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CCD vs. CCR – Meaningful Use Options

February 10th, 2010 by Jon Mertz Print Friendly

We are starting a new healthcare standards poll today (see lower right column of this site). In the Healthcare Standards IFR, Stage 1 (2011) calls for an option:  (1) Use the Continuity of Care Record (CCR) standard or (2) HL7 Continuity of Care Document (CCD) standard. It is your choice, but it will be “converged” later.

“Converging” or “harmonizing” CCR and CCD is a good direction, as pointed out in a recent ZDNet healthcare blog post, yet too many options create hurdles which need to be overcome and add time to implementation schedules.

With all of the effort being placed on implementing projects to achieve Meaningful Use, clarity – rather than vagueness – is essential. By not clearly defining a direction upfront, healthcare providers have to support the complexity of multiple healthcare standards rather than focusing implementation efforts on a more definitive approach. This is frustrating, especially when it is stated that this will be converged later.

In 2008, we wrote a satirical blog entitled What If There Was an Election on Healthcare Standards? In retrospect, it is closer to where we are today than we knew!

Regardless, now is your opportunity to vote. Rather than wait until after 2011 to determine which one wins, let’s vote today. Which standard should be used — CCD or CCR? Vote now to clarify the direction!

Posted in CCD, CCR, Meaningful Use
  • http://e-CareManagement.com Vince Kuraitis

    Allowing both the CCD and CCR to be used is a good move by CMS, as they serve relatively separate HIT markets.

    Please see a detailed explanation at:
    http://e-caremanagement.com/the-third-rail-in-hitech-implementation-please-dont-make-us-all-speak-latin/

  • http://www.macadamian.com/insight/healthcare Didier Thizy

    Whenever people discuss interoperability and standards, the arguments of harmonizing different standards or agreeing on “1 official” standard always come up :) I agree with the idea of converging CCR and CCD in theory, but in practice I’m skeptical we could ever move forward with 1 official standard.

    To make a comparison to the world of VoIP, different platforms take different liberties with the now-standard SIP protocol. Avaya SES might use a particular SIP header differently than Microsoft OCS, and this does cause some interop headaches. But the fact that they could agree at all on the SIP protocol and not another alternative such as H323 was a huge leap forward.

    The VoIP industry however had a big advantage – there are arguably only a few big players in that space. A unilateral move on their part to adopt a particular protocol (even if they speak different “dialects”) was enough to move that standard forward. On the other hand, there is no small group of big players in Healthcare. Even Microsoft and Google, normally considered big players in any field, are quite small in healthcare.

    Sean Nolan, the Microsoft health architect makes a really good point – “I believe that anointing just one standard misses the point — the hard part is collecting the information to share in the first place. We should be encouraging anything that accelerates that task — and leveraging all of the work that has already been done against the problem. Once information is available, transforming it between near-equivalent standards becomes a much smaller task. ”

    Indeed, converting information from CCR to CCD, etc. is actually a really straightforward programmatic endeavor. See my post about this -http://tinyurl.com/yh7l964 (or just find a good XSLT programmer! :)

    But I agree it’s a neat idea to hold a standards “election”, definitely got my attention :)

  • http://axolotl.com Daren Nicholson

    I echo Didier’s comment about converting between CCR and CCD. All you need is someone smart enough to write a good XSLT. At my company, we’ve done just that. We’re outputting documents in CCD format, then successfully transforming them to CCR format for consumption by an external system. It works rather well, though writing XSLTs is no fun.

  • Glenn Kessler

    So is that xslt going on the public domain? :-)