Bye bye IHE XDS and CDA.
Publication date: Sep 01, 2021
IHE XDS.b has reached the end of its life cycle - requirements in healthcare have moved beyond the mere exchange of documents,
and the underlying technology is getting to be too old. We're no longer offering IHE XDS.b courses. There is a future in hybrid
architectures which support document-based exchanges as well as other workflows.
When it comes to interoperability standards training courses act as the proverbial canary in the coalmine: when demand for training
in a standard drops, this implies that the number of new projects using that standard is dwindling. If in cunjunction
with a drop in interest in training courses one sees a drop in the number of volunteers working on a standard, and a drop
in the number of (open source / commercial) tools that support the use and/or development of that standard, then this is a sure sign that usage is in decline.
CDA and CDA training courses
We've experienced a sharp decline for HL7 version 3 training courses in the past, and demand for CDA courses suddenly plummeted
about 7 years ago. Some (national/regional) projects have heavily invested in CDA, and they still produce new CDA implementation guides.
That's just a few countries however (e.g. Austria, Saudi Arabia). Others (e.g. the US) still use CDA, whilst working on porting the current CDA capabilities to FHIR documents.
For the reasons above we've decided to no longer offer any CDA training courses.
The 'clinical document' principles (a suitable option for some healthcare data exchange scenarios) will be covered as part of our FHIR training course.
As already indicated in a blogpost from 2015 the future of (the principles underlying) CDA will be based on FHIR.
IHE XDS and XDS training courses
IHE XDS.b (the second/current iteration of the IHE XDS workflow profile) was created in 2005. Many healthcare organizations were working on their intial
architecture to exchange summary information with other organizations, and as such IHE XDS offered a good solution.
XDS.b is used all over the world and it will be used for some time to come. The following two key issues have arisen over the past few years:
- No longer fit for todays requirements: the healthcare sector has moved on, partly because of (national) legislation or incentives (e.g. European GDPR, US Cures Act) - the requirement nowadays
is to move beyond the exchange of (static) documents, and to combine such exchanges with the support for non-document based workflows (e.g. electronic order management,
scheduling) which require the exchange of structured transactional data. IHE have tried to enhance XDS with 'on demand documents' and XDW-workflow support,
but to me these are symptoms of 'if all you support is documents, everything must be a document'. Grouping data in a document is a powerful exchange mechanism,
but there's more than just that.
- Old technology stack: XDS.b uses an old technology stack dating back to the 2000s (WebServices/WS-*, ebRIM as a standard to express document metadata). Now that's fine
for powerful back-end systems, but not so nice if one wishes to create light-weigth web based applications.
To use the udnerlying architectural model of XDS (document exchange, based on a registry with document metadata) effectively,
XDS will need to be upgraded to
- Use a more modern technology stack (FHIR/REST based, see my XDS.c blogpost from 2016).
IHE has published the MHD profile, as well as the MHDS meta-profile to accomplish this update, but they haven't gone as far as stating that
this will be the next version of XDS.
- To better allow for the XDS architectural model to be mixed with non-document based exchanges. The switch to FHIR/REST (as per MHD/MHDS) will certainly make
such mixed architectural models easier to implement.
For the reasons above we've decided to no longer offer any IHE XDS.b training courses.
The XDS document exchange principles (a suitable option for some healthcare data exchange scenarios) will be covered as part of our FHIR training course.
We expect MHD and MHDS gain more traction, and we'll introduce a new training course to cover these profiles as implementation picks up.
