Improving Public Health through Public Reporting

In 2007, as the National Healthcare Safety Network (NHSN) was gearing up to collect information on healthcare associated infections (HAIs), they needed a mechanism to pull information captured in local infection control applications and EHRs without redundant data entry. The prevalent standards for data sharing could not easily model the reports and were not compatible…

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CDA in the Wild: Conclusion (Installment #8)

Clinical Documents were never meant to hold 10 pounds of coded data. CDA is a 5-pound bag, containing the actual words, either written directly by a clinician or spoken and transcribed, with the minimal coding necessary for the use case.

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New Public CDA Stylesheet

Lantana is happy to announce the release of a new public CDA Stylesheet, an open-source renderer for CDA documents. The stylesheet transforms the XML of a CDA document into a webpage that can be viewed in a browser or other XSLT-compatible application.

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CDA in the Wild: Timing is Everything (Installment #7)

Will time be cruel to CDA? Some think so, we think it is still alive and kicking. The hard part of CDA has always been its HL7 V3 heritage, and it is HL7 V3, not CDA that needs to join the dinosaurs, buried in shale and crushed into carbon.

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CDA in the Wild: Coded Data Issues (Installment #6)

  This week, I have left the bush behind and retreated to the comfort of my office. I am attempting to decode the works of the famous biologist Brice Schneuer, who spent the later part of his career dedicated to Wild CDA research.   Although he published many authoritative works on the species, Schneuer jealously…

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Trifolia Release 3: New Functionalities

Co-author: Robin Williams, RN   Trifolia (https://trifolia.lantanagroup.com/) is a web-based tool for standards development work. Trifolia produces HL7 Clinical Document Architecture (CDA) templates and Fast Healthcare Interoperability Resources (FHIR) profiles. Trifolia helps users rapidly develop standards-compliant electronic documents for cost-effective standards implementation. See https://www.lantanagroup.com/resources/trifolia/ for a full description of Trifolia and its existing features.  …

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Conversation from the Sidelines: HL7 January 2016 in Orlando, FL

  “Conversation from the Sidelines” is a new series at Lantana’s blog. We’ll share experiences from conferences or events that gave us a different perspective on the industry.   First up, the HL7 January 2016 Working Group Meeting (WGM) in Orlando, FL. gave me an opportunity to fill-in for Crystal Kallem as an Interim Co-Chair…

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CDA in the Wild: Narrative Issues (Installment #5)

  A solitary Wild CDA has left its pride. We can only presume it is searching for a mate by its extravagantly complex header and the swish of its long tail of codes. However, research tells us that while a long code tail is nice to have, it is the mating call of the CDA,…

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CDA in the Wild: Validation and Schematron (Installment #4)

  It has been weeks since our last episode. Frankly, the sight of that genetically mutated Wild-CDA/North-American-XHTML hybrid left my team so repulsed that many could not continue. But after discussing the importance of this work, and a few crew changes, we are back in the field.   And we are documenting something never seen…

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CDA in the Wild: Validation – XML Schema (Installment #3)

  During our last episode, we stumbled upon a wild CDA lying dead in the grass. Not wanting to pass up such an opportunity, we decided to dissect the beast to uncover the cause of death. The immediate cause turned out to be a malformed end tag that resulted in catastrophic system failure.   Further…

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CDA In The Wild: Basic XML Issues (Installment #2)

  Move in closer now…do you see that? It’s a wild CDA lying motionless in the grass. Surely it’s waiting for prey to…wait, it’s not moving – something’s wrong…   Ah, this one was dead when we got here.   A fair number of wild CDAs suffer from basic XML issues. This means they are…

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CDA in the Wild – Introduction

Shh…
…beyond the bushes ahead you will see the Wild CDA in its natural habitat…
Lantana Consulting Group presents the first installment of CDA in the Wild by Rick Geimer, a blog series that identifies top errors found in CDAs (and how to fix them).

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FHIR CDA Position Statement and Roadmap

This position statement addresses the relationship between HL7’s Clinical Document Architecture (CDA) product line and the Fast Health Interoperability Resource (FHIR) product line. It was prepared jointly by Lantana Consulting Group—a recognized leader in the CDA community—and Grahame Grieve, Health Intersections, the FHIR project lead. This statement is not official policy. It is our hope…

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What’s new in Trifolia 2.14

Trifolia version 2.14 is now available. Several updates have been made to the user interface, template editor, template viewer and browsing functions to improve user experience.

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Rest Secure

A security update for the long-standing CDA style sheet is available from Lantana Consulting Group here. This update addresses a potential vulnerability exposed by use of the style sheet in many current internet applications by preventing malicious insertion of executable code into the display instructions for non-XML clinical documents (allowed as the body in Consolidated…

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Conformance Drift in Consolidated CDA R2; Part Two of Three

The HL7 Consolidated Clinical Document Architecture (C-CDA) Release 2 ballot received an unprecedented 1,000+ comments. A number of those comments include proposals to tighten various constraints within the document. Here are some arguments towards constraint tightening.

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Conformance Drift in Consolidated CDA R2; Part One of Three

The HL7 Consolidated Clinical Document Architecture (C-CDA) Release 2 ballot received an unprecedented 1,000+ comments. A number of those comments include proposals to tighten various constraints within the document. Although tightened constraints sometimes are necessary, they may also represent bad spec design in the form of a “conformance drift,” a situation in which increasingly restrictive conformance verbs are applied to truly optional elements thus idealizing one implementation of the spec to the exclusion of others.

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Template Versioning for Consolidated CDA (C-CDA)

The HL7 Structured Documents Working Group (SDWG) is discussing approaches to template versioning in Consolidated CDA (C-CDA). I suggest here a strategy that is consistent with current policy on identifiers.

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