As mentioned in previous posts, the Continuity of Care Record (CCR) provides a way to send data between clinics, hospitals, labs, etc that are using various EMR, HIS, RIS, PACS, dictations, etc systems. The CCR is an XML-based standard that is related to and different from the HL7 2.X messaging standard.
While I posted a short description comparing CDA and CCR, there is a formal article written by Ed Hammond et al and is titled, The Clinical Document Architecture and the Continuity of Care Record: A Critical Analysis. This article was published in the Journal of the American Medical Informatics Association (JAMIA). Later in the month, I’ll summarize this article. For now, here is the abstract:
The Clinical Document Architecture and the Continuity of Care Record: A Critical Analysis
Jeffrey M. Ferranti, MD, R. Clayton Musser, MD, MS, Kensaku Kawamoto and W. Ed Hammond, PhD
Health care provides many opportunities in which the sharing of data between independent sites is highly desirable. Several standards are required to produce the functional and semantic interoperability necessary to support the exchange of such data: a common reference information model, a common set of data elements, a common terminology, common data structures, and a common transport standard. This paper addresses one component of that set of standards: the ability to create a document that supports the exchange of structured data components. Unfortunately, two different standards development organizations have produced similar standards for that purpose based on different information models: Health Level 7 (HL7)’s Clinical Document Architecture (CDA) and The American Society for Testing and Materials (ASTM International) Continuity of Care Record (CCR). The coexistence of both standards might require mapping from one standard to the other, which could be accompanied by a loss of information and functionality. This paper examines and compares the two standards, emphasizes the strengths and weaknesses of each, and proposes a strategy of harmonization to enhance future progress. While some of the authors are members of HL7 and/or ASTM International, the authors stress that the viewpoints represented in this paper are those of the authors and do not represent the official viewpoints of either HL7 or of ASTM International.
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