CDA R3 - Support signing content within documents

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Submitted by: Calvin E. Beebe	Revision date: Sept. 14, 2009
Submitted date: Sept. 14, 2009	Change request ID: <<Change Request ID>>

Issue

Currently CDA R2 does not support signing portions of a document or content authored by a given participant. In cases where more that one author as contributed content to a document, all verifications found in the header span the entire document. Authors & contributors to clinical documents need the ability to sign their content and signal their verification of their contribution.

Recommendation

• Allow authors to sign their narrative text contributions.

In this proposal, we acknowledge that sometimes authors / contributors will answer some questions in a document or section, but not all, leaving unanswered questions for later contributors. These authors also want to sign and indicate verification of their contributions.

Entries contained on the right hand side of the CDA model, currently have author participations, we would add verifier participations and using links between the narrative text and these entries, it would be possible to indicate content verified by a given participant. If authors signed or initialed, their content, verifier participations with signatures could be included.

Rationale

Currently contributors to a poly-authored clinical document can indicate their authorship, but can not sign their contribution to a document. Using this proposal, it should be possible to indicate signatures for individual contributions within a clinical document. Enabling authors to sign their contribution will enable poly-authored documents to convey verifications in the final document.

Resolution

SDWG Feb 23 - add signatureCode to author participant at section and entry level. [abstain: 0; opposed: 0; in favor: 9]