Consolidated Clinical Document Architecture: Analysis and Evaluation to Support the Interoperability of Tunisian Health Systems

Abstract

Clinical Document Architecture (CDA) (Dolin RH, Alschuler, L, Beebe C, Biron PV, Boyer SL, Essin D, Kimber E, Lincoln T, Mattison JE JAMIA 8:552–569, 2001) is the base standard for the exchange of electronic clinical documents. CDA provides a common architecture, coding, semantic framework, and markup language to support the exchange of structured data component. The main purpose of CDA is to promote interoperability and to help healthcare institutions share data in a meaningful way. However, working with the base standard resulted in different possible implementations and document definitions for the same purpose, which led to interoperability issues. Consolidated Clinical Document Architecture (C-CDA) (https://www.hl7.org/implement/standards/product_brief.cfm?product_id=258. Accessed 20 July 2018), an implementation guide designed for the US realm, aims to solve these problems by reducing the standard’s ambiguity and inconsistencies. This paper presents C-CDA and discusses possible contribution of the Continuity of Care Document (CCD) (INTERNATIONAL, H.L.S.: ‘HL7 Implementation Guide for CDA Release 2:Consolidated CDA Templates for Clinical Notes (US Realm) Volume 2—Templates and Supporting Material’, in Editor (Ed.)^(Eds.): ‘Book HL7 Implementation Guide for CDA Release 2:Consolidated CDA Templates for Clinical Notes (US Realm) Volume 2—Templates and Supporting Material’ (HL7 INTERNATIONAL, 2018, edn.), pp 929) to enhance Tunisian health system interoperability.