CDA levels of interoperability

what does interoperability means in terms of the richness of the data when it comes to CDA documents? the CDA document has 3 levels of interoperability:

  • level1: CDA header + body of unstructured blob (pdf for example)
  • level2: CDA header + xml with narrative blocks, each block is code identified
  • level3: CDA header + xml with narrative blocks + entries (SNOMED, CPT, ICD-9 encoded etc)

as you can see, the richness of the data grows with each level and so does the capabilities of interoperability and quality of use. the coding for level2 and level3 is a requirement and adds clarity and consistency to the transaction. moreover, with level3, entries are encoded at varying levels of specificity, which is what HL7 refers to as “incremental semantic interoperability”, which allows the vertical and easy way into implementing the standards. as interoperability goes, the richness of the data is as important as the ability to exchange it, thus CDA level3 is what HIS should strive for, which will yield better care all across.

ACA and medicaid thoughts

there are 60 million americans who are covered by their state. now with the passing of the ACA, medicaid programs are going to pick up. 30 million americans are about to get health coverage, from which 17 million are of medicaid low income patients. as eligibility is raised from 100% of the poverty line to 133%, states wil be paying for coverage via federal funding from 2012-2014, from that date onward the states will start contributing to the cost, as fed share will not be lower than 90%. this pretty much means that medicaid will be become bigger and better and certainly more important.