Thats a good point. In the US the ONC/HIT at HHS has put out recommendations and rules for the schemas for data storage. Which is what the documents you reference are about they are about defining the building blocks used to store and capture health data. But, they do not define how they are transported or exchanged. The C-CDA even notes this, the "CDA DOES NOT specify how documents are transported, simply how critical data elements should be encoded for exchange and interoperability". Its the same thing for HL7 and all those great ICD9 and ICD10 codes. They are just building blocks not rules for transport. (I also know a thing or two about the field. We are magnetic buddies.)