Understanding The Continuity of Care Record
It would be overtly obvious to suggest that technology moves and advances quickly. In healthcare, the rate of new technology introductions has moved far more quickly than the industry can accommodate and implement.
In other industries, accelerated technology adoptions may be considered “par for the course”. Healthcare, though, is unique. As much as business issues are a real factor, so too is the need for a level of cooperation and symmetry in order to comply with the first objective – quality patient care.
To address this workflow void, standards such as the Continuity of Care Document (CCD) and Continuity of Care Record (CCR) were introduced to begin solving the problem of patient-data portability and interoperability.
This white paper, the first in a series on the many healthcare standards, will serve to:
1. Briefly describe the CCD and how the CCR and the CCD work together
2. Describe the CCR and why it was created
3. Outline the components of the CCR and its intended use
The Continuity of Care Document
In the healthcare industry, there was a building divide in regards to the messaging standards to be used for the electronic exchange of clinical data. Some preferred ASTMs CCR while others have adopted HL7s Clinical Document Architecture (CDA). Hence, the Continuity of Care Document (CCD) was developed as the result of a joint collaboration between the HL7 and ASTM organizations to “harmonize” the two standards.
The purpose of the CCD is to provide an overall summary of a patient’s care. In contrast to the CCR, which is a snapshot in time of relevant medical information or specific condition, the CCD is a compilation of medical data used to create an historical record of received care.
Additionally, the CCD is intended to improve patient care by enabling physicians to engage in the electronic exchange of medical information electronically across applications or facilities.
The CCR and CCD: Working Together
Stated in a joint press release by HL7 and ASTM on February 12, 2007 to announce the CCD:
“The CCD represents a complete implementation of CCR, combining the best of HL7 technologies with the richness of CCR’s clinical data representation, and does not disrupt the existing data flows in payer, provider, or pharmacy organizations.”
The result of this collaboration has been very positive. The CCD has been endorsed by the Healthcare Information Technology Standards Panel (HITSP) and is also being used more heavily by the Certification Commission for Healthcare Information Technology (CCHIT) as part of its certification.The underlying belief from members of both ASTM and HL7 is that the CCD will help promote CCR adoption, thereby accelerating Electronic Medical Record (EMR) and Electronic Health Record (EHR) adoption. As an XML-based standard, older legacy IT systems used by many medical facilities will be able use the CCR format within their systems.
The following is an example of how both the CCR and CCD could be used: A patient’s CCD would contain their entire immunization history. This data would be very important in conjunction with a CCR as a patient visits a new provider for a particular condition.
The patient’s CCR would contain data relevant to their current medical status such as allergies, current medication dosages and recent diagnostic results, while their CCD would hold important referential data the provider can access as he or she deems necessary such as inoculation dates, treatment history and past procedures.
This expedites a provider’s ability to treat existing, potentially time-sensitive issues (CCR), while building an historical document that contains all of the treatment a patient has received (CCD).
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| Understanding-the-Continuity-of-Care-Record-CCR.pdf | 101.1 KB |
