This is your Questionaire submitted by on Tuesday September 9, 2008, 21:42:3

Show Me Your CDA! My questionnaire

A. Basics

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1. CDA Project Name:   Implantable Device (Cardiac) Follow-up
   
2. Project Web Site:      http://h-elga.at
   
3. Contact Name:           Alexander Kollmann
   
4. Contact E-mail*:         alexander.kollmann@arcsmed.at
   *Primary contact for information about the project; one or more
   
5. Geographic location:Austria / Graz
   
6. Summary description: (Please write a paragraph describing your project. Include installation sites, demonstrations, and primary purpose 250 words)
   The Austrian eHealth strategy recommends a nationwide electronic health record (EHR) and the use of data standards (including CDA Release 2, LOINC, DICOM, and ICD-10) for exchange, storage, and classification of clinical information. In this case study a CDA specification that covers the needs of cardiologists for standardised information exchange in the cardiac rhythm management (CRM) domain is presented. For this purpose the existing discharge letter for patients with implantable cardiac devices (e.g. pacemakers), which was previously developed in consent with the cardiologists at the Medical University Graz, was adopted to fit the CDA R2 specification. The outcome is a fully level 2 (section level) and partly level 3 (entry level) coded CDA discharge letter which summarises the results of a follow-up examination. The CDA header was built in conformance with the specification proposed by the Austrian HL7 working group (currently in ballot status). The CDA body consists the following sections: anamnesis, general physical findings, cardiophysiological parameters, specific programming parameters of the implantable device, medication, further therapy recommendation, and details on the next follow-up. We conclude that the CDA provides an appropriate solution to integrate device, diagnostic, therapeutic, and classification data from different sources into a single document and facilitates the extensive information exchange in the CRM domain.
   
   

B. Business Case

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1. What are the exchange sites? [choose multiple]
   Primary care provider (i.e. General Practice)
   Emergency
   Hospital
   Tetriary care
   Document repository (not affiliated with a single provider)
   Internally within an enterprise (provider))
   
2. What were the reasons for beginning your CDA exchange? [choose multiple]
   Improve the delivery of care
   Government mandate
   Business drivers (cost effectiveness)
   Public health reporting
   Quality Reporting
   Standardizing clinical reporting
   

   C. CDA Usage

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   1. What document types do you use? [choose multiple]
      Discharge summary (inpatient or outpatient)
      Transfer of Care, Referral or Medical Summary (e.g. U.S. CCD)
      Operative Note
      History and Physical
      Consultation Note
      Progress Note
      Admission Note
      Nursing Assessment
      Public Health Reports
      
   2. Do you use an implementation guide? [choose multiple]
      HL7 Implementation Guide
      HL7 Affiliate Implementation Guide
      IHE Implementation Guide
      Other: German CDA Implementation Guide
      
      
   3. What level of coding do you use?
      Level 0 (non-XML)
      Level 2 (coded sections)
      Level 3 (some coded entries)
      Mixture or unsure
      
      
   4. Did your initial exchange begin at a lower level of coding?
      Yes
      No
      If yes, please describe:
      
      
   5. How are your CDA documents generated: [choose multiple]
      Electronic Medical Record export
      Scanning
      Word processing (converted to XML or left as non-XML)
      Dictation
      Conversion from alternative standard (HL7 V2, DICOM SR, other)
      Natural Language Processing
      Speech recognition
      
   6. Please describe your CDA volume:
      Number of CDA documents exchanged over the last year:
      Number of CDA documents exchanged last month:            
      If other, please describe:
      Prototype
      
   7. Do you make your CDAs available to patients through a Personal Health Record system
      or provider portal?
      Yes
      No
      
      
   8. Did you extend CDA to fulfill your use case? Have you submitted requirements for consideration in CDA R3?
      Yes
      No
      If yes, please describe:
      
      
   9. Have you carried out educational seminars on CDA use?
      Yes
      No
      
      
   10. Have you used terminology for...
       10.1 clinical document types: [choose multiple]:
       Local Vocabulary
       LOINC
       SNOMED
       If other, please describe:
       - ISO/IEEE 11073 Point of Care Medical Device Communication Standards nomenclature - HL7 abnormal flags
       
       
   10.2 Section Codes [choose multiple]:
   Local Vocabulary
   LOINC
   SNOMED
   If other, please describe:
   
   
   10.3 Clinical Information [choose multiple]:
   Local Vocabulary
   LOINC
   SNOMED
   ICD
   If other, please describe:
   
   
   

   D. Health Information Exchange Methodology

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   1. How many sites are involved in exchanging CDA in this project?2
      
      
   2. How do you exchange/transport your CDA documents? [choose multiple]:
      Web Services
      ebXML
      SOAP (Simple Object Access Protocol)
      SOA (Service Oriented Architecture mechanism)
      CD/DVD
      Memory stick/Thumb drives
      HL7 v2x MDM
      HL7 v3 RCMR
      IHE XDR/XDS
      If other, please describe:
      
      
      
      

   E. Vendor Applications

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   Please share some information about the applications in use:

   Vendor/In-house	Product Name	Functionality	Product Status
   Austrian Research Centers - eHealth systems	H.ELGA	Electronic Health Record for Patientes with Implantable Cardiac Devices	Clinical Evaluation

   Vendor or In House development: Name of vendor or in-house development
   Supported Functions: Authoring, Distribution, Display, EMPI, Enrichment (Natural Language Processing, coding, etc), Management, Electronic Medical Record (EMR)
   Product Status: pre-released, released (Note: applies to the version of the product with the CDA capabilities you are using. If released, but the CDA capability is in beta, indicate pre-release)

   F. Bibliography

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   Please list any existing bibliographic references to your work including scientific papers, articles in your own language, implementation guides, etc.) * Electronic health record for patient with implantable cardiac devices (www.h-elga.at) * German CDA Implementation Guide (www.vhitg.de) * Sabutsch, S. et al.: Interoperability-Framework zur automatisierten Integration von Herzschrittmacher-Daten in die H.ELGA (Herzschrittmacher . Elektronische Gesundheitsakte). Tagungsband der eHealth2008: Medical Informatics meets eHealth. Wien, Austria, 2008.