RE: {C-CDA Samples} [HL7 CDA R2.1] Consolidated clinical document with CCD + CarePlan

[Lisa R. Nelson]

This is a very good question. We don't have a way to keep track of "hybrid" C-CDA documents. I recently saw a vendor produce a "hybrid" Procedure Note and Progress Note. It wasn't one or the other, but rather a sort of mixture of the two.

Document templates in C-CDA are all open, but I'm not sure we have addressed the question of what do when a Care Plan document adds enough sections to also pass the CCD validation, or vice versa. You have only one spot for ClinicalDocument.code, so you would need to pick.

We don't have a LOINC code that is for a "blended" document that uses C-CDA sections, but in a grouping that no existing C-CDA Document type calls out.

I am seeing pressures in both directions. The folks I know from the transcription world are not happy to see documents deviate from the set of "headings" (sections) they are accustomed to seeing in a document of a "known type" like consultation note or H&P. At the same I am seeing novel approaches to blending of document types, like in NY where they are piloting with a document that is a hybrid CCD and Care Plan document.

The problem is how to set expectations. When a document is indexed into a registry as being of type XYZ, then how will retrievers know what sections of information to expect?

I don't think we have an answer right now, but I think the document creators are developing enough capability with C-CDA that it is time to start thinking about this question.

Could you come onto a SDWG call and start the dialog there? I think more input will be needed from the community.

I also think I will pose this question in the talks we are having with LOINC about the use of codes from their document ontology. (CC-ing Swapna to loop her in on this question.)

Regards,

Lisa

Lisa R. Nelson, MS, MBA
401.219.1165
LisaR...@cox.net
Rhode Island-EDT

www.LisaRNelson.com
Any views or opinions presented in this email are solely those of the author.

-----Original Message-----
From: ccda_s...@googlegroups.com [mailto:ccda_s...@googlegroups.com] On Behalf Of devi.hea...@gmail.com
Sent: Tuesday, September 19, 2017 9:01 AM
To: C-CDA Samples <ccda_s...@googlegroups.com>
Subject: {C-CDA Samples} [HL7 CDA R2.1] Consolidated clinical document with CCD + CarePlan

Can i consolidate CCD sections and care plan document sections into one document and generate a single document?

If yes, then what document level template ID should i use?

As like HL7v2 message spec customization between two health partners, i would like to customize CDA documents. I'm looking for some inputs on the same.

Please advise. Your inputs here is highly appreciated.

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