CCD-Continuity of Care Document

The Continuity of Care Document (CCD) is built using HL7 Clinical Document Architecture (CDA) elements and contains data that is defined by the ASTM Continuity of Care Record (CCR). It is used to share summary information about the patient within the broader context of the personal health record.

The CCD was formed through a joint collaboration between Health Level 7 and ASTM International as a way to address the divide between those who had adopted HL7 CDA and those who had adopted ASTM CCR. It was endorsed by the Certification Commission for Health Information Technology (CCHIT) as part of their EHR certification requirements in June 2008, and was predicted to drive the use of electronic exchange for clinical data.

Continuity of Care Document (CCD) Goals

  • Apply CCR content to the already accepted framework of CDA.
  • Provide the necessary health information for the continuation of care.
  • Reduce medical errors.

CCD is compatible with any document or standard that uses RIM-based specifications, including new versions of HL7, new types of public safety reports, IHE specifications, HITSP specifications and CDISC. Because of its small fixed XML tag set, CCD can be universally rendered as HTML or PDF without requiring specialized communication efforts.

CCD uses a detailed set of constraints (or templates) for CDA elements, providing the framework of the CCD. The templates define how to use CDA elements to communicate clinical data, but the scope of the data within the templates is determined by the CCR dataset.

CCD Templates* include:

  1. Header
  2. Allergies
  3. Problems
  4. Procedures
  5. Family history
  6. Social history
  7. Payers
  8. Advance directives
  9. Medications
  10. Immunizations
  11. Medical equipment
  12. Vital signs
  13. Functional stats
  14. Results
  15. Encounters
  16. Plan of care

*excludes supporting templates

Additional information can be found on the HL7 Standards resource site and in Corepoint Health’s Resource Center:

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