Sample MAMC CDA R2 Level 2 Outpatient SOAP note

Madigan Army Medical Center (MAMC) created a CDA R2 implementation guide for sending inpatient notes with a non-XML body (L1).  
That I.G. was used as the basis for creating an outpatient SOAP note from Madigan to send to the VA with a more structured L2 body.  
This was successfully implemented in March 2007 and notes are currently being sent from MAMC to the VA using a CDA R2 with a Level 
2 structured body.

The original version of the note is included as a PDF file and the CDA R2 L2 version of the note is included as an XML file with 
a .txt extension.

We didn't use any standard tools to create the CDA R2.  What we did was create an XML file from the data in the database.  
That XML file was based on the structure of the database and was something the database application was already able to create.  
Then we mapped the elements of that XML file over to a CDA R2 document using an XSLT (transforming it from one XML structure to 
another XML structure).  Some of the fields needed to create the CDA, such as facility names and IDs, were not part of the database, 
so they were simply hard coded into the XSLT.  This process worked well and was relatively easy to modify.  I'm sure there are 
other XML tools that could do the same thing, but this easily integrated with the web services we were using to share data.