CDA — The HL7 Document Standard
The HL7 document standard: each CDA file carries a human-readable narrative plus a machine-readable coded section.
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Understanding Clinical Document Architecture
CDA and C-CDA are XML standards for structuring clinical documents so they can be exchanged across any EHR or health system.
C-CDA — The U.S. Implementation
The ONC-mandated U.S. implementation, defining the templates every certified EHR must support: CCD, Discharge Summary, Referral Note, Care Plan.
Coded Vocabularies
SNOMED CT, LOINC, RxNorm, and ICD-10-CM — the standard vocabularies that make C-CDA content machine-readable.
What CDA & C-CDA Exchange Covers — Generation, Parsing, and Exchange
Clinical document exchange for care management platforms, transitional care products, and referral networks needing structured patient data.
Generate conformant C-CDA R2.1 documents — CCDs, Discharge Summaries, Referral Notes, Care Plans — validated against ONC criteria.
Parse inbound C-CDA from any certified EHR — extracting medications, allergies, problems, results, and vitals into your data model.
Exchange C-CDA documents over Direct — the U.S. standard for secure, point-to-point provider messaging — for referrals and transitions.
Connect to Health Information Exchanges that aggregate C-CDA across regional networks — accessing a patient's longitudinal record.
Bidirectional C-CDA to FHIR conversion so content flows between legacy EHRs and modern FHIR platforms — aligned with ONC and HL7.
Document exchange across Canadian provinces — Ontario eReferral/eConsult, Alberta Netcare, BC — with provincial privacy law.
Why Clinical Document Exchange Is Critical for Care Continuity
The U.S. handles millions of care transitions a year, and information gaps during them drive readmissions, medication errors, and adverse events.
Transitions Are Where Information Gets Lost
A patient's clinical story must travel with them through discharge, transfer, or referral. Gaps at these transitions drive readmissions and errors.
Structured Data Without a Custom API Per Provider
C-CDA delivers structured data from across a patient's history — for care management, chronic disease, and referral products — with no custom integration per provider.
C-CDA Quality Varies — Handle It Deliberately
The standard leaves room in how optional sections are populated and coded. Robust parsing handles that variability instead of assuming clean conformance.
Canada Is Building It Province by Province
Ontario eReferral/eConsult, Alberta Netcare, and Canada Health Infoway are building structured clinical document exchange province by province.
C-CDA Exchange — Step by Step
Five stages from workflow definition to transport setup.
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Use Case Definition
Use Case Definition
Identify the workflows you must support — discharge summaries, referrals, care transitions — driving templates and transport.
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Document Template Selection
Document Template Selection
Choose the right C-CDA template — CCD, Discharge Summary, Referral Note — each with its own sections and rules.
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Terminology Mapping
Terminology Mapping
Translate local codes to the vocabularies C-CDA requires — SNOMED CT, LOINC, RxNorm, ICD-10 — for every document.
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Document Generation & Validation
Document Generation & Validation
Generate C-CDA XML and validate against schematron rules using ONC ETT or the SITE C-CDA Validator before connecting to production.
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Exchange Mechanism Setup
Exchange Mechanism Setup
Set up the right transport — Direct Secure Messaging, FHIR Document endpoints, or HIE query interfaces — based on your exchange partners.
Who This Is For
We build clinical document exchange for products that depend on a patient's history travelling with them.
Care Management & Transitional Care
Discharge summaries, care plans, and problem lists that follow the patient into your workflows.
Referral & Care Coordination Networks
Referral notes and consultation reports move as C-CDA over Direct, keeping referral loops closed.
Digital Health Products
Structured clinical data across a patient's history via C-CDA documents, Direct, and HIE query.
Health Systems & EHR Vendors
C-CDA for ONC certification and provider exchange — conformant generation, parsing, and FHIR conversion.
Templates, Vocabularies & Exchange — The Building Blocks of Clinical Document Interoperability
The document templates, coded vocabularies, transport, and Canadian provincial programs that make up C-CDA exchange.
Templates
C-CDA Document Types
C-CDA R2.1 templates every certified EHR must generate.
Vocabularies
Coded Clinical Terminologies
Standard vocabularies that make documents machine-readable.
Exchange
How Documents Move
Transport mechanisms carrying C-CDA between providers.
Conformance
Validation & Certification
Rules and tools confirming C-CDA conformance pre-production.
Conversion
C-CDA ↔ FHIR
Bidirectional conversion between legacy C-CDA and FHIR.
Canada
Canadian Provincial Programs
Provincial document exchange infrastructure and identifiers.
The Clinical Document Stack We Build On
The standards, templates, and validation tools a conformant C-CDA implementation depends on.
H
HL7 CDA R2
C
C-CDA R2.1
C
CCD
D
Discharge / Referral / Care Plan
H
HL7 FHIR
S
SNOMED CT
L
LOINC
R
RxNorm
I
ICD-10-CM
D
Direct Secure Messaging
H
HIE Query
F
FHIR Document Endpoints
X
XDS / XCA
S
Schematron
O
ONC ETT
S
SITE C-CDA Validator
O
ONC Certification
O
Ontario eReferral / eConsult
A
Alberta Netcare
B
BC Provincial Exchange
C
Canada Health Infoway
A
AWS GovCloud
A
Azure Health Data Services
D
Docker / Kubernetes
M
Monitoring & Alerting
A Patient's Clinical Story Should Travel With Them. C-CDA Is How It Does.
Generation, parsing, and exchange over Direct, HIEs, and FHIR endpoints, with terminology that keeps meaning intact. Book a consultation to map your C-CDA implementation.
Book a C-CDA Consult
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Frequently Asked Questions
[ 1 ]
What is the difference between CDA and C-CDA?
CDA (Clinical Document Architecture) is the international HL7 standard for structured clinical documents. C-CDA is the U.S. implementation guide on top of it, defining specific templates like CCD and Discharge Summary plus conformance rules.
[ 2 ]
What clinical data is typically found in a C-CDA document?
A complete Continuity of Care Document (CCD) carries active problems, medications, allergies, recent lab results, vital signs, immunizations, procedures, and relevant history.
[ 3 ]
Why do C-CDA documents from different EHRs vary so much in quality?
The standard sets conformance rules but leaves room in how optional sections are populated. Vendors implemented C-CDA differently, and coding quality varies by institution.
[ 4 ]
What is Direct messaging and how does it relate to C-CDA?
Direct is a U.S. standard for secure, point-to-point clinical messaging between providers — like email, but with healthcare-specific security. C-CDA documents are the payload commonly attached, such as a discharge summary.
[ 5 ]
Is C-CDA being replaced by FHIR?
C-CDA and FHIR are increasingly used together, not as replacements. Many health systems add FHIR APIs while keeping C-CDA exchange, which is still required for records from older or smaller systems.
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