The next Consolidated Clinical Document Architecture (C-CDA) Implementation-A-Thon (IAT) is scheduled this September 14-15 in Atlanta, Georgia. It will be held as a track within the HL7 FHIR Connectathon, allowing attendees to optimize participation across CDA and FHIR-related tracks.
Did you know HL7 offers certification and proficiency exams for its healthcare information technology standards?
Our ongoing tooling journey at HL7 continues, neither as a sprint nor a marathon. For us, it’s really more like an odyssey – an ongoing journey where there is always something more to be done, another path to explore, and a final destination (retirement, for example) seems far out of reach. In the case of HL7 tooling, a fair number of tooling retirements are well overdue.
Despite the wait, it’s gratifying to see when tangible progress is actually achieved. On the Confluence front, we’re in the home stretch of phase 1 of the rollout, though there’s a whole new course to pursue just around the bend. We now have all work groups on Confluence (!) and have also migrated many more projects, committees and collaborations. New functions and help features in Confluence (including a major facelift for confluence.hl7.org) are being added regularly, and you can keep up with these by checking the CTO Tooling Update page. This enabling platform is already unleashing many new opportunities within the HL7 community. Our next target is to work toward optimizing our processes with online forms and workflow. The online project scope statement (PSS) pilot is now available and will give us an opportunity to speed up reviews and approvals as well as make new projects more visible to the community in the hope we can avoid last minute catchups.
Are you HL7 certified?
HL7 offers certification in its primary standards for health information technology including Version 2 (V2), Version 3 (V3), Clinical Document Architecture (CDA®) and HL7 Fast Healthcare Interoperability Resources (FHIR®). The testing is designed to help professionals achieve industry-recognized levels of proficiency and expertise.
A Little About HL7
Small but Mighty
HL7 Austria's annual assembly has become an insider’s guide to the eHealth community. This small but mighty event was held on March 15, 2017 at its regular location, the Heuriger, a local winemaker’s tavern, with a record attendance of more than 100 participants. The annual assembly included a a full day of presentations with timley information, education and networking. We also celebrated the 10th anniversary of HL7 Austria.
More than 20 speakers from four countries delivered engaging talks on the importance of standardization and HL7 in the eHealth area. The presentations covered a wide range of topics that demonstrated what goals have already been accomplished and what work still needs to be done to support interoperable electronic health data exchange in the future.
Introducing the HL7 Companion Guide to Consolidated Clinical Document Architecture (C-CDA®) 2.1
On March 3, 2017, Health Level Seven International and the Duteau Design Inc. team of Jean Duteau, Joginder Madra, Helen Stevens, and Lisa Nelson published the Companion Guide to Consolidated Clinical Document Architecture (C-CDA) 2.1. This companion guide is a supplement to HL7's CDA R2 Implementation Guide (IG): C-CDA Templates for Clinical Notes STU Release 2.1.
Working Together: Our best option to improve C-CDA® Content
Most people have heard of HL7 Fast Healthcare Interoperability Resources (FHIR®) Connectathon events, as well as IHE North America and European Connectathon events, which focus on testing the interoperability of solutions. But did you know that one of the most important content efforts – improving C-CDA® (Consolidated Clinical Document Architecture) documents – is also underway? At each HL7 C-CDA® Implementation-A-Thon, health IT activists have met to improve C-CDA quality and resolve industry differences that result from varying interpretations of standards and implementation guides.
Efforts to Improve the Content of the C-CDA
Many efforts are underway across the industry to help all of us improve the content of C-CDA documents. For example, the Relevant and Pertinent project and the ONC Site C-CDA Scorecard. For anyone who wants to improve C-CDA content quality, you will make the best use of your time at an HL7 C-CDA Implementation-a-Thon.
These two-day events provide an opportunity for multiple participants (20 – 30) from a diverse cross-section of companies and government agencies (16 – 20) to tackle specific use cases for both content creation and content consumption.
What We’ve Accomplished So Far at the C-CDA Implementation-A-Thons
Through the past three C-CDA Implementation-A-Thons, we have accomplished the following:
- Identified many inconsistencies in how document content has been created and consumed
- Clarified language in implementation guides
- Suggested and actually written material for the upcoming C-CDA R2.1 Companion Guide (see C-CDA R1 Companion Guide here)
- Made best-practice statements on a variety of topics
- Exchanged ideas with ONC about certification, validation and document scoring
At Allscripts, we have products that cross the continuum of care, with the ability to both produce and consume CDA-based documents. I am fortunate to work with the very talented Community Solutions group, which is responsible for the creation and consumption of all CDA-based documents for Allscripts products.
Yet, even with this single, focused approach at Allscripts, we are still faced with a number of interesting choices about data, and the construction and consumption of CDA documents. Participation in the C-CDA Implementation-a-Thon events resulted in us making some useful changes, and feeling confident that these were changes made with an industrial consensus for producing an improved quality of C-CDA.
A little history
Studying HL7 history, our standards went from a plain text, replication/messaging-based paradigm in the 1980s to the current, Internet 2.0, resource-based paradigm. We also created document-based standards such as the Clinical Document Architecture (CDA®) Release 2 and SOA based standards like Common Terminology Services (CTS).
These 30 years of history gave us a good insight on what we need as standards users and developers.
What do we need as standards users?
People who implement and use standards want open access to standards and implementation guides. They need understandable and short specifications, off-the-shelf tools, reference implementations, friendly representation of information (instances), easy access to vocabularies, automated validation of instances, affordable education, a formal extension mechanism.
Finally, they need examples, examples, and more examples. They need lots of examples!
What do we need as standards developers?
Standards developers have different needs. They want easy profiling with graphical user interfaces (GUI) and the ability to reuse templates. They also want one-click, automated publishing, validation and QA profiles, validation of instances, global profile registry, and ease of vocabulary binding.
The Power of Community in HL7
I first became involved with HL7 a decade ago as I transitioned from medical practice to clinical informatics. I attended my first HL7 meeting, as many do, to take advantage of the tutorial sessions offered around foundational standards like HL7 Version 2 and the Clinical Document Architecture (CDA®). The most valuable takeaway from that first meeting however was not the knowledge of the standards but the beginning of my relationship with the community of individuals who are HL7.
HL7 is a diverse community
It is a remarkable community of individuals that are as diverse as the countries they call home, the organizations that employ them, and their backgrounds of education and experience. The one thing that is common and shared across the community is the sense that we move the needle as a community; move the needle a little with each use case enabled with an HL7 standard and each project that ends with consensus on a new data standard.