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Welcome! This is the space for Structured Documents Work Group.

Welcome to Structured Documents Work Group. You'll find links to most of our content on the page below on in the sidebar to the left.

Leadership

Meetings

Projects

Position: Technical Specialist II
Department: Enterprise Application Services
Location: Mayo Clinic, Rochester, MN

Phone: 949-302-8082
Position: Namaste Informatics
Department: Principal
Location: Rogue Valley, Oregon

Phone: 816-201-3336
Position: Director & Solution Strategist
Department: Platform Development, Interop
Location: Kansas City, MO

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Decisions

WGM

Recently Updated

Mission & Charter


Mission

The group supports the HL7 mission through development of structured document standards for each of the product families where appropriate.  Structured Documents is responsible for the implementation guide methodology for the Clinical Document Architecture (CDA) Standard.

Charter

Work Products and Contributions to HL7 Processes

The Work Group will produce a comprehensive architecture to facilitate exchange and processing of electronic healthcare documents. The Work Group will support HL7 through education in the development, evolution, and use of structured document specifications. The specifications created by this committee will follow the accepted HL7 development processes. The Work Group will support specifications such as CDA and HL7 FHIR delivering structured document capabilities.

Specific Work Product Ownership includes:

  • CDA (R1, R2, R2.1)
  • FHIR Composition, DocumentReference, DocumentManifest resources
  • Version 2 Chapter 9 Medical Records
  • A number of derived specifications (implementation guides)
  • CDA Implementation Guide Quality Criteria

Formal Relationships with Other HL7 Groups

The Work Group will collaborate with V3 RIM class stewards Vocabulary to resolve issues arising from requirements for V3 document specifications. This will include, but not be limited to, participation in RIM harmonization and development of vocabulary domain tables.

The work group will collaborate with the FHIR Management Group and the FHIR Infrastructure work group to resolve FHIR specification issues arising from requirements for document specifications. This will include overseeing development of Document related FHIR resources.

The Work Group will collaborate with the V2 Management Group and the V2 methodology group to resolve V2 Chapter 9 issues arising from requirements for medical record document exchange or changes in infrastructure message requirements.

The Work Group will collaborate with the CDA Management Group to resolve CDA issues arising from Implementation Guide (IG) quality or requirements that involve further investigation.

Orders and Observations, Patient Care, and other Work Groups define the clinical content used in the specifications created by the Structured Document Work Group. The Structured Document Work Group will collaborate with these groups to establish a consistent approach to information exchange.

The work group will collaborate with Modeling and Methodology and Vocabulary work groups to document and formalize a CDA Methodology.

The work group will collaborate with the Cross-Group Projects on cross-cutting projects.

Formal Relationship with Groups Outside of HL7

None.

Informal Relationship with Groups Outside of HL7

The Structured Document Work Group will collaborate with groups developing standards, implementation guides or other resources that rely upon the materials developed by the Structured Documents Work Group.

Blog Stream

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Supporting Documents

Blog stream

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Clinical Document Architecture (CDA)

General

CDA R2

3 Year Plan

Deprecated/Outdated

  • C-CDA Maintenance & Update
    • Value set ownership and maintenance
    • Publishing new Releases of C-CDA
    • Errata Releases of C-CDA
    • C-CDA Supplements
  • Project to express CDA Templates as FHIR StructureDefinition Resource
  • Project to complete FHIR/CDA Logical Model  (Needs Project Scope Statement)
  • Updated to a web based publication (FHIR like)
  • Maintenance projects related to technical artifacts (schema, schematron, etc.)
  • Maintain CDA IG Quality Criteria

Copyright © Health Level Seven International ® ALL RIGHTS RESERVED. The reproduction of this material in any form is strictly forbidden without the written permission of the publisher.

SWOT

Strength

  • Highly relevant committee with a lot of interest and plenty of participants
  • Cited in US Regulations and implemented in other countries (Spain, France, Netherlands, …)
  • Broad scope and templating strategy
  • Expanding international use and sharing of IGs
  • Stable and world wide implemented standards for clinical documents
  • Good 3rd Party Tools exist for building CDA and FHIR implementation guides
  • Examples task force supporting the CDA implementer community
  • Established process for managing vocabulary with C-CDA and other specifications
  • FHIR – aligning FHIR documents with CDA
  • Developing improved C-CDA quality via the Scorecard
  • The implementation-a-thon for C-CDA (vendors, ONC and HL7 together)
  • Improved examples access and discovery via Search tool
  • Continuing support from ONC for C-CDA
  • FHIR Knowledge within the SDWG
  • We are the CDA Methodology Group
  • Leveraging HQ/ONC initiatives to develop user-friendly tools & documentation to support implementations

Weakness

  • Bandwidth limitations (work, meetings)
  • Understanding the process of sustaining/maintaining existing work
  • Lack of an HL7 International registry / repository for CDA Templates and historical artifacts
  • The size of C-CDA is a challenge to support in a purely volunteer environment.
  • Ownership of templates by Domain Committees is less effective than FHIR
  • Uneven level of implementation support for multimedia in CDA documents
  • CDA Publication format (Word Document, PDF’s)
  • Little or no 508d support in our publications
  • CDA R2 semantic expressivity limitations

Opportunity

  • Collaboration with external groups
    • IHE
    • ONC, DOD, VA, FDA, CDC, CMS, …
    • HIMSS
    • DICOM
    • NCCN
    • Professional Societies
    • AMIA, ACP, …
    • Payers and Attachments
  • Have major impact on the global healthcare community and healthcare delivery
  • Support implementation concerns and improve interoperability
  • Showcasing International CDA Implementation
  • Work with the CDA Management Group
  • CDA R2.1 remains an opportunity to support long term needs
  • C-CDA Supplement strategy will enable C-CDA to evolve  
  • Look at FHIR strategies to see what can be adopted for CDA
  • Coordination between US Realm and International IG’s to improve interoperability

Threat

  • Competing areas of interest, pulling resources away
  • Potential loss of senior knowledge and experience
  • The potential for rapid changes in the political landscape
  • Loss of knowledge in the V3 space

Copyright © Health Level Seven International ® ALL RIGHTS RESERVED. The reproduction of this material in any form is strictly forbidden without the written permission of the publisher.

Copyright © Health Level Seven International ® ALL RIGHTS RESERVED. The reproduction of this material in any form is strictly forbidden without the written permission of the publisher.