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Update from the trenches on CDA R2.1/R3 and HL7v2.

Publication date: Oct 15, 2015

HL7 version 2 and CDA are probably the most commonly implemented HL7 standards. What's the futire direction of these standards?


HL7 is currently working on CDA Release 2.1, an update/patch of the widely used CDA Release 2 specification. R2.1 has the following goals:
  • To update the CDA model to use the latest version of the RIM (version 2.35r1, the last version on Data Types R1 which is used by CDA R2)
  • To be wire compatible with R2. The XML Schema for R2.1 will be able to validate CDA R2 instances. This also means using datatypes R1, given that the use of datatypes R2 would result in a non-backwards compatible schema.
  • To add a minimal set of the most commonly extended attributes like multipleBirthInd. Although present in the RIM, some attributes had been removed in the CDA R2 model, forcing implementers to use an extension to support the concept. In CDA R2.1 the standard RIM attributes will be re-introduced.

Calvin Beebe discussing future CDA releases

The creation of a normative R2.1 specification may take another year or two. Once R2.1 has been finalized work will start on R3, which is likely to be based on FHIR Resources instead of the HL7 v3 RIM. Such work will largely depend on the maturity level of the various FHIR components at that point in time.

HL7 version 2

After HL7 v2.9, HL7 will move to a different way of publishing HL7 version 2. Up to now the main method for publishing v2.x is in the form of Word documents, and to do so only after a multi-year ballot cycle. Especially of we look at FHIR (HL7s latest standard) where HTML documentation is generated from a database, and which uses an annual ballot cycle, there is room for improvement when it comes to the HL7 version 2 publication process.

Frank Oemig discussing future releases of HL7 Version 2

Recently HL7 has decided to start a project to study how the documentation process of HL7v2 could be optimized, and it was decied to move to an annual release. So after 2.9 there won't be a 2.10, 2.11, etc. - there will be a 2106 release, 2017 release etc. instead. This is only partly because of the optimalization of the v2 publishing process, it also has to do with the fact that most vendors implement "v2" (a blend of various v2.x artefacts) rather than any specific version.

Even when FHIR is 'hot' right now - standards like HL7v2 and CDA are alive and kicking ;-)


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Ringholm bv is a group of European experts in the field of messaging standards and systems integration in healthcare IT. We provide the industry's most advanced training courses and consulting on healthcare information exchange standards.
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