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CDA R3 Right Hand Side of Model Analysis

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SDWG page.

CDA R2 Design Principles

The goals of the CDA are:

  • Give priority to delivery of patient care.
  • Allow cost effective implementation across as wide a spectrum of systems as possible.
  • Support exchange of human-readable documents between users, including those with different levels of technical sophistication.
  • Promote longevity of all information encoded according to this architecture.
  • Enable a wide range of post-exchange processing applications.
  • Be compatible with a wide range of document creation applications.
  • Promote exchange that is independent of the underlying transfer or storage mechanism.
  • Prepare the design reasonably quickly.
  • Enable policy-makers to control their own information requirements without extension to this specification.

A number of design principles follow from consideration of the above goals:

  • This architecture must be compatible with XML and the HL7 RIM.
  • This architecture must be compatible with representations of clinical information arising from other HL7 committees.
  • Technical barriers to use of the architecture should be minimized.
  • The architecture specifies the representation of instances required for exchange.
  • The architecture should impose minimal constraints or requirements on document structure and content required for exchange.
  • The architecture must be scalable to accommodate fine-grained markup such as highly structured text and coded data.
  • Document specifications based on this architecture should accommodate such constraints and requirements as supplied by appropriate professional, commercial, and regulatory agencies.
  • Document specifications for document creation and processing, if intended for exchange, should map to this exchange architecture.
  • CDA documents must be human readable using widely-available and commonly-deployed XML-aware browsers and print drivers and a generic CDA style sheet written in a standard style sheet language.
  • Use open standards.

CDA R3 requirements for right side of model

  • Scope:
    • Administrative and Financial Data needs to be addressed
    • Expressivity (GG: how? what? so?)
  • Consistency
    • Support for domain models from other committees
    • Internal consistency across domains
    • Clear forwards migration path from CDA R2
  • Formalization of best practices established over the past five years. (GG: aren't this a general CDA thing? what do they say about RHS?)
    • Extension mechanisms
    • Creator and Recipient Roles and Responsibilities
    • Adopt existing extensions
  • Implementation
    • Enter into the architecture at varying degrees of sophistication (levels of CDA)
    • Simplicity for implementers
    • Limited/Fixed set of CDA -Schemas- Instance formats for implementers
    • explicit schema validation support for RIM based extensions
    • Support for schema tooling (e.g., binding, API creation, et cetera). (GG: support how?)


  • Identical XML between HL7 V3 standards
    • May want to consider a different ITS

Potential Metrics for decision making

  • how much work required on HL7's part to produce?

Potential Solution Notes

  • Bob’s Idea: Take the SDA Approach, build one model that has four choice boxes [one for each backbone class]...
  • Ensure that use of components is invariant (e.g., C-METS) for some period of time based on review.