Product CDA R2 IG
Contents
- 1 Product Brief - CDA R2 Implementation Guides
- 1.1 Product Name - CDA R2 IG HAIRPT
- 1.2 Product Name - CDA R2 IG Consult Note
- 1.3 Product Name - CDA R2 IG H&P
- 1.4 Product Name - CDA R2 IG EHR Interop Profile
- 1.5 Product Name - CDA R2 IG PHM Reports
- 1.6 Product Name - CDA R2 IG Operative Note
- 1.7 Product Name - CDA R2 IG QA (Questionnaire Assessments)
- 1.8 Product Name - CDA R2 IG QRDA
- 1.9 Product Name - CDA R2 IG DIR
- 1.10 Product Name - CCD
- 1.11 Product Name - CDA R2 IG CRS
Product Brief - CDA R2 Implementation Guides
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Product Name - CDA R2 IG HAIRPT
- HL7 Implementation Guide for CDA Release 2: Healthcare Associated Infection Reports
Type
DSTU
Releases
- HL7 Implementation Guide for CDA Release 2: Healthcare Associated Infection Reports, Release 1; DSTU ending March 2010
- HL7 Implementation Guide for CDA Release 2 - Level 3: Healthcare Associated Infection Reports, Release 2 (US Realm); DSTU ends Mar 2011
- HL7 Implementation Guide CDA Release 2 - Level 3: Healthcare Associated Infection Reports, Release 3 (US Realm); DSTU ends October 2011
Summary
This specification is a set of constraints on existing work and the extent to which it can accommodate the expressive requirements of HAI reporting over time is a function of the richness of the model on which it is built, the HL7 Reference Information Model (RIM) and the RIM document standard, and the Clinical Document Architecture Release 2 (CDA R2).
Business Case (Intended Use, Customers)
This DSTU was produced and developed in conjunction with the Division of Healthcare Quality Promotion, National Center for Preparedness, Detection, and Control of Infectious Diseases (NCPDCID), and Centers for Disease Control and Prevention (CDC). Its development and ultimate deployment is a result of the dedication of the team, led by Daniel A. Pollock, M.D., Surveillance Branch Chief, Division of Healthcare Quality Promotion, NCPDCID, CDC, and their support of the development of interoperable data standards for the CDC’s National Healthcare Safety Network (NHSN).
Benefits
The best standards are those driven by business requirements. Each stage of the development of this DSTU has been monitored, evaluated, and tested by a strong set of HAI surveillance application vendors.
Implementations/ Case Studies (Actual Users)
Those vendors who participated in the 2007-2008 pilot activities of Bloodstream Infection Reports and Surgical Site Infection deserve special thanks and acknowledgment: MedMined™ services from Cardinal Health, EpiQuest, ICPA, Premier, TheraDoc, and Vecna Technologies.
Resources
Work Groups
Relationship to/ Dependencies on, other standards
- CDA
Links to current projects in development
- Project Insight ID # 319 Implementation Guide for CDA Release 2 Level 3 Healthcare Associated Infection Reports (HAI II)
Product Name - CDA R2 IG Consult Note
- HL7 Implementation Guide for CDA Release 2: Consult Notes, Release 1; DSTU ending August 2010
Type
DSTU
Releases
Release 1
Summary
This DSTU describes how CDA is used to record information for a Consult Note. The Consult Note may contain both narrative and coded data.
See http://www.healthstory.com/standards/sec/consult_note.htm
Business Case (Intended Use, Customers)
- Healthcare Providers,
- Healthcare IT Vendors,
- EHR Systems,
- Transcription/Dictation Systems,
- Departmental Systems
Benefits
Integrating narrative notes into the EHR is a key benefit as is the fact that it supports meaningful use with minimal change to current practice.
Implementations/ Case Studies (Actual Users)
coming soon
Resources
Work Groups
Relationship to/ Dependencies on, other standards
- CDA
Links to current projects in development
- none
Product Name - CDA R2 IG H&P
- HL7 Implementation Guide for CDA Release 2: History and Physical (H&P) Notes, Release 1; DSTU ending August 2010
Type
DSTU
Releases
Release 1
Summary
This DSTU describes how CDA is used to record information for a History and Physical Note. The History and Physical Note may contain both narrative and coded data.
See http://www.healthstory.com/standards/sec/history_physical.htm
Business Case (Intended Use, Customers)
- Healthcare Providers,
- Healthcare IT Vendors,
- EHR Systems,
- Transcription/Dictation Systems,
- Departmental Systems
Benefits
Integrating narrative notes into the EHR is a key benefit as is the fact that it supports meaningful use with minimal change to current practice.
Implementations/ Case Studies (Actual Users)
coming soon
Resources
Work Groups
Relationship to/ Dependencies on, other standards
- CDA
Links to current projects in development
- none
Product Name - CDA R2 IG EHR Interop Profile
- HL7 Implementation Guide for CDA Release 2: Reference Profile for EHR Interoperability, Release 1; DSTU ending Sep 2010
Type
DSTU
Releases
Release 1
Summary
Description
Business Case (Intended Use, Customers)
Benefits
Implementations/ Case Studies (Actual Users)
Resources
Work Groups
Relationship to/ Dependencies on, other standards
- CDA
Links to current projects in development
- none
Product Name - CDA R2 IG PHM Reports
- HL7 Implementation Guide for CDA Release 2: Personal Healthcare Monitoring Report, Release 1; DSTU ending Nov 2010
Type
DSTU
Releases
Release 1
Summary
The implementation guide specifies CDA based representation of data/information (mostly containing analysed and raw information of data generated by personal healthcare monitoring devices such as glucometers, BP cuffs, thermometers, weight scales).
