C-CDA on FHIR
2.0.0-ballot - STU 2 Ballot

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-ballot 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

## FHIR to C-CDA Problems

FHIR US Core → C-CDA Mapping

While multiple vendors participated in CDA → FHIR mappings at a connectathon, only a single vendor (Cerner/Oracle) has participated in the FHIR → CDA mapping. We welcome feedback on these mappings which represent less than a multi-vendor consensus at this time.

This page provides a mapping from FHIR to CDA. For the CDA to FHIR mapping, please refer to Problems CDA → FHIR. For guidance on how to read the table below, see Reading the C-CDA ↔ FHIR Mapping Pages

### FHIR to C-CDA

FHIR Condition and Health Concern | C-CDA¹ Problem observation | Transform Steps
--- | --- | ---
.identifier | /id | CDA id ↔ FHIR identifier
.clinicalStatus | (act parent to observation) ../../statusCode & Problem Status /entryRelationship/observation[code/@code="33999-4"]/value | FHIR clinicalStatus → CDA Problem Status Observation value For more information on how status is managed in Problem Concern Act wrapper, refer to C-CDA guidance, see 5.2.6.1
.category | /code This also affects the C-CDA document section: Problems Health Concerns Encounters | CDA coding ↔ FHIR CodeableConcept FHIR category → CDA section
.code | /value | Constraint: When FHIR concept does not represent negated concept CDA coding ↔ FHIR CodeableConcept
.code | /value & set @negationInd="true" | Constraint: When FHIR concept represents negated concept
.onsetDateTime | /effectiveTime/low | CDA ↔ FHIR Time/Dates
.onsetPeriod.start | /effectiveTime/low | CDA ↔ FHIR Time/Dates effectiveTime/high should not be mapped from onsetPeriod
.abatementDateTime | /effectiveTime/high | CDA ↔ FHIR Time/Dates
.recordedDate | Date of Diagnosis entryRelationship/act[code/@code="77975-1"]/effectiveTime & /assignedAuthor/time | CDA ↔ FHIR Time/Dates
.recorder | /assignedAuthor | CDA ↔ FHIR Provenance
.asserter | /informant | CDA ↔ FHIR Provenance
Annotation .note | Comment Activity entryRelationship/act[code/@code="48767-8"]/text |

1. XPath abbrievated for C-CDA Problem observation as:
ClinicalDocument/component/structuredBody/component/section[code/@code="11450-4"]/entry/act/entryRelationship/observation

### Illustrative example

#### Links to example content

Note that these mappings have only been implemented by a single vendor to date.

- Condition FHIR example
- Problem CDA example

### Prior work and Expanded Spreadsheets

As reviewed in the methodology, a more comprehensive review was performed via spreadsheets. These spreadsheets have been consolidated and further revised in the tables above but are provided for reference here