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Clinical Document Architecture (CDA) Standards for Public Health

Communicable Diseases | EHDI

The PHDSC and the Council for State and Territorial Epidemiologists (CSTE) in collaboration with the Association of Public Health Laboratories (APHL) conducted a pilot project to use HL7 Clinical Document Architecture (CDA) standards for public health case reporting. CDA is an HL7 standard that allows representation of clinical or public health information in a structured format (i.e., CDA templates) that is similar or identical to the paper forms formats.

The CDA standard has been named in the Meaningful Use (MU) of Health IT Stage 1 for information exchanges between Electronic Health Record (EHR) systems. The CDA standard was selected in MU Stage 2 for Cancer Reporting and quality measure reporting for Early Hearing Detection and Intervention program.

The project included two components:

CDA Templates for Public Health Case Reporting

The CSTE-APHL-PHDSC team collaborated with IBM Research to develop CDA templates for public health case reports for 15 conditions using the open source Model Driven Health Tool (MDHT). MDHT is a tool used by the Office of National Coordinator for Health IT (ONC) and other agencies, e.g., Centers for Medicaid and Medicare Services (CMS), to build CDA templates for medical information in EHR systems. The data content for the CDA-based public health case reports templates is defined based on CSTE Position Statements. CSTE and Centers for Disease Control and Prevention (CDC) recruited epidemiologists subject matter experts (SMEs) to inform the development of the templates for the selected conditions.

CDA for Public Health State Pilot Projects

To test feasibility of CDA-based data exchanges between clinicians and public health, PHDSC collaborated with State of Delaware, San Diego County and State of New York in the CDA for Public Health Pilot Project. Representatives from six jurisdictions (MI, CT, MA, OK, SC and WA) participated in the project as observers to guide the project design.

For more information, please visit project wiki pages at