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Using CCR and CCD

with HealthVault
Matt Wagner
Program Manager
Microsoft Corporation

Jeff Jones
Technical Lead
Microsoft Corporation
Agenda
What are CCR and CCD?
Why use CCR or CCD with HealthVault?
Representation in HealthVault
Reconcile Process
Initiating Reconcile Process
Reconcile UI
Conversion to HealthVault Types
Code Snippets
Future Improvements
What are CCR and CCD?
ASTM Continuity of Care Record (CCR)
Standard is XML based.
Aggregate and transmit patient data.
Common use case is a “snapshot in time”
HL7 Continuity of Care Document (CCD)
Implementation of CCR using the XML based
HL7 Clinical Document Architecture (CDA)
Why use CCR and CCD?
Source system already uses CCR or CCD
Integrate with multiple EHRs or PHRs
Uploading a data “snapshot”
Data is meant to be consumed holistically
Representation in HealthVault
CCR and CCD are HealthVault data types
Use the CCR and CCD schemas
No semantic validation
Immutable – data cannot be changed
Content can be viewed in HealthVault Shell
“Form” transforms available to all applications.
Data inside file is not automatically
converted and split into discrete types.
Reconcile Process
Enables users to extract data from file and
add it to the record as discrete data types.
Initiating the Reconcile Process
Online applications
Offline applications
HealthVault Shell
Initiating the Reconcile Process:
Online Applications
Use HealthVault Shell redirect interface

Browser Redirect: RECONCILE Target

Application Shell

Browser Redirect: RECONCILECOMPLETE


Initiating the Reconcile Process:
Offline Applications
Uploading a CCR or CCD triggers an e-mail
notification to record custodians.
Initiating the Reconcile Process:
HealthVault Shell
Data grid in HealthVault Shell
“Add items” will initiate the reconcile interface.
Information in the Description and From
columns can be set by the uploading
application or pulled from the CCR or CCD.
Reconcile UI
Conversion to HealthVault Types
“To-HealthVault” Transforms
Convert data to native HealthVault types.
Applications can use the transforms directly.
Data Mappings
CCR to HealthVault documentation on MSDN.
CCD to HealthVault documentation will be
made available in the future.
Code Sample:
Upload CCR and Reconcile
XmlDocument ccrDoc = new XmlDocument();
ccrDoc.Load(ccrFilePath);

HealthRecordItem newCcrItem =
new HealthRecordItem(
new Guid(“1e1ccbfc-a55d-4d91-8940-fa2fbf73c195”), ccrDoc);

PersonInfo.SelectedRecord.NewItem(newCcrItem);

string targetParams =
string.Format(
“appid={0}&extrecordid={1}&thingid={2}”,
ApplicationId, PersonInfo.SelectedRecord.Id,
newCcrItem.Key.Id);

WebApplicationUtilities.RedirectToShellUrl(
HttpContext.Current,
“RECONCILE”, targetParams);
Code Sample:
Using To-HealthVault Transforms
HealthRecordItemTypeDefinition ccrDefinition =
ItemTypeManager.GetHealthRecordItemTypeDefinition(
new Guid(“1e1ccbfc-a55d-4d91-8940-fa2fbf73c195”),
connection);

string items = ccrDefinition.TransformItem(“tohv”, newCcrItem);


Future Improvements…
Improved CCR-to-HealthVault transforms
with expanded data mapping
Export to CCR
Reconcile UI redesign
Automatic detection of duplicate items
Improved MSDN documentation
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