Continuity of Care Document

The Continuity of Care Document (CCD) specification is an XML-based markup standard intended to specify the encoding, structure and semantics of a patient summary clinical document for exchange.

The CCD specification is a constraint on the HL7 Clinical Document Architecture (CDA) standard. The CDA specifies that the content of the document consists of a mandatory textual part (which ensures human interpretation of the document contents) and optional structured parts (for software processing). The structured part is based on the HL7 Reference Information Model (RIM) and provides a framework for referring to concepts from coding systems such as from SNOMED and LOINC.

The patient summary contains 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. 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. Its primary use case is to provide a snapshot in time containing the pertinent clinical, demographic, and administrative data for a specific patient.

The CCD specification contains U.S. specific requirements; its use is therefore limited to the U.S. The U.S. Healthcare Information Technology Standards Panel has selected the CCD as one of its standards.

Development History

CCD was developed by HL7 with consultation and advice from several members of ASTM E31, the technical committee responsible for development and maintenance of the Continuity of Care Record, CCR, standard. In the opinion of HL7 and its members, the CDA CCD combines the benefits of ASTMs Continuity of Care Record (CCR) and the HL7 Clinical Document Architecture (CDA) specifications. 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.

Competition and Internet Health Industry Standards

CCD and Continuity of Care Record (CCR) are often seen as competing standards.^[1] Google Health supports a subset of CCR^[2], while Microsoft HealthVault claims to support a subset of both CCR and CCD.^[3]

See also

• HL7
• Clinical Document Architecture
• Healthcare Information Technology Standards Panel
• Continuity of Care Record (CCR)

References

1. ^ http://e-caremanagement.com/untangling-the-electronic-health-data-exchange/
2. ^ http://code.google.com/apis/health/ccrg_reference.html
3. ^ http://blogs.msdn.com/familyhealthguy/archive/2008/07/13/again-with-the-standards-thing.aspx

4. http://www.corepointhealth.com/whitepapers/continuity-care-document-ccd-changing-landscape-healthcare-information-exchange

External links

• Structured Documents Group of HL7
• CDA Resource Page
• CCD XML Instance Examples
• Online CCD instance validation tool at NIST
• Introduction to the HL7 Standards