CCD, CDA, C-CDA … What’s in a name?

March 30, 2017
Nick Hatt Staff Software Engineer, Tech Lead

The healthcare industry is infamous for it’s aggressive use of acronyms that often confuse people more than they help. Chief among these confusing acronyms is CCD… and CDA, C-CDA. Though similar in both name and function, these terms don’t always mean the same thing.

Luckily, our resident HL7 Whisperer, Nick Hatt, is here to help you decipher what these terms mean, what they don’t, and how they relate to each other when it comes to sharing patient data with EHRs.

Is every CCD a CDA?

No, CCD stands for Continuity of Care Document, and it has origins as a paper document.

If I say “CCD” to someone at Redox, what will they think I mean?

We would think you are referring to a CDA document.

What’s a CDA?

A CDA is an electronic document written in the Clinical Document Architecture.

Is every C-CDA a CDA?

Yes. C-CDA is set of rules for CDAs to follow so that they are easy to exchange.

Is every CDA a C-CDA?

No. C-CDA is an implementation guide. It sets very specific rules about how to use CDA. C-CDA originated around 2010/Meaningful Use timeframe, and CDA is about 10 years older than that.

Is every C-CDA a CCD?

No. C-CDA spells out many different documents including CCD, but also Progress NoteDiagnostic Imaging Report, andDischarge Summary. Each of those has different rules for what it should include.

Are there CCDs that aren’t C-CDAs?

Yes. There have been many iterations of the CCD concept, most notably C32 which was the de-facto standard before C-CDA was published.

What’s in CCD, why do they keep changing it?

Medications, Problems, Allergies, and Results are the required sections in C-CDA version 1.1, but there are many more optional pieces.

They keep changing it to meet government regulations and to fix mistakes in the specification itself.

Wait, there’s versions?

Yes, but most people only care about C-CDA v1.1 because the government mandated using that for the Meaningful Use program.

Does FHIR replace CDA?

Yes, hopefully.

Does FHIR replace CCD?

It can, but there need to be rules put in place, just like with C-CDA. Think C-FHIR. So far, no one has really taken that leap because FHIR is still unstable.

If you have any questions about these terms (or anything else healthcare related), feel free to reach out—we’re happy to clarify.

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