Currently I'm working on implementing HL7 CDA for a large hospital which has both outpatient and inpatient clinics. To decrease average duration of consultation, consulting physicians use electronic forms. Forms must be thoroughly formalized (and ideally require minimum keyboard input).
In practice it appears that simplest formalized Consultation Note form contains not less than 40-50 input fields.
For example, an ordinary otolaryngologist's Consultation Note "Physical Examination" section includes the following sub-sections: external nose, internal nose, throat, larynx, trachea; note that nose is symmetric, and that each organ can be described by 10-15 characteristics - so as a result I have an input form with about 100 input fields. Add to this form other required sections defined by the HL7 CDA Consultation Note spec (reason for visit, history of illness, problems, medications) - and you have got ~150 fields. Consequently, my HL7 CDA level 3 document body shall contain the same number of [observation] elements.
During an ordinary in-patient case physicians can register up to 10-100 documents. And each document contains 20-100-200 meaningful parameters. In total: ~10000 parameters.
At the end of the in-patient case a physician shall create a summary document which gathers data from other documents registered earlier. And at this point I feel that I misunderstand HL7 CDA spec. A human being cannot operate with 10000 parameters easily. Could you please give me an advise (or example) on how to design ergonomic user form that allows a physician to create a brief Summary Document?
