This blog post is gonna be a weird one dealing all of a sudden with the healthcare IT terminologies. But trust me I wont bore you people. This thing what I’m writing will help you understand what these mind wobbling terminologies are.

As usual is to start with the reason, why these now?… the best thing in living this life is “We Don’t know whats going to happen in the next second” Somehow I sailed in a boat to reach a shore where I found all these things arranged like a jigsaw puzzle, I’m writing this blog so that I won’t forget the pieces that I want to arrange to complete the big picture.

Let’s begin.

WHAT IS CCD?

CCD literally stands for CONTINUITY OF CARE DOCUMENT proposed by the HL7 organization.  This comes under HL7 CLINICAL DOCUMENT ARCHITECTURE so called as CDA. The HL7 organization defines both healthcare messaging as well as document standards, The Healthcare messages of HL7 organization includes the HL7v2 and HL7V3 types of messages to communicate between the health industries. while the document standards involves a structural format providing the standards of the patient records. This document architecture of HL7 organization is called CDA architecture. CONTINUITY OF CARE is one of the  document which comes under CLINICAL DOCUMENT ARCHITECTURE, there are also many documents which comes under the CDA. CCD is one such document which comes under the HL7 proposed Clinical document architecture.

WHAT DOES CCD CONTAIN?

CCD do not provide the complete patient’s health records / details. CCD provides information that has to be given importance in short notice or to put in simple words it provides the information critical to effectively continue care. (i.e) what are all the informations that are need immediate effectively to continue care/treatment for the patient, only those informations will be provided in this CCD.

HOW DATA IS ALIGNED IN CCD?

The above said data will be available in CCD in the form of broken XML . All the needed entries of the patient to continue treatment for him will be there in the sections of this CCD.  The list of available sections in the HL7 CCD is here:

1.Header
2.Purpose
3.Problems
4.Procedures
5.Family history
6.Social history
7.Payers
8.Advance directives
9.Alerts
10.Medications
11.Immunizations
12.Medical equipment
13.Vital signs
14.Functional stats
15.Results
16.Encounters
17.Plan of care

These 17 sections information will provide the necessary information that is needed for the patient to continue his treatment. But just because we have social history, family history, doesn’t mean that this document provides the complete details of the patient.

WHAT CCD IS USED FOR?

The HL7 organization defines the CCD as “standard that specifies the structure and semantics of ‘clinical documents’ for the purpose of exchange.”  (i.e) The CCD given information is much useful when the patient is being transferred from one place/clinic to other. During the transfer (exchange) from one clinic to other what details must be needed for the patient?.. all those details will be available in the CCD document.

ANYONE CAN VIEW THIS CCD?

To answer in one word…….. YES everyone including the physician and the  patient can view this CCD without the provision of any software, all the CCD are created in XML format, this XML format message is designed to be in human readable format, any XML is viewable in the browser in a human readable format with XSLT tag. So the CCD document is primarily built with this XSLT tag of XML to provision the better readability.


WHY DO I NEED TO KNOW ALL THESE?
oh……fuck I thought not to ask this question again…. but I couldn’t resist. It’s  knowledge so learn and practise  to teach others….. mindset–recreated….. remember im in a shore to make a fix for all these jigsaw puzzle so now I got a overview of what is CCD so one puzzle fixed.

WHY CONSOLIDATED CDA?

With CDA and specifically CCD, which is a specific document within the CDA standard, there were many sources of truth. For example, in Meaningful Use Stage 1 rules, the document standard referenced was C32, which is a constraint of the CCD document defined by Health Information Technology Standards Panel (HITSP). Essentially this was HITSP’s version of CCD. So to understand the full meaning of C32, a user would have to traverse documentation from HL7 and HITSP. There were other organizations with constraints as well, such as Health Story and Integrating the Healthcare Enterprise (IHE). Consolidated CDA aims to organize all the documentation in one place.

WHAT ARE THE DIFFERENT DOCUMENTS COMES UNDER CCDA?

1.Continuity of Care Document
2.Consultation Notes
3.Discharge Summary
4.Imaging Integration, and DICOM Diagnostic Imaging Reports
5.History and Physical
6.Operative Note
7.Progress Note
8.Procedure Note
9.Unstructured Documents

These are the 9 different documents that comes under the CCDA architecture. These 9 different documents are defined with their specific structure in the “Consolidated” CDA architecture.

In a pictorial sectional representation to know about the differences use the below link.
http://publicaa.ansi.org/sites/apdl/hitspadmin/Matrices/HITSP_09_N_451.pdf