Question

Compare CDA, CCD, CCR, describe each of them and who uses these standard for what purpose?

Answer 1

First let us understand what is meant by CDA, CCD, CCR.

CDA –

Clinical Document Architecture which is in short known as CDA is a popular, flexible markup standard developed by Health Level 7 International, this defines the structure of certain medical records, such as discharge summaries and progress notes. It is the way to exchange this information between providers and patients.   

CDA moves clinical documents between medical systems. Documents like discharge summaries, progress notes, history and physical reports, prior lab results, etc. The CDA uses XML for encoding of the documents and breaks down the document in generic, unnamed, and non templated sections.

CDA defines a very generic structure for delivering any document between systems. What is missing in the CDA standard is a listing of a particular the sections of that document, which means that a template of the particular sections that should appear in a given type of document. For example, on a history and physical document, sections could be named Current Medications, Prior Immunizations, Social History, etc; etc.

Ignoring the political or technical motivation, a group was formed and worked to define a standard for moving documents between systems. Initially, this standard was unrelated to HL7’s CDA standard. It is fair to say the standards competed for mind share and each expressed a different integration philosophy. In later efforts, the two standards groups agreed to effectively make the standards compatible with each other.

CCD –

CCD is a term that stands for Continuity of Care Document and is based on the HL7 CDA architecture, CDA, is a document standard, governed by the HL7 organization. HL7 is the leader in healthcare IT standards, The CCD is built using CDA elements and contains data that is defined by the CCR. It is used to share summary information about the patient within the broader context of the personal health record.

CCR –

The Continuity of Care Record is termed as CCR. It is a standard for the creation of electronic summaries of patient health. Its aim is to improve the quality of health care and to reduce medical errors by making current information readily available to physicians.

In short is would be conclude that CCR as a specialization of the CDA. The CCR provides a template of the expected sections that will be provided in CDA format. This CCR content profile is a tightly controlled list of document sections answering the major bits of data to be sent.

For the healthcare professionals, some of these questions seems a bit foreign and serve as a source of confusion when it comes to discuss how to get the most from their data sharing options. Experts on the topic suggest that the CCD is an important step toward reaching the overarching goals laid out for the next phase of meaningful use and beyond. While it may be easier to avoid the intricacies of these concepts, healthcare organizations that want to position themselves at the forefront of the electronic movement should make an effort to gain an understanding of a CCD’s benefits.

This is an effective means to jump start clinician entry into data sharing, it provides a solid way to share information and bridge the differences that currently exists.

CDA, CDA and CCR are a part of information sharing, and interoperability discussions for several years. Confusing each of these terms represents a piece of the movement. However, experts tend to agree that the CCD is the element that sets the stage for the next phase of meaningful use.

CCD represents a merger of the CCR and the CDA as it covers the same information as the CCR but is built on top of the CDA framework.

The new CCD standard was formed through a joint collaboration that exists between providers who have adopted the CDA and those who have adopted the CCR. Endorsed by the Certification Commission for Health Information Technology, the CCD is predicted to be a key player in the electronic data exchange movement as the industry heads into phase 2 of meaningful use. In fact, CCD use is required for several phase 1 meaningful useful criteria.

CCD is part of an overarching interoperability framework, if you’ve already implemented CDA, the amount of effort involved with implementing CCD is relatively low.