Integrating the Healthcare Enterprise ihe pcc technical Framework Supplement cda harmonization Draft in preparation for Public Comment

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Integrating the Healthcare Enterprise


Technical Framework Supplement

CDA Harmonization

Draft in preparation for Public Comment

Date: March 14, 2013

Author: Keith W. Boone



This is a supplement to the IHE PCC Technical Framework . Each supplement undergoes a process of public comment and trial implementation before being incorporated into the volumes of the Technical Frameworks.

This supplement is published on for Public Comment. Comments are invited and may be submitted at In order to be considered in development of the Trial Implementation version of the supplement, comments must be received by .

This supplement describes changes to the existing technical framework documents.

“Boxed” instructions like the sample below indicate to the Volume Editor how to integrate the relevant section(s) into the relevant Technical Framework volume.

Amend section X.X by the following:

Where the amendment adds text, make the added text bold underline. Where the amendment removes text, make the removed text bold strikethrough. When entire new sections are added, introduce with editor’s instructions to “add new text” or similar, which for readability are not bolded or underlined.

General information about IHE can be found at:

Information about the IHE PCC domain can be found at:

Information about the organization of IHE Technical Frameworks and Supplements and the process used to create them can be found at: and

The current version of the IHE PCCTechnical Framework can be found at: Please enter comments/issues as soon as they are found. Do not wait until a future review cycle is announced.

Introduction to this Supplement 4

Open Issues and Questions 4

Closed Issues 4

General Introduction 6

Appendix A - Actor Summary Definitions 6

Appendix B - Transaction Summary Definitions 6

Glossary 6

Glossary 6

Volume 1 – Profiles 7

Volume 1 – Profiles 7

Copyright Licenses 7

X CDA Profile 8

X.1 CDA Actors, Transactions, and Content Modules 8

X.1.1 Actor Descriptions and Actor Profile Requirements 9

X.2 CDA Actor Options 9

X.3 CDA Required Actor Groupings 10

X.4 CDA Overview 12

X.4.1 Concepts 12

X.4.1.1 Template 12

X.4.2 Use Cases 14

X.5 CDA Security Considerations 14

X.6 CDA Cross Profile Considerations 14

Appendices 15

Appendices 15

Appendix A – 15

A.1 15

Appendix B – 15

B.1 15

Appendices 16

Appendices 16

Appendix A – Template Considerations 16

A.1.2 Backwards Compatibility 17

Appendix B – 17

B.1 18

Volume 2 Namespace Additions 18

Volume 3 – Content Modules 19

Volume 3 – Content Modules 19

5. Namespaces and Vocabularies 20

6. Content Modules 21

6.3.1 CDA Document Content Modules 21

6.3.2 CDA Header Content Modules 30

6.3.3 CDA Section Content Modules 34

6.3.4 CDA Entry Content Modules 39

6.4 Section not applicable 44

6.5 PCC Value Sets 44

6.5.x 45

Appendices 46

Appendices 46

Appendix A – 46

A.1 46

Appendix B – 46

B.1 46

Volume 3 Namespace Additions 46

Volume 4 – National Extensions 47

Volume 4 – National Extensions 47

4 National Extensions 47

4.I National Extensions for 47

4.I.1 Comment Submission 47

4.I.1 Comment Submission 47


<(Profile Acronym)> 47

<(Profile Acronym)> 47

4.I+1.1 National Extensions for 48

More Open Issues 48

Introduction to this Supplement

The purpose of this supplement is to update IHE PCC Templates to be consistent with the most recent version of HL7 templates published in the IHE Health Story Consolidation Implementation Guide. This supplement addresses how IHE templates are to be versioned, and how new versions of templates can be created to replace existing templates.

Open Issues and Questions

Closed Issues

  1. What text should be used to identify a template version? Should versions be sequentially numbered? If so, should we start with version 1 or version 2, given that existing templates did not have a version number. Should we use the date of publication of the template? If dates are used, how do we deal with changes between publication for public comment and final text? If numbers are used, would we also indicate state (e.g., PC, TI, FT).
    We will use version numbers in the form Major.minor. Existing templates will be defined as being version 1.0, but will not have an extension denoting that.
  2. With the introduction of template versions, how can a consumer of content determine whether they support the versions of the templates present in a document? Can this be structured/declared in a way that does not require inspection of all templates in the document being consumed?

    We will create a template for each revision of the PCC Technical Framework which can be used within a document to indicate the minimum version of the PCC TF that must be understood in order to be able to understand the PCC TF Content.

  3. When templates are versioned, some new versions will be backwards compatible with previous versions, and others may not be. Is there a way to mark these version changes (e.g., major/minor)?
    A backwards compatible change is one where the receiver of a CDA document can still correctly understand a template without having to be modified (even though it may not understand additional content). A change that is not backwards compatible is considered a change to the major revision of a template.

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