The Use of the CCD as a Possible Way to Provide Data for the Patient
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The document standards for HL7 v3 is CDA, and one of the documents within the CDA architecture is CCD."
Continuity of Care Documents (CCDs) were developed to meet this need and their usage is being bolstered by Promoting Interoperability Program (formally meaningful use). As the technology evolves and health systems become more interoperable, document exchange will be seen more and more. Here are some frequently asked questions on CCDs, and the C-CDA framework those documents are a part of, to help you understand them better. CCD is a generic term for an electronically generated, patient-specific clinical summary document. As a result, CCDs are sometimes called a few different names – Continuity of Care Document, Summary of Care Document, Summarization of Episode Note – just to name a few. For this explanation, we will use Continuity of Care Document or CCD. The purpose of a CCD is to improve communication between health care providers during a transition of care – when a patient is being referred to another provider or coming back to their normal provider after a hospital stay, for example. CCDs are generated out of a provider’s electronic health record (EHR) system and include care summary information. CCDs can also include advance directives, family history, social history and insurance information. For Promoting Interoperability Program (formally Meaningful use), there are more required data elements, including smoking status, vital signs, care plans and more. When done optimally, CCD exchange can reduce staff time spent gathering patient clinical information during transitions of care. And CCDs generally expand the clinical information available to community providers and give them more details on the care patients received at outside facilities. Combined with existing medication, imaging and lab data being shared from hospitals and labs, CCDs may give providers the additional clinical data needed at the point of care.
This observation led the President’s Council of Advisors on Science and Technology and the Institute of Medicine2 to recently identify interoperability as the major deficit of current health information technology. From their perspectives, fluid and secure data exchange has the most immediate potential to improve care quality and efficiency nationwide. Achieving robust interoperability requires common language and structures to medical data so communication is seamless to care providers. This contrasts with current practice. Today, implementations of medical data exchange force both senders and recipients of medical data to plan in advance the content and format of exchange (Graham DJ, Campen D, 2005).
Functional interoperability is a goal that can be achieved in the near term with significant gains in improving workflow and reducing duplication of effort for providers and patients participating in registries. The successive development, testing, and adoption of open-standard building blocks, which improve functional interoperability and move us incrementally toward a fully interoperable solution, is a bridging strategy that provides benefits to providers, patients, EHR vendors, and registry developers today.
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