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 Problems

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



C-CDA to FHIR

C-CDA¹
Problem observation		 FHIR
Condition and Health Concern		 Transform Steps
(section parent to observation)../../../../@code .category CDA section → FHIR category
(act parent to observation) ../../@statusCode .clinicalStatus For more information on how status is managed in Problem Concern Act wrapper, refer to C-CDA guidance, see 5.2.6.1
@negationInd=true set verificationStatus=”refuted” or adjust .code for negated concept  
/id .identifier CDA id ↔ FHIR identifier
/effectiveTime/low .onsetDateTime CDA ↔ FHIR Time/Dates
/effectiveTime/high .abatementDateTime CDA ↔ FHIR Time/Dates
/value .code Constraint: When CDA negation is absent or false
CDA coding ↔ FHIR CodeableConcept
/author .recorder
&
Provenance		 CDA ↔ FHIR Provenance
Problem Status
observation/code@code="33999-4"
/entryRelationship/observation/value		 .clinicalStatus CDA Problem Status Observation value → FHIR clinicalStatus
Date of Diagnosis
entryRelationship/act/code@code="77975-1"
/entryRelationship/act/effectiveTime
&
/assignedAuthor/time		 .recordedDate
or
.extension:assertedDate
or
.onsetDate		 CDA ↔ FHIR Time/Dates
There is no single location in Condition that represents date of diagnosis. See US CORE Condition for additional guidance
Comment Activity
entryRelationship/act/code@code="48767-8"
/entryRelationship/act/text		 Annotation
.note		  

1. XPath abbrievated for C-CDA Problem observation as:
ClinicalDocument/component/structuredBody/component/section[(@code="11450-4")]/entry/act/entryRelationship/observation

When authors or other provenance are recorded in the parent Problem Concern Act, it is recommended that those data be mapped to the FHIR Condition.

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