C-CDA on FHIR
1.2.0-ballot - CI Build United States of America flag

This page is part of the C-CDA on FHIR Implementation Guide (v1.2.0-ballot: STU 1 Ballot 4) based on FHIR R4. The current version which supercedes this version is 1.1.0. For a full list of available versions, see the Directory of published versions

C-CDA to FHIR Medications

This page provides a mapping from CDA to FHIR. For the FHIR to CDA mapping, please refer to Medications FHIR → CDA. For guidance on how to read the table below, see Reading the C-CDA ↔ FHIR Mapping Pages

Medications to MedicationRequest

Medications shown below represent the moodCode="INT" in CDA. For mapping histories of medication use from CDA, no consensus was established. We welcome feedback on this topic. For more information, please see chat.fhir.org and related stream

C-CDA to FHIR

C-CDA¹
Medication Activity substanceAdministration		 FHIR
MedicationRequest		 Transform Steps
@negationInd=”true” set .doNotPerform=true  
/id .identifier CDA id ↔ FHIR identifier
/statusCode .status CDA statusCode → FHIR status
/effectiveTime@value .dosageInstruction.timing.event Constraint: Use this when effectiveTime@value is populated
CDA ↔ FHIR Time/Dates
/effectiveTime.low .dosageInstruction.timing.repeat.boundsPeriod.start Constraint: Use this when effectiveTime@value is not populated
CDA ↔ FHIR Time/Dates
/effectiveTime.high .dosageInstruction.timing.repeat.boundsPeriod.end Constraint: Use this when effectiveTime@value is not populated
CDA ↔ FHIR Time/Dates
/routeCode .dosageInstruction.route CDA coding ↔ FHIR CodeableConcept
/doseQuantity .dosageInstruction.doseAndRate.doseQuantity  
/rateQuantity .dosageInstruction.doseAndRate.rateQuantity  
/maxDoseQuantity .dosageInstruction.maxDosePerAdministration  
/consumable/manufacturedProduct/manufacturedMaterial/code .medicationCodeableConcept CDA coding ↔ FHIR CodeableConcept
/author .requester
&
Provenance		 CDA ↔ FHIR Provenance
Indication
entryRelationship@typeCode="RSON"
/entryRelationship/observation/value		 .reasonCode CDA coding ↔ FHIR CodeableConcept
Instruction
entryRelationship@typeCode="SUBJ"
/entryRelationship/act/code		 .dosageInstruction.additionalInstruction CDA coding ↔ FHIR CodeableConcept
Free text sig
entryRelationship/substanceAdministration/code@code="76662-6"
/entryRelationship/substanceAdministration/text		 .dosageInstruction.patientInstruction  
Comment Activity
entryRelationship/act/code@code="48767-8"
/entryRelationship/act/text		 Annotation
.note		  

1. XPath abbrievated for C-CDA Medication Activity as:
ClinicalDocument/component/structuredBody/component/section[(@code="10160-0")]/entry/substanceAdministration

Illustrative example

An illustrative example with higlighting is shown above based on the consensus of mapping and guidance. Not all possible elements in CDA or FHIR may be represented. To access the content for the above example, click on the links below.


Links to example content

The consensus mapping example developed through multiple vendors are available below:

Prior work and Expanded Spreadsheets

As reviewed in the methodology, a more comprehensive review was performed via spreadsheets. These spreadsheets have been consolidated and further revised in the tables above but are provided for reference here