This wiki has undergone a migration to Confluence found Here
<meta name="googlebot" content="noindex">

Simplify Graphics Referencing in CDA

From HL7Wiki
Jump to navigation Jump to search

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.

Submitted by: Rick Geimer Revision date: October 14, 2008
Submitted date: October 14, 2008 Change request ID:


CDA defines several "levels" that identify the expected amount of computable data in a clinical document. Any document with "entry" elements is assumed to be a level 3 CDA.

However, the current approach for referencing graphics in the narrative block requires the use of an entry element as follows:

 <text>Erythematous rash, palmar surface, left index finger.
     <renderMultiMedia referencedObject="MM1"/>
     <observationMedia classCode="OBS" moodCode="EVN">
         <value mediaType="image/gif">
             <reference value="lefthand.gif"/>

This means that any document with a graphic is "level 3".

And also it seems like we are forcing people to jump through hoops just to reference a gif.


  • Something like the following would be preferable:
  <renderMultiMedia mediaType="image/gif" value="lefthand.gif"/>
  ... or if we decide to allow XHTML in the body:
  <xhtml:img src="lefthand.gif"/> 



Recommended Action Items


March 09, 2010: For attested images, we need full RIM context. For non attested images, there is a simpler way to reference, using established narrative block markup. abstain: 0; opposed: 0; in favor: 8.