The meaningful exchange of health information is as desirable as it is challenging to achieve. Consolidated Clinical Document Architecture (C-CDA) represents a promising vehicle to such interoperability – both in capability and in regulatory acceptance. C-CDA is both easier to utilize and more capable than many health IT professionals realize. However, some misconceptions are common. The HIMSS Health Story Project Roundtable helps explain the principles in their recent February Roundtable presentation.
It's all in the name: An early application of Clinical Document Architecture (CDA, prior to the advancements of Consolidation) was the Continuity of Care Document (CCD). The popularity of the CCD represented an early achievement of CDA. In fact, when I query health IT people about their level of familiarity with C-CDA, one of the most common responses is something like, “Yes, we send CCDs.” The association with the CCD goes so far that sometimes they pronounce C-CDA as CCD-A, as if the first three letters of the C-CDA acronym stand for Continuity of Care.
To the contrary, the new CCD is just one of a dozen valuable document templates defined by C-CDA. Each template was carefully constructed by health IT professionals, and eventually “consolidated” over a period of years to meet specific use cases.
When technologies or users get comfortable with only one or a few of the templates, they do themselves and their collaborators a disservice. Becoming familiar with each type of template, and selecting the most appropriate for a particular use-case, will enhance meaningful exchange. Comparable to expanding your vocabulary to express yourself more precisely, using the most appropriate template to convey health information is very helpful.
Narrative as a key design component: Any discussion of C-CDA would be remiss to omit the concept of narrative as a key design component of the collection of standardized templates. As electronic health records have emerged and matured over the past decade, structured data fields have often replaced the unstructured, freely formatted narrative records that providers commonly dictated in the past. While structured data is helpful where appropriate, C-CDA templates were designed around the recognition that both structured data and narrative data are often required to adequately capture and communicate a patient’s true health story.
Tune into this roundtable presentation recording to learn the fundamental differences among each of the C-CDA document templates, practical applications and benefits associated with using templates designed for specific purposes.