ASTM E2369 - 05e2 standard specification for continuity of care record (CCR)
The Continuity of Care Record (CCR) is a core data set of the most relevant administrative, demographic, and clinical information facts about a patient's healthcare, covering one or more healthcare encounters. It provides a means for one healthcare practitioner, system, or setting to aggregate all of the pertinent data about a patient and forward it to another practitioner, system, or setting to support the continuity of care. The primary use case for the CCR is to provide a snapshot in time containing the pertinent clinical, demographic, and administrative data for a specific patient. To ensure interchangeability of electronic CCRs, this specification specifies XML coding that is required when the CCR is created in a structured electronic format. Conditions of security and privacy for a CCR instance must be established in a way that allows only properly authenticated and authorized access to the CCR document instance or its elements. The CCR consists of three core components: the CCR Header, the CCR Body, and the CCR Footer.
This abstract is a brief summary of the referenced standard. It is informational only and not an official part of the standard; the full text of the standard itself must be referred to for its use and application. ASTM does not give any warranty express or implied or make any representation that the contents of this abstract are accurate, complete or up to date.
1. Scope
1.1 The Continuity of Care Record (CCR) is a core data set of the most relevant administrative, demographic, and clinical information facts about a patient’s healthcare, covering one or more healthcare encounters. It provides a means for one healthcare practitioner, system, or setting to aggregate all of the pertinent data about a patient and forward it to another practitioner, system, or setting to support the continuity of care.
1.1.1 The CCR data set includes a summary of the patient’s health status (for example, problems, medications, allergies) and basic information about insurance, advance directives, care documentation, and the patient’s care plan. It also includes identifying information and the purpose of the CCR. (See 5.1 for a description of the CCR’s components and sections, and Annex A1 for the detailed data fields of the CCR.)
1.1.2 The CCR may be prepared, displayed, and transmitted on paper or electronically, provided the information required by this specification is included. When prepared in a structured electronic format, strict adherence to an XML schema and an accompanying implementation guide is required to support standards-compliant interoperability. The Adjunct to this specification contains a W3C XML schema and Annex A2 contains an Implementation Guide for such representation.
1.2 The primary use case for the CCR is to provide a snapshot in time containing the pertinent clinical, demographic, and administrative data for a specific patient.
1.2.1 This specification does not speak to other use cases or to workflows, but is intended to facilitate the implementation of use cases and workflows. Any examples offered in this specification are not to be considered normative.
1.3 To ensure interchangeability of electronic CCRs, this specification specifies XML coding that is required when the CCR is created in a structured electronic format. This specified XML coding provides flexibility that will allow users to prepare, transmit, and view the CCR in multiple ways, for example, in a browser, as an element in a Health Level 7 (HL7) message or CDA compliant document, in a secure email, as a PDF file, as an HTML file, or as a word processing document. It will further permit users to display the fields of the CCR in multiple formats.
1.3.1 The CCR XML schema or .xsd (see the Adjunct to this specification) is defined as a data object that represents a snapshot of a patient’s relevant administrative, demographic, and clinical information at a specific moment in time. The CCR XML is not a persistent document, and it is not a messaging standard.
Note 1—The CCR XML schema can also be used to define an XML representation for the CCR data elements, subject to the constraints specified in the accompanying Implementation Guide (see Annex A2).
1.3.2 Using the required XML schema in the Adjunct to this specification or other XML schemas that may be authorized through joints efforts of ASTM and other standards development organizations, properly designed electronic healthcare record (EHR) systems will be able to import and export all CCR data to enable automated healthcare information transmission with minimal workflow disruption for practitioners. Equally important, it will allow the interchange of the CCR data between otherwise incompatible EHR systems.
1.4 Security—The data contained within the CCR are patient data and, if those data are identifiable, then end-to-end CCR document integrity and confidentiality must be provided while conforming to regulations or other security, confidentiality, or privacy protections as applicable within the scope of this specification.
1.4.1 Conditions of security and privacy for a CCR instance must be established in a way that allows only properly authenticated and authorized access to the CCR document instance or its elements. The CCR document instance must be self-protecting when possible, and carry sufficient data embedded in the document instance to permit access decisions to be made based upon confidentiality constraints or limitations specific to that instance.
1.4.2 Additional Subcommittee E31.20 on Security and Privacy guides, practices, and specifications will be published in support of the security and privacy needs of specific CCR use cases. When a specification is necessary to assure interoperability or other required functionality, the CCR core schema will be extended to meet the profile requirements of the underlying use case, building upon existing standards and specifications whenever possible.
1.4.2.1 For profiles that require digital signatures, W3C’s XML digital signature standard (http://www.w3.org/TR/xmldsig-core) will be used with digital certificates. Encryption will be provided using W3C’s XML encryption standard (http://www.w3.org/TR/xmlenc-core).
1.5 The CCR is an outgrowth of the Patient Care Referral Form (PCRF) designed and mandated by the Massachusetts Department of Public Health for use primarily in inpatient settings.
1.5.1 Unlike the PCRF, the CCR is designed for use in all clinical care settings.
1.6 It is assumed that information contained in a CCR will be confirmed as appropriate in clinical practice. For example, the CCR insurance fields should not be construed to address all reimbursement, authorization, or eligibility issues, and current medications and other critical data should be validated.
