Simplify Graphic Referencing

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Submitted by: Rick Geimer	Revision date: 2010-05-05
Submitted date: 2010-05-05	Change request ID: <<Change Request ID>>

Issue

The method for adding external graphics to CDA documents is quite cumbersome for cases where a user just wants to add an image without defining participants, etc. It is necessary to define an observationMedia element, which is then referenced from the narrative block as follows:

<text>Erythematous rash, palmar surface, left index finger.
     <renderMultiMedia referencedObject="MM1"/>
 </text>
 <entry>
     <observationMedia classCode="OBS" moodCode="EVN">
         <value mediaType="image/gif">
             <reference value="lefthand.gif"/>
         </value>
     </observationMedia>
 </entry>

This is a lot of overhead to just reference a graphic. Also, it requires that all documents containing graphics are, by definition, "level 3" CDA documents (any document with entries is a level 3 document).

Recommendation

• Allow direct referencing of external graphics in the renderMultiMedia element as follows:

 <renderMultiMedia mediaType="image/gif" value="lefthand.gif"/>

Note: this is not intended as a replacement for observationMedia in cases where participants and other info need to be associated with a graphic. Rather, it provides a shortcut for the simplest case where a user just wishes to reference a graphic, much as they would in HTML.

Resolution

(Resolution is to be recorded here and in the referenced minutes, which are the authoritative source of resolution).