Comment:

Current ballot content

The implementation guide is presented as profiles on the Composition resource. I dont think this does justice to the strengths of both standards - CDA and FHIR. Instead of attempting to recreate a C-CDA document as a set of compositions, the implementation guide would be much more useful addressing two actual use cases:

? when a C-CDA needs to be generated based on existing, possibly distributed data available in the form of FHIR resources

? when data from existing C-CDA content needs to be presented to consumer of FHIR resources

Proposed ballot content

As the ballot already mentions, some of the work of representing C-CDA information as FHIR resources is already done as part of the DAF profiles. This implementation guide should illustrate the above-mentioned use cases with this existing content, and develop anything missing. The focus should be on the amount of data from using vanilla FHIR resources that can be represented or used for building a C-CDA document, and highlight any extensions necessary. This will also allow for the identifications of any gaps regarding the implementation of each of the base standards, FHIR and C-CDA.

Summary:

Current and proposed ballot issues.