Clinical Document Architecture
Encyclopedia
The HL7
Clinical Document Architecture (CDA) is an XML
-based markup standard intended to specify the encoding, structure and semantics of clinical documents for exchange.
CDA is part of the HL7 version 3 standard. Akin to other parts of the HL7 version 3 standard it was developed using the HL7 Development Framework (HDF) and it is based on the HL7 Reference Information Model (RIM) and the HL7 Version 3 Data Types. CDA documents are persistent in nature.
The CDA specifies that the content of the document consists of a mandatory textual part (which ensures human interpretation of the document contents) and optional structured parts (for software processing). The structured part relies on coding systems (such as from SNOMED
and LOINC
) to represent concepts.
, MIME
attachments to email
, http
or ftp
.
(CCD) specification, based on the data model as specified by ASTMs Continuity of Care Record
. The U.S. Healthcare Information Technology Standards Panel
has selected the CCD as one of its standards.
Health Level 7
Health Level Seven , is an all-volunteer, non-profit organization involved in development of international healthcare informatics interoperability standards...
Clinical Document Architecture (CDA) is an XML
XML
Extensible Markup Language is a set of rules for encoding documents in machine-readable form. It is defined in the XML 1.0 Specification produced by the W3C, and several other related specifications, all gratis open standards....
-based markup standard intended to specify the encoding, structure and semantics of clinical documents for exchange.
CDA is part of the HL7 version 3 standard. Akin to other parts of the HL7 version 3 standard it was developed using the HL7 Development Framework (HDF) and it is based on the HL7 Reference Information Model (RIM) and the HL7 Version 3 Data Types. CDA documents are persistent in nature.
The CDA specifies that the content of the document consists of a mandatory textual part (which ensures human interpretation of the document contents) and optional structured parts (for software processing). The structured part relies on coding systems (such as from SNOMED
Systematized Nomenclature of Medicine
The Systematized Nomenclature of Medicine is a multiaxial, hierarchical classification system . As in any such system, a disease may be located in a body organ which results in a code in a topography axis and may lead to morphological alterations represented by a morphology code.-Purpose:SNOMED...
and LOINC
LOINC
Logical Observation Identifiers Names and Codes is a database and universal standard for identifying medical laboratory observations. It was developed and is maintained by the Regenstrief Institute, a US non-profit medical research organization, in 1994...
) to represent concepts.
Transport
The CDA standard doesn't specify how the documents should be transported. CDA documents can be transported using HL7 version 2 messages, HL7 version 3 messages, as well as by other mechanisms, such as DICOMDigital Imaging and Communications in Medicine
DICOM is a standard for handling, storing, printing, and transmitting information in medical imaging. It includes a file format definition and a network communications protocol. The communication protocol is an application protocol that uses TCP/IP to communicate between systems...
, MIME
MIME
Multipurpose Internet Mail Extensions is an Internet standard that extends the format of email to support:* Text in character sets other than ASCII* Non-text attachments* Message bodies with multiple parts...
attachments to email
E-mail
Electronic mail, commonly known as email or e-mail, is a method of exchanging digital messages from an author to one or more recipients. Modern email operates across the Internet or other computer networks. Some early email systems required that the author and the recipient both be online at the...
, http
Hypertext Transfer Protocol
The Hypertext Transfer Protocol is a networking protocol for distributed, collaborative, hypermedia information systems. HTTP is the foundation of data communication for the World Wide Web....
or ftp
File Transfer Protocol
File Transfer Protocol is a standard network protocol used to transfer files from one host to another host over a TCP-based network, such as the Internet. FTP is built on a client-server architecture and utilizes separate control and data connections between the client and server...
.
Country specific notes
In the U.S. the CDA standard is probably best known as the basis for the Continuity of Care DocumentContinuity of Care Document
The Continuity of Care Document specification is an XML-based markup standard intended to specify the encoding, structure and semantics of a patient summary clinical document for exchange....
(CCD) specification, based on the data model as specified by ASTMs Continuity of Care Record
Continuity of Care Record
Continuity of Care Record is a health record standard specification developed jointly by ASTM International, the Massachusetts Medical Society , the Healthcare Information and Management Systems Society , the American Academy of Family Physicians , the American Academy of Pediatrics , and other...
. The U.S. Healthcare Information Technology Standards Panel
Healthcare Information Technology Standards Panel
The American National Standards Institute Healthcare Information Technology Standards Panel was created in 2005 as part of efforts by the Office of the National Coordinator for Health Information Technology to promote interoperability in health care by harmonizing health information technology...
has selected the CCD as one of its standards.
See also
- HL7
- EHRcom
- Health Informatics Service Architecture (HISA)
- Continuity of Care RecordContinuity of Care RecordContinuity of Care Record is a health record standard specification developed jointly by ASTM International, the Massachusetts Medical Society , the Healthcare Information and Management Systems Society , the American Academy of Family Physicians , the American Academy of Pediatrics , and other...
- Gello Expression LanguageGello Expression LanguageThe GELLO Expression Language was started in 2001 and introduced in 2002; in 2005, GELLO was adopted as an international standard by HL7 International and ANSI for a decision support language...