×

HL7's new AMS is live!   We are working with Fonteva to resolve log in issues. My Account

HL7 Standards - Section 1a: Clinical Document Architecture (CDA®)

Clinical Document Architecture (CDA®)

Click a Standard to link to more detail.

Name Description Type
C-CDA (HL7 CDA® R2 Implementation Guide: Consolidated CDA Templates for Clinical Notes - US Realm)

C-CDA Online: A navigation website for C-CDA 2.1

The Consolidated CDA (C-CDA) implementation guide contains a library of CDA templates, incorporating and harmonizing previous efforts from Health Level Seven...

STU
CDA® (HL7 Clinical Document Architecture)

The HL7 Version 3 Clinical Document Architecture (CDA®) is a document markup standard that specifies the structure and semantics of "clinical documents" for the purpose of exchange between healthcare provi...

Normative
CDA® R2.1 (HL7 Clinical Document Architecture, Release 2.1)

The HL7 Version 3 Clinical Document Architecture (CDA®) is a document markup standard that specifies the structure and semantics of "clinical documents" for the purpose of exchange between healthcare provi...

Normative
CDA® Release 1 Normative
CDA® Release 2

The HL7 Version 3 Clinical Document Architecture (CDA®) is a document markup standard that specifies the structure and semantics of "clinical documents" for the purpose of exchange between healthcare provi...

Normative
Claims Attachments XML Package (AIS Supporting Files) (2003)

Claims Attachments CDA Header XML Schema and stylesheet files that are provided are not part of the balloted content of the standard. Their use by implementers of the standard is entirely optional. HL7 intends to issue...

HL7 CCD to ASCII Blue Button Transform, Release 1

The healthcare system is in the midst of a revolution in healthcare information technology. Central to this revolution are technologies that facilitate health information exchange between providers and promote patient engagement and self-...

HL7 CDA ® Release 2 Implementation Guide: Reporting to Public Health Cancer Registries from Ambulatory Healthcare Providers, Release 1, DSTU Release 1.1 – US Realm

Population-based cancer surveillance is critical in North America for cancer control activities aimed at reducing the morbidity and mortality of cancer, the second leading cause of death in the United States (U.S.) and the leading cause...

DSTU
HL7 CDA R2 Implementation Guide: Dental Data Exchange, Release 1, STU 1 - US Realm

This implementation guide provides an HL7 CDA-based set of templates defining the Dental Referral Note and Dental Consultation Note. These standardized documents are intended to support bi-directional information exchange between a medic...

STU
HL7 CDA® R2 Attachment Implementation Guide: Exchange of C-CDA Based Documents, Release 2 - US Realm

This implementation guide (Guide) defines the requirements for sending and receiving standards-based electronic attachments. It does so by applying additional constraints onto standards in common use for clinical documentation and by defin...

Informative, STU
HL7 CDA® R2 IG: C-CDA Templates for Clinical Notes R1 Companion Guide, Release 1 - US Realm

The Companion Guide to Consolidated Clinical Document Architecture (C-CDA) provides supplemental guidance to the Health Level Seven (HL7) CDA® R2 IG: C-CDA Templates for Clinical Notes STU Release 2.1 in support of the ONC 2015 Editi...

Informative
HL7 CDA® R2 IG: C-CDA Templates for Clinical Notes R2.1 Companion Guide, Release 3 - US Realm



The Companion Guide to Consolidated Clinical Document Archi...

STU
HL7 CDA® R2 Implementation Guide International Patient Summary, Release 1

An International Patient Summary (IPS) document is an electronic health record extract containing essential healthcare information intended for use in the unscheduled, cross-border care scenario, comprising at least the required eleme...

STU
HL7 CDA® R2 Implementation Guide: Ambulatory and Hospital Healthcare Provider Reporting to Birth Defect Registries Release 1 , STU 2 -US Realm

More than 40 US states have population based birth defect surveillance programs.  Many have mandated requirements for health care professionals to report to the surveillance program.  However, to-date a standard for elect...

