C-CDA on FHIR, published by HL7 International / Cross-Group Projects. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/ccda-on-fhir/ and changes regularly. See the Directory of published versions

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Official URL: http://hl7.org/fhir/us/ccda/ImplementationGuide/hl7.fhir.us.ccda				Version: 2.0.0	Highlight text changes?
IG Standards status: Trial-use				Maturity Level: 2	Computable Name: CCDAonFHIR

Overview

Consolidated CDA (C-CDA) is one of the most widely implemented implementation guides for CDA and covers a significant scope of clinical care. Its target of the 'common/essential' elements of healthcare is closely aligned with FHIR's focus on the '80%'. There is significant interest in industry and government in the ability to interoperate between CDA and FHIR and C-CDA is a logical starting point. Implementers and regulators have both expressed an interest in the ability to map between FHIR and C-CDA.

This Implementation Guide (IG) contains mapping guidance for creating FHIR resources from C-CDA documents.

Clinical Document Profiles

Prior versions of this IG included a series of FHIR profiles on the Composition resource to represent the various document types in C-CDA. This content has not been updated, and some of the guidance is now outdated. However, for implementers wishing to access these profiles, they are available in an older version of this IG: C-CDA on FHIR STU 1.1.

Additionally, the FHIR Clinical Documents is an updated profile demonstrating how to transfer clinical documents (the 'CD' of CDA) using FHIR Document Bundles and Composition Resources. Should this C-CDA-on-FHIR IG resurrect document profiles, they will build upon this already-completed work.

Authors (C-CDA ↔ FHIR Mapping)

Name	Email/URL
HL7 Cross Group Projects	http://hl7.org/Special/committees/cgp
HL7 Structured Documents Working Group	http://hl7.org/Special/committees/structure
Jay Lyle	jay.lyle@jpsys.com
John D'Amore	johnd@moreinformatics.com
Natalee Agassi	natalee.agassi@oracle.com
Chun Li	Chun.Li@availity.com
Ken Lord	klord@mdixinc.com
Catherine Hoang	Catherine.Hoang2@va.gov
Bill Ormerod	william.ormerod@oracle.com
Benjamin Flessner	benjamin.flessner@availity.com
Brett Marquard	brett@waveoneassociates.com
Christopher Vitale	Christopher.Vitale@availity.com
Sajjad Hussain	sshussain@google.com
Gene Beyer	gene.beyer@oracle.com
Gay Dolin	gdolin@namasteinformatics.com
Lisa Nelson	LNelson@advaultinc.com
Deb Loniewski	loniewskid@michigan.gov

Dependencies

Package hl7.fhir.uv.extensions.r4#1.0.0 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Sun, Mar 26, 2023 08:46+1100+11:00)

Package hl7.fhir.uv.bulkdata#2.0.0 FHIR based approach for exporting large data sets from a FHIR server to a client application (built Fri, Nov 26, 2021 05:56+1100+11:00)

Package hl7.fhir.uv.sdc#3.0.0 The SDC specification provides an infrastructure to standardize the capture and expanded use of patient-level data collected within an EHR. This includes two components: * Support more sophisticated questionnaire/form use-cases such as those needed for research, oncology, pathology and other clinical domains. *Support pre-population and auto-population of EHR data into forms/questionnaires for uses outside direct clinical care (patient safety, adverse event reporting, public health reporting, etc.). (built Tue, Mar 8, 2022 18:32+0000+00:00)

Package ihe.formatcode.fhir#1.1.0 Implementation Guide for IHE defined FormatCode vocabulary. (built Thu, Feb 24, 2022 16:55-0600-06:00)

Package hl7.fhir.us.core#6.1.0 The US Core Implementation Guide is based on FHIR Version R4 and defines the minimum conformance requirements for accessing patient data. The Argonaut pilot implementations, ONC 2015 Edition Common Clinical Data Set (CCDS), and ONC U.S. Core Data for Interoperability (USCDI) v1 provided the requirements for this guide. The prior Argonaut search and vocabulary requirements, based on FHIR DSTU2, are updated in this guide to support FHIR Version R4. This guide was used as the basis for further testing and guidance by the Argonaut Project Team to provide additional content and guidance specific to Data Query Access for purpose of ONC Certification testing. These profiles are the foundation for future US Realm FHIR implementation guides. In addition to Argonaut, they are used by DAF-Research, QI-Core, and CIMI. Under the guidance of HL7 and the HL7 US Realm Steering Committee, the content will expand in future versions to meet the needs specific to the US Realm. These requirements were originally developed, balloted, and published in FHIR DSTU2 as part of the Office of the National Coordinator for Health Information Technology (ONC) sponsored Data Access Framework (DAF) project. For more information on how DAF became US Core see the US Core change notes. (built Fri, Jun 30, 2023 14:02+0000+00:00)

Package hl7.fhir.uv.extensions.r4#5.1.0 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Sat, Apr 27, 2024 18:39+1000+10:00)

Package hl7.fhir.uv.tools.r4#1.1.2 This IG defines the extensions that the tools use internally. Some of these extensions are content that are being evaluated for elevation into the main spec, and others are tooling concerns (built Tue, Mar 24, 2026 11:13+1100+11:00)

This is an R4 IG. None of the features it uses are changed in R4B, so it can be used as is with R4B systems. Packages for both R4 (hl7.fhir.us.ccda.r4) and R4B (hl7.fhir.us.ccda.r4b) are available.

