Resources

Comprehensive list of resources for working with C-CDA and HL7 standards.

Official HL7 Specifications

C-CDA Specifications

• C-CDA Release 2.1 (Current)
• HL7 C-CDA R2.1 Implementation Guide
• Standard publication with full conformance requirements

• Published: 2015, with ongoing companion guides

• C-CDA Companion Guides

• C-CDA R2.1 Companion Guide
• Clarifications, examples, and best practices

• Updated regularly with implementation guidance

• C-CDA Templates

• Art-Decor C-CDA Template Browser
• Interactive template explorer
• View all templates, constraints, and examples

Base CDA Specifications

• CDA Release 2.0
• HL7 CDA R2 Base Standard
• Foundation for C-CDA

• XML schema and base semantics

• CDA Examples Task Force

• CDA Examples Repository
• Sample documents and snippets
• Community-contributed examples

HL7 Organization Resources

Official Sites

• HL7 International
• https://www.hl7.org
• Standards organization homepage

• Membership, events, publications

• HL7 Product Brief

• Standards Product Brief
• All HL7 specifications

• Download specifications (members only for newest versions)

• HL7 Terminology Services

• https://terminology.hl7.org
• Official value sets and code systems
• FHIR terminology server

HL7 Working Groups

• Structured Documents Working Group
• Primary group for CDA/C-CDA
• https://confluence.hl7.org/display/SD

• Meetings, ballots, ongoing work

• Clinical Quality Information (CQI)

• Quality measures and reporting

• QRDA specifications (CDA-based)

• Patient Care Working Group

• Clinical content and use cases
• Document types and sections

ONC and Federal Resources

ONC Certification

• ONC Health IT Certification Program
• https://www.healthit.gov/topic/certification-ehrs/certification-health-it
• Certification requirements and process

• Test procedures and tools

• Certification Companion Guides

• ONC C-CDA Companion Guide
• Additional requirements for certification

• Clarifications and interpretations

• Interoperability Standards Advisory (ISA)

• HealthIT.gov ISA
• Recommended standards for specific use cases
• Annual updates

NIST Resources

• NIST C-CDA Validation
• https://github.com/onc-healthit/content-validator-api
• Official validation service

• Reference implementation

• NIST Test Artifacts

• https://github.com/onc-healthit/ett
• Test files and scenarios
• Edge cases and examples

Terminology Servers and Browsers

SNOMED CT

• US SNOMED CT Browser
• https://browser.ihtsdotools.org/
• Search SNOMED concepts

• View hierarchies and relationships

• SNOMED CT International

• https://www.snomed.org
• Licensing and downloads
• Documentation and training

LOINC

• LOINC Search
• https://loinc.org/search
• Search LOINC codes

• Download database

• RELMA (Regenstrief LOINC Mapping Assistant)

• https://loinc.org/relma/
• Desktop tool for LOINC mapping
• Free download

RxNorm

• RxNav
• https://mor.nlm.nih.gov/RxNav/
• Search drug names and codes

• Relationships and mappings

• RxNorm API

• https://lhncbc.nlm.nih.gov/RxNav/APIs.html
• Programmatic access
• Free, no authentication required

Value Set Authority Center (VSAC)

• VSAC Portal
• https://vsac.nlm.nih.gov/
• Official US value sets

• Download and API access (requires UMLS account)

• VSAC API

• VSAC FHIR API
• Programmatic value set retrieval
• FHIR-based

UCUM (Units of Measure)

• UCUM Website
• https://ucum.org
• Official specification

• Case-sensitive codes

• UCUM Validator

• https://ucum.nlm.nih.gov/ucum-lhc/demo.html
• Validate unit codes
• Convert between units

Validation Tools

Online Validators

• MDHT C-CDA Validator
• https://cda-validation.nist.gov/cda-validation/validation.html
• Schema and Schematron validation

• Reference vocabulary validation

• SITE C-CDA Validator

• https://site.healthit.gov/sandbox-ccda/ccda-validator
• ONC certification-based validation

