Support a Transition of Care or Referral to Another Health Care Provider

Type	Standard / Implementation Specification	Standards Process Maturity	Implementation Maturity	Adoption Level	Federally required	Cost	Test Tool Availability
Implementation Specification	HL7 Implementation Guide for CDA Release 2: Consolidated CDA Templates for Clinical Notes (US Realm), Draft Standard for Trial Use, Release 2.1	Final	Production		Yes	Free	Yes
Implementation Specification	HL7 Consolidated CDA Release 1.1 (HL7 Implementation Guide for CDA Release 2: IHE Health Story Consolidation, DSTU Release 1.1 - US Realm)	Balloted Draft	Production		Yes	Free	Yes
Standard	HL7® Clinical Document Architecture (CDA®), Release 2.0, Final Edition	Final	Production		No	Free	Yes
Emerging Implementation Specification	IHE Patient Care Coordination Technical Framework Supplement 360 Exchange Closed Loop Referral (360X) Rev. 1.1 – Trial Implementation	Balloted Draft	Pilot		No	Free	No
Implementation Specification	NCPDP® SCRIPT Standard, Implementation Guide, Version 2020101	Final	Production		No	$	No
Implementation Specification	HL7 FHIR® DaVinci Payer Coverage Decision Exchange (PCDE) Implementation Guide	Balloted Draft	Pilot		No	Free	No
Implementation Specification	HL7 CDA R2 IG: C-CDA Templates for Clinical Notes R2.1 Companion Guide, Release 3 - US Realm	Balloted Draft	Production	Feedback Requested	No	Free	No
Implementation Specification	HL7 CDA R2 IG: C‐CDA Templates for Clinical Notes R2.1 Companion Guide, Release 2 ‐ US Realm	Balloted Draft	Production	Feedback Requested	No	Free	No
Implementation Specification	HL7 Da Vinci Clinical Data Exchange (CDex) Implementation Guide	Balloted Draft	Feedback requested	Feedback Requested	No	Free	No
Implementation Specification	NCPDP SCRIPT Standard, Implementation Guide, Version 2023011	Final	Production		Yes	$	No

Limitations, Dependencies, and Preconditions for Consideration	Applicable Security Patterns for Consideration
There are several specific document templates within the C-CDA implementation specification. Trading partners will need to ensure that their systems are capable of supporting specific document templates. HL7 provides a C-CDA Example repository which contains a set of example C-CDA files that have undergone a review and vetting process to ensure completeness and rigor. The IHE 360X specification listed is designed to track and manage referrals across health IT platforms. The NCPDP Specialized Standard supports request/referral for Medication Therapy Management services. Implementers should explore use of emerging CDA on FHIR and C-CDA on FHIR to support this interoperability need. The HL7 CDA R2 IG: C-CDA Templates for Clinical Notes R2.1 Companion Guide, Release 3 - US Realm is a newer version of the standard that is available for health IT developers to voluntarily update and provide to their customers. It became available when it was added to the Approved Standards for 2022 through ASTP's Standards Version Advancement Process (SVAP).	Feedback requested.

Limitations, Dependencies, and Preconditions for Consideration

Applicable Security Patterns for Consideration

There are several specific document templates within the C-CDA implementation specification. Trading partners will need to ensure that their systems are capable of supporting specific document templates.
HL7 provides a C-CDA Example repository which contains a set of example C-CDA files that have undergone a review and vetting process to ensure completeness and rigor.
The IHE 360X specification listed is designed to track and manage referrals across health IT platforms.
The NCPDP Specialized Standard supports request/referral for Medication Therapy Management services.
Implementers should explore use of emerging CDA on FHIR and C-CDA on FHIR to support this interoperability need.
The HL7 CDA R2 IG: C-CDA Templates for Clinical Notes R2.1 Companion Guide, Release 3 - US Realm is a newer version of the standard that is available for health IT developers to voluntarily update and provide to their customers. It became available when it was added to the Approved Standards for 2022 through ASTP's Standards Version Advancement Process (SVAP).

Feedback requested.

Comment

Submitted by pwilson@ncpdp.org on 2017-11-20

NCPDP - Comment

In Emerging Implementation Specification add the following:

NCPDP Specialized Standard supports request/referral for MTM Services may be initiated by the payer, treating or prescribing physician, pharmacist, a hospital or other facility, and/or the patient or caregiver.
CCDA R2 is the basis for NCPDP recommendations for Pharmacy Transition of Care, Pharmacy/Pharmacist care notes, and HL7 CDA® R2 Implementation Guide: Medication Therapy Management (MTM) Templates, Release 1 - US also known as HL7 IG for CDAR2: Medication Therapy Management (MTM) Templates, R1", MTM CMR Take-away document; MTM CMS document, CDAR2, MTM
Adoption Level should be a 1.