Convert your FHIR JSON -> XML and back here. The CDA Book is sometimes listed for Kindle here and it is also SHIPPING from Amazon! See here for Errata.

Ask me a Question

This page was inspired by Grahame Grieve.  Simply post a comment with your question or topic suggestion below.  I'll either answer it in a followup comment, or write a post on it.

[Note: Due to increases in spamming on other pages, your comment may not be published immediately.  Don't worry, I'll accept all comments so long as they aren't spam, and if I cannot answer it, I'll let you know.  One benefit of this new approach is that it should encourage me to answer your questions sooner!]

The rules are simple:
  1. Topics I'll cover include anything in the Tag cloud to the right...
    (Please do not ask me questions about my employer's products.  While I may sometimes be the right person to answer these, this blog is not related to my employment, and isn't the proper channel to ask or respond to those questions.  If uncertain, you can always contact me directly).
    (Also don't ask me questions about Meaningful Use certification (e.g., how to pass a test).  I'm not an authority there, and while I can tell you what is correct in the standard, I don't want to give bad advice about certification).
  2. All questions and suggestions posted are subject to this Blog's Policies.  
  3. If I don't know or cannot otherwise answer your question, I'll let you know.  
  4. Questions are not necessarily answered or addressed in the order received.  Note, the SLA here is when I can get to it, which is probably not what you are looking for.  However, I do encourage other readers to answer when possible.
Answers and Questions from 2011 have been Archived.
Answers and Questions from 2012 have been Archived.
Answers and Questions from 2013 have been Archived.
Answers and Questions from 2014 have been Archived.
Answers and Questions from 2015-2016 have been Archived.


26 comments:

  1. what CCD type is this 'small' thing that some want... as I understand it they just want allergies/problems/medications (just the basics) and no episode stuff?

    ReplyDelete
  2. Hi,

    As we are building a RESTful API based on FHIR standards for sending query about a patient and receiving back the requested information, do we have standard/format/schema defined in FHIR for sending a query with patient's ID or other demographics?

    ReplyDelete
    Replies
    1. It's a restful thing. For Patient it would be:
      [base]/Patient?query-parameters
      Where possible query parameters can be found here:
      http://www.hl7.org/fhir/patient.html#search

      Delete
  3. Fairly (I think) simple question: where would I place a medicare provider identifier for an inpaitent hospital (for use in an X12 transmission, eventually) in a v3 CDA?

    I'm looking at Grahame's book, which suggests that all information to 'contact, bill to and collect from' the payer should be in the payer section, but it seems to make sense that if the PNI sits in the recordTarget/providerOrganization then the medicare id would as well.

    ReplyDelete
    Replies
    1. When I Google Medicare provider identifier, all I get are pages referencing NPI. It would appear to be the same thing. But if not the same thing, it would certqinly go into the same place. NPI is not about how to reach the payer, so much as it is how to identify the provider to the payer, any payer, or, to identify them to anyone else for that matter

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  4. After reading Grahame's book, where he describes that in a CCD all information to authorize, bill, contact and collect from a payer should be in the payer section: would the medicare identifier for a hospital go in there, or be in the provider organization under clinicaldocument?

    ReplyDelete
  5. Hi Keith,

    I have always been a fan and learn so much from the discussions over the years on your blog. I am a first timer asking a question. I have been reviewing the CCDA r2 document and looking for an answer which I am having problems with. I read through the implementation guide but I am trying to find out if clinical indicators should be included in the machine readable section of the CCDA. I am not a developer but am trying to learn more about the CCDA and this is one of my first questions. I understand HL7 but if you could point me in the right direction for an answer, I would appreciate it. My assumption upon my research is they are not required to be included. Thank you for your itme.

    ReplyDelete
    Replies
    1. If, by "Clinical Indicators", you mean indications for a procedure, diagnostic test, medication or other therapy, you are correct in noting that these are NOT required in most implementation guides (including CCDA). However, they are supported by many of them, including CCDA, and by the base CDA standard. They are often shown as the "Reason" or indication. See the relationships tab on Indication here in Trifolia.

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    2. Dude you Rock. That is exactly what I meant. I appreciate the quick response. I am reviewing our recommendation. Thanks again.

      Delete
  6. We are running into aggregated CCDAs with XML/HTML reports inside the lab result values. Our current stylesheets cannot handle that. Any suggestions on how to go about rendering these lab results using the stylesheet.

