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 several 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 Connectivity Implementation Guide provides an overview of the AS2 connectivity protocol supported by the HIE.
  • 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 Direct Messaging. Information about using this submission methodology is provided in the OneHealthPort Direct Messaging Implementation Guide.

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 Managed 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 Format Conformance Testing

Test your C-CDA file for message structure and format conformance to ensure your file meets national standards and can be processed by the CDR or another HIE participating organization. C-CDA files are validated against the CDA_R2 version of the C-CDA. Validation testing provides immediate results and feedback provides detailed information for any formatting errors that need to be corrected, or information that will help correct errors that contribute to data parsing issues. No data content is retained as part of the testing process. There are several options for C-CDA validation testing.

  • National Institute of Standards and Technology (NIST) public website. Use sample or test C-CDA files for testing on this website.
  • C-CDA Validation Testing on the OneHealthPort Application Portal. Organizations contracted with the OneHealthPort HIE may access this secure site for testing C-CDA files. 
  • website offers the C-CDA Smart Scorecard testing harness that provides more detailed error reporting about the structured data found in the C-CDA that may be causing parsing errors. Use sample or test C-CDA files for testing on this website.

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. Vendors and organizations are provided information for setting up access to the UAT clinical portal when they begin testing. Clinical information verification is an important step to complete before beginning C-CDA message submission to production.

The C-CDA End-to-End Testing User's Guide outlines the testing process. The End-to-End Testing Tracking spreadsheet is used to record testing results. To schedule end-to-end testing, submit a support form.

C-CDA Document Submission in Production

When C-CDA messages have met format conformance, 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 submission, please submit a support request.