DSTU
HL7 CDA® R2 Implementation Guide: Birth and Fetal Death Reporting, Release 1, STU Release 2 - US Realm

The Vital Records birth and fetal death reporting (BFDR) CDA had been first published as an STU in Feb, 2015 and expired in 2017. It provided a format for using HL7's Clinical Document Architecture to transmit medical/health infor...

DSTU, STU
HL7 CDA® R2 Implementation Guide: C-CDA R2.1 Supplemental Templates for Infectious Disease, Release 1, STU 1 - US Realm

This guide defines optional additions to the C-CDA R2.1 Continuity of Care Document (CCD), Transfer Summary, and Discharge Summary standards. These additional templates are  available for use ...

STU
HL7 CDA® R2 Implementation Guide: C-CDA R2.1 Supplemental Templates for Nutrition, Release 1 - US Realm

This document describes constraints on the Clinical Document Architecture Release 2 (CDA R2) header and body elements that are derived from requirements set forth by the Academy of Nutrition and ...

STU
HL7 CDA® R2 Implementation Guide: C-CDA R2.1 Supplemental Templates for Pregnancy Status, Release 1 - US Realm

This implementation guide (IG) provides consistent guidance for capturing key pregnancy status information in healthcare information technology (HIT) products and contains optional supplemental pregnancy status templates for curre...

STU
HL7 CDA® R2 Implementation Guide: C-CDA R2.1; Advance Directives Templates, Release 1 - US Realm

Advance Directive Templates are important components of the C-CDA standard, yet to date, use of these templates in data exchange, sharing and retrieval of patient’s clinical and care planning information has been optional. Optional requi...

STU
HL7 CDA® R2 Implementation Guide: C-CDA Supplemental Templates for Unique Device Identifier (UDI) for Implantable Medical Devices, Release 1 - US Realm

This specification has been retired. Please see: HL7 CDA® R2 IG: C-CDA Templates for Clinical Notes STU Companion Guide, Release 3 - US Realm for UDI related templates.

 

STU
HL7 CDA® R2 Implementation Guide: Clinical Oncology Treatment Plan and Summary, Release 1 - US Realm

This document describes constraints on the Clinical Document Architecture Release 2 (CDA R2) header and body elements for the Clinical Oncology Treatment Plan and Summary (COTPS) documents, whic...

DSTU, STU
HL7 CDA® R2 Implementation Guide: Clinical Summary Relevant and Pertinent Data, Release 1

This guide is primarily focused on improving the relevance and pertinence of C-CDA documents as experienced by the clinician, which means as displayed or “rendered.” Other guides, incl...

Informative
HL7 CDA® R2 Implementation Guide: Data Provenance, Release 1 - US Realm

The Implementation Guide for CDA (R) Release 2: Data Provenance, Release 1, September 2014 is the result of collaborative efforts between HL7 and the US Health and Human Services Office of National Coordinators Standards and Inter...

DSTU
HL7 CDA® R2 Implementation Guide: Emergency Medical Services; Patient Care Report, Release 1 – US Realm

This implementation guide supports the provision of emergency medical service data from provider agencies to hospital emergency departments using the CDA standard. The clinical specifications were developed by the National EMS Infor...

Normative
HL7 CDA® R2 Implementation Guide: ePOLST: Portable Medical Orders About Resuscitation and Initial Treatment, Release 1 - US Realm

A CDA R2 implementation guide (US Realm) for the National POLST Portable Medical Orders form, building on the extensive analysis of data elements and stakeholder engagement by National POLST (https://polst.org/). A POLST Portable Medic...

STU
HL7 CDA® R2 Implementation Guide: Exchange of C-CDA Based Documents; Periodontal Attachment, Release 1 - US Realm

The Periodontal attachment is used to convey information about periodontal related services.  This includes the business use of claims attachments, prior authorization and pre-determinations.  It may also be used for other...

STU
HL7 CDA® R2 Implementation Guide: Healthcare Associated Infection (HAI) Reports, Release 3 - US Realm

This project developed an implementation guide constraining CDA Release 2. The implementation guide supports electronic submission of HAI data to the National Healthcare Safety Network. CDC provided NHSN developers, vocab...

