Successful deployment of Electronic Health Record helps improve patient safety and quality of care, but it has the prerequisite of interoperability between Health Information Exchange at different hospitals. The Clinical Document Architecture (CDA) developed by HL7 is a core document standard to ensure such interoperability, and propagation of this document format is critical for interoperability. Unfortunately, hospitals are reluctant to adopt interoperable HIS due to its deployment cost except for in a handful countries.
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