Work on PCEHR projects continues. CCA for HI and SMD is on the short term plan. HI service test cases don't make much sense for a middle-ware vendor, we don't control the behaviour of systems we connect to so having mandatory requirements wrt application operation is not really possible. Prescriptive application functions are nice in theory but what is really mandatory?
SMD CCA is much more digestible; service/data compliance makes sense in general. The certificate validation points are suitably wooly (NASH?) but most everything else seems fair enough.
CDA content has been parked for a while; this was the easier bit overall. We have been using it internally for a few years and Care Provision (HL7 V3) for years before that. (Level 3a NEHTA’s Common Conformance Requirements). Can anyone do SNOMED-CT and AMT to a great extent?
CDA packaging needs some work, we have some interesting business needs for 'complete' health record extracts including clinical documents as attachments. Not sure what is actually happening in the real world but some users seem to want attach masses of massive documents - what is a practical limit?