What do you understand by the term Continuity of Care Document (CCD)? It is a standard healthcare EHR that is used to exchange data depending on the requirements outlined in the information. It is based on HL7 CDA Architecture and is governed by the
HL7 organization.
CCD includes the patient’s information about its current and past health status that could be shared by EMR (Electronic Medical Record), web browsers, and other applications. CCD is the result of the collaborative effort of the Health Level 7 and ASTM Organizations.
Health Level 7 refers to a set of international standards for exchanging clinical, administrative data between applications by different healthcare providers. Healthcare provider organizations have different computer systems that are used for tracking billing records and the patient’s status. All the systems communicate with each other when they receive new information. HL7 considers several standards as its primary standards.
Let us look at how CCD is beneficial in the healthcare industry.
Why CCDs are Important in the Healthcare Industry
With the improvement in the healthcare industry, the need for a way to exchange clinical documents between providers became easier. As technology is improving every day, the need for health systems and the exchange of documents are seen as an important sector of the healthcare field. Data that is shared in CCD include allergies, medications, problem lists, immunizations, health risk factors, social history, and insurance information.
The benefit of CCD exchange is that it reduces the staff time in collecting the patient’s clinical information during care. Also, CCDs give detailed information to the health professionals about the services/hospital facilities they would need. Plus, it reduces the risk of unnecessary testing and medical errors. The healthcare provider already knows everything about you, which helps in making the best decision for you. Overall, it provides the services needed at the point of care.
Sometimes, it may happen that the doctor that you took advice from is not available and have to seek another healthcare professional. Here, CCD relates to the medical transformation between the healthcare provider and health specialist. But do not be sure that your record is available to all providers at the same time. With the improvement in healthcare IT technologies, this too would progress soon.
Difference Between CCD and CDA
The common phrases used here are CCD, CDA, and CCR. Some people believe that these phrases are common, but in reality, they differ in many ways. CDA is a Clinical Document Architecture and an XML based markup standard to specify the structure of clinical documents for exchange. This could include text, sounds, images, and other content. Common examples of CDA are pathology report, imaging report, and content that carries a signature. The documents are shared through IHE protocols such as MIME, XDS, and more. It includes a human-readable section and contains structured sections.
CCD (Continuity of Care Document), on the other hand, is a commonly used CDA document. Before CCD, CCR was released. CCR is a Continuity of Care that provides a summary of a patient's health status that should be useful to another provider. A CCD is an electronic summary document that shares the basic information of a patient’s current and past status. It is compatible with any standard that uses RIM-based specifications and the latest versions of HL7.
Structure of CCD
The CCD is a constraint on the HL7 CDA standard. It includes the content of the document and the structured parts.
The structured parts are based on the HL7 reference and provide a framework for different coding systems. The patient summary in CCD contains a data set of the most relevant demographic and clinical information about a patient's health and covers different healthcare counters. Its main use is to provide a picture containing administrative data for each patient.
Development History of CCD
It was developed by Health Level Seven International along with advice from members of ASTM E31. It is a committee that is responsible for the maintenance and development of CCR standards.
The public library is limited to CCD’s available for developers to check how the medical data is using the structure and format of the CCD. Several EHRs have implemented CCD standards in very unusual ways. It is sometimes also known as Summary of Care Document and Summarization of Episode Note.
What Do You Understand by C-CDA?
C-CDA has been adopted as a major standard for creating patient summary documents. The best example of an improvement that you could see in the healthcare industry is through C-CDA. The data that is exchanged via C-CDA is machine-readable. Its format is a requirement for EHR vendors pursuing ONC Certifications.
CCDA and Stage 1
As a part of US federal Incentives for the adoption of EHR, the CCD and CCR were selected as acceptable extract formats for clinical care summaries. To become certifiable for a program, an EHR must generate a CCD that has different sections of medication, laboratory results, and other patient’s information.
Most EHR vendors preferred using CCD rather than CCR as it is a new format that meets the Continuity of Care Record and the HL7 Clinical Document Architecture specification.
CCD and Stage 2 - CCD is Included as a Part of Standard for Clinical Data Exchange
In the second stage, CCD is included and not CCR, as a part of clinical data exchange. The C-CDA, developed by Health Level 7, includes different document types. The second stage requires the healthcare providers to use C-CDA document exchange in care transitions.
These documents must be capable of adding data elements that include the Patient’s gender, smoking status, medications, laboratory results, and other information. Furthermore, it also includes referral reasons and discharges information if required in any case.
Limitations of CCD
This may happen that the sender has sent the entire information about the patient in their system, resulting in unwanted information. It is observed that Hospitals usually send the longest CCDs.
Also, in some cases, the sender adds a little information, which could cause the gap, and requires a phone call to note down the missing information. For CCD exchange to be valuable, the information should be proper and enough to track everything about a patient’s current situation.
Final Words
In today's scenario, Healthcare must provide or exchange data between independent sites. Undoubtedly, the healthcare industry has changed a lot in the past few years. Today, healthcare IT promises for a great future. IT technologies are making the world a healthier place to live. As technology is growing,
HIS and HMIS are becoming advanced and offering benefits to the healthcare world.
When it comes to any healthcare IT solutions, we build market-centric solutions with several medical standards to empower healthcare providers. We could help you to be at the top of technological innovations while offering expertise in a wide range of standards such as ICD-9, ICD-10, HL7, and more.
