This is your Questionaire submitted by on Thursday September 18, 2008, 22:3:50

Show Me Your CDA! My questionnaire

A. Basics

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1. CDA Project Name:   CDA-CH
   
2. Project Web Site:      www.hl7.ch
   
3. Contact Name:           Tony Schaller
   
4. Contact E-mail*:         tony.schaller@medshare.net
   *Primary contact for information about the project; one or more
   
5. Geographic location:Bern, Switzerland
   
6. Summary description: (Please write a paragraph describing your project. Include installation sites, demonstrations, and primary purpose 250 words)
   During a complex treatment the patient needs to visit many institutions. Between those institutions many documents with medical content are exchanged. Today, these documents are mainly exchanged in the form of letters on paper, fax or e-mail. In many cases, the patient is used as a courier of the documents (for example, discharge report, X-ray image, recipe). He personally brings the document (created by e.g. hospital or X-ray Institute) to the next appointment in another institution (such as medical practice or pharmacy). The need to exchange medical documents is therefore obvious. In light of today's technical capabilities the used media (the paper) and the used transmission (the patient) surprises. The HL7 affiliate Switzerland has developed a specification about sharing medical documents in the context of the national eHealth Strategy. This specification is based on HL7 V3, CDA and the German VHitG Arztbrief. This specification allows to electronically exchange medical documents between participants in the Swiss health care system without losing information caused by media breaks. It will act as a successor standard for medical information in free text documents (such as PDF, TIF, Word or e-mail). Using the case study "hip replacement" ten possible examples of medical documents exchanged between the involved health professionals were identified. Paper based examples of these documents can be found in the annex of the specification. Based on these sample documents real CDA documents (XML, XSD, XSL) were produced. They can now be used to illustrate how CDA documents based on the CDA-CH specification may look like.
   
   

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))
   Other: All participants of the swiss helath care system
   
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
      Other: All documents in the swiss health care system
      
      
   2. Do you use an implementation guide? [choose multiple]
      HL7 Implementation Guide
      HL7 Affiliate Implementation Guide
      IHE Implementation Guide
      Other: VHitG
      
      
   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:
      Currently the specification only standardizes the header but not the body. "CDA Templates" standardizing the body will be created in the future.
      
   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
      Other: all possible but not implemented, yet.
      
      
   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:
      There are several projects on track but we do not know an amount of documents.
      
   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:
       
       
       
   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:
   ICPC Ticono-Code (Swiss specific)
   
   

   D. Health Information Exchange Methodology

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   1. How many sites are involved in exchanging CDA in this project??
      
      
   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:
      all sorts of point-to-point and hub-and-spoke file transfer
      
      
      

   E. Vendor Applications

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   Please share some information about the applications in use:

   Vendor/In-house	Product Name	Functionality	Product Status

   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.) HL7 Working Group Event May, 20th 2008 SGMI-Jahrestagung 2008, Sierre eHealth Summit 2008, Bern E-Health-Com 4/2008 Schweizerische Aerztezeitung (37/2008)