Stream: implementers
Topic: CDA with Attachments
Ramandeep Dhanoa (Feb 26 2020 at 17:03):
While mapping from CDA to FHIR how to denote CDA attachments (PDF, word, etc) in FHIR? Reading documentation around DocumentReference and Binary resources, however unclear on where actual attachment is going and how it will reference back to Composition resource?
Lloyd McKenzie (Feb 26 2020 at 17:11):
The attachment won't point to the Composition - the Composition will point to the attachment. Typically this would be handled using DocumentReference which provides some degree of metadata about the attachment content. The binary content of the attachment itself could be inside the DocumentReference or pointed to as a separate Binary.
Ramandeep Dhanoa (Feb 26 2020 at 17:43):
Thanks @Lloyd McKenzie Yes, my bad I meant Composition referencing DocumentReference, so the way I understand is:
Composisiton.section.entry (Referencing to DocumentReference resource)
and actual PDF mapped to DocumentReference.content.Attachment.data
When you say 'pointed to as a separate Binary' - does that mean Composition directly referencing Binary resource (where metadata is not needed)?
Let me know if I am missing something.
John Moehrke (Feb 26 2020 at 17:53):
the DocumentReference.content.attachment has two different models. There is a pointer .attachment.url to a Binary, or one can encode the content using base64 encoding into .attachment.data. Using binary is more flexible, but some feel it is a burden of one more link to follow. the use of encapsulated base64 .data might also be more friendly when the size of the content is very small (like a short note).
Ramandeep Dhanoa (Feb 26 2020 at 19:47):
Thanks @John Moehrke for the clarification!
Last updated: Apr 12 2022 at 19:14 UTC
