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Standards for health information systems: Continuity of Care Record


name Continuity of Care Record
summary XML-based patient care record summary standard designed to provide a standard format to support core data sharing between care providers and systems.

"The Continuity of Care Record (CCR) is a core data set of the most relevant administrative, demographic, and clinical information facts about a patients healthcare, covering one or more healthcare encounters. It provides a means for one healthcare practitioner, system, or setting to aggregate all of the pertinent data about a patient and forward it to another practitioner, system, or setting to support the continuity of care" (ASTM).

Commercial developres and vendors of EMRs/EHRs employing the CCR include Medical Communication Systems, Inc. (Woburn, Massachusetts).

location Developed in USA
sponsor organisation Consortium of sponsoring organizations: ASTM International, Massachusetts Medical Society, HIMSS, American Academy of Family Physicians, American Academy of Pediatrics, American Medical Association, Patient Safety Institute, American Health Care Association, National Association for the Support of LTC.
adoption date 2005
clinical domains N/A
keywords Document template, document archetype, document management, core data set, Patient Core Data Set, patient summary, patient identifying information, patient data transfer, data sharing, interoperability, electronic health record, EHR, personal health record, PHR, patient safety, medical errors, WWW, XML, XML document, XML schema, standards.
developed by ASTM International Health Care Informatics Committee
links  bullet  CCR (on ASTM)  bullet  Unofficial CCR FAQ Standard by David C. Kibbe, MD  bullet  CCR Generator Tool (demonstrator) [OC]  bullet  myPHR (personal health record using CCR) [OC]  bullet  iHealth Record from Medem Inc. (personal health record using CCR) [OC]  bullet  E-HealthKEY (portable personal health record using CCR) [OC]  bullet  HealthFrame personal health record using CCR from Records For Living, Inc., USA [OC]  bullet  HealthFrame Viewer (free tool from Records For Living, Inc., USA, for browsing EMR data stored in CCR format) [OC]  bullet  Clinical Document Architecture (CDA) [OC]  bullet  Medical Communication Systems, Inc., USA  bullet  Tolven - developer of Open Source health information systems [OC]

Ferranti JM, Musser RC, Kawamoto K, Hammond WE. The clinical document architecture and the continuity of care record: a critical analysis. J Am Med Inform Assoc. 2006 May-Jun;13(3):245-52.

[PubMed]   []

" Health care provides many opportunities in which the sharing of data between independent sites is highly desirable. Several standards are required to produce the functional and semantic interoperability necessary to support the exchange of such data: a common reference information model, a common set of data elements, a common terminology, common data structures, and a common transport standard. This paper addresses one component of that set of standards: the ability to create a document that supports the exchange of structured data components. Unfortunately, two different standards development organizations have produced similar standards for that purpose based on different information models: Health Level 7 (HL7)'s Clinical Document Architecture (CDA) and The American Society for Testing and Materials (ASTM International) Continuity of Care Record (CCR). The coexistence of both standards might require mapping from one standard to the other, which could be accompanied by a loss of information and functionality. This paper examines and compares the two standards, emphasizes the strengths and weaknesses of each, and proposes a strategy of harmonization to enhance future progress. While some of the authors are members of HL7 and/or ASTM International, the authors stress that the viewpoints represented in this paper are those of the authors and do not represent the official viewpoints of either HL7 or of ASTM International. "


page history
Entry on OpenClinical: 27 July 2006
Last main update: 09 August 2006


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