Normative, STU
HL7 CDA® R2 Implementation Guide: Medication Therapy Management (MTM) Templates, Release 1 - US Realm

This two volume guide supports the documentation and communication needs of the expanding Medication Therapy Management (MTM) services arena and the CMS Medicare Part D reporting and patient information requirements for MTM. ...

Informative
HL7 CDA® R2 Implementation Guide: National Health Care Surveys (NHCS), R1 STU Release 3.1 - US Realm

This standard is an HL7 Clinical Document Architecture (CDA) Implementation Guide for representing data extracted from provider systems as required by the Centers for Disease Control and Prevention's National Center for Health Stati...

DSTU, STU
HL7 CDA® R2 Implementation Guide: National Healthcare Safety Network (NHSN) Healthcare Associated Infection (HAI) Reports for Long Term Care Facilities (HAI-LTCF-CDA), Release 1, STU 1 - US Realm

This implementation guide (IG) specifies standards for electronic submission of Healthcare Associated Infection (HAI) reports to the National Healthcare Safety Network (NHSN) of the Centers for ...

STU
HL7 CDA® R2 Implementation Guide: NHSN Healthcare Associated Infection (HAI) Reports, Release 4, STU 2 - US Realm

This project developed an implementation guide constraining CDA Release 2. The implementation guide supports electronic submission of HAI data to the National Healthcare Safety Network.

STU
HL7 CDA® R2 Implementation Guide: Orthodontic Attachment, Release 1 - US Realm
The purpose of this implementation guide is to provide a HL7 CDA-based set of templates defining a standardized document that can be used to convey supporting clinical documentation from a dent...
STU
HL7 CDA® R2 Implementation Guide: Personal Advance Care Plan (PACP) Document, Release 1 - US Realm STU Release 2

The PACP document is a CDA document template designed to share information created by an individual to express his or her care and medical treatment goals, preferences, and priorities for some future point in time, under certain circu...

STU
HL7 CDA® R2 Implementation Guide: Personal Healthcare Monitoring Report, Release 1

The Personal Healthcare Monitoring Report (PHMR) is a document that carries personal healthcare monitoring information, or patient measurement data taken by consumer medical devices. The primary use case around which the PHMR ...

Normative
HL7 CDA® R2 Implementation Guide: Pharmacist Care Plan Document, Release 1 - US Realm

This implementation guide specifies constraints on the Clinical Document Architecture Release 2 (CDA R2) header and body elements for the Pharmacist Care Plan, which are derived from requirements set forth by the Pharmacy Health Infor...

STU
HL7 CDA® R2 Implementation Guide: Pharmacy Templates, Release 1

This Implementation Guide provides CDA R2 templates for Medication Order and Medication Statement, Medication Dispense and Medication Administration that can be used by HL7 standards developers and external projects to develop models for p...

STU
HL7 CDA® R2 Implementation Guide: Privacy Consent Directives, Release 1

This is a structured document specification to exchange signed Consent Directives. This specification will make use of the concepts identified in the Composite Privacy Consent Directive - Domain Analysis Model - and the CDA R2 speci...

Normative
HL7 CDA® R2 Implementation Guide: Public Health Case Report - the Electronic Initial Case Report (eICR) Release 2, STU Release 3.1 - US Realm

The purpose of this implementation guide (IG) is to specify a standard for electronic submission of electronic initial public health case reports using HL7 Version 3 Clinical Document Architecture (CDA), Release 2 format. This imple...

STU
HL7 CDA® R2 Implementation Guide: Public Health Case Report, Release 1 - US Realm

The purpose of this implementation guide (IG) is to specify a standard for electronic submission of electronic initial public health case reports using HL7 Version 3 Clinical Document Architecture (CDA), Release 2 format. This imple...

Informative
HL7 CDA® R2 Implementation Guide: Quality Reporting Document Architecture (QRDA III), Release 1 - US Realm

A QRDA Category III report is an aggregate quality report. Each report contains calculated summary data for one or more measures for a specified population of patients within a particular health system over a specific period of time....

