CDA is a broad and flexible standard that serves as a framework for defining more specific/focused standards for particular types of clinical documents. CDA-derived standards are published via CDA Implementation Guides that define CDA templates.

Each CDA template defines additional syntax rules and semantics for a specific part of a specific kind of CDA document. Those additional rules constrain the baseline overall CDA syntax and semantic rules, which all CDA documents share.

So, a CDA Implementation Guide is essentially a published specification that defines a CDA-derived standard that is more specific than CDA overall.

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