CCD (Continuity of Care Document) is a standard way of reporting and sharing patient summary information with the patient and among providers and other health care entities, such as hospitals.
A patient's CCD summarizes the most commonly needed pertinent information about current and past health status in a form that can be shared by all computer applications, from web browsers to electronic medical records.
Compulink has integrated CCD as our method of creating/exchanging electronic information.
Click here to about right click options to customize data elements on the CCD.
CCRs are Continuity of Care Records from other entities involved with the patient's care that may be imported into their Advantage medical record.
The terms CDA, CCD and CCR are all related to the exchange of Patient Health Care Summaries in a standardized format that can be shared electronically and interpreted by humans and by computers.
CDA CCD is a Patient Health Care Summary in the HL7 Clinical Document Architecture.
CCD is a Continuity of Care Document.
CCR is a Continuity of Care Record, a format originally designed by health care practitioners, based on their views of the data they may want to share in any given situation.
CDA is Clinical Document Architecture or specifications for the document contents; textual (human readable) and structural based on HL7 (for software processing).
CDA is an ANSI-certified standard from Health Level Seven (HL7.org)
Print will generate a printed copy of the displayed CCD.
Remember that a CCD contains Protected Health Information and must be handled securely per HIPAA requirements.
Validate - new with Version 12, the CCD can be validated for missing or erroneous codes.
View Hash - new with Version 12, this option may be used to verify a hash for the CCD being viewed.
A hash is an alphanumeric string that is generated according to a file's contents.
If the file has been changed in any way, the hash value changes as well.
This option would generally be used by your IT professional in the event of a security concern.
If a party might have intercepted the CCD data, you could compare the hash on a received CCD against the hash originally generated by the sender.
When you are the sender of the CCD, you are given an option to save the hash that was generated for your records.
Re-sending a CCD will generate the same hash as the original transmission, as long as the medical record has not been altered.
The CDA Viewing Preferences table can be used to customize the content viewed in a CCD by individual user.
Located under the EHR Look-up table menu in Version 12 and greater, the table has no entries by default. All users have the standard view.
Each table entry is assigned the standard CCD sections, with Hide and Display Order options for each. These create a customized view.
Should you decide to create custom viewing profiles here, they can be assigned to individual users in the Login IDs table.
Portal Communication Function:
CCDs can be uploaded to the Patient Portal in a batch process.
The function searches for new exams that are signed off, with no CCD Hold date, that have not previously been uploaded to the Portal.
Send CCD to Patient
You can upload a CCD to the Patient Portal for an individual patient using the Exam commandMU > SEND CCD TO PATIENT PORTAL.
The patient must have a valid e-mail address and date of birth on their demographic screen.
The patient must not have the Opt Out Portal field checked in their Demographic record.
An e-mail is sent to the patient informing them that secure information has been uploaded to the Patient Portal for them.
Accessing the Portal
Patients sign onto the Portal with a secure Member Name and Password to access their health information.
This will include CCDs, plus any educational resources that are not marked delivered in the patient's medical record.
You can also provide a printed copy of the patient's Clinical Summary with the Exam PRINT > CCD DOCUMENT command.
The patient's CCD (with their problem list, test results, active medications and medication allergies) is displayed and available for printing in the Continuity of Care Document Viewer.
Remember when printing that you are generating a document containing PHI which should be accessible to the intended recipient only, per the protection regulations of the Health Insurance Portability and Accountability Act (HIPAA).
The Direct E-Mail Receive function is used to import Health Care Summaries received via the 'Direct' protocol and connect them to your Advantage patient records. Direct E-Mail Receive
CCDs can also be imported from a file using the Exam > MU > Import CCD from Disk command. (Click here) for information.
CCD Data Elements and the Advantage Patient Record with simplified SQL Scripts. Sample CCD
The Location's NPI number, plus the patient unique number becomes the patient identifier on the CCD.
If the NPI number is not available, it will use the last 4 digits of the patient’s Social, plus the patient unique number.
If the Social is not available, the section will be marked as unknown (UNK).
ALLERGIES: Records added to the Allergies grid on the Medication tab that are not expired.
Select * from ExamAlgy where patunique = :patunique and expired is null and not (name is null)
REASON FOR VISIT: Records added to the Complaint tab.
All ExamComp entries.
FAMILY HISTORY: Records added to the Family grid (category of 'Family) on the Health History tab.
All ExamHealthHistory where the Category is family.
IMMUNIZATIONS: Records added to the Immunization tab without an expired date.
Select * from ExamImmunization where patunique = :patunique AND IFNULL(Expires,Convert('12/30/1899',SQL_DATE)) < :ExamDate
INSTRUCTIONS: Test records with Patient Instructions on the Test Summary tab added for this exam.
Select * from ExamTest where examunique = :examunique and not empty(patinstrct)
MEDICATION ACTIVITY: Records added to the Medications grid on the Medication tab.
* from ExamMed where patunique = :patunique
and not (name is null)
and (not start is null)
and ((stop is null) or (stop<Curdate()))
MEDICATIONS ADMINISTERED: Records added to the Medications grid on the Medication tab for this exam.
Select * from ExamMed where examunique = :examunique and MedDelSTDC=6269
PROBLEMS: Records added to the Diagnosis grid on the Plan tab.
* from ExamDiag where (Code is not null)
and [DESC] is not null
and Resolved is null
PROCEDURES: Orders, Surgeries and Treatment records.
All ExamOrder entries, All ExamSurg entries, All ExamTreatment entries.
RESULTS: Lab Test records with a Value for this exam.
Select * from ExamTest where examunique = :examunique and not empty(value) and TestTypeSTDC=6463 and (not (reportdate is null)) and ((:ExamDate - reportdate) < 470)
SOCIAL HISTORY: Records with a Category of 'tobacco' added to the Social History grid on the Health History tab.
All ExamHealthHistory where the Category is tobacco.
VITAL SIGNS: The most recent record added to the Vital Signs grid on the Review of Systems tab.
Most recent ExamVital entry.
FUTURE APPOINTMENTS: Records in the Appointment Schedule that are after the exam date.
select * from Appt where PatUnique = :PatUnique and date > :ExamDate and (Appt.Status NOT IN ('C','R')) order by date
TESTS PENDING: Lab Test records added for this exam that do not have a Performed date.
select * from ExamTest
where examunique = :examunique
and Performed is NULL
and Ordered <= :ExamDate
TESTS SCHEDULED: Lab Test recorded ordered after the date of this exam.
Select * from ExamTest
where examunique = :examunique
and Ordered < :ExamDate
REFERRAL(S) TO OTHER PROVIDERS: Records for Referrals 'Out' added to the Referral History/Eligibility screen on or after the exam.
select * from patref where patunique = :patUnique and start >= :ExamDate and Last is not NULL
DECISION AIDS: Records added to the Education grid on the Plan tab.
All ExamEducation entries.
GOALS: Records added to the Goals grid on the Plan tab.
All ExamGoal entries.