C-CDA to and from FHIR Structural Mapping (Jira PSS-1811)

This project will establish definitive HL7 mapping guidance for C-CDA templates to FHIR resources conformant with US Core profiles where possible. It also will establish definitive HL7 mapping guidance from US Core profiles and base FHIR resources to C-CDA templates. The scope of the work includes templates in C-CDA R2.1, templates in C-CDA Companion Guide R2 (used in the 2015 Certification Edition Cures Update) and templates relevant for USCDI v2.

The project will be addressed in phases. Phase I. includes CCD, Discharge Summary, Referral Note, Consultation Note, Procedure Note, History and Physical, Progress Note, and Unstructured document types, and focuses on section and entry templates that are associated with USCDI V2 data classes and elements, and on section and entry templates that are required by EHR certification.

The project will:

1. Produce mappings for C-CDA section and C-CDA entry templates to and from FHIR resources using US Core profiles when available. The mappings include mapping at the value set level. This includes relevant entries associated with USCDI V2 data classes and data elements including provenance. High-priority sections include (using C-CDA Section Names): Patients, Encounters, Problems, Allergies/Intolerances, Vital Signs, Results, Medications Administered, Social History, Procedures, Immunizations, History of Present Illness, Medications, Plan of Treatment, Reason for Visit, and other sections of interest and agreed to using as a starting point the initial mappings established in the C-CDA on FHIR R1 implementation guide, as well as community developed mappings.

2. Propose additional FHIR attributes, extensions and/or FHIR Core additions through the respective FHIR resource stewards as identified and appropriate.

3. Propose additional CDA extensions and new template designs or revisions for existing C-CDA templates through SDWG as appropriate.

4. Contribute to the list of value set alignment issues being documented under the 2021 Annual Value Set Update for C-CDA project (PSS 1696). The work of PSS 1696 focuses on building the list of known value set correspondences across C-CDA value sets and value sets used in US Core profiles, and summarizing the status of the alignment.

5. Establish a publication format, informed by the v2-to-FHIR and other mapping efforts, to ballot and publish the proposed definitive mappings, that also enables FHIR standard/IGs and C-CDA IG to reference applicable mappings in context.

Not in scope:

1. Incorporation of new FHIR extensions and/or profiles within the US Core Implementation Guide. The US Core project may consider any proposed FHIR extensions and/or attribute updates for inclusion.

2. Incorporation of new C-CDA templates within the C-CDA Implementation Guide. The Structured Documents workgroup may consider any proposed templates for inclusion.

3. Additional document types of interest not listed in Phase I above, although they may be added through a PSS update when agreed to.

4. Changes to the logical model that is covered in the CDA IG Web Publishing project (PSS-1684).

5. Updates to RIM (V3) mappings in FHIR R4 or updates to mappings in the C-CDA on FHIR IG. This will be managed by the respective projects maintaining those specifications.