Normative, STU
HL7 CDA® R2 Implementation Guide: Quality Reporting Document Architecture - Category I (QRDA I) - US Realm

This two-volume implementation guide (IG) describes constraints on the Clinical Document Architecture Release 2 (CDA R2) header and body elements for Quality Reporting Document Architecture (QRDA) documents. The Institute of Medic...

STU
HL7 CDA® R2 Implementation Guide: Reportability Response, Release 1, STU Release 1.1 - US Realm

The purpose of this implementation guide (IG) is to specify a standard for a response document for a public health electronic Initial Case Report (HL7 eICR v1.1) using HL7 Version 3 Clinical Document Architecture (CDA), Release 2 forma...

STU
HL7 CDA® R2 Implementation Guide: Supplemental QRDA Clinical Quality Data Sharing User Guide, Release 1

Clinicians who report to quality programs have expressed a need to more successfully exchange (both send and receive) data for quality. This both allows providers to ensure that patient care is adhering to quality standards without repea...

Informative
HL7 CDA® R2 Implementation Guide: Trauma Registry Data Submission, Release 1 - US Realm

This implementation guide supports the transfer of data elements defined by the American College of Surgeons’ Committee on Trauma for Trauma Registries in a CDA document.

Normative
HL7 CDA® R2 Implementation Guide: Trauma Registry Data Submission, Release 2 - US Realm

This document provides data to support submission from providers to the American College of Surgeons’ National Trauma Data Bank

Normative
HL7 CDA® R2 Implementation Guide: Vital Records Death Reporting, Release 1 STU 2.1 - US Realm

This document describes constraints on the Clinical Document Architecture Release 2 (CDA R2) header and body elements for U.S. Standard Certificate of Death Documents, which are derived from the 2003 Revision of the U.S. Standard Certi...

DSTU, STU
HL7 CDA® Release 2 Implementation Guide: Additional CDA R2 Templates – Clinical Documents for Payers Set 1, Release 1 – US Realm

The purpose of this implementation guide (IG) is to provide guidance on a standardized, implementable, interoperable electronic solution to reduce the time and expense related to the exchange of clinical and administrative infor...

DSTU
HL7 Implementation Guide for CDA® R2 - Supplement to Consolidated CDA for Attachments, Release 1

This informative standard is intended to provide guidance in implementing the C-CDA for attachment purposes, including but not limited to claims/encounters, referrals, prior-authorizations, post-adjudicated claims audit...

Informative
HL7 Implementation Guide for CDA® R2: Consult Notes, Release 1

This implementation guide (IG) (currently a DSTU) describes how HL7 Version 3 Clinical Document Architecture (CDA) Release 2 is used to record information for a Consult Note. The Consult Note may contain both narrative and coded data. For t...

DSTU
HL7 Implementation Guide for CDA® R2: History and Physical (H&P) Notes, Release 1

This Draft Standard for Trial Use (DSTU) describes how The HL7 Version 3 Clinical Document Architecture (CDA) Release 2 is used to record information for a History and Physical Note. The History and Physical Note may contain both narra...

DSTU
HL7 Implementation Guide for CDA® R2: Patient Generated Document Header Template, Release 1

The integration of patient generated health data (PGHD) into HIT is an important change to the HIT ecosystem.  Although patients have long been the source of information recorded in the EHR,...

Informative
HL7 Implementation Guide for CDA® R2: Plan-to-Plan Personal Health Record (PHR) Data Transfer, Release 1

This document describes constraints on the Health Level Seven International (HL7®) Clinical Document Architecture (CDA®) Release 2 - Continuity of Care Documents (CCD) specification to support personal health record data ...

Informative
HL7 Implementation Guide for CDA® R2: Progress Note

A Progress Note documents a patient’s clinical status during a hospitalization or outpatient visit, thus is associated with an encounter. The method used to develop the HL7 Implementation Guide for CDA Release 2: Progress Note,...

