CDA, CCD - HL7 version 3

Question

I am working on CDA as well as CCD of HL7 version 3. Can someone tell me what is the purpose of CDA and CCD and why it is used? I tried a lot to figure out but i can't, please help me. (if i get all the information through HL7 version 2 why should i use HL7 version 3?)

Answer 1

RE: CDA vs. CCD

Source: HITSP_09_N_451.pdf

Clinical Document Architecture (CDA) - CDA is an HL7 document markup standard that specifies the structure and semantics of "clinical documents" for the purpose of exchange. CDA documents derive their machine processable meaning from the HL7 Reference Information Model (RIM) and use the HL7 Version 3 Data Types. CDA is a flexible XML-based clinical document architecture. CDA itself is not a specific document, but can be used to express many types of documents.

A CDA document can contain many data sections, all of which contain narrative text, and some of which contain structured data elements, some of which are coded.

There are many types of CDA documents, including CCD, XDS-MS Discharge Summary (HITSP C48), History and Physical (HITSP C84), Lab Report (HITSP C37), etc.

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Continuity of Care Document (CCD) - CCD describes constraints on the HL7 Clinical Document Architecture, Release 2 (CDA) specification in accordance with requirements set forward in ASTM E2369-05 Standard Specification for Continuity of Care Record (CCR). It is intended as an alternate implementation to the one specified in ASTM ADJE2369 for those institutions or organizations committed to implementation of the HL7 Clinical Document Architecture. The Continuity of Care Record (CCR) is a core data set of the most relevant administrative, demographic, and clinical information facts about a patient’s healthcare, covering one or more healthcare encounters.2 It provides a means for one healthcare practitioner, system, or setting to aggregate all of the pertinent data about a patient and forward it to another practitioner, system, or setting to support the continuity of care.

CCD is just one type of CDA document. Other types of CDA documents can contain some of the same CCD sections, but different sections as well.

The source PDF includes some additional information.

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RE: HL7 v2 vs HL7 v3 See:

• Whitepaper: "The HL7 Evolution: Comparing HL7 Versions 2 and 3"

Quoting from that paper (which I believe was written in 2012):

To date, HL7 V3 messages have not been widely adopted within the United States as a means to exchange clinical data. Current HL7 V2 vendors are generally in a “waitand-see” mode until their customers demand V3. Regulatory agencies are one exception.

An obvious question can be asked: “Will HL7 V2 simply disappear now that V3 is released?” We believe the answer is “Not anytime soon.” Millions of dollars and countless hours have gone into developing and maintaining HL7 V2 interfaces. From a financial perspective alone, it is inconceivable that HL7 V2 will quickly disappear.

The whitepaper includes significantly more information on the topic. You might also check out this roadmap showing planned work towards CDA R3. I'm not an expert in this field. (Thankfully so. This stuff is crazy complex.) I suspect a more useful answer on benefits of v2 vs. v3 would require assessing your specific situation.

(Fwiw, I'm not sure this question classifies as programming related. You might have better luck here: http://healthcareit.stackexchange.com/ (UPD: The Healthcare IT site didn't have enough activity during the beta, and has been closed))

Answer 2

CCD is a specific type of CDA. CCD (Continuity of Care Documents) is the ASTM CCR (Continuity of Care Record) implementation from HL7, using CDA documents.