Exchange Consolidated Clinical Document Architecture
(C-CDA)
The Exchange C-CDA use case aims to facilitate the exchange of a summary of a patient’s treatment information (known as a CCD or Continuity of Care Document), at the time of discharge with other care team members and active care organizations.
Use Case Summary, Implementation Guide and Supporting Documents
Exchange C-CDA Use Case Exhibit
Ambulatory Use Case Implementation Guide
Medication Reconciliation Use Case Implementation Guide
About this Use Case
The Continuity of Care Document (CCD) is a commonly used comprehensive electronic representation of a patient’s medical history and current condition and can include the following sections, each of which contains several data elements: Advance directives; Alerts; Encounters; Family history; Functional status; Immunizations; Medical equipment; Medications; Payers; Plan of care; Problem; Procedures; Purpose; Results; Social history; Vital signs.
The data within a CCD is exchanged via C-CDA (Consolidated Clinical Document Architecture), a machine-readable HL7 format that includes different document types, including medication reconciliation. C-CDA documents can be extensive – a sender can send all the data about the patient in this framework which can amount to over 200 pages, and bring with it unwanted information. The C-CDA is only valuable as the data the sender includes. Sending little information causes a gap and requires extra work for the rest of a care team.
MiHIN has requirements for hospitals and physicians, practices, pharmacies, transitional facilities (such as outpatient and skilled nursing facilities) sending C-CDA’s through the network to their patients’ other care team providers, which can be found in these implementation guides:
Ambulatory (Summary of Care) Use Case Implementation Guide
Medication Reconciliation Use Case Implementation Guide