PermaLink to this page: http://www.ringholm.com/column/bye_bye_IHE_XDS_and_CDA.htm
Index of columns:
- Bye bye IHE XDS and CDA. (Sep 01, 2021)
- Advantages of online training courses (Oct 12, 2020)
- Combining the best of IHE XDS with HL7 FHIR (Jun 27, 2019)
- FHIR DevDays and the year in review (Dec 27, 2018)
- Creation and Curation of FHIR Profiles - process and governance (Dec 14, 2017)
- De Algemene Verordening Gegevensbescherming (AVG) in de zorg (Dutch, Sep 19, 2017)
- Impact of the GDPR on the use of interoperability standards (Jun 27, 2017)
- News from the FHIR DevDays in Amsterdam (Dec 15, 2016)
- Next XDS Release (Oct 27, 2016)
- Five years of FHIR (Aug 11, 2016)
- 2016 FHIR Jedi Calendar (Jan 06, 2016)
- Update from the trenches on CDA R2.1/R3 and HL7v2. (Oct 15, 2015)
- IHE XDS - testing and implementation tools (Aug 25, 2015)
- Most often implemented IHE Profiles (Jun 08, 2015)
- Mapping HL7v2 messages to FHIR. (Apr 13, 2015)
- Analysis of CDA R2 testing tools - most requirements are neither tested nor respected. (Feb 13, 2015)
- HL7 and IHE in Sweden (Feb 08, 2015)
- 2015 FHIR Chiefs Calendar (Jan 07, 2015)
- The Merry FHIR Choir caroling the 12 Days of Christmas (Dec 09, 2014)
- Chicago FHIR Update (Oct 13, 2014)
- Internationalization of HL7 (Sep 25, 2014)
- Recent and Future developments of the DICOM standard (Mar 06, 2014)
- Report from the HL7 WGM in Cambridge (Oct 16, 2013)
- Documenting the history of HL7 (Sep 03, 2013)
- Histology Lab Device Automation using HL7 version 2 (Jul 23, 2013)
- Interoperability Standards - the no-sales pitch (Jul 09, 2013)
- Validation and error correction at the IHE Connectathon (Apr 25, 2013)
- CDA Implementation Guides - (not) invented here (Apr 17, 2013)
- Usage of IHE Profiles (Feb 25, 2013)
- 10 year anniversary - Dutch Ringholm HL7 v2 training courses. (Feb 19, 2013)
- Musings on free HL7 IP (Oct 01, 2012)
- HL7 Connectathons (Sep 09, 2012)
- Renovate HL7 version 3 (Aug 03, 2012)
- Frequency of use of HL7 message types (Jul 24, 2012)
- Lighting the FHIR, HL7s new major interoperability standard (Jun 15, 2012)
- Reflections on the HL7 membership model - the affiliate life cycle (Dec 28, 2011)
- Thinking like an OWL reasoner (Sep 17, 2011)
- RFH (Resources for Health): HL7 version 3 taken to the next step (Aug 18, 2011)
- What's so great about the HL7 organization? (Aug 04, 2011)
- A HL7 RIMBAA update (Apr 21, 2011)
- Timezone Hotel (Mar 29, 2011)
- HL7 and openEHR are cooperating (finally) (Jan 21, 2011)
- Context issues with the IHE QED profile (Dec 15, 2010)
- The changing role of HL7 country organizations (Jul 16, 2010)
- Adding openness to a closed world (Feb 09, 2010)
- How to lower the hurdle for HL7 v3 implementers (Jan 21, 2010)
- HL7 v3 deployment statistics (Dec 17, 2009)
- There's Trouble in Paradigm (Sep 25, 2009)
- Internationalization of HL7 (Sep 24, 2009)
- HL7 UK signs deal with Ringholm to deliver HL7 v2/v3 training courses in London (Sep 17, 2009)
- The Next Web Conference in Amsterdam (Apr 17, 2009)
- The HL7 roadmap for CDA R3 and the CCD (Jan 17, 2009)
- HL7 Affiliates Meeting in Orlando (Jan 11, 2009)
- Devices and Prizes (Nov 22, 2008)
- HL7 creates a RIM Based Application Architecture (RIMBAA) group (May 18, 2008)
- Notes from the HL7 WGM in Phoenix (May 08, 2008)
- HL7 v3 RIM based applications: an unintended side effect (Jan 19, 2008)
- Collaborative Tools (Jun 21, 2007)
- HL7 based Tree inventory system (Jan 30, 2007)
- The link between HL7 and Open Source Software (Jan 06, 2007)
- Workflow Bribery (Sep 15, 2006)
- Timezones in HL7 (Jan 23, 2004)
- Controlled vocabularies: "@*%!!!" ? (Sep 01, 2003)
- Trusting the other Party (Nov 01, 2002)
About Ringholm bv
Ringholm bv is a group of European experts in the field of messaging standards and systems integration in healthcare IT.
We provide the industry's most advanced training courses and consulting on healthcare information exchange standards.
See http://www.ringholm.com or call +31 33 7 630 636 for additional information.
Rene is the Tutor-in-chief of Ringholm.