Clinical Document Architecture

Synonyms

CDA; CDA R1; CDA R2

Definition

The Clinical Document Architecture (CDA) is a document markup standard that specifies the structure and semantics of clinical documents for the purpose of exchange and share of patient data. The standard is developed by Health Level Seven (HL7) – a Standards Development Organization [2] focused on the area of healthcare. At the time of writing this entry, two releases of CDA were approved: CDA R1 was approved in 2000 and CDA R2 in 2005. Both releases are part of the HL7 new generation of standards (V3), all derived from a core reference information model (RIM) that assures semantic consistency across the various standards such as laboratory, medications, care provision and so forth. The RIM is based on common data types and vocabularies, and together these components constitute the HL7 V3 Foundation that is an inherent part of the CDA standard specification.

Key Points

Clinical documents such as discharge summaries, operative notes and referral...