Landmark Study on Interoperability of C-CDA Documents


Newton, MA – A landmark study on the interoperability of Consolidated Clinical Document Architecture (C-CDA) documents was published today with the leading journal for medical informatics, JAMIA (Journal of the American Medical Informatics Association). The study examined C-CDA documents from major electronic health record vendors and outlined implementation and policy challenges of the C-CDA, which is the primary document standard for Stage 2 of Meaningful Use. John D’Amore, President and CTO of Diameter Health, is a primary author on the publication which includes senior informatics staff from Harvard Medical, Boston Children’s Hospital and Lantana Consulting Group.

“In this study, we scrutinized C-CDA documents for their semantic interoperability, which means the ability of a receiver to interpret the XML without prior coordination of the sender,” stated John D’Amore.  “The resulting findings were both encouraging and alarming. We were encouraged that many EHR and Health IT vendors were eager to improve document quality and that XML parsing generally occurred without schema errors. We were alarmed that many semantic mistakes were present in the submissions. As observed in the article, this demonstrates the need for normalizing technology of C-CDA documents, a critical component of Diameter Health’s platform.” Diameter Health offers C-CDA and Continuity of Care Document (CCD) normalization through its Fusion software offering.

“This landmark publication and John’s lead role in its authoring further validate Diameter Health’s strategy and the need for efficient and scalable technology to manage and leverage the wealth of data in clinical documents” observed Eric Rosow, CEO of Diameter Health. This research draws from Diameter Health’s work with the SMART C-CDA Collaborative in 2013, sponsored by the Office of the National Coordinator for Health Information Technology.  In total, 21 major health technologies were represented in the study, which account for a majority of Stage 1 Meaningful Use attestations. The Journal of the American Medical Informatics Association published the work and it is freely available online:

JAMIA (Journal of the American Medical Informatics Association) is American Medical Informatics Association’s premier peer-reviewed journal for biomedical and health informatics. Covering the full spectrum of activities in the field, JAMIA includes informatics articles in the areas of clinical care, clinical research, translational science, implementation science, imaging, education, consumer health, public health, and policy. JAMIA’s articles describe innovative informatics research and systems that help to advance biomedical science and to promote health. Case reports, perspectives and reviews also help readers stay connected with the most important informatics developments in implementation, policy and education.

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