A new model for collaboration: building CDA documents in MDHT.

Clinical Document Architecture implementation guides (IGs) specify a standard format for electronic submission and are typically developed by a few standards specialists working in national committees that do not have the resources to address the range of use cases needed for community-wide document-based health information exchange. To accommodate the variation inherent in these use cases we must be able to customize a base IG according to state and local rules, and to document ownership of these constrained guides. Model Driven Health Tools (MDHT) is an open source framework that enables community authoring. The Public Health Data Standards Consortium assembled a cross-disciplinary team to develop Public Health Case Report IGs for 15 reportable conditions using MDHT, with the goal of supporting state and local customization. This paper describes our experience learning MDHT and evaluates how well MDHT meets our objectives.