The C-CDA Scorecard Continues to Improve C-CDA Implementation across Health IT Settings

Matthew Rahn | June 3, 2020

ONC is excited to announce the Consolidated Clinical Document Architecture (C-CDA) Scorecard 2.0. The updated Scorecard includes Health Level Seven International (HL7) approved best practices, quantitative scoring, a new user interface, updated issue checking, and performance is improved by 20 percent.

The C-CDA Scorecard promotes best practices in C-CDA implementation by assessing key aspects of the structured data found in individual documents. It is designed to allow implementers to gain insight and information into industry best practices and usage overall. It also provides a rough quantitative assessment and highlights areas of improvement that implementers can make today.  In the past year, the C-CDA Scorecard provided feedback on over 100,000 C-CDAs!

In order to develop consensus data quality improvements, ONC partnered with HL7 to ballot and publish a C-CDA Rubric Informative Guide. The C-CDA Rubric Informative Guide builds on best practices previously approved by the HL7 Structured Documents Workgroup (SDWG). The SDWG plans to update C-CDA Rubric on a regular basis, and ONC will continue to update the Scorecard as new rules are created.

We regularly hear that C-CDA quality is critical, especially as the growth of document exchange continues to accelerate. From local and state-based health information exchanges to nationwide networks to registries, document exchange has become a key transactional capability, with hundreds of millions of documents being exchanged per year.  ONC supports ongoing work to improve C-CDA quality, and thanks to HL7 and a joint effort by Commonwell and Carequality to constrain the C-CDA standard, the exchange and use of C-CDAs will continue to grow and improve.

We hope that providers and health IT developers will use the tool to identify and resolve issues of C-CDA document interoperability in their health IT systems. If you have any questions, please send an inquiry to