Clinical Document Architecture
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Worldwide, Clinical Document Architecture (CDA) is the most widely adopted application of HL7 V3. The CDA paradigm takes the document metaphor seriously.
It is illuminating to compare the differences between the database transaction and document metaphors (Benson 1997; Spronk 2007).
Databases are organized for rapid search and retrieval and are updated by transactions. The database structure is designed by a computer professional, updated by various people, who may or may not know each other, and is accessed by others using queries. The person who updates the database is seldom able to control who, if anyone, will read the data, or for what purpose. The person who uses the data may not know who entered them and lack of context makes it difficult to evaluate whether or not they can be relied on.