Clinical Document Architecture (CDA) is a common HL7 standard, based on XML. It’s used for exactly what its name suggests: To exchange general clinical data. CDAs could include documents like discharge summaries, visit summaries, or other documents with a patient’s history or treatment. Read about CDA.
FHIR® is a modern, adaptable, and quick way to exchange healthcare data. Learn about the Redox FHIR® API.
These are both useful, popular healthcare standards, and sometimes you need data to go back and forth between them. The good news is that we can translate data in either direction with the FHIR® Composition resource.
This translation option can benefit customers like these:
- Providers establishing a new patient’s history before providing treatment.
- Providers supporting a document-based business process (e.g., generating PDFs).
- Providers exchanging data over clinical networks, where both FHIR® and CDA are possible.
- Vendors consuming patient data for service within their app.
- Payers wanting data for member engagement to recommend preventative care or more cost-effective services.
- Payers tracking a patient’s treatments for billing purposes (e.g., services included in a hospital stay).
We convert CDA sections into a bundle of the best-fitting FHIR® resources. Check out some examples below.
CDA section | FHIR® resource(s) |
|---|---|
Allergies | AllergyIntolerance |
Assessment Health conditions Problems Reason for visit Resolved problems | Condition |
Discharge medications Medications | MedicationRequest and/or MedicationStatement |
Encounters | Encounter |
Family history | FamilyHistory |
Functional status | Observation and SupplyRequest |
Health concerns | Condition |
Insurances | Coverage |
MedicalEquipment | DeviceRequest |
Results | DiagnosticReport |
Vital signs | Observation |
We can produce an XML document for you based on the FHIR® resources you provide. You can organize your FHIR® resources into these CDA sections.
FHIR® resource | CDA section |
|---|---|
AllergyIntolerance | Allergies |
Appointment MedicationRequest ServiceRequest SupplyRequest | Plan of treatment |
Condition | Problems |
DiagnosticReport Observation | Results |
Encounter | Encounters |
Immunization | Immunization |
MedicationRequest | Medications |
Observation | Vital signs Social history |
Procedure | Procedure |
Ultimately, Redox converts CDA-specific aspects into FHIR® standards while maintaining accuracy. See some general examples you may come across in most FHIR® resources:
General CDA data | FHIR® field or value | Notes |
|---|---|---|
nullFlavor | data-absent-reason extension | There may be sections of a CDA document that use nullFlavor. Refer to these guides for more details: (a) Section 5.1.5 of this CDA companion guide; or (b) Section 3.6 of this CDA implementation guide. We convert this to a data absent reason in FHIR®. |
Terminology Object IDs (OIDs) | FHIR® terminology | We use the OID from the codeSystem and/or implied value set of a coded value in CDA to look up the appropriate FHIR® Terminology system. Review FHIR® Terminology. |
patientRole | Reference to Patient resource | CDAs must include the patient info, which translates into a FHIR® reference to the related Patient resource. For example, ClinicalDocument.recordTarget.patientRole would translate to AllergyIntolerance.patient. |
effectiveTime | Any of these: (a) date; (b) dateTime; (c) instant; (d) period; (e) onsetDateTime | Different FHIR® resources have different expressions of time, all depending on the context. So the effectiveTime converts to the most applicable FHIR® time field. |
section.code | General CDA data | The CDA section identifier helps us map the data within that section to the most appropriate FHIR® resource. For example, if the section.code=48765-2 then we map the data to the AllergyIntolerance resource. |
section.entry.reference | Relevant FHIR® resource | This is a reference to a FHIR® resource in the FHIR® bundle that can be translated to a given CDA section. |