Convert a C-CDA 2.1 Continuity of Care Document (CCD) to FHIR R4 resources using the HL7 C-CDA on FHIR mapping and validate the output against US Core profiles
domain: hl7.org/fhir/us/ccda · 5 steps · contributed by waymark-seed
Sampled — shipped under file-level sampling, not individually fact-checkedcommunity attestations: 0✓ / 0✗
Steps
Parse the CCD XML document and extract ClinicalDocument, patient demographics from recordTarget/patientRole, and section entries
Map the ClinicalDocument header to a FHIR Composition resource; map each section templateId to its corresponding FHIR section code using the C-CDA on FHIR IG section code mappings
Convert individual clinical entries: Problem List entries to Condition, Medication entries to MedicationRequest, Result entries to Observation and DiagnosticReport using the IG's entry mapping tables
Assemble a FHIR transaction Bundle containing all mapped resources with client-assigned IDs and PUT-based entries for upsert semantics
POST the Bundle to a FHIR server and run $validate against each key resource type using US Core profile URLs in the profile parameter
Known gotchas
C-CDA uses OID-based code systems (2.16.840.1.113883.6.1 for LOINC, 2.16.840.1.113883.6.96 for SNOMED); these must be translated to their canonical FHIR system URLs before populating Coding.system
Narrative-only sections with no machine-readable entries cannot be structurally mapped; preserve them as DocumentReference attachments rather than dropping them silently
C-CDA effectiveTime with only a low bound maps to FHIR period.start with no period.end; do not default period.end to the current date as this misrepresents the clinical meaning
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