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Continuity of Care Record

December 18, 2023

Continuity of Care Record (CCR)[1] is a health record standard specification developed jointly by ASTM International, the Massachusetts Medical Society (MMS), the Healthcare Information and Management Systems Society (HIMSS), the American Academy of Family Physicians (AAFP), the American Academy of Pediatrics (AAP), and other health informatics vendors.[1]

Continuity of Care Record
ASTM E2369 - 12: Standard Specification for Continuity of Care Record (CCR)
AbbreviationCCR
OrganizationASTM International
CommitteeE31.25
Base standardsXML
DomainElectronic health records
LicenseProprietary
Websitewww.astm.org/Standards/E2369.htm

Although there is no official "death" of the CCR standard announced anywhere, the CCR is effectively dead in any major industry use, with most organizations now transmitting documents and information with HL7 standards (V2, CDA/C-CDA, or FHIR). Another indication of its death is that the ASTM standard specification for CCR has not been updated since 2010.[1]

Background and scope edit

The CCR was generated by health care practitioners based on their views of the data they may want to share in any given situation.[2][failed verification] The CCR document is used to allow timely and focused transmission of information to other health professionals involved in the patient's care.[2] The CCR aims to increase the role of the patient in managing their health and reduce error while improving continuity of patient care.[3] The CCR standard is a patient health summary standard. It is a way to create flexible documents that contain the most relevant and timely core health information about a patient, and to send these electronically from one caregiver to another. The CCR's intent is also to create a standard of health information transportability when a patient is transferred or referred, or is seen by another healthcare professional.[4]

Development edit

The CCR is a unique development effort via a syndicate of the following sponsors:

Content edit

The CCR data set contains a summary of the patient's health status including problems, medications, allergies, and basic information about health insurance, care documentation, and the patient's care plan.[4] These represent a "snapshot" of a patient's health data that can be useful or possibly lifesaving, if available at the time of clinical encounter.[2] The ASTM CCR standard's purpose is to permit easy creation by a physician using an electronic health record (EHR) system at the end of an encounter.[2] More specifically within the CCR, there are mandated core elements in 6 sections.[4]
These 6 sections are:

  1. Header
  2. Patient Identifying Information
  3. Patient Financial and Insurance Information
  4. Health Status of the Patient
  5. Care Documentation
  6. Care Plan Recommendation

CCR standard and structure edit

Because it is expressed in the standard data interchange language known as XML, a CCR can potentially be created, read, and interpreted by any EHR or EMR software application. A CCR can also be exported to other formats, such as PDF or Office Open XML (Microsoft Word 2007 format).[4]

The Continuity of Care Document (CCD) is an HL7 CDA implementation of the Continuity of Care Record (CCR). A CCR document can generally be converted into CCD using Extensible Stylesheet Language Transformations (XSLT), but it is not always possible to perform the inverse transformation, since some CCD features are not supported in CCR.[5] HITSP provides reference information that demonstrates how CCD and CCR (as HITSP C32) are embedded in CDA.[6]

Although the CCR and CCD standards could continue to coexist, with CCR providing for basic information requests and CCD servicing more detailed requests, the newer CCD standard might eventually completely supplant CCR.[7]

Technology edit

As mentioned, the CCR standard uses eXtensible Markup Language (XML) as it is aimed at being technology neutral to allow for maximum applicability.[4] This specified XML coding provides flexibility that will allow users to formulate, transfer, and view the CCR in a number of ways, for example, in a browser, in a Health Level 7 (HL7) message, in a secure email, as a PDF file, as an HTML file, or as a word document. This is aimed at producing flexible expression of structured data in avenues such as electronic health record (EHR) systems.[8] In terms of the CCR's transportability, secure carriage and transmission of the electronic file can occur via physical transport media, for example on a USB thumb drive, tablet or phone, CD ROM, or smart card, and in an electronic sense, secure transmission can occur via a network line, or the Internet.[8]

