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CDA R2 Errata

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Section 1.2.2 The “A” in “CDA”

  • Example 2 – hierarchy isn’t correct. Bottom 4 bullets each need to move one step to the right.

Section 3: CDA Document Exchange in HL7 Messages

  • Table 4: HL7 V3 Medical Records :: CDA Mapping will need to be updated when the V3 Medical Records ballot becomes normative.

Section 4 CDA R-MIM

  • (Technical Correction) Visio diagram doesn't show ObservationInterpretation as vocabulary for Observation.interpretationCode (even though it does appear in the Hierarchical Description).

Section 4.3.5 Section Narrative Block

  • (Technical Correction) To improve readability and to minimize ambiguity, the following [<xs:complexType name="StrucDoc.Sup" mixed="true"/>] should be changed to [<xs:element name="StrucDoc.Sup" type="xsd:string"/>].

Section List

  • Cardinality of listType attribute is ambiguous. Section says it's required, but it is optional in the normative narrative block markup (and is not present in the example that we distributed).

Section A.2 Sample CDA Instance

  • Where Observation.classCode=”COND”, refer to latest recommendations from Patient Care TC regarding how to value Observation.statusCode.
  • Incorrect OID. Change OID from “2.16.840.1.113883.5.10588” to “2.16.840.1.113883.5.111” here:
 <healthCareFacility classCode="DSDLOC">
   <code code="GIM" codeSystem="2.16.840.1.113883.5.10588" displayName="General internal medicine clinic"/>
  • Incorrect LOINC codes. Replace 10153-2, 10223-2, 10157-2 respectively with: 11348-0 HISTORY OF PAST ILLNESS, 10200-4 PHYSICAL FINDINGS HEART, 10157-6 HISTORY OF FAMILY MEMBER DISEASES
  • Incorrect Date. Replace “200004071530” with “200004071430” as shown.
 <observation classCode="OBS" moodCode="EVN">
   <code code="251076008" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Cuff blood pressure"/>
   <statusCode code="completed"/>
   <effectiveTime value="200004071430"/>
   <targetSiteCode code="368208006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Left arm"/>
   <entryRelationship typeCode="COMP">
     <observation classCode="OBS" moodCode="EVN">
       <code code="271649006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Systolic BP"/>
       <statusCode code="completed"/>
       <effectiveTime value="200004071530 --> 200004071430"/>
       <value xsi:type="PQ" value="132" unit="mm[Hg]"/>
   <entryRelationship typeCode="COMP">
     <observation classCode="OBS" moodCode="EVN">
       <code code="271650006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Diastolic BP"/>
       <statusCode code="completed"/>
       <effectiveTime value="200004071530 --> 200004071430"/>
       <value xsi:type="PQ" value="86" unit="mm[Hg]"/>
  • <priorityCode code="PRN"/> should include codeSystem attribute, valued with "2.16.840.1.113883.5.7".
  • <routeCode code="IPINHL" codeSystem="2.16.840.1.113883.5.112" ... should be <routeCode code="ORINHL" codeSystem="2.16.840.1.113883.5.112" ...
  • <act classCode="ACT" moodCode="INT"><id/> - Remove the element.

Section 1.3 Conformance

  • Clarification on conformance Kboone 16:22, 30 April 2007 (CDT)

A conformant CDA document is one that at a minimum validates against the CDA Schema once all extensions have been removed from the instance, and that restricts its use of coded vocabulary to values allowable within the specified vocabulary domains. However a computer cannot validate every aspect of conformance. The focus of this section is to highlight these aspects of CDA that cannot be machine validated - particularly those aspects related to the CDA human readability requirements.