ADT vs. CCDA data gap

Question

We are developing a provide and register web service for CCDAs. Our vendor requires ADT as the patient registration portion. I can create a bare ADT message from the information provided to me in the CCDA in order to simplify the onboarding process (eliminate a dedicated ADT feed) and reduce the cost. BUT there are data elements (NK1, IN1, GT) that are either not included in the CCDA or not as robust.

1. I wanted to know if there are any documented data gaps between these two message (CCDA vs. ADT).
2. I wanted to get feedback to my approach.
3. I wanted to know the governing process for CCDA, as it makes sense to eventually include some of these ADT data points in the CCDA.

Thanks!

Answer 1

I don't think there is any specific documentation on data gaps between C-CDA and HL7 V2.x ADT messages. Generally it's fine to extract content from C-CDA and use that to construct an ADT message, but obviously you won't get everything. Governance is handled by the Structured Documents workgroup; anyone is welcome to join and submit change proposals.

Answer 2

May be you can find the additional information at CDA sections entries. C-CDA does not requires, for example, a CDA document to contain an immunizations sections with entries, but yes it defines how to include this information. If your CDA includes that information, that may be a good option. Martí

Answer 3

Remember that CDA/CCDAs are not a replacement for clinical or administrative messages. Your approach is fine, but StrucDoc may push back on adding content that is directed toward workflow concerns. CDAs are static objects, they are not intended to trigger action.

As Marti points out, consider what information is possible the specific document you are using ... Or in the base CCDA specification. As long as your document template does not exclude a base specification section, that section can be included in a instance of that document template.

Answer 4

Without appropriate details it's hard to say for certain.

Does the system requiring ADT need encounters? In that case, you're going to need an encounters section from the CDA, which then needs to be turned into multiple A08s.

Do they just need demographics? That's probably do-able.

I would ask for specs around what event types they expect and what fields are required (or at least will bomb out on their side), and just go through the list a sample C-CDA or two on your side.