Adding encompassingEncounter section to C-CDA?

[TronActive]

Has there been any discussion about adding some new sections to C-CDA template? I would like to at least add encompassingEncounter section. I would also like to add Goals, Family and Medical History, and payers' section templateId 2.16.840.1.113883.10.20.22.2.18.

I have no idea what it would take to do this.

[jawalonoski]

Apologies for the late response -- your question somehow fell through the cracks.

We don't have any plans to update the C-CDA templates except for bug fixes.

The template format is Apache Freemarker. If you want to add a new section, you have to modify the templates (files). For instance:

synthea/src/main/resources/templates/ccda/encounters.ftl

Lines 5 to 11 in 8f363ad

	<section>
	<templateId root="2.16.840.1.113883.10.20.22.2.22" extension="2015-08-01"/> <!-- CCDA Template id -->
	<!--Encounters section template-->
	<code code="46240-8" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="History of encounters"/>
	<title>Encounters</title>
	<@narrative.narrative entries=ehr_encounters section="encounters"/>
	<#list ehr_encounters as entry>

If you know C-CDA, adding the new section to the Freemarker template should be pretty straight-forward.

Depending on what the contents of that particular section are, it is possible you might want to create some custom data fields that you can reference inside the Freemarker template in order to make the export easier. If so, you could edit the Java to add those custom data fields. For example,

synthea/src/main/java/org/mitre/synthea/export/CCDAExporter.java

Lines 123 to 132 in 8f363ad

	Observation smokingHistory = person.record.getLatestObservation("72166-2");
	if (smokingHistory != null) {
	person.attributes.put("ehr_smoking_history", smokingHistory);
	}
	person.attributes.put("time", time);
	person.attributes.put("race_lookup", RaceAndEthnicity.LOOK_UP_CDC_RACE);
	person.attributes.put("ethnicity_lookup", RaceAndEthnicity.LOOK_UP_CDC_ETHNICITY_CODE);
	person.attributes.put("ethnicity_display_lookup",
	RaceAndEthnicity.LOOK_UP_CDC_ETHNICITY_DISPLAY);

Hope this helps.