Exchange Consolidated Clinical Document Architecture


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.

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