A continuity of care document, or CCD, is an electronic summary of a patient’s relevant health information that can be shared between care settings. It brings together information such as medications, allergies, problems and test results from one or more encounters. A receiving clinician can use it to understand prior care.
A CCD is a snapshot. Its document date, the dates attached to individual entries and the sending organization help you judge what it tells you about the patient today. For a pharmacy reviewing medications after a hospital stay, that means comparing the summary with discharge information and what the patient reports taking.
What is in a CCD?
A CCD combines identifying and source information with clinical sections. Look for the patient identifiers, author or sending organization, document date and the period of care covered, then read the relevant clinical sections. HL7’s