C-CDA on FHIR
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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

FHIR to C-CDA Problems

FHIR US Core → C-CDA Mapping

While multiple vendors participated in CDA → FHIR mappings at a connectathon, only a single vendor (Cerner/Oracle) has participated in the FHIR → CDA mapping. We welcome feedback on these mappings which represent less than a multi-vendor consensus at this time.


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

FHIR to C-CDA

FHIR
Condition and Health Concern		 C-CDA¹
Problem observation		 Transform Steps
.identifier /id CDA id ↔ FHIR identifier
.clinicalStatus (act parent to observation) ../../statusCode
&
Problem Status
observation/code@code="33999-4"
/entryRelationship/observation/value		 FHIR clinicalStatus → CDA Problem Status Observation value
For more information on how status is managed in Problem Concern Act wrapper, refer to C-CDA guidance, see 5.2.6.1
.category /code
This also affects the C-CDA document section:
Problems
Health Concerns
Encounters		 CDA coding ↔ FHIR CodeableConcept
FHIR category → CDA section
.code /value Constraint: When FHIR concept does not represent negated concept
CDA coding ↔ FHIR CodeableConcept
.code /value
&
set @negationInd=”true”		 Constraint: When FHIR concept represents negated concept
.onsetDateTime /effectiveTime/low CDA ↔ FHIR Time/Dates
.onsetPeriod.start /effectiveTime/low CDA ↔ FHIR Time/Dates
effectiveTime/high should not be mapped from onsetPeriod
.abatementDateTime /effectiveTime/high CDA ↔ FHIR Time/Dates
.recordedDate Date of Diagnosis
entryRelationship/act/code@code="77975-1"
/entryRelationship/act/effectiveTime
&
/assignedAuthor/time		 CDA ↔ FHIR Time/Dates
.recorder /assignedAuthor CDA ↔ FHIR Provenance
.asserter /informant CDA ↔ FHIR Provenance
Annotation
.note		 Comment Activity
entryRelationship/act/code@code="48767-8"
/entryRelationship/act/text		  

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

Illustrative example

Links to example content

Note that these mappings have only been implemented by a single vendor to date.

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