FHIR offers.
Compared to the previous STU specification, developments took place mainly around additional data to be conveyed (Alert, Patient Story), input that comes from the underlying ISO Standard 27269:2021 Health informatics — International patient summary and its updates.
In addition, terminology aspects have been discussed and further developed. With a few exceptions, FHIR and CDA terminologies used are the same. One exception is the update Allergy and Intolerances Value Set, in FHIR made for binding at one place in the associated profile but in CDA these are still two Value Sets as substances and conditions are bound to different elements in CDA.
The list of changes includes the following areas of the CDA IPS, mainly regarding the Value Sets used:
- Medications
- Problems
- Procedures
- Immunizations
- Specimen Collection
- Allergy and Intolerances
- Laboratory/Pathology
- Radiology
- Social History (Smoking)
- Pregnancy and Estimated Delivery Date Observation
- New section: Alert
- New section: Patient Story
The Template Definition of the document level template in ART-DECOR can be found here. From that all other header, section and entry level templates are listed.
The ballot period is up for comments and votes and ends on September 16.
As a pilot, efforts have been made to convert the definitions of the HL7 CDA® R2 Implementation Guide of the International Patient Summary, that were done in ART-DECOR using the former HL7 Templates Standard: Specification and Use of Reusable Information Constraint Templates, in short Templates IST, into FHIR Structure Definitions and to use the FHIR IG publisher for the CDA IG. As a start, this is experimental for now but will be continously enhanced.