DSTU
HL7 Implementation Guide for CDA® Release 2 - Level 1 and 2 - Care Record Summary (US realm)

The Implementation Guide for CDA Release 2 – Level 1 and 2 – Care Record Summary (US realm) describes constraints on the CDA Header and Body elements for Care Record Summary docu...

Informative
HL7 Implementation Guide for CDA® Release 2 - Level 3: Healthcare Associated Infection Reports, Release 2 - US Realm

This project developed an implementation guide constraining CDA Release 2. The implementation guide supports electronic submission of HAI data to the National Healthcare Safety Network. CDC provided NHSN developers, vocab...

Normative
HL7 Implementation Guide for CDA® Release 2: Care Record Summary Discharge Summary

The CDA Implementation Guide for Care Record Summary, Release 2, Discharge Summary provides disparate hospital systems a standard format to report back to a primary care provider or other parties interested in the patient's hospital care....

DSTU
HL7 Implementation Guide for CDA® Release 2: CDA Framework for Questionnaire Assessments, DSTU Release 2

This specification has been retired and will be retained for historical purposes.

The intent of the current project is two-fold: carry forward the Implementation Guide for CDA Release 2 CDA Framework for Questionnaire Ass...

DSTU
HL7 Implementation Guide for CDA® Release 2: Digital Signatures and Delegation of Rights, Release 1

The Digital Signature and Delegation of Rights Implementation Guides provide a standardized method of applying Digital Signatures to CDA documents.  The standard provides for multiple signers, signer’s declaration of their...

DSTU
HL7 Implementation Guide for CDA® Release 2: Exchange of Clinical Trial Subject Data; Patient Narratives, Release 1 - US Realm

The scope of this CDA implementation guide is limited to the exchange of patient narratives, which are created as a summary document during the conduct of a clinical trial.  The CDA Implementation Guide will focus on a constrained datas...

DSTU
HL7 Implementation Guide for CDA® Release 2: Genetic Testing Reports, Release 1

The purpose of this CDA R2 Implementation Guide is to specify a standard for genetic testing reports, targeted at both human readability and machine processability. Genetic tests have recently become an important tool in clinical care that ...

DSTU
HL7 Implementation Guide for CDA® Release 2: Healthcare Associated Infection (HAI) Reports, Release 1

This project developed an implementation guide constraining CDA Release 2. The implementation guide supports electronic submission of HAI data to the National Healthcare Safety Network. CDC provided NHSN developers, vocab...

Normative
HL7 Implementation Guide for CDA® Release 2: HIV/AIDS Services Report, Release 1 - US Realm

This document describes constraints on the Clinical Document Architecture Release 2 (CDA R2) header and body for an HIV/AIDS services report. The primary use case for this guide is the Ryan Whit...

Informative
HL7 Implementation Guide for CDA® Release 2: Long-Term Post-Acute Care Summary, DSTU Release 1 (US Realm)

This guide describes the requirements to create a Long-Term Post-Acute Care (LTPAC) Summary Clinical Document Architechture (CDA) document. It leverages the CDA templates in the HL7 Implementation Guide for CDA Release 2.0, Conso...

DSTU
HL7 Implementation Guide for CDA® Release 2: Patient Assessments, Release 1

This Implementation Guide (IG) facilitates a standard electronic communication for electronic submission to CDA of their Questionnaire Assessments. These allow healthcare facilities and providers a standard way to communicate reports in an in...

DSTU
HL7 Implementation Guide for CDA® Release 2: Questionnaire Form Definition Document, Release 1

The purpose of a Questionnaire Form Definition document is to capture the health survey questions or question sets to be administered to a patient. Questionnaire Form Definition documents enable the definition of quest...

HL7 Implementation Guide for CDA® Release 2: Questionnaire Response Document, Release 1

The purpose of a Questionnaire Response document is to capture the health survey answers or answer sets to questions that have been administered to a patient. Questionnaire Response documents enable the capture of responses for surve...