Business Case (Intended Use, Customers)
The guide will be used by personal health management organizations (such as disease management organizations) to transfer remotely monitored patient data to electronic health records.
Benefits
Implementations/ Case Studies (Actual Users)
Resources
Work Groups
Relationship to/ Dependencies on, other standards
- CDA
Links to current projects in development
- Project Insight ID # 209 IG for CDA R2 - Lvl 3 Personal Healthcare Monitoring Reports, R1
Product Name - CDA R2 IG Operative Note
- HL7 Implementation Guide for CDA Release 2: Operative Notes, Release 1; DSTU ending Mar 2011
Type
DSTU
Releases
Release 1
Summary
This DSTU describes how CDA is used to record information for an Operative Note. The Operative Note may contain both narrative and coded data.
See http://www.healthstory.com/standards/sec/op_note.htm
Business Case (Intended Use, Customers)
- Healthcare Providers,
- Healthcare IT Vendors,
- EHR Systems,
- Transcription/Dictation Systems,
- Departmental Systems
Benefits
Integrating narrative notes into the EHR is a key benefit as is the fact that it supports meaningful use with minimal change to current practice.
Implementations/ Case Studies (Actual Users)
coming soon
Resources
Work Groups
Relationship to/ Dependencies on, other standards
- CCD, CDA
Links to current projects in development
- none
Product Name - CDA R2 IG QA (Questionnaire Assessments)
- HL7 Implementation Guide for CDA Release 2: CDA Framework for Questionnaire Assessments, Release 1; DSTU ends Apr 2011
Type
DSTU
Releases
Release 1
Summary
Description
Business Case (Intended Use, Customers)
Benefits
Implementations/ Case Studies (Actual Users)
Resources
Work Groups
Relationship to/ Dependencies on, other standards
- CDA
Links to current projects in development
- none
Product Name - CDA R2 IG QRDA
- HL7 Implementation Guide for CDA Release 2: Quality Reporting Document Architecture (QRDA), Release 1; DSTU ends Apr 2011
Type
DSTU
Releases
Release 1
Summary
Health care institutions routinely collect and report performance measure data to improve the quality of care provided to patients. Measure data conforms to the requirements of defined "quality measures" which are written and maintained by institutions concerned about health care quality. This project will define and bring to ballot a set of specifications for communicating quality measure definitions to, and reporting quality data from, electronic health records.
Description
Business Case (Intended Use, Customers)
Benefits
The specification will foster the development of fully automated EHR-based data submission and reporting. As needed, it will be compatible with semi-automated reporting which continues to rely on information derived from manual chart review and abstraction.
Implementations/ Case Studies (Actual Users)
Resources
Work Groups
Relationship to/ Dependencies on, other standards
- CDA
Links to current projects in development
- Project Insight ID # 210 Quality Reporting Document Architecture
Product Name - CDA R2 IG DIR
- HL7 Implementation Guide for CDA Release 2: Diagnostic Imaging Reports, Release 1 (Informative)
Type
Informative
Releases
Release 1
Summary
This DSTU describes how CDA is used to record information for a Diagnostic Imaging Report. Is consistent with the DICOM guide for transforming DICOM Structured Reports to CDA. The report may contain both narrative and coded data.
See http://www.healthstory.com/standards/sec/dir.htm
Business Case (Intended Use, Customers)
- Healthcare Providers,
- Healthcare IT Vendors,
- EHR Systems,
- Transcription/Dictation Systems,
- Departmental Systems
- RAD information systems
Benefits
Integrating narrative notes into the EHR is a key benefit as is the fact that it supports meaningful use with minimal change to current practice.
Implementations/ Case Studies (Actual Users)
coming soon
Resources
Work Groups
Relationship to/ Dependencies on, other standards
- CDA
Links to current projects in development
- Project Insight ID # 528 II coordination with Diagnostic Imaging Report SR/CDA Transformation Guide (DICOM Supplement 135)
Product Name - CCD
- HL7 Implementation Guide for CDA Release 2: HL7/ASTM Continuity of Care Document (Informative)
Type
Informative
Product Name - CDA R2 IG CRS
- HL7 Implementation Guide for CDA Release 2: Level 1 and 2 Care Record Summary (US Realm)(Informative)
Type
Informative
Releases
Release 1
Summary
The Care Record Summary, issued in June 23, 2006, was the first balloted Implementation Guide for CDA R2. CRS covered CDA Levels 1, 2, however, did not specify Level 3 templates (CDA entries). CCD, meanwhile, developed a rich set of Level 3 templates, however, CCD is not a Discharge Summary and does not specify a hospital course. The purpose of this update will be to issue a Discharge Summary-specific CRS updated for compliance with the current approach to CDA templates in CCD and the HL7 Health Story implementation guides. The resulting specification will be consistent with IHE XDS-MS for Discharge Summary and HITSP C48 and will not introduce conflicting requirements.
Description
Business Case (Intended Use, Customers)
Benefits
Implementations/ Case Studies (Actual Users)
Resources
Work Groups
Relationship to/ Dependencies on, other standards
- CDA
Links to current projects in development
- Project Insight ID # 510 Care Record Summary, Release 2: Discharge Summary
