CDA Evaluator

A software utility to display, validate, anonymize, and convert CDA messages that have been formatted according to the Implementation Guide for Ambulatory Healthcare Provider Reporting to Central Cancer Registries as defined for Meaningful Use Stage 2. It is designed to help debug and test cancer patient messages sent from a reporting facility to a cancer registry, it is not meant to be used in a production environment.
Warning: It is now known that some software vendors generate CDA Cancer Reports in a format that defeats the anonymize feature in versions 1.9 and earlier (see discussion below).  Although Version 1.9.1 handles all currently known examples of this behavior, it remains vital for a human being to review anonymized documents for residual PHI.
Meaningful Use note: CDA Evaluator is intended to examine documents produced according to the Implementation Guide for Stage 2 Meaningful Use, published in 2012. It may produce unpredictable errors if used on documents constructed according to the Implementation Guide for Meaningful Use Stage 3 published in 2015.

CDA Evaluator Features List

download Download the latest version

  • 2017-05-19 Improved handling of anonymization (1.9.1_BETA)
  • 2016-06-03 Added command-line interface (1.9_BETA)
  • 2016-03-09 Minor enhancement (1.8.3_BETA)
  • 2014-12-06 Minor enhancement (1.8.2_BETA)
  • 2014-08-14 New release (1.8_BETA)
  • 2014-03-21 New release (1.7_BETA)
  • 2014-02-13 Minor enhancement (1.6.2_BETA)
  • 2014-01-28 Bugfix (1.6.1 BETA)
  • 2014-01-09 New release (1.6 BETA)
  • 2013-12-20 Bugfix (1.3.1 BETA)
  • 2013-10-15 Updated to include source code (1.3 BETA)

This software is still under development, bugs and feature requests should be e-mailed to:

cda-eval-support at kcr.uky.edu

Technical Requirements

  • Java 1.6 or higher

Quick Start

(More complete documentation is included in the docs directory of the ZIP file above.)

  1. Make sure your computer has Java 1.6 or higher installed, you can test this by typing “java -version” from a command prompt or terminal session
  2. Download and unzip the latest version of CDA Evaluator, double-click on the CdaEval.jar file to launch the App
  3. When the main screen appears, click “Open” in the top left corner of the App, specify a CDA XML file, and then click Open in the File dialog
  4. After file processing is complete, you will see the raw CDA XML on the left and a tabbed interface with several options on the right

A Note of Caution about the Anonymize feature

  • Private health information may be missed since the CDA Evaluator uses an automated process to identify private health information from XML elements according to the standard.
  • It is important that any document anonymized by the CDA Evaluator software is reviewed by a human being before it is communicated over an unsecured channel.
  • It has been reported that some software vendors systematically put PHI into fields not expected to contain it (specifically, including the patient’s name in the document title.) This always escapes the automatic anonymization in versions 1.9 and older. Version 1.9.1 handles this and similar conditions correctly, but files must still be checked by human review.

An implementation-compliant CDA document should be deidentified correctly, but it is always possible for the document creator to make a mistake, e.g. by mentioning the patient’s name in a diagnosis field where it doesn’t belong.

Copyrights and Credits

Health Level Seven, Inc., holds the copyright to some of the schema files used for validation. HL7 grants an unlimited license for distribution and use of these files provided their copyright notice and disclaimer are retained. HL7 is also the authority and copyright holder for the Clinical Document Architecture on which Cancer Reporting CDA documents are based.

Much of the validation module is derivative work from a basic validator developed at the National Institute of Standards and Technology by a team led by Andrew McCaffrey.

The Implementation Guide for Ambulatory Healthcare Provider Reporting to Central Cancer Registries has been jointly developed by HL7, CDC, NCI, and NAACCR, as well as the Kentucky Cancer Registry and other NAACCR member organizations.

Standards pertaining to the NAACCR record output module were obtained from NAACCR’s publicly available online reference materials.

Other background information used in constructing the CDA Evaluator was obtained from several working groups coordinated through the CDC.

All other software development not derived from the sources above was done at the Cancer Research Informatics Shared Resource Facility of the University of Kentucky Markey Cancer Center and the Kentucky Cancer Registry. This work was supported by CDC/ICF International Award 635243-10S-1572 as part of the American Recovery and Reinvestment Act (ARRA) Comparative Effectiveness Research activities through the Centers for Disease Control and Prevention.