#FHIR CDA Position Statement & Roadmap: Joint Statement with Lantana

Aug 1, 2014

Lantana Consulting Group invited me to take part in the Spring CDA Academy after the HL7 Working meeting in Phoenix in May, which I enjoyed greatly. While I was there, we spent some time discussing the relationship between CDA and FHIR, both where things are today, and where we think they should be. This is a pretty important subject, and from the beginning of our work on FHIR, one of the most common questions that we have been asked about FHIR is “what about CDA?”. Sometime, we get asked a more specific question:  ”What does Lantana think about FHIR?”.

Since the CDA Academy, we’ve been working on a joint statement that summarizes the outcome of our discussions, a shared expression of where we believe that we are, and should be. Today, Lantana Consulting Group have posted our position statement on FHIR and CDA (see their blog post):

This position statement addresses the relationship between HL7’s Clinical Document Architecture (CDA) product line and the Fast Health Interoperability Resource (FHIR) product line. It was prepared jointly by Lantana Consulting Group—a recognized leader in the CDA community—and Grahame Grieve, Health Intersections, the FHIR project lead. This statement is not official policy. It is our hope that it will stimulate discussion and possibly guide policy makers, architects, and implementers as well as standards developers.

An underlying key concept for this position statement is that difference between a “package of data and narrative” and interactive access to the narrative and data in a patient or institution’s record, and that both have their place for exchange. Quoting from the document: 

CDA addresses interoperability for clinical documents, mixing narrative and structured data. FHIR provides granular access to data, a contemporary, streamlined approach to interoperability, and is easy to implement. FHIR can be the future of CDA, but it is not there yet.

FHIR offers considerable promise, but it’s certainly true that we have a long way to go yet. The joint statement issues a call to action:

FHIR DSTU 1 is not a replacement for CDA or C-CDA. Building out the specification so that it can represent existing documents as FHIR resources, and ensuring that FHIR resources can be integrated into CDA documents should be the focus of the next iteration of the DSTU

This is explicitly part of the scope of the next DSTU version of FHIR: to address the areas that CCDA covers, and several Lantana employees have already been working with us on this; I look forward to increased focus on this work.