Clinical Document Architecture (CDA) is a common HL7 standard, based on XML. It’s used for exchanging general clinical documents, including discharge summaries, visit summaries, or other documents with a patient’s history or treatment. Read about CDA.
However, FHIR® is a modern, adaptable, and quick way to exchange general clinical data (learn about the Redox FHIR® API). Sometimes you need data to go back and forth between these two useful healthcare standards. Redox can support you by translating data in either direction with the FHIR® Composition resource.
CDA and FHIR® translation is helpful for these use cases:
- 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 |
| AssessmentHealth conditionsProblemsReason for visitResolved problems | Condition |
| Discharge medicationsMedications | 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 |
| AppointmentMedicationRequestServiceRequestSupplyRequest | Plan of treatment |
| Condition | Problems |
| DiagnosticReportObservation | Results |
| Encounter | Encounters |
| Immunization | Immunization |
| MedicationRequest | Medications |
| Observation | Vital signsSocial history |
| Procedure | Procedure |
Ultimately, Redox converts CDA-specific aspects into FHIR® standards while maintaining accuracy. See some general examples you might come across in most FHIR® resources:
| General CDA data | FHIR® field or value | Notes |
|---|---|---|
| nullFlavor | data-absent-reason extension | There might 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 code system 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. 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 we have 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. |