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  7. We are running into aggregated Cda documents with XML/HTML (full body html documents) inside the lab result nodes. Our stylesheet does not handle displaying such embedded test results. Are there any stylesheets out to display these test results properly?

    ReplyDelete
    Replies
    1. The real question here is whether this embedded test result proper?

      Delete
  8. Hi Keith,

    We're looking for looking for sample clinical docs CCDA, C32, but from the vendor community, e.g.Epic CCDA's Cerner CCDAs, NextGen, GE, etc. We've found Josh Mandel's work on Git (https://github.com/chb/sample_ccdas), which is great stuff and some of the work from the CDA example task force work,
    which is vendor agnostic. Are there additional resources similar to Josh's work that provide vendor/product/version specific examples (but contain no PHI/PID) that you know of?

    Thanks
    Mike

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  9. Mike, if your company participated in IHE Connectathon, you'd have access to a large number of sample CCDAs as well for additional testing. Otherwise, I'm not aware of other test sets available.

    ReplyDelete
  10. Hi,
    I am looking for a CCDA template for Mu3 requirement. I found few CCDA 2.1 version files but not finding a full CCDA template file with its XSD file.
    I need to know that there in CCDA file, lot of templateid's so need some description (which template ID should come where) of it.
    Can anyone help me into this.

    Also i need to create XDM package file for MU3 and for that i need CCDA file its MetaData.XML file template also.

    Thanks
    Anil

    ReplyDelete
    Replies
    1. You need to read the standards themselves to understand this better. You can find the CCDA Standard on the HL7 Web Site and the XDM Profile on the IHE Web Site (look in Volume 3 of the ITI Technical Framework).

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  11. What are the most important differences between C-CDA R2.1 and R1.1?

    ReplyDelete
    Replies
    1. Criticality in Allergy instead of severity and the new Care Plan templates

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  12. I am validating my CCDA file with file "170.315_b1_toc_amb_sample1_v13.pdf" and validation objective "170.315_b1_ToC_Amb". I have added component section for Medical Equipment. Now i am getting below error:

    cvc-complex-type.2.4.a: Invalid content was found starting with element 'templateId'. One of '{"urn:hl7-org:v3":id, "urn:hl7-org:v3":code, "urn:hl7-org:v3":addr, "urn:hl7-org:v3":telecom, "urn:hl7-org:v3":playingDevice, "urn:hl7-org:v3":playingEntity, "urn:hl7-org:v3":scopingEntity}' is expected.

    Can you please help?

    ReplyDelete
    Replies
    1. This is a schema related error. It appears as if you have a element after the element within the , and it should be before it. That's the only explanation I can think of that would have caused this error without actually seeing the XML.

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  13. Hi Keith,

    My Client is using Mirth result as a CDR. I'm new to CDR. Wanted to understand what are pros and cons of Mirth Result CDR over other CDR available in the market (I dont know others CDRs)?

    Thank you!

    ReplyDelete
    Replies
    1. This is not a product I have used. You would be better off looking at Klas reports on CDRs or reviews by others.

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  14. Hi Keith,

    I'm working on Reconciliation of Allergies from CCDA R2.1.

    I have no known allergies, unknown allergies, not allergic to a specific substance.

    All those three sections looks identical and they all have the negation indicator.

    I only want to reconcile the No Known Allergies.

    Is there any way to differentiate between No Known Allergy, Unknown Allergy and Not Allergic to specific substance?

    I appreciate any help you can provide.

    Thanks,
    Satish.

    ReplyDelete
  15. Hi Satish,

    Keith might have other references, but one reference that might be helpful is the HL7 Example Task Force site. Here is the link for the Allergies samples: http://hl7-c-cda-examples.herokuapp.com/sections/595166e8e6ca6a48c70dac56

    Hope this helps.

    Regards,
    May

    ReplyDelete
  16. I have written a moderately successful EHR system for small behavioral health agencies and I decided that I need to get ONC 2015 Edition certified. I have been researching for about a week and it seems all the documentation assumes you already understand all the other documentation plus the standards have changed over time, so it is slow going. Is there any one place that can tell me what the what the current standard is, english translations of the terms, and whether or not something is optional (for behavioral health I know I must include a vital statistics section, but that information is always going to be blank)? For example, what does "Clinical Information Reconciliation and Incorporation" mean?

    ReplyDelete