A Clinical Document Repository for CDA Documents

To harvest the potential benefits of electronic health record (EHR), the health record data must be in a standard, structured and computer understandable form. The Health Level 7 Clinical Document Architecture (CDA) is an American National Standards Institute (ANSI)-approved standard that specifies the hierarchical structure and semantics of clinical documents for the purpose of exchange. As CDA is used more widely, the efficient management, storage and retrieval of CDA documents become an issue. This paper describes a clinical repository for CDA documents based on Oracle XML database. In the repository, clinical documents exist in the form of enhanced CDA with digital signature. This repository supports both traditional database features with statistical analysis ability and standard protocol for common file management. We implemented this clinical document repository in an EHR system.