There are no Global profiles defined

Parameter	Value
system-version	SNOMED CT[US]

IP Statements

This publication includes IP covered under the following statements.

• ISO Maintains the copyright on the country codes, and controls it's use carefully. For futher details see the ISO 3166 web page: https://www.iso.org/iso-3166-country-codes.html
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  • ISO 3166-1 Codes for the representation of names of countries and their subdivisions — Part 1: Country code: CCDAonFHIR, CCDAtoFHIRAddressUse... Show 41 more, CCDAtoFHIRAdminsitrativeGender, CCDAtoFHIRAllergyIntoleranceCategory, CCDAtoFHIRAllergyIntoleranceType, CCDAtoFHIRAllergyStatus, CCDAtoFHIRConditionClinicalStatus, CCDAtoFHIRCriticality, CCDAtoFHIREncounterStatus, CCDAtoFHIRImmunizationStatus, CCDAtoFHIRMedActivityMood, CCDAtoFHIRMedicationStatus, CCDAtoFHIRNameUse, CCDAtoFHIRNoKnownAllergies, CCDAtoFHIRNullFlavorDataAbsentReason, CCDAtoFHIRProblemCategory, CCDAtoFHIRProblemStatus, CCDAtoFHIRProcedureStatus, CCDAtoFHIRResultReportStatus, CCDAtoFHIRResultStatus, CCDAtoFHIRSeverity, CCDAtoFHIRTelecomType, CCDAtoFHIRTelecomUse, FHIRtoCCDAAddressUse, FHIRtoCCDAAdminsitrativeGender, FHIRtoCCDAAllergyIntoleranceCategory, FHIRtoCCDAAllergyIntoleranceType, FHIRtoCCDAAllergyStatus, FHIRtoCCDACriticality, FHIRtoCCDADataAbsentReasonNullFlavor, FHIRtoCCDAImmunizationRefusal, FHIRtoCCDAImmunizationSite, FHIRtoCCDAImmunizationStatus, FHIRtoCCDAMedicationStatus, FHIRtoCCDANameUse, FHIRtoCCDANoKnownAllergies, FHIRtoCCDAObservationStatus, FHIRtoCCDAProblemCategory, FHIRtoCCDAProblemStatus, FHIRtoCCDAProcedureStatus, FHIRtoCCDASeverity, FHIRtoCCDATelecomType and FHIRtoCCDATelecomUse
• Most of the information on the CDC and ATSDR websites is not subject to copyright, is in the public domain, and may be freely used or reproduced without obtaining copyright permission. For information and exceptions regarding use of CDC material please see https://www.cdc.gov/other/agencymaterials.html
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  • Vaccine Administered Code Set (CVX): Immunization/CF-immunization and Immunization/FC-immunization
• Most of the information on the CDC and ATSDR websites is not subject to copyright, is in the public domain, and may be freely used or reproduced without obtaining copyright permission.For information and exceptions regarding use of CDC material please see https://www.cdc.gov/other/agencymaterials.html.
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  • CDC Race and Ethnicity: Patient/CF-patient
• This material contains content that is copyright of SNOMED International. Implementers of these specifications must have the appropriate SNOMED CT Affiliate license - for more information contact https://www.snomed.org/get-snomed or info@snomed.org.
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  • SNOMED Clinical Terms® (SNOMED CT®): AllergyIntolerance/CF-allergy, AllergyIntolerance/FC-allergy, Condition/CF-problem, Condition/FC-problem and Procedure/CF-procedure
• This material derives from the HL7 Terminology (THO). THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license.html
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  • AllergyIntolerance Clinical Status Codes: AllergyIntolerance/CF-allergy and AllergyIntolerance/FC-allergy
  • Condition Category Codes: Condition/CF-problem and Condition/FC-problem
  • Condition Clinical Status Codes: Condition/CF-problem and Condition/FC-problem
  • Organization type: Acme Clinic and Acme Labs
  • identifierType: Practitioner/ccda-practitioner-example
  • Confidentiality: AllergyIntolerance/FC-allergy, Condition/FC-problem, Immunization/FC-immunization and MedicationRequest/FC-medication
• Using RxNorm codes of type SAB=RXNORM as this specification describes does not require a UMLS license. Access to the full set of RxNorm definitions, and/or additional use of other RxNorm structures and information requires a UMLS license. The use of RxNorm in this specification is pursuant to HL7's status as a licensee of the NLM UMLS. HL7's license does not convey the right to use RxNorm to any users of this specification; implementers must acquire a license to use RxNorm in their own right.
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  • RxNorm: AllergyIntolerance/CF-allergy, AllergyIntolerance/FC-allergy, MedicationRequest/CF-medication and MedicationRequest/FC-medication