DSTU
HL7 Implementation Guide for CDA® Release 2: Reporting to Public Health Cancer Registries from Ambulatory Healthcare Providers, Release 1 - US Realm

Population-based cancer surveillance is critical in North America for cancer control activities aimed at reducing the morbidity and mortality of cancer, the second leading cause of death in the United States (U.S.) and the leading cause...

DSTU
HL7 Implementation Guide for CDA®, Release 2: Procedure Note, Release 1

This document describes constraints on the Clinical Document Architecture (CDA) Header and Body elements for Procedure Note documents. The Procedure Note or Report is created immediately following a non-operative procedure and records the i...

DSTU
HL7 Implementation Guide for CDA®, Release 2: Unstructured Documents

This Implementation Guide provides consistent guidance for sending/receiving unstructured clinical documents including images, scanned documents, faxed and word processor output. This Implementation Guide describes const...

DSTU
HL7 Implementation Guide: Data Segmentation for Privacy (DS4P), Release 1

The Office of the National Coordinator DS4P Implementation Guide (IG) will provide the core input into the HL7 DS4P IG project. The project scope is the publication of a U.S. realm DS4P normative specification as an exemplar for an IG that ...

Normative
HL7 Implementation Guide: S&I Framework Transitions of Care Companion Guide to Consolidated-CDA for Meaningful Use Stage 2, Release 1 – US Realm

The Companion Guide to Consolidated Clinical Document Architecture (CDA) for Meaningful Use Stage 2 provides supplemental guidance to the “HL7 Implementation Guide for CDA Release 2: Integrating Health Enterprise (IHE) Health Story Conso...

Informative
HL7 Implementation Guides for CDA® R2: greenCDA Modules for CCD®, Release 1

The Clinical Document Architecture Release 2.0 (CDA R2) addresses universal requirements for exchange and management of structured clinical documents. The approach described in this document, The HL7 Implementation Guide for CDA&r...

Informative
HL7 Informative Document: C-CDA Rubric Criteria, Release 1 - US Realm

This informative implementation guide contains rubric criteria created through an ongoing project in the HL7 Structured Documents Work Group (SDWG), originating in 2016. Throughout 2018 a group of HL7 members created a new set of rubri...

Informative
HL7 Standard for CDA® Release 2: Imaging Integration; Basic Imaging Reports in CDA and DICOM, Release 1

This HL7 implementation guide describes how the HL7 Version 3 Clinical Document Architecture (CDA) Release 2 is used to record information for a Diagnostic Imaging Report. A Diagnostic Imaging Repo...

Informative
HL7 Templates Registry Business Process Requirements Analysis, Release 1

Many groups are creating many types of templates independently and there is a need to discover what templates are available, how they are represented, what their approval state is and how they can be accessed and used. The Templ...

Informative
HL7 Version 3 Implementation Guide for CDA Release 2 - Level 3: Emergency Medical Services; Patient Care Report, Release 2 - US Realm

This implementation guide supports the provision of emergency medical service data from provider agencies to hospital emergency departments using the CDA standard. The clinical specifications were developed by the National EMS Infor...

Normative
HL7 Version 3 Implementation Guide for CDA® R2 L3: Neonatal Care Reports (NCR), R1

This implementation guide (IG) specifies a standard for electronic submission of neonatal care records (NCRs) in a Clinical Document Architecture (CDA), Release 2 (R2) format. This facilitates electronic extraction of a subset of the C...

DSTU
HL7/ASTM Implementation Guide for CDA® R2 -Continuity of Care Document (CCD®) Release 1

The Continuity of Care Document (CCD) is a joint effort of HL7 International and ASTM. CCD fosters interoperability of clinical data by allowing physicians to send electronic medical information to other providers without loss of meani...

Informative
Presentation: Overview of Care Record Summary

The purpose of this document is to describe constraints on the CDA Document Body elements for a Care Record Summary document. A Care Record Summary document contains patient's relevant health history for some time period. It is inten...

Quick Start Guide for CDA R2

The purpose of this Quick Start Guide is to aid implementers in developing applications that produce simple CDA documents.

Informative