Also Consolidated Clinical Document Architecture, CCD, Continuity of Care Document
When a network query returns a patient’s records, most of what comes back is C-CDA. It is an XML document with two layers: a human-readable narrative that renders like a chart printout, and coded entries beneath it that a receiving system can parse into its own problem list, medication list and results. The Continuity of Care Document, the CCD, is the C-CDA template most organizations publish as their summary of a patient; discharge summaries, consult notes and progress notes are others.
The standard fixes the sections and the codes. A problem is a SNOMED CT concept; a medication is RxNorm; a result is LOINC; an encounter has a date, a type and a performer. The United States Core Data for Interoperability lists which classes of data a certified EHR must be able to send and receive this way, and that list has grown with every version.
What that means for the agency reading the result:
- The same section appears from every source. Twelve organizations’ documents all carry a medications section, so a reconciled medication list can be built across them instead of from one.
- Each document is one organization’s view. A CCD is what that system knew. The hospital’s says nothing about the cardiologist; the cardiologist’s says nothing about the home health episode. Completeness comes from the set, not any one document.
- Duplication is built in. Every organization’s summary restates the history it knows, so the same diagnosis arrives from six places. Organizing the record means collapsing those into one entry with six sources, which is the part of the work a raw query leaves undone.
Attached files, such as a scanned PDF a practice placed in its chart, can also come back, and some do. But the structured core of an outside record is C-CDA, and that is what makes it possible to turn a pile of documents into one record with the source on every line.