For better or worse, healthcare IT vendors have to accommodate a variety of standard formats to send clients’ data from Point A to Point B. In the olden days (aka pre-Meaningful Use), the decision of selecting a preferred format was entirely owned by the vendor. MUStage 1 requirements corralled everyone to adopt the same standard: the Continuity of Care Document (CCD). The CCD is an XML-based standard that marries the best of HL7 technologies to the richness of the clinical data representation provided in a Continuity of Care Record (CCR), without interrupting existing data flows.
Problem solved, right? Not exactly. CCD isn’t specific enough and some fields are optional. The Healthcare Information Technology Standards Panel (HITSP) decided to “further constrain” (read: add more rules) the standard to require certain sections in a specific format within a CCD. Although that’s progress, the specification provided guidance regarding data encoding, but did not require that it be followed.
MU Stage 2, which begins fiscal year 2014 for eligible hospitals/critical access hospitals and calendar year 2014 for eligible professionals, will use the Consolidated-Clinical Document Architecture (C-CDA). CDA is a base standard which provides a common architecture, coding, semantic framework, and markup language for the creation of electronic clinical documents. In general, C-CDA squeezes nine different file types, progress notes, clinical summaries, consult notes, and the CCD into one file, with consistent headers.
Although it reads on paper like the ultimate solution, the standard still requires vendors to understand the intricacies of each file type. As with any standard, there are pros and cons for each format.
Date: April 28,2 014