Prepare the C-CDA

Every certified Electronic Health Record (EHR) system has the ability to generate a Consolidated-Clinical Data Architecture (C-CDA) document, the standard for clinical information exchange. The steps listed below will help you prepare, test, and submit C-CDA documents to a Clinical Data Repository (CDR) or with other HIE participating organizations.  


Preparing for C-CDA Exchange

Connecting for C-CDA Document Submission

OneHealthPort provides options for secure transport of the C-CDAs to the CDR. Once connected you can begin submission of the prepared C-CDA documents to the CDR.

  • The OneHealthPort Web Services Implementation Guide provides detailed information for using web services for standard protocols such as the ITI-41 XDS.b data submission protocol. Organizations that are required by company policy to perform system availability monitoring may do so using HealthCheck.
  • C-CDAs may be submitted to the CDR using HTTPS POSTs with APIs and OAuth 2.0 JWT tokens to securely post CCDs to the OneHealthPort HIE gateway for delivery to the CDR. This API connectivity meets security requirements supported by the Washington State Office of the CIO (OCIO) and requirements for use of APIs as set forth by the Office of the National Coordinator for HIT (ONC) and the Centers for Medicare and Medicaid Services (CMS).

C-CDA Implementation Guide

C-CDA files must be prepared in accordance with specifications and include identifiers to successfully process at the HIE, and be delivered to a clinical data repository or another HIE participating organization. The guide and additional information are provided below:

  • C-CDA Implementation Guide – The guide provides information about the specifications including a list of sponsors, health plans and products used for the C-CDA file generation and submission that you can share with your electronic health record (EHR) vendor.
  • Health Care Authority Integrated Medicaid Health Plan List - Download the sponsor, health plan and product information file for use in identifying patients for which C-CDAs need to be submitted to the CDR.
  • Link4Health Data Inclusion and Classification – This document, prepared by the Washington State Health Care Authority (HCA), provides information about data inclusion and classification for C-CDA data submissions.
  • ICD and CPT Classification Code Sets – The HCA created this listing for use in assigning confidentiality code classifications to claims data provided to the CDR. The listing is available to providers and vendors for use in developing confidentiality code data classification capabilities in electronic health record systems.  
  • OneHealthPort Object Identifiers  - Organizations participating in the OneHealthPort HIE are assigned identifiers for use in messages sent through the HIE. This document describes use of these identifiers and includes a listing of identifiers for HIE participating organizations. 

C-CDA File Format Validation

C-CDA files submitted to the CDR are sent through an automated schema validation tool to ensure the file conforms with national standards before being processed by the CDR. Files that fail the validation are not processed, and schema validation error information is sent back to the submitting organization in the error response messages. For more information see Automated Schema Validation for C-CDA Files.

C-CDA End-to-End Testing

End-to-end testing provides vendors and organizations an opportunity to test C-CDA data submission and receipt of CDR processing messages before beginning data submissions in the production environment. Submitted C-CDA messages may also be verified in the CDR user acceptance testing (UAT) clinical portal to ensure documents render and data parses in the patient record. 

To receive step-by-step instructions for test patient set-up and the end-to-end testing process, please submit a support request.

C-CDA Document Submission in Production

When C-CDA messages have met end-to-end submission testing and data verification requirements, you can submit your messages through the production environment of the OneHealthPort HIE to the CDR.

To move to production for C-CDA submissions, please submit a support request.