Question: Exchanging CDA

Dec 12, 2013

Question:

I am a CDA newbie; my task is to include a report (in PDF format) in a CDA document. I have managed to find the right implementation guide (for unstructured documents); so what I have managed to do so far is successful construction of a CDA document. My question is: what are some of the best practices for distributing the CDA document? I am especially interested in sending it via HL7 V2 messaging scheme. Please shed some light on CDA distribution

Answer: Well, if I was asked to rank exchange methods for CDA in order or importance/prevalence, the order would look like this

  • XDS - This the major mechanism for distributing CDA documents
  • MDM messages (HL7 v2.x chapter 9) - Messages for managing documents (we use these in Australia for exchanging CDA documents0, and they would be a logical choice where you have v2 exchange already set up
  • If you in USA:Direct- Using Encrypted SMTP. This had a big push from ONC in the recent past, but I’m hearing that it’s falling out of focus (I say that as a non-US observer)

There’s a bunch of other ways - sneakernet, or FTP, for instance. There’s a new way coming too: With FHIR there’s a way to store a CDA document, and make an entry about it to a registry so it can easily be found. David Hay has been explaining how to do this:

Fhir is not done and ready - yet. But it will be soon.