This document seeks to provide technical documentation related to the implementation of Clinical Document Architecture (CDA) within the OpenSHR implementation.
OpenSHR is implemented as a series of modules which can be installed into OpenMRS to fulfill the requirements of an OpenHIE compliant Shared Health Record (SHR) actor. There are several features of OpenSHR which make it an OpenHIE compliant SHR:

• IHE XDS (Cross-Enterprise Document Sharing): The XDS module for OpenSHR allows it to behave as an XDS.b document repository. In this role, OpenSHR can receive documents submitted via a Provide and Register (ITI-41) transaction and serve requests to retrieve submitted documents via a Retrieve Document Set (ITI-43) transactions.
• Content Consumer: The CDA handler module allows OpenSHR to parse CDA documents submitted via XDS into its discrete data elements, or sections (depending on the quality of the submitted CDA document).
• IHE ODD (On-Demand Documents): The ODD module for OpenSHR allows the SHR to generate summary documents for patients whenever requested. These documents are registered with an XDS Registry and, unlike stable documents, do not exist until retrieved.
• Auditing & Accountability: The ATNA module for OpenSHR allows it to produce RFC-3881 compliant audit messages whenever data is imported or exported to/from the OpenSHR data store respectively. These audits are collected in a central audit repository within the OpenHIE compliant Audit Repository.