Consolidated CDA Templates Suggested Enhancements

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NOTE: Membership on this list bestows no special privileges. The list is just a convenient catalog of various comments received along the way. Each of these suggested enhancements will need use case backing, a formal proposal, etc before being considered for the Consolidated Templates DSTU. There is no requirement that an item be on this list to be considered for the Consolidated Templates DSTU.

Enhancement Process

Requirements

1. Ability to add new content, sections/entries/documents types, without requiring existing implementers to update their system
2. Regular update cycle, minimum of 12-months
3. Clear versioning of Consolidation IG
4. The Consolidation DSTU brought together multiple documents into one, and keeping them in one guide is preferred.
5. SDWG will define guidance for how future DSTUs are added to Consolidation.
6. SWDG will be the project sponsor when new documents are added to Consolidation.

Potential Solutions based on Requirements above

1. Updates and additions of SHOULD/MAY constraints through a ballot process without requiring templateId updates.
2. Updates and additions of SHALL constraints will go through a template harmonization process and added at the periodic update.
3. New document types will be balloted as a separate document and folded at the periodic update.

Enhancement Suggestions

Add section describing use of statusCode versus Status Observation
Add section to discuss the use of statusCode and the previous status observation in CCD. For example, the Consolidated Templates DSTU removed the status code observation on a substance administration and should provide guidance on how to indicate a medication is active.

SDWG recommendation for active medication:

       <templateId root="2.16.840.1.113883.10.20.22.4.16"/>
       <id root="cdbd33f0-6cde-11db-9fe1-0800200c9a66"/>
       <text>...</text>
       <statusCode code="active"/> --> should be "active" or "completed” with additional status template as entryRelationship?
       <effectiveTime xsi:type="IVL_TS">
               <low value="20110502"/>
         <high nullFlavor=”NA”/>  --> if a medication is active without stop date, how to represent <high>?
       </effectiveTime>

Add the ability to assign a LanguageCommunication content module for the recordTaget/guardian/person, author/assignedAuthor/person, informant/relatedEntity/person, and participant/associatedEntity/person. Lisa Nelson (PGD Ballot Comment)
Should participant, authenticator and legalAuthenticator have a choice block to make relatedEntity an option?Lisa Nelson (PGD Ballot Comment)