• Detailed error reporting

• Lantana C-CDA Scorecard

• https://www.ccdascorecard.com/
• Quality and conformance scoring
• Best practice recommendations

Downloadable Validators

• MDHT (Model Driven Health Tools)
• https://github.com/mdht/mdht-models
• Eclipse-based validation

• Java API for validation

• HL7 Validator

• https://github.com/hapifhir/org.hl7.fhir.core
• Supports CDA validation

• Command-line tool

• Schematron Quick Fix

• https://github.com/Schematron/schematron
• Pure Schematron validation
• XSLT-based

Sample Documents and Test Data

Official Samples

• HL7 C-CDA Examples
• https://github.com/HL7/C-CDA-Examples
• Companion guide examples

• Various document types

• SMART C-CDA Scorecard Samples

• https://github.com/smart-on-fhir/sample-patients-stu3
• Synthetic patient data
• Multiple formats including C-CDA

Test Data Generators

• Synthea
• https://github.com/synthetichealth/synthea
• Generate synthetic patients

• Outputs C-CDA documents

• CDA Generator

• https://github.com/jddamore/cda-generator
• Create C-CDA from templates
• Educational tool

Community Resources

Forums and Discussion

• HL7 FHIR Chat
• https://chat.fhir.org
• Zulip chat for all HL7 standards

• Active CDA/C-CDA streams

• HL7 Confluence

• https://confluence.hl7.org
• Wiki for working groups

• Meeting minutes and decisions

• Stack Overflow

• HL7 Tag
• C-CDA Tag
• Community Q&A

Blogs and Tutorials

• Adrian Gropper's Blog
• https://www.healthcareitnews.com/users/adrian-gropper
• Health IT interoperability

• Standards perspectives

• HL7 Soup

• http://www.hl7soup.com/
• HL7 tutorials and examples

• Community contributions

• FHIR Blog

• https://blog.fire.ly
• Firely team insights
• Standards updates

Professional Organizations

• HIMSS (Healthcare Information and Management Systems Society)
• https://www.himss.org
• Conferences and education

• Networking and resources

• AMIA (American Medical Informatics Association)

• https://www.amia.org
• Research and education
• Annual conferences

Development Tools and Libraries

XML Tools

• Oxygen XML Editor
• https://www.oxygenxml.com/
• Professional XML IDE

• Schema validation, XSLT debugging

• XMLSpy

• https://www.altova.com/xmlspy-xml-editor
• XML development environment

• Commercial tool

• Visual Studio Code

• XML Extension
• Free, lightweight
• Good for viewing/editing CDA

Programming Libraries

Python

• lxml
• https://lxml.de/
• XML processing

• Fast and feature-rich

• ccdakit (this library!)

• Pythonic C-CDA generation
• Type-safe, validated

Java

• MDHT
• https://github.com/mdht/mdht-models
• Java API for CDA

• Model-driven approach

• HAPI

• https://hapifhir.io/
• Supports CDA parsing
• Primarily FHIR-focused

JavaScript/TypeScript

• blue-button
• https://github.com/amida-tech/blue-button
• Parse C-CDA to JSON

• Node.js library

• ccda-parser

• https://github.com/amida-tech/blue-button
• JavaScript C-CDA parser
• Extract structured data

C

• Everest Framework
• http://everest.marc-hi.ca/
• .NET library for HL7
• CDA generation and parsing

Training and Education

Online Courses

• HL7 Training
• https://www.hl7.org/training/index.cfm
• Official courses

• CDA fundamentals

• edX Health Informatics

• Various courses on health IT standards
• Free and paid options

Books

• "HL7 for Dummies"
• Practical guide to HL7 standards

• Good starting point

• "CDA Best Practices"

