Short Description

C-CDAs are everywhere in the United States and HL7 is developing a map to guide transformation from C-CDA to FHIR (and back!). Please join multiple vendors engaged in this important work

Long Description

Current estimates are that billions of C-CDA clinical documents are exchanged annually in the United States. To make this data easier to use and integrate with newer FHIR R4 US CORE conformant resources, the Cross Group Project workgroup ( launched a project ( to develop a mapping between the standards. This also includes the ability to take US CORE conformant FHIR resources and present that information in C-CDA clinical documents.

The work to date has created multiple spreadsheets and informative guidance on this process. At this connectathon, we are looking to work with vendors to transform various data samples between C-CDA and FHIR. We intend to ballot and publish mappings between the standards in a future HL7 ballot.


Test a mapping and planned implementation guide. 

Track Prerequisites

Have developed mappings for at least one C-CDA entry to the relevant FHIR resource 

Have basic knowledge on C-CDA and FHIR IG

Track Lead(s)

Chun Li, PhD, Diameter Health

Track Lead Email(s)

Specification Information

Information about the project can be found on Confluence: launched a project (

Call for participants

Vendors who generate or consume C-CDA/FHIR data and are interested in mapping information between the respective standards.

Zulip stream

Track Kick off Call

September 12th, 10am (EST)

Meeting ID: 797 263 3415
Passcode: 4SMbb5
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Recording: (Passcode: =ggBQKn7)


Clinical Input Required?To be determined
Related Tracks?

Testing Scenario:

System Roles:

1)      Vendors that currently produce C-CDA clinical documents and seeks to produce the same data as US CORE conformant FHIR R4 resources.

2)      An organization (or vendor) which receives C-CDA clinical documents and seeks to transform these data to US CORE conformant FHIR resources

3)      Vendors that host FHIR servers and are seeking guidance for how to assemble these data into C-CDA 2.1 conformant clinical documents.

We will work with interested vendors in advance to come with some example mappings between the standards to facilitate discussion during the connectathon. Vendors do not need active servers to participate, although technologies that can facilitate real-time mapping are very welcome.

We will use the same inbound CCD example to compare the outbound FHIR resources. The CCD example can be found in here: The vendor's output will be uploaded to the same repo. 

We may use multiple tools for the visualization of C-CDA and FHIR data. We may also use previously developed tools to facilitate the visualization of mapping data between relevant standards (e.g.


1)      Two or more vendors independently choose a C-CDA conformant clinical document with data in the some or all of the following domains:

-          Patient demographics

-          Allergies

-          Clinical Notes

-          Immunizations

-          Medications

-          Plan of Care / Treatment Plan

-          Problems

-          Procedures

-          Results (Lab)

-          Social History

-          Vital Signs

We welcome anyone who have developed mappings for at least one C-CDA entry to the relevant FHIR resource in the discussion. The session will focus on mapping C-CDA entries to FHIR resources, and if there is time and interest, we will consider mapping from FHIR to C-CDA below.

2)      Two or more vendors independently choose a set of FHIR R4 US CORE conformant resources (organized in a FHIR R4 Composition) and transform this to a C-CDA 2.1 conformant clinical document.

Bonus point:

-          Bring active development servers to perform real-time transformation during the event

-          Contribute new samples (either C-CDA or FHIR) to be used in transformations

-          Mapping of the Encounter section


No test scripts will be used 

Security and Privacy Considerations:

No PHI will be used during the event. C-CDA and FHIR both have privacy considerations which may be part of mapping.