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Austin Kreisler



Minutes Approved as Presented 

This is to approve minutes via general consent. "You have received the minutes. Are there any corrections to the minutes? (pause) Hearing none, if there are no objections, the minutes are approved as printed."


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  1. Call to order
  2. Materials relevant to the review
    1. ISA-Bookmarked for CDA.pdf
    2. ISA information site:
    3. 2019ISAReferenceEdition.pdf
  3. Review ISA content related to CDA
  4. Time permitting, review other ISA content
  5. Approve comments to be submitted to HL7 PAC by August 28th.
  6. Adjournment


Discussion on the ONC ISA,  

The Policy Committee is requesting feedback by the 28th of Aug.  Our intent is to vote on any recommendations that SDWG would like to submit during this comment period.

Gay identified one issue she found:

Statements around the HAI Guides (Reporting Antimicrobial Use and Resistance Information to Public Health Agencies)

Level of Adoption - some places indicated as 1 other place 2

George noted that they did not call out the FHIR ballot also.

Care Plan - pg 31 in PDF

Implementation Specification - reference Pilot should be changes

Documenting and sharing Mediation Related Care Plans by Pharmacist  (pg 32)

Why is there a cost "$" is identified, there is not one for the CDA implementation guide

Domain or Disease-Specific Care Plan Standards (pg 32)

HL7 is not aware that ASCO is going to continue supporting this guide.

HL7 CDA® R2 Implementation Guide: Clinical Oncology Treatment Plan and Summary, Release 1 – US Realm

It is also likely that the

IHE Quality, Research, and Public Health Technical Framework Supplement, Early Hearing Detection and Intervention(EHDI), Rev 2.1 Trial Implementation  is possibly.  may not be currently supported.

Data Provenance (Pg 37)

Establishing the Authenticity, Reliability, and Trustworthiness of Content Between Trading Partners

HL7 CDA® Release 2 Implementation Guide Data Provenance, Release 1 - US Realm  - there is a new IG on this topic in progress.  (check with PCBCP)

Diet and Nutrition (pg 37)

Exchanging Diet and Nutrition Orders Across the Continuum of Care

This referenced material has been published:

In addition to the specifications listed above, work is underway to create a HL7 CDA R2 Implementation Guide: C-CDA R2.1 Supplemental Templates for  Nutrition, Release 1 (US Realm).  with this - HL7 CDA R2 Implementation Guide: C-CDA R2.1 Supplemental Templates for Nutrition, Release 1 - US Realm

Images (pg 81)

Format of Medical Imaging Reports for Exchange and Distribution

PS3.20 Digital Imaging and Communications in Medicine (DICOM) Standard – Part 20: Imaging Reports using HL7 Clinical Document Architecture

( no comment from SDWG)

Patient Preference/Consent (pg 68)

Recording Patient Preferences for Electronic Consent to Access and/or Share their Health Information with Other Care Providers

Should remove 1st word in title"Emerging Implementation Specification"

Public Health Reporting (pg 69)

Case Reporting to Public Health Agencies = these are public health standards

Reporting Antimicrobial Use and Resistance Information to Public Health Agencies  (pg 73)

HL7 Implementation Guide for CDA® Release 2 – Level 3: Healthcare Associated Infection Reports, Release 1, U.S. Realm.  - for this Reporting Antimicrobial Use and Resistance Information  use case is this the right version that they want cited,  They may want to check with the CDC program that is responsible.  There are more current versions of this standard available.

 (pg 73-75) these are public health WG

Reporting Birth and Fetal Death to Public Health Agencies

Reporting Death Records to Public Health Agencies

Reporting Cancer Cases to Public Health Agencies

Reporting Newborn Screening Results to Public Health Agencies

Sending Health Care Survey Information to Public Health Agencies  (pg 77)

Suggest that they consistently cite the base standard or not.   - Public Health WG

Data Collection for Submission to Registries and Reporting Authorities  (pg 77)

Is it intentional that sometimes there is a base standard cited (CDA) vs citing a specific CDA IG ?

Submission of Clinical Research Data Contained in EHRs and Other Health IT Systems for General Purpose or Preserving Specific FDA

Requirements (Pg 79)     Is it intentional that sometimes there is a base standard cited (CDA) vs citing a specific CDA IG ?

Data Segmentation of Sensitive Information (pg 82)

HL7 Clinical Document Architecture (CDA®), Release 2.0, Final Edition -  Is it intentional that sometimes there is a base standard cited (CDA) vs citing a specific CDA IG ?

Support a Transition of Care or Referral to Another Health Care Provider (pg 83)

HL7 Consolidated CDA® Release 1.1 (HL7 Implementation Guide for CDA® Release 2: IHE Health Story Consolidation, DSTU Release 1.1 - US Realm) this standard should be sunset  - HL7 does not recommend using this old standard

We would recommend that these references be used:

Implementation Specification, Production wide spread adoption currently

Remove Emerging

Implementers should explore use of emerging CDA on FHIR and FHIR US Core and CCDA on FHIR to support this interoperability need

Administrative Transactions to Support Clinical Care

Health Care Attachments to Support Claims, Referrals and Authorizations (pg 108)

HL7 CDA® R2 Attachment Implementation Guide: Exchange of C-CDA Based Documents, Release 1 - US Realm

HL7 CDA R2 Implementation Guide: Consolidated CDA Templates for Clinical Notes (US Realm) Draft Standard for Trial Use Release 2.1  - this should not be pilot but production. 

Administrative Transactions - Non-Claims

Enrollment and Disenrollment in a Health Plan  - this is all X12

Motion to approve the comments discussed once they are cleaned up and submit them to the policy committee. opposed 0 abstain: 0 For 10

Vocabulary issues  (PG 5)

US CDI - where is lists clinical notes - the LOINC codes to be used need to be identified.  We need LOINC codes for Narrative Laboratory Reports and Narrative Pathology Reports.

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