1.7 Committee E31 gratefully acknowledges the Massachusetts Medical Society, HIMSS (Health Information Management and Systems Society), the American Academy of Family Physicians, the American Academy of Pediatrics, the American Medical Association, the Patient Safety Institute, the American Health Care Association, the National Association for the Support of Long Term Care, the Mobile Healthcare Alliance (MoHCA), the Medical Group Management Association (MGMA) and the American College of Osteopathic Family Physicians (ACOFP) as co-leaders with ASTM in the standard’s development and adoption, and joins them in inviting the collaboration of all stakeholders, including other clinical specialty societies, other professional organizations, insurers, vendors, other healthcare institutions, departments of public health, and other government agencies.
1.8 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety and health practices and determine the applicability of regulatory limitations prior to use.
2. Referenced Documents (purchase separately)
ASTM Standards
E1382 Test Methods for Determining Average Grain Size Using Semiautomatic and Automatic Image Analysis
E1384 Practice for Content and Structure of the Electronic Health Record (EHR)
E1762 Guide for Electronic Authentication of Health Care Information
E1869 Guide for Confidentiality, Privacy, Access, and Data Security Principles for Health Information Including Electronic Health Records
E1985 Guide for User Authentication and Authorization
E1986 Guide for Information Access Privileges to Health Information
E2084 Specification for Authentication of Healthcare Information Using Digital Signatures
E2085 Guide on Security Framework for Healthcare Information
E2086 Guide for Internet and Intranet Healthcare Security
E2147 Specification for Audit and Disclosure Logs for Use in Health Information Systems
E2182 Specification for Clinical XML DTDs in Healthcare
E2183 Guide for XML DTD Design, Architecture, and Implementation
E2184 Specification for Healthcare Document Formats
E2211 Specification for Relationship Between a Person (Consumer) and a Supplier of an Electronic Personal (Consumer) Health Record
E2212 Specification for Health Certificate Policy
Other References
W3CXMLEncryptionStan (http://www.w3.org/TR/xmlenc-core)
Index Terms
actor; advance directives; adverse reactions; alerts; allergies; attribute; care documentation; CCR; CCR Body; CCR components; CCR Footer; CCR Header; coding; comment; complex data type or group; condition; Continuity of Care Record; core data set; data field; data object; date/time; diagnosis; digital signature; discharge; disease management; document object; electronic health record; EHR; encounter; encryption; enumeration; external CCR link; family history; field; from; functional status; health risk factors; health status; healthcare provider; HIPAA-compliant; immunization; insurance; integrity; internal CCR link; laboratory results; language; medical equipment; medication; normalization; optionality; patient; patient health record; patient health status; patient identifying information; payer; personal health record; PHR; physiological measurements; plan of care; practitioner; problem; procedure; purpose; referral; reference; required data; result; sections; security; SIG; signature; social history; source; status; support; to; transfer; unique identifier; vendor configurable fields; version; vital signs; W3C; XML; XML code; XML document; XML schema; XML signature; .xsd; .xsl: CCR (Continuity of Care Record); Continuity of Care Record (CCR)
ICS Code
DOI: 10.1520/E2369-05E02
ASTM International is a member of CrossRef.
Related news
-
The Indoor Microbiome and Its Impact on Indoor Environmental Quality
Last year, the U.S. Environmental Protection Agency (EPA) announced the release of a new webpage to provide information about the indoor microbiome. All of the living microorganisms inside of an indoor environment, and their by-products, are collectively known as the indoor microbiome. The indoor microbiome that surrounds each of us is diverse and dynamic, made up of bacteria, viruses, fungi and other single-celled organisms. These microorganisms may be growing or inactive, and may be present in different life...
-
Creative BioMart Established a Novel Sub-brand Creative BioMart Recombinant Allergen
Creative BioMart, an internationally recognized leading supplier of recombinant proteins, recently established a novel sub-brand “Creative BioMart Recombinant Allergen” that focuses on allergen-related study. Allergy is a common hypersensitivity disease in the world. It can be treated by allergen-specific immunotherapy (AIT). Natural allergen extracts do not meet the regulatory requirements for the production of allergy vaccines, the allergens are unstable, the number of allergens varies, pollution,...
-
Olansi air purifier review : Can Olansi Air Purifiers Help Avoid Allergies?
This is one of the most questions about air purifiers. Most people wonder if AP air purifiers can help them with allergies. In this article, we are going to talk about this question. The short answer is, yes these units can help avoid allergies caused by dust, dander, and pet hair. Read on to find out. First of all, we should talk about the most common household allergens that can be found in almost every home. Pet Fur Pet fur is one of the most common allergens. In fact, since these allergies are quite...
-
Indee Labs Awarded Grant from the National Institute of Allergy & Infectious Disease
Indee Labs is a biotechnology company developing the µVS Delivery SystemTM for non-viral intracellular or gene delivery. The team at Indee Labs was awarded a grant from the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH), to develop the µVS Delivery SystemTM for modified regulatory T cells. “Cellular immunotherapies using regulatory T cells (Tregs) show tremendous promise for the treatment of autoimmune disease, transplant rejection,...
-
Nature Scientific Reports has published a peer reviewed paper showing important immune response benefits associated with AOBiome`s B244 Ammonia Oxidizing Bacteria drug therapy
B244 inhibits Th2 immune polarization in human primary immune cells in both the active and the inactive state. CAMBRIDGE, Mass., July 15, 2021 /PRNewswire/ — AOBiome Therapeutics, Inc. (“AOBiome”), a leading clinical-stage microbiome company focusing on inflammatory conditions, announced new findings indicating a link between Ammonia Oxidizing Bacteria (AOB) and the human immune system. The company’s lead clinical asset, B244, is composed of a unique patented single strain of AOB and is...
Customer comments
No comments were found for ASTM E2369 - 05e2 standard specification for continuity of care record (CCR). Be the first to comment!