Comparison of CCR and CCD

In response to my previous post about CCR and CCD, I’ve learned a whole bunch about the two different standards for healthcare data exchange. Although, I must admit that it’s all a bit messy right now.

Since I know that many of you don’t read all the comments on the site, nor do you get to read the emails I receive, I think you’ll find some of the following links about CCR and CCD quite interesting.

First is a description of the difference between CCR and CCD. This is written by David Kibbe who helped create the CCR specifications. So, keep that in perspective, but it’s a really interesting write up comparing the two standards.

Dr. Jeff also put together this interesting “summary” of CCR and CCD. It’s a little scattered, but has some good nuggets in it that expanded my knowledge of the various standards.

The other good thing that came out of my previous post is an interview with Dr. David Kibbe which I’ll be posting next week. He ducks some of the politically charged questions, but I think you’ll really enjoy the interview. If you don’t, I’m sure you’ll be willing to let me know that too.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference,, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


  • Dr. Jeff’s post is quite helpful.

    I don’t understand is why are so many different standards required to transmit patient data.

    If you take all possible things a patient record can have and fit it in one XML format (perhaps CCD?), then different organizations will need and use small subset of that XML. Make it a well-defined XML, where field definitions are exact, without any ambiguities. Software can parse this XML and perform the right operations.

    Why doesn’t medical community agree to one format and stick to it?
    These incompatibilities increase vendor’s cost to implement and maintain any software, which is then passed on to the physicians. Besides both physicians and the patients loose, because of document incompatibilities between vendors prevent any meaningful data interchange.

    I guess this will never change.
    End of rant πŸ˜‰


  • I just took a look a some of the billion company sites entrusted with efficient universal secure purveyance of medical records so that they be available where and when a patient happened to get sick. So the US could improve its substandard care and maybe save a buck.

    I didn’t see one meaningful recommendation in all the sites I looked at. It looked like they had been working on an off shore international financial conglomerate that got raided by the IRS. You can imagine coffee cup heaped on the floor and phone ripped out of the wall.

    EMR’s are supposed to be a system for patients and all venues where health care is provided. Instead we get new certification attempts, organizations in services.

    This condition is a bold faced message to care givers and the American Public a chance at first-world-country-medical-standards for prices where every family in the US hasn’t gone broke.

    In best cases, bicycle couriers, taxis, milk runs and shoe leather will be fueling our billions of dollars worth of mobile-secure-accessible medical information.

    The new whispers for the day are, “seal the assets right now!”

  • Abhi,
    I don’t think CCD uses XML. CCR does though.

    I don’t completely understand why the medical community can’t get together around one standard either. I think the answer is likely politics though.

  • John,
    Both CCD and CCR use XML. Their structures are slightly different. (I did not find examples for you on the HL7 website)

    Politics may be the issue. Though look at other industries, wireless networking for example. There is only one standard 802.11. Every few years IEEE releases new versions and all vendors support it.

    Do the wireless vendors really want to cooperate? Probably not, but they do and the consumers win in terms of compatible, low priced devices.

    The health care community is causing itself a lot of trouble, not helping the consumers – sure way of inviting Government intervention.

  • They certainly should work towards one standard, but haven’t because of politics I think. I’ve said before that I think that the stimulus money should have been spent on establishing the interoperability standard and the tools to be able to exchange the data.

    We’ll see how it plays out, but government intervention does seem likely if we’re going to see this happen on a broad scale.

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