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  • Lisa Nelson (MaxMD)
  • Jean Duteau (Duteau Design)
  • Joginder Madra (Madra Consulting)


  • Improve consistency and quality of information representation in C-CDA exchange documents

Sign in:   Attendee List

Executive Summary of the Event Results

Participant System Roles

Role 1: Document Creator – A system that creates a specific type of document. (Note: this track focuses primarily on the creation of C-CDA Documents, but the material covered is relevant to Document Creators who make FHIR Documents as well.)

Role 2: Document Consumer - A system that receives a document and processes it in one or more of 4 possible ways:

  • (Required) Renders the document for human readers

  • (Optional) Imports the document into its system

  • (Optional) Imports the narrative information from one or more portions of the document (section(s)), into its system

  • (Optional) Imports the discrete data from one or more portions of the document (section(s)), into its system

Bonus Role (for Data Provenance Discussion, Sunday Q1)

Role 5: HIE Transformer- A systems that receives documents and processes the data in them to aggregate, de-duplicate and re-assemble information to be shared in document-based exchange

Bonus Roles (for Saturday Q5)

Role 3: Document Transformer – A system that converts a C-CDA document into a FHIR Document of the same type or a FHIR document into a C-CDA document of the same type following one of 3 possibilities:

  • (Required) Transforms the header and body of the document without transforming any machine-coded entries.

  • (Optional)Transforms the header and body of the document and transforms some by not all machine-coded entries.

  • (Optional) Transforms the header and the body of the document and transforms all of the included machine-coded entries.

Role 4: Document Registry/Repository – A system that offers a FHIR API for storing and querying/retrieving documents. Documents may be any type of document.

  • (Required) Supports DocumentReference resource for documents available to be queried.

  • (Optional)Supports DocumentManifest for documents available to be retrieved as part of a set of documents intended to be kept together as a collection.


Testing will utilize the tools available at:

One Click Scorecard can be accessed using a Direct

C-CDA Scorecard includes validation against CDA schema and C-CDA template, plus other C-CDA document “best practice” criteria.

Security and Privacy Considerations

Do not supply, test or post sample files that include any PHI that has not been consented to be shared for educational purposes. 

Event Notes 


Using C-CDA Document to support Quality Measurement
Encounter Documents
Rendering, being explicit about contained content and Human readability
Section Time Range
Care Team Templates

Clinical Notes

C-CDA Rubric

Action/Followup Items



Responsible for Follow-up

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