As part of interoperability we find several issues with CCR/CCD output. Some of the errors are very basic such as there is no handling of special characters resulting in malformed xml or if a problem is associated with multiple encounters with multiple providers, the same problem is reported multiple times.
Then there are other more complex issues such as (based on cursory review):
Prescriptions vs Medications - Report does a UNION which will result in an interesting problem for the recipient…
Procedure results values show up without any descriptions.
No support for custom lists
No support for multiple codes associated with an issue (only one code is considered as per documentation)
Also the targets of date filters need an review - e.g. Problems are selected based on date added to system rather than begin and end date of the problem.
Is there any update we failed to apply?
If anyone has already addressed the problems with this important functionality, would you please share?
I think ZH Healthcare is working on this stuff in addition to the newer consolidated CDA format.
The code that creates of the CCR/CCD docs are minimal, at best. Lots of work to be done, especially now that these reports will be used to transfer patient records etc. Large refactoring (not really much of a refactoring since there’s not much code to begin with) is likely in order, but would check in with ZH Healthcare to ensure not working on the same things.
ZH Healthcare don’t post very often. It’s the end of the year and with the holidays, they are less likely to post.
Eldho Chacko has been been very helpful in the past. Consider an email to him, eldho@zhservices.com and let us know if there has been new developements.
We have almost completed the development CCDA. CCD is one of the components of CCDA. Once the CCDA is completed, we can use the same mechanism for CCD.