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Welcome to "Document" discussion page. Please put any comments about this page here. Contents will be reviewed periodically.


  • MessageHeader.instant - why not call this "created" or "creationTime", "instant" does not carry meaning of what the instant is capturing.

Section vs. Resource disconnect and requirements for Organizer

CCDA has a number of sections that are essentially rooted in Organizer. The section represents a Collection of things, and thus the text rendering also reflects a collection rather than having separate text for each element in the collection. This rendering might be as a list with items or even as a table. With FHIR, we render resources individually and have not (yet) introduced the idea of Organizers. Introducing Organizers creates a number of issues in terms of ensuring consistency across paradigms.

One possible solution is to allow text to appear any place we allow a collection of resource references. This could either be handled by the tooling or by always referencing a particular construct whenever we reference a collection of resources.

Mapping between CDA Narrative and FHIR text

When transforming between CDA and FHIR documents, a particular issue is the CDA Narrative to/from FHIR Text, as the formed is a set of elements that is specific to CDA (and only loosely modelled in HTML), while FHIR is a subset of XHTML. The following tables give a suggested mapping between the two - accepting that it will not be possible to achieve a perfect mapping with regard to format, but at least the textual parts should be able to be mapped.

Note that this is very much a work in progress...

CDA Narrative to FHIR Text

CDA Narrative Element FHIR Text equivalent Comment
content div
linkHtml a
sub div/@class=cdaSub
sup div/@class=cdaSup
br br
footnote div/@class=cdaFootnote
footnoteRef a the href attribute points to the id of the target element (which can be any element)
renderMultiMedia img The id of the img tag points either to a blob in the text element, or an attachment in the resource
paragraph p
list ul
list.caption a Place an id on the referenced ul element. The a/@href attribute can reference that id
table table
@ID @id
@stylecode @class<value>

FHIR Text to CDA Narrative

Converting from FHIR text to CDA narrative will be more complex. The basic philosophy will be some specific mappings (in the table below), and everything else into a content element. If it is at all possible, then constraining the use of the CDA narrative in an Implementation Guide will make the conversion process easier.

FHIR text CDA Comment
table table
ul / ol list
everything else content Could be a paragraph element I expect