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C-CDA R2.1 Volume 3 Update – Advance Directives Templates Clarifications

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Basics

C-CDA R2.1 Volume 3 Update – Advance Directives Templates Clarifications

1323
Ballot - STU to Normative


V3 Documents-Clinical (e.g. CDA)

Revise Current Standard, Implementation Guide

Details

This project will examine issues identified with the Advance Directives Templates defined in C-CDA R2.1. It will develop new-version or substitute templates for the existing Advance Directive templates to address these problems and add more/clearer guidance within the templates to address implementer's questions.

The following C-CDA R2.1 Templates are in scope:

1. Advance Directives Section

2. Advance Directives Organizer

3. Advance Directive Observation

4. US Realm Header (guidance on optional use of the ServiceEvent element)

The new template versions may affect value set content and binding. The goal is to be backward-compatible with C-CDA R2.1. However, some implementer feedback is questioning the technical changes that were made to the value set bindings in these templates between C-CDA R1.1 and C-CDA R2.1. Therefore, some value set related revisions may be non-backwards compatible in order to address this reported problem.

These Advance Directives refinement templates (proposed new-version or substitute templates) fall within the scope of CDA R2.1 Volume 3—the new volume of optional templates that may be used to augment C-CDA Documents.


Advance Directive Templates are (arguably) important components of the C-CDA standard, yet to date, their usage in the standard has been optional.

New focus within the industry on patient-centered care plans and value based care has raised implementer interest in including advance directive information that communicates the patient’s health goals and treatment preferences. This new interest has caused new trial usage of the existing Advance Directive Templates in C-CDA R2.1 and that use has led to reported problems and questions about their design and intended use.

For these reasons the intended uses for Advance Directive Templates need to be clarified, and the designs of Advance Directive Templates need to be revised.



Project Launch Feb 10, 2017 Review Cycle (Dependent on C-CDA R2.1 Volume 3): Target TBD – SDWG Publication (Dependent on C-CDA R2.1 Volume 3): Target TBD – SDWG


SDWG Wiki

N/A

This project is dependent on the publication of C-CDA R2.1 Volume 3.


1) Epic 2) Cerner

None currently known – New focus on Patient Goals as an important part of information collection and exchange. Also, increased focus on sharing information that indicates if a person has an advance care plan or not and where the patient’s goals and preferences are documented.

C-CDA R2.1 Additional Volume 3 Templates - for Advance Directives Templates

The templates published in the updated C-CA R2.1 Volume 3 will supersede the templates in the C-CDA companion guide appendix.

Yes

Don't Know

No

2022 April: TSC approved STU Publication Request for CDA R2 Implementation Guide: Consolidated CDA Templates for Clinical Notes; Advance Directives Templates, Release 1 - US Realm for 2 years 2022 February: TSC approved STU Publication Request for CDA R2 Implementation Guide: Consolidated CDA Templates for Clinical Notes; Advance Directives Templates, Release 1 - US Realm for 2 years 2020 June: TSC approved STU Extension Request for C-CDA R2.1 Advance Directives Supplement R1 for 24 months HL7 CDA R2 Implementation Guide: C-CDA R2.1; Advance Directives Templates, Release 1 - US Realm in STU through March 23, 2020 2018 March: Work Group submitted STU Publication request for C-CDA Advance Directives Templates at TSC Tracker 15765
Organization & Realm

Realm Specific - Enter "U.S." or name of HL7 Affiliate below

U.S.
People

Lisa Nelson



Structured Documents Work Group

No Selection

Status & Dates

Active

STU - Test Period/Accepting Comments

03/15/2017

05/01/2026

2026 May WGM/Ballot

01/01/2026

2026 Jan WGM/Ballot

2022 Jan Ballot Cycle Info: STU Ballot Results: Did not meet basic vote requirements. 23 Negatives to reconcile Document Name: HL7 CDA R2 Implementation Guide: Consolidated CDA Templates for Clinical Notes; Advance Directives Templates, Release 1 - US Realm (PI ID: 1323) (See Jira Ballot Dashboard) 2017 Sept Ballot Cycle Info: STU Ballot results: Met basic vote requirements. 23 Negatives to reconcile Document Name: HL7 CDA R2 Implementation Guide: Consolidated CDA Templates for Clinical Notes; Advance Directives Templates, Release 1 - US Realm
Approvals

07/24/2017


Received


All Received




System Info



View Ballot Items (with NIBs)




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