Stakeholders Look to Improve C-CDA as FHIR Matures

As the healthcare industry continues to wrestle with interoperability challenges, two standards are poised to play a central role in facilitating the electronic exchange of health information—one is a blunt tool for data sharing, while the other is a surgical instrument. First adopted in 2012 as part of the Office of National Coordinator for Health IT’s 2014 Edition final rule, the Consolidated Clinical Document Architecture (C-CDA) version 1.1—developed through the joint efforts of ONC and Health Level Seven (HL7) International—is now widely used among healthcare providers.

However, as HL7’s emerging Fast Health Interoperability Resources (FHIR) standard matures, stakeholders are taking stock of their respective strengths and weaknesses. “C-CDA is a document standard for pushing complete medical record or encounter data from one organization to another,” says John Halamka, MD, chief information officer at Boston’s Beth Israel Deaconess Medical Center. “FHIR is a query/response transaction for pulling specific data types on demand, such as problems, medications, and allergies.”

As a result, Micky Tripathi, president and CEO of the Massachusetts eHealth Collaborative, sees C-CDA and FHIR complement each other. “C-CDAs are unwieldy because they contain a lot of data and XML ‘overhead,’ while FHIR is very clean by comparison because it focuses at the data level,” observes Tripathi, who is also project manager of the Argonaut Project, an industry-wide effort to accelerate the development and adoption of FHIR...