Is the <ClinicalDocument> tag the first thing in this CCDA document file? Or are there one or two xml instructions at the very top like this (or maybe both on the same line):
<?xml version="1.0" encoding="UTF-8" standalone="yes"?>
<?xml-stylesheet type="text/xsl" href="_CDA_Stylesheet.xsl"?\>
In order for the CCDA Document to function as a valid "well-formed" xml document, it needs to have this xml instruction as the first thing in the file,
<?xml version="1.0" encoding="UTF-8" standalone="yes"?>
above the root or Document Element, which is the <ClinicalDocument > tag in the CCDA.
The second xml instruction should indicate what xsl stylesheet is used to display the document in a web browser like Chrome, Edge, IE whatever.
If the 2nd xml instruction in your file looks something like this:
<?xml-stylesheet type="text/xsl" href="_CDA_Stylesheet.xsl"?\>
Then you would know that the stylesheet that the CCDA needs is an xsl stylesheet file with the name:
_CDA_Stylesheet.xsl
and it needs to be located in the same folder as the ccda xml document.
Or, the xsl stylesheet could be located in a folder that all ccda.xml users have access to, then the relative path to that xsl file can be included in the "href" attribute's value in the ccda.xml document's 2nd XML Instruction, something like:
<?xml-stylesheet type="text/xsl" href=".\..\xslLibrary\_CDA_Stylesheet.xsl"?\>
If you have edited the ccda.xml file in Notepad, and made sure that the 2 xml instructions are at the top of the document, and you have put both the CCDA document and its required stylesheet (*.xsl) file into the same folder, you should be able to browse to the ccda.xml document and display it in your web browser.
This will allow you to read the document in a coherent, inexpensive and relatively easy manner like so:
If, however, you are not looking for a clerical/clinical use of the document, you
can use Microsoft Access 2012 or 2016 and "import" the "external" xml file with
"Structure and Data" - and I think this will load it into a database with tables that
are named after each xml element in the document. I don't recommend this, as it
loads the xml data elements as unrelated tables in MS Access. If, however, you could
transform the standard ccda into a specially designed xml/xslt document with
appropriate relational attributes added into the xml, you may be able to come up with
an xml document that imports easily into MS Access - then you could export each table
as an Excel csv or tab-delimited file.
by the way, I found my example xslt stylesheet by searching HL7.org website looking for testing information. If you do find a suitable xsl stylesheet for ccda, you will have to edit the 2nd XML instruction to enter the appropriate stylesheet name.
