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 (https://confluence.hl7.org/display/CGP/Cross-Group+Projects+Home) launched a project (https://confluence.hl7.org/display/CGP/C-CDA+to+and+from+US+Core+Mapping) 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 ( ; also at bit.ly/ccda2fhirmaps). The project group has also collected mapping samples from multiple vendors from a common input CCD to compare and ultimately, align on best practice recommendation. At this Connectathon, we are looking to continue this effort and generate mapping artifacts to support the a future HL7 ballot for this mapping project.

Type

Test mappings and planned implementation guide. 

Related Tracks?

None

Call for participants

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

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, Diameter Health (now an Availity company);

Benjamin Flessner, Redox

Track Lead Email(s)

cli@diameterhealth.com (or chun.li@availity.com); benjamin@redoxengine.com

Specification Information

See below.

Weekend Zoom

https://redoxengine.zoom.us/j/3263612801?pwd=Wkx0QjcraDF5MVZWQ09telF1OWNZdz09

Zulip stream

https://chat.fhir.org/#narrow/stream/179273-CCDA-.2F-FHIR-mapping-stream

Track Kick off Call

December 12th, 10am EST 

Recording:

https://diameterhealth.zoom.us/rec/share/5HUhLJ9KR-tsqLVpAzER7sZKVRrYYJPBM0hmhoBnm4DUdtFrF1ShP1IeldEXcLjk.xUQi4x-t6PfRn06t
Passcode: V80S+yff 


Attendance Link: 

Specification Information

https://www.hl7.org/fhir/us/core/

https://www.healthit.gov/isa/united-states-core-data-interoperability-uscdi

Past Connectathon Track Page: 2022 - 09 C-CDA to FHIR Mapping

Project Confluence Page: C-CDA to and from US Core Mapping

Existing Mapping Guidance Draft:

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: https://github.com/chunli866/CCDAtoFHIRSamples/tree/main/Input. 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. http://ccda.online/).

Testing Scenario:

The focus will be to make progress towards finalizing mapping artifacts and best practice recommendations for the following clinical domains:

Priority 1 domains:

-          Patient demographics

-          Allergies

-          Immunizations

-          Medications

-          Problems

Priority 2 domains:

-          Procedures

-          Results (Lab)

-          Vital Signs

-          Social History

Priority 3 domains:

-          Clinical Notes

-          Plan of Care / Treatment Plan

-          Encounter

-          Other ancillary area


Action:

Collect different vendor's mappings and compare them. Discuss the common and different approaches and align on a consensus mapping recommendation, which will be part of the future ballot.


Precondition:

Having a pool of vendors' mappings from the common CCD construct to ease the comparison. These are hosted in https://github.com/chunli866/CCDAtoFHIRSamples.

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.


Success Criteria:

Create mapping artifacts of recommendations.

  

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


TestScript(s):

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.