IG:CDA für die elektronische Fallakte - Versionsgeschichte

Jcaumanns am 26. Februar 2013 um 21:32 Uhr

2013-02-26T21:32:21Z

Foemig: /* References */

2013-02-01T08:19:39Z

‎References

Foemig: /* Entry Content Modules */

2013-01-31T22:50:24Z

‎Entry Content Modules

Foemig: /* Consent Directive Observation */

2013-01-31T22:20:33Z

‎Consent Directive Observation

Wikiadmin: /* eCR Encompassing Organizational Act */

2012-03-27T12:22:38Z

‎eCR Encompassing Organizational Act

Foemig am 19. März 2012 um 19:42 Uhr

2012-03-19T19:42:18Z

Jcaumanns: /* Syntactical Conventions */

2012-03-18T15:44:20Z

‎Syntactical Conventions

Jcaumanns: /* About electronic Case Records */

2012-03-18T11:15:37Z

‎About electronic Case Records

Jcaumanns: /* Related Documents */

2012-03-18T10:04:51Z

‎Related Documents

Jcaumanns: /* Document Reference */

2012-03-18T09:59:20Z

‎Document Reference

← Nächstältere Version		Version vom 26. Februar 2013, 21:32 Uhr
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−	''As part of the »eCR in a Box« specification, the EFA-Verein defined an interface for encoding eCR management operations within HL7v2 CDA documents. Due to the modular approach of this work a strong separation among eCR-specifc settings and general definions can be done. In December 2011 it was decided by EFA Verein and the German Interoperability Forum to extract the generic definitions from the eCR specification and to provide it as input for standardization efforts of the national boards working in this field. During this process the Interoperability Forum will be responsible for organizing a commenting and approval process on behalf of HL7 Germany and IHE Germany.''	+	''As part of the »eCR in a Box« specification, the EFA-Verein defined an interface for encoding eCR management operations within HL7v2 CDA documents. Due to the modular approach of this work a strong separation among eCR-specifc settings and general definions can be done. In December 2011 it was decided by EFA Verein and the German Interoperability Forum to extract the generic definitions from the [[cdaefa:EFA Spezifikation v2.0 \| eCR specification]] and to provide it as input for standardization efforts of the national boards working in this field. During this process the Interoperability Forum will be responsible for organizing a commenting and approval process on behalf of HL7 Germany and IHE Germany.''

	== About electronic Case Records ==		== About electronic Case Records ==

@@ Zeile 176: / Zeile 176: @@
 *[[cdaefa:Healthcare Professional Instance Identifiers|Healthcare Professional Instance Identifiers]]
 *[[cdaefa:Healthcare Professional Organization Instance Identifiers|Healthcare Professional Organization Instance Identifiers]]
 == References ==
 ...

@@ Zeile 153: / Zeile 153: @@
 === Document Reference ===
 A Document Reference Entry refers to a single information object (e.g. within an eCR or another type of health record). With eCR-in-a-Box, Document Reference entries are used for registering documents with an eCR instance.
-* CDA Content Module Specification: [[cdaefa:1.2.276.0.76.3.1.81.81.6.4.4|Document Reference (1.2.276.0.76.3.1.81.81.6.4.4)]]
+* CDA Content Module Specification: [[cdaefa:Document Reference (Entry)|Document Reference (1.2.276.0.76.3.1.81.81.6.4.4)]]
 == Codesystems ==

@@ Zeile 149: / Zeile 149: @@
 === Consent Directive Observation ===
 A Consent Directive Observation is a specialization of the [http://wiki.ihe.net/index.php?title=Simple_Observations IHE PCC simple observation content module] for registering relevant consents and contracts with a care episode or an electronic record.
-* CDA Content Module Specification: [[cdaefa:1.2.276.0.76.3.1.81.81.6.4.1|Consent Directive Observation (1.2.276.0.76.3.1.81.81.6.4.1)]]
+* CDA Content Module Specification: [[cdaefa:Consent_Directive_Observation_(Entry)|Consent Directive Observation (1.2.276.0.76.3.1.81.81.6.4.1)]]
 === Document Reference ===

@@ Zeile 170: / Zeile 170: @@
 === eCR Encompassing Organizational Act ===
 eCR Encompassing Organizational Acts encode the kind of an eCR container object. This is always a "case record" on the top level. 2nd level containers may be inpatient visits, administrative acts, etc.
-*Codesystem: [[cdaefa:1.2.276.0.76.3.1.81.81.5.4|eCR Encompassing Organizational Act ((1.2.276.0.76.3.1.81.81.5.4)]]
+*Codesystem: [[cdaefa:1.2.276.0.76.3.1.81.81.5.4|eCR Encompassing Organizational Act (1.2.276.0.76.3.1.81.81.5.4)]]
 == German Profile: Instance Identifiers	==