• Available from HL7
• In-depth implementation guidance

Webinars and Conferences

• HL7 Working Group Meetings
• Quarterly meetings

• Virtual attendance available

• HL7 FHIR DevDays

• https://www.devdays.com/
• Hands-on training

• Includes CDA sessions

• HIMSS Conference

• Annual healthcare IT conference
• Standards tracks and tutorials

Standards Comparison and Migration

C-CDA to FHIR

• C-CDA on FHIR Implementation Guide
• http://hl7.org/fhir/us/ccda/
• FHIR profiles matching C-CDA semantics

• Migration guidance

• C-CDA to FHIR Mapping

• ConceptMap Resources
• Element-level mappings
• Transformation guidance

Other Standards

• FHIR Bulk Data
• https://hl7.org/fhir/uv/bulkdata/
• Large-scale data exchange

• Alternative to C-CDA for some uses

• QRDA (Quality Reporting Document Architecture)

• Quality Reporting Specs
• CDA-based quality reporting
• Related to C-CDA

Regulatory and Policy

Federal Rules

• 21st Century Cures Act
• https://www.healthit.gov/cures/
• Interoperability requirements

• Patient access rules

• TEFCA (Trusted Exchange Framework)

• https://www.healthit.gov/topic/interoperability/policy/trusted-exchange-framework-and-common-agreement-tefca
• Nationwide interoperability
• Exchange requirements

State and Regional

• Carequality
• https://carequality.org/
• Interoperability framework

• Uses C-CDA

• CommonWell Health Alliance

• https://www.commonwellalliance.org/
• Health data sharing network
• C-CDA support

Security and Privacy

HIPAA Resources

• HHS HIPAA Information
• https://www.hhs.gov/hipaa/
• Privacy and security rules
• Compliance guidance

Security Guides

• NIST Cybersecurity Framework
• https://www.nist.gov/cyberframework
• Security best practices

• Healthcare-applicable

• HITRUST

• https://hitrustalliance.net/
• Security certification
• Healthcare focus

Research and Publications

Academic Journals

• Journal of the American Medical Informatics Association (JAMIA)
• Health informatics research

• Standards evaluation studies

• Journal of Biomedical Informatics

• Informatics research
• Standards and interoperability

White Papers

• ONC Data Briefs
• https://www.healthit.gov/data/data-briefs
• Usage statistics
• Adoption trends

ccdakit-Specific Resources

Documentation

• ccdakit Documentation
• API Reference
• User Guides
• Examples

Source Code

• GitHub Repository
• https://github.com/your-org/ccdakit
• Issues and discussions
• Contribution guidelines

Community

• Issue Tracker
• Report bugs
• Request features

• Ask questions

• Discussions

• Share implementations
• Best practices
• Community support

Quick Reference Checklist

When starting a C-CDA implementation project:

• [ ] Download C-CDA R2.1 specification
• [ ] Review companion guides
• [ ] Set up validation tools (SITE, Scorecard)
• [ ] Get VSAC account for value sets
• [ ] Bookmark terminology browsers (LOINC, SNOMED, RxNorm)
• [ ] Review sample documents
• [ ] Join HL7 FHIR chat for questions
• [ ] Set up development environment with XML tools
• [ ] Review ONC certification requirements if applicable
• [ ] Check state/regional interoperability requirements

Staying Current

• Subscribe to HL7 announcements
• Follow HL7 working group activities
• Monitor ONC/NIST updates
• Join community discussions
• Attend conferences and webinars
• Review updated companion guides
• Watch for specification updates and errata

Contributing to Standards

Interested in contributing to C-CDA development?

1. Join HL7 (individual or organizational membership)
2. Participate in Structured Documents WG calls
3. Submit comments during ballot cycles
4. Contribute examples to community repositories
5. Share implementation experience
6. Report specification issues

Getting Help

When you need assistance:

1. Check official specification first
2. Review companion guides
3. Search existing issues/discussions
4. Try validation tools
5. Ask in community forums
6. Contact HL7 help desk
7. Consult with HL7 implementation experts

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This resource list is maintained and updated regularly. Bookmark this page and check back for new resources and links.