Allow structuredBody text

Return to SDTC page; Return to CDA R3 Formal Proposals page.

See CDA R3 Formal Proposals for instructions on using this form. Failure to adhere to these instructions may result in delays. Editing of formal proposals is restricted to the submitter and SDTC co-chairs. Other changes will be undone. Comments can be captured in the associated discussion page.

(This is a template. Do not edit! Copy and paste source into to a new page)

(An announcement of this proposal must be submitted to the Structured Documents list to be formally submitted.)

Submitted by: Rick Geimer	Revision date: 2009-08-04
Submitted date: 2009-08-04	Change request ID: <<Change Request ID>>

Issue

There are many cases where organizations have existing human readable content in the form of PDFs, etc. that they wish to exchange along with computable content. Currently CDA does not allow this, thus implementers must choose between their existing presentation format or the computable content.

Recommendation

• I propose allowing a structuredBody/text element to facilitate the exchange of coded data along with non-XML content for human display. The content of structuredBody/text would be the same as allowed for nonXMLBody/text, and would contain the entire narrative content for the document as a whole in one location. The behaviour would be as follows:
  • if structuredBody.text is populated (not null), then section.text is not required (the narrative requirements for all contained sections are considered to be satisfied).
  • if structuredBody.text is null, then the section.text requirements are the same as CDA R2.
• Specific IGs could prohibit the use of structuredBody.text (CCD R2 might do this).

Rationale

• If we have already decided that non-XML content like PDFs are sufficient for display, why do we prohibit the ability to add coded content as well?

• I have heard some organizations outside the U.S. state that they are required to send pre-formatted files with actual readable signatures, etc. (someone at IHIC told me this...didn't catch their name, so it is strictly anecdotal).

• Sample use case: You have scanned documents and human abstractors who want to enter data necessary for quality reporting.

Resolution

April 20, 2010: The use case is clear, but there is concern about misuse. Given that there are other workarounds, the committee finds the proposal not persuasive. opposed: 1; abstain: 2; in favor: 6.