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Structured Document Template Design Pilot

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Project scope

  • objectives: Test evolving CDA template tooling against tooling committee requirements and SDWG Implementation Guide production process via a small project.
  • scope: [1] Test functionality of tools as they currently exist;[2] Produce a (mock, small) CDA IG using the participant tools

The Structured Documents Working Group, together with developers of the OHT MDHT CDA tools [1], the OHT NHS Static Model Designer [2], and the Mitre tools, will work through an end to end development of a small mock CDA R2 Implementation Guide. The end to end process will span from templates development through publication of the implementation guide and associated technical artifacts, including architectural integration points used for implementation.

Out of scope is the introduction of new functionality not currently available in the existing tools. The project is focused on a rapid assessment of the current state of the tools, either working singularly or together, and the identification of gaps and suggestions for subsequent tooling enhancements.

Project Process

  • Wilfred Bonney ( is a project manager for this project.
  • Bi-weekly telecon on Fridays at 12:00PM ET using Tooling's telecon +1 770-657-9270; Participant PassCode: 946251# unless a request is made to resolve an emerging issue.
    • GoToMeeting URL:
    • Tentative Schedule of Conference Calls:
      • Friday, February 26, 2010 @ 12:00 PM ET --> Milestone One Call
      • Friday, March 12, 2010 @ 12:00 PM ET
      • Friday, March 26, 2010 @ 12:00 PM ET --> Milestone Two Call
      • Friday, April 9, 2010 @ 12:00 PM ET
      • Friday, April 23, 2010 @ 12:00 PM ET --> Milestone Three Call
      • Friday, April 30, 2010 @ 12:00 PM ET
      • Friday, May 7, 2010 @ 12:00 PM ET --> Milestone Four Call
      • Friday, June 11 2010 @ 12:00 PM ET --> Project Concluding Call
  • Standing Agenda Items
    • Review of project plan and tasks
      • Each Sub-Project maintains current status on their respective wiki page and the teleconference will review and address any issues
    • Opportunity to ask questions and issue resolution or future planning

Project objectives and deliverables

  • Objectives
- Compare tools against requirements to determine gaps.
- Develop suggestions for tooling enhancements.
- Determine if there are optimal overlaps of tools that better achieve the requirements than any single tool alone.
- Determine the extent to which the tools can demonstrate traceability from requirements through to implementation artifacts.
- Maintain liaison with the Templates Registry Pilot to share learnings
  • Deliverables
    • Sample CDA IG(s) based on the tools (see zip file@
    • Sample CDA IG, built "the old-fashioned way" (as a comparison baseline)
    • Summary of steps used to create sample CDA IG(s)
      • Comparison against requirements
      • Manual steps needed
      • Quantitative measures (e.g. hours to produce)
    • Summary of "architectural integration" points (e.g. a description of artifacts and connection points among tools that can be used to facilitate implementation).
    • Final report regarding how tool / tool combinations stacked up against requirements.

Rio presentations (draft ideas)Scheduled for Monday Q3 & Q4

  • Q3
        • Pilot project background
        • summary of stuff on this wiki page (process, constraints tested, ...)
        • overall end to end and where each tool fits
        • relationship to template registry project
      • for NHS and MDHT projects (20 minutes)
        • template authoring
        • implementation guide publishing
        • instance validation
      • for HData project
  • Q4
      • architectural integration
      • Template identification
      • Relationship with Templates Registry pilot
      • Integration / next steps

Test case

  • Build a CDA R2 Tuberculosis follow up progress note, end to end (from requirements to final publication).
    • CDA R2 Tuberculosis follow up progress note (templateID "2.16.840.1.113883.") SHALL contain 1..1 TB Results Section (templateId "2.16.840.1.113883.");
      • there can be any number of patient names, but at least one of them must include a given and family name.
      • TB Results Section (templateId "2.16.840.1.113883."):
        • CONFORMS TO CCD Results Section (templateId: 2.16.840.1.113883.;
        • SHALL contain [1..1] code/@code="30954-2" Relevant diagnostic tests and/or laboratory data (CodeSystem: 2.16.840.1.113883.6.1 LOINC) STATIC;
        • SHALL contain [1..1] title="Relevant diagnostic tests and/or laboratory data";
        • SHALL contain [1..1] text
        • MAY contain [0..*] TB Result organizer (templateId "2.16.840.1.113883.");
        • MAY contain [0..*] TB Result observation(templateId "2.16.840.1.113883.");
      • TB Result organizer (templateId "2.16.840.1.113883."):
        • CONFORMS TO CCD Result Organizer (templateId "2.16.840.1.113883.");
        • SHALL contain 1..1 code/@code, which SHALL be selected from ValueSet 2.16.840.1.114222.4.11.3205 Lab Test Result Name (TB) DYNAMIC
        • SHALL contain 1..1 TB Result observation (templateId 2.16.840.1.113883.");
      • TB Result observation(templateId 2.16.840.1.113883.");
        • CONFORMS TO CCD Result Observation(templateId "2.16.840.1.113883.");
        • classCode SHALL be "OBS";
        • SHALL contain 1..1 code/@code, which SHALL be selected from ValueSet 2.16.840.1.114222.4.11.3205 Lab Test Result Name (TB) DYNAMIC
        • SHALL contain 1..1 statusCode/@code="completed" (CodeSystem: 2.16.840.1.113883.5.14 HL7ActStatus) STATIC

Test Instances


  • Primary Sponsor/Work Group: Structured Documents Work Group
  • Co-sponsor Work Group(s): Templates, Tooling
  • Project facilitator: Bob Dolin
  • Other interested parties
    • Dave Carlson;
    • John Timm;
    • Ravi Natarajan;
    • Townend Ian;
    • Andy Gregorowicz;
    • Lyssa Neel;
    • Austin Kreisler;
  • Modeling facilitator: Bob Dolin
  • Publishing facilitator:Peter Gilbert
  • Vocabulary facilitator: n/a
  • Domain expert rep: n/a
  • Data Analyst facilitator: n/a
  • Business requirement analyst
    • Keith Boone;
    • Liora Alschuler
  • Requirements process facilitator
    • Jane Curry;
    • Mark Shafarman