See also edit

References edit

  1. ^ a b c Standard Specification for Continuity of Care Record (CCR) (Active standard). ASTM International. 2012. doi:10.1520/E2369-12. ASTM E2369 - 12.
  2. ^ a b c d Ferranti, Jeffrey M.; Musser, R. Clayton; Kawamoto, Kensaku; Hammond, W. Ed (May–June 2006). "The Clinical Document Architecture and the Continuity of Care Record: A Critical Analysis". Journal of the American Medical Informatics Association. 13 (3): 245–252. doi:10.1197/jamia.M1963. PMC 1513652. PMID 16501180.
  3. ^ Kibbe, David C.; Phillips, Robert L. Jr.; Green, Larry A. (1 October 2004). "The Continuity of Care Record". Editorial. American Family Physician. 70 (7): 1. 220, 1222–3. PMID 15508532.
  4. ^ a b c d e Continuity of Care Record:The Concept Paper of the CCR (Report). American Society for Testing and Materials. 2013.
  5. ^ Trotter, Fred; Uhlman, David (2011). . Getting to Meaningful Use and Beyond. O'Reilly Media. ISBN 978-1-4493-0502-4. from the original on 3 September 2011. Retrieved 22 August 2017.
  6. ^ (PDF). ANSI Public Document Library. December 2009. Archived from the original (PDF) on 2011-10-01. Retrieved 2011-08-06.
  7. ^ Kibbe, David C. (19 June 2008). "Untangling the Electronic Health Data Exchange". e-CareManagement Blog. Better Health Technologies, LLC.
  8. ^ a b Kibbe, David C. (10 August 2006). (PDF). NCHICA. North Carolina Healthcare Information and Communications Alliance, Inc. Archived from the original (PDF) on 2013-01-14. Retrieved 2013-06-09.

External links edit

  • ASTM CCR Standard E2369-05
  • Center for Health Information Technology (CHiT)
  • CCR Java library