@@ Zeile 37: / Zeile 37: @@
 == About eCR CDA Content Modules ==
-This document provides a specification of Content Modules which normalize the use of German healthcare identifiers within medical documents. A Content Module is a template on a specific HL7v2 CDA entity such as a document, a section or an entry. The templates defined in this specification describe how an entity is to be used by document based services within the German healthcare system. E. g. the Patient Role Content Module consists of a template that defines how the new German Electronic Health Card is to be used for patient identification within medical documents.
+This document provides a specification of Content Modules which normalize the use of German healthcare identifiers within medical documents. A Content Module is a template on a specific HL7 V3 CDA entity such as a document, a section or an entry. The templates defined in this specification describe how an entity is to be used by document based services within the German healthcare system. E. g. the Patient Role Content Module consists of a template that defines how the new German Electronic Health Card is to be used for patient identification within medical documents.
 Each template is identified by an OID. By assigning this OID as a <templateId> to a CDA entity, implementations of this entity are forced to comply with the template . An entity can be assigned multiple <templateId>s to denote compliance with multiple Content Modules. Content Modules can be profiles on already existing Content Modules by defining further constraints on that Content Module. Most of the Content Modules defined in this specification are profiles on Content Modules already defined in the [http://wiki.ihe.net/index.php?title=Category:Content_Profile_Templates IHE Patient Care and Coordination domain (IHE PCC)].
@@ Zeile 93: / Zeile 93: @@
 ;<element1>
-:If an element is constraint by one or more templates, the respective OIDs are listed within <templateId> elements after the element.
+:If an element is constrained by one or more templates, the respective OIDs are listed within <templateId> elements after the element.
 ;<element2>
 : Elements shown without highlighing MUST be present but are not profiled by this specification. Further attributes or sub-elements MAY be added to such elements as long as this does not conflict with the CDA schema and – if defined – other templates that are registered for the element.
@@ Zeile 176: / Zeile 176: @@
 *[[cdaefa:Healthcare Professional Instance Identifiers|Healthcare Professional Instance Identifiers]]
 *[[cdaefa:Healthcare Professional Organization Instance Identifiers|Healthcare Professional Organization Instance Identifiers]]

@@ Zeile 81: / Zeile 81: @@
 The following example shows the conventions used in this document:
-<code>
+<syntaxhighlight lang="xml" valid="true" heading="template (OID)" highlight="6">
     <element1>
        <templateId id='...'/>
        <templateId id='...'/>
        <element2>
-          <element3 value='fixed'/></code><code style="color:red;">
+          <element3 value='fixed'/>
-          <element4 value='...'/></code><code style="text-decoration:line-through;">
+          <element4 value='...'/>
        </element2>
     </element1>
-</code>
+</syntaxhighlight>
 ;<element1>
 :If an element is constraint by one or more templates, the respective OIDs are listed within <templateId> elements after the element.
 ;<element2>
-: Elements shown in normal font weight MUST be present but are not profiled by this specification. Further attributes or sub-elements MAY be added to such elements as long as this does not conflict with the CDA schema and – if defined – other templates that are registered for the element.
+: Elements shown without highlighing MUST be present but are not profiled by this specification. Further attributes or sub-elements MAY be added to such elements as long as this does not conflict with the CDA schema and – if defined – other templates that are registered for the element.
 ;<element3>
 : If a value is given for an attribute, this value is considered as fixed and MUST NOT be omitted or changed.
 ;<element4>
-: Elements in red color are profiled by this specification. They MUST be used as defined in the text underneath the template.
+: Highlighted elements are profiled by this specification. They MUST be used as defined in the text underneath the template.
 == Header Content Modules ==

@@ Zeile 31: / Zeile 31: @@
 eCR in a Box is an innovative deployment concept that introduces a plug&play capsule for eCR services. This capsule (»eCR Plugs«) decouples document sources from eCR services and allows for managing case records - including their scoping and permissions - on the abstraction level of medical documents. By hiding most of the security services and privacy enhancing technologies between rather simple client- and provider-side interfaces, eCR can be operated like a black box (»eCR Box«) that adds intelligent document sharing services to regional healthcare networks while being almost invisible to its users.
 All eCR technical specifications and operation guidelines are open to the public at http://www.fallakte.de.
 == About eCR CDA Content Modules ==

@@ Zeile 68: / Zeile 68: @@
 === Related Documents ===
 In addition, the following specifications and guidelines are of particular relevance for the implementation, deployment, and operation of eCR CDA Content Modules:
-* HL7 CDA specification
+* [http://www.hl7.org/documentcenter/private/standards/cda/r2/cda_r2_normativewebedition.zip HL7 CDA Release 2]
 * [http://www.ihe.net/Technical_Framework/index.cfm#pcc IHE PCC Technical Framework Vol. 1 and 2]
 * [http://www.amazon.de/The-CDA-book-Keith-Boone/dp/0857293354/ref=sr_1_1?ie=UTF8&qid=1332063763&sr=8-1 Boone, Keith: ''The CDA Book.'' Springer, 2011.]