Combine CDA Templates for Personal ACP and POLST document types into a single CDA IG in SD Format (Jira PSS-2657)

The project will create a CDA Implementation Guide (IG) in StructureDefinition (SD) Format using HL7 IG Publisher. The focus of the IG will be a combined set of CDA document, section, and entry templates which evolve the current CDA templates toward designs that align with the work being done in this domain area in the FHIR Advance Healthcare Directive Interoperability (ADI) IG.

This CDA IG is being developed and balloted separately, but the intension is for it to be treated as part of the FHIR ADI IG collection.

The overarching FHIR ADI IG is being developed within the project PI 1652 (Project Proposal: PSS-1664) Project Scope Statement: https://confluence.hl7.org/spaces/PE/pages/91991987/PACIO+Project+PSS+for+Advance+Directives .

The ADI Use Cases are documented in the FHIR ADI IG. They are relevant regardless if an advance healthcare directive document is represented in FHIR or CDA or pdf format.

Initially, the first version of CDA ADI IG will cover Personal Advance Care Plan and Portable Medical Order documents as minimally structured documents.

Based on industry adoption, it may evolve to include more templates that cover a broader range of advance healthcare directive document types or to include more section or entry templates. The growth roadmap will follow the progression of balloted FHIR profiles maturing in the companion FHIR ADI IG.

This PSS replaces two prior project:

CDA PACP PI 1204 (no PSS)

CDA ePOLST PI 1724 (PSS-1827)

Templates created in these prior works will evolve within this new project. When the purpose of a template remains unchanged and the design can be evolved without causing backwards compatibility issues, the root OID of the previously established template will be used and a newer version number will be applied. However, when the evolution to align with the FHIR ADI profiles causes backward compatibility issues, new templates may be developed to replace prior work. This IG may deprecate previously utilized templates as well.

Prior adoption of earlier work had been very low (only one known adopter) and so this approach has a low risk of causing implementer burden. Alignment with the FHIR ADI profiles offers significant interoperability improvements for implementers and justifies potential backward incompatibilities being introduced if needed to achieve this goal.

While the FHIR ADI IG is consistent with US Core 4.0.1, this CDA ADI IG will be consistent with C-CDA 3.0 and to the largest extent possible will align with the profile designs in FHIR ADI 2.0.

The FHIR ADI IG covers the use of RESTful API interactions for query, retrieve, post, and verification operations between systems. These document exchange and interoperability mechanisms apply to all formats of advance healthcare directive documents.

The CDA ADI IG will reference the FHIR ADI IG for all content that applies and is already documented there. Only guidance that is unique to creating or exchanging a CDA format document will be covered in this IG.

If this CDA implementation guide develops templates that overlap with existing C-CDA templates we will request approval from US Realm SC, and provide the US Realm approved rationale for deviation in the implementation guide.