December 18, 2023
continuity, care, record, health, record, standard, specification, developed, jointly, astm, international, massachusetts, medical, society, healthcare, information, management, systems, society, himss, american, academy, family, physicians, aafp, american, ac. Continuity of Care Record CCR 1 is a health record standard specification developed jointly by ASTM International the Massachusetts Medical Society MMS the Healthcare Information and Management Systems Society HIMSS the American Academy of Family Physicians AAFP the American Academy of Pediatrics AAP and other health informatics vendors 1 Continuity of Care RecordASTM E2369 12 Standard Specification for Continuity of Care Record CCR AbbreviationCCROrganizationASTM InternationalCommitteeE31 25Base standardsXMLDomainElectronic health recordsLicenseProprietaryWebsitewww wbr astm wbr org wbr Standards wbr E2369 wbr htmAlthough there is no official death of the CCR standard announced anywhere the CCR is effectively dead in any major industry use with most organizations now transmitting documents and information with HL7 standards V2 CDA C CDA or FHIR Another indication of its death is that the ASTM standard specification for CCR has not been updated since 2010 1 Contents 1 Background and scope 2 Development 3 Content 4 CCR standard and structure 5 Technology 6 See also 7 References 8 External linksBackground and scope editThe CCR was generated by health care practitioners based on their views of the data they may want to share in any given situation 2 failed verification The CCR document is used to allow timely and focused transmission of information to other health professionals involved in the patient s care 2 The CCR aims to increase the role of the patient in managing their health and reduce error while improving continuity of patient care 3 The CCR standard is a patient health summary standard It is a way to create flexible documents that contain the most relevant and timely core health information about a patient and to send these electronically from one caregiver to another The CCR s intent is also to create a standard of health information transportability when a patient is transferred or referred or is seen by another healthcare professional 4 Development editThis section does not cite any sources Please help improve this section by adding citations to reliable sources Unsourced material may be challenged and removed August 2017 Learn how and when to remove this template message The CCR is a unique development effort via a syndicate of the following sponsors 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 LTCContent editThe CCR data set contains a summary of the patient s health status including problems medications allergies and basic information about health insurance care documentation and the patient s care plan 4 These represent a snapshot of a patient s health data that can be useful or possibly lifesaving if available at the time of clinical encounter 2 The ASTM CCR standard s purpose is to permit easy creation by a physician using an electronic health record EHR system at the end of an encounter 2 More specifically within the CCR there are mandated core elements in 6 sections 4 These 6 sections are Header Patient Identifying Information Patient Financial and Insurance Information Health Status of the Patient Care Documentation Care Plan RecommendationCCR standard and structure editBecause it is expressed in the standard data interchange language known as XML a CCR can potentially be created read and interpreted by any EHR or EMR software application A CCR can also be exported to other formats such as PDF or Office Open XML Microsoft Word 2007 format 4 The Continuity of Care Document CCD is an HL7 CDA implementation of the Continuity of Care Record CCR A CCR document can generally be converted into CCD using Extensible Stylesheet Language Transformations XSLT but it is not always possible to perform the inverse transformation since some CCD features are not supported in CCR 5 HITSP provides reference information that demonstrates how CCD and CCR as HITSP C32 are embedded in CDA 6 Although the CCR and CCD standards could continue to coexist with CCR providing for basic information requests and CCD servicing more detailed requests the newer CCD standard might eventually completely supplant CCR 7 Technology editAs mentioned the CCR standard uses eXtensible Markup Language XML as it is aimed at being technology neutral to allow for maximum applicability 4 This specified XML coding provides flexibility that will allow users to formulate transfer and view the CCR in a number of ways for example in a browser in a Health Level 7 HL7 message in a secure email as a PDF file as an HTML file or as a word document This is aimed at producing flexible expression of structured data in avenues such as electronic health record EHR systems 8 In terms of the CCR s transportability secure carriage and transmission of the electronic file can occur via physical transport media for example on a USB thumb drive tablet or phone CD ROM or smart card and in an electronic sense secure transmission can occur via a network line or the Internet 8 See also editClinical Document Architecture Continuity of Care Document Electronic health recordReferences edit a b c Standard Specification for Continuity of Care Record CCR Active standard ASTM International 2012 doi 10 1520 E2369 12 ASTM E2369 12 a b c d Ferranti Jeffrey M Musser R Clayton Kawamoto Kensaku Hammond W Ed May June 2006 The Clinical Document Architecture and the Continuity of Care Record A Critical Analysis Journal of the American Medical Informatics Association 13 3 245 252 doi 10 1197 jamia M1963 PMC 1513652 PMID 16501180 Kibbe David C Phillips Robert L Jr Green Larry A 1 October 2004 The Continuity of Care Record Editorial American Family Physician 70 7 1 220 1222 3 PMID 15508532 a b c d e Continuity of Care Record The Concept Paper of the CCR Report American Society for Testing and Materials 2013 Trotter Fred Uhlman David 2011 Chapter 10 Interoperability Getting to Meaningful Use and Beyond O Reilly Media ISBN 978 1 4493 0502 4 Archived from the original on 3 September 2011 Retrieved 22 August 2017 HITSP 09 N 451 Comparison of CCR CCD CDA Documents and HITSP Products PDF ANSI Public Document Library December 2009 Archived from the original PDF on 2011 10 01 Retrieved 2011 08 06 Kibbe David C 19 June 2008 Untangling the Electronic Health Data Exchange e CareManagement Blog Better Health Technologies LLC a b Kibbe David C 10 August 2006 An Overview of the ASTM Continuity of Care Record CCR PDF NCHICA North Carolina Healthcare Information and Communications Alliance Inc Archived from the original PDF on 2013 01 14 Retrieved 2013 06 09 External links editASTM CCR Standard E2369 05 Center for Health Information Technology CHiT CCR Java library Retrieved from https en wikipedia org w index php title Continuity of Care Record amp oldid 1188407522, wikipedia, wiki, book, books, library,

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