Dual Implementation Guides in FHIR and CDA

Background: The Fast Healthcare Interoperability Resources (FHIR) and Clinical Document Architecture (CDA) are standards for the healthcare industry, designed to improve the exchange of health data by interoperability. Both standards are constrained through what are known as Implementation Guides (IG) for specific use. Objectives: Both of these two standards are widely in use and play an important role in the Austrian healthcare system. Concepts existing in CDA and FHIR must be aligned between both standards. Methods: Many existing approaches are presented and discussed, none are fully suited to the needs in Austria. Results: The IG Publisher has already been used for CDA IGs, beside of its intended FHIR support, but never for both in one IG. Even the International Patient Summary (IPS), existing as CDA and FHIR specification, does not solve the needed comparability between these two. Conclusion: As the IG Publisher is widely used and supports CDA, it should be used for Dual Implementation Guides. Further work and extension of IG Publisher is necessary to enhance the readability of the resulting IGs.