Rob,
THANK YOU for your feedback in this extremely important topic. It is very exciting to see hospitals such as the ones in your area, starting to accept patient-initiated exchanges (import/export) of electronic health records.
Our CCD support complies (i.e. 'no errors') with the CDA R2 format rules, as tested using the NIST validation tool set:
http://xreg2.nist.gov/cda-validation/validation.html. This is also known as the HL7 CDA R2 (with no extensions) version, whereas the version you mentioned, includes HITSP/C83 Extensions. You may want to inquire (we will also on our part) as to whether the RelayHealth tool supports using CDA without extensions - maybe there is a configuration setting for that.
It is also interesting that the NIST validation tools support testing for HITSP C32 Versions 2.1, 2.4, and 2.5 - but not 2.3... We will need to investigate whether independent verification for 2.3 will be possible. Maybe RelayHealth should also consider upgrading their support to a version that is supported by NIST's suite (e.g. 2.4).
We will look into upgrading our plug-in, and we would hope to perhaps continue to count on your feedback as to how the integration works with RelayHealth?
Thank you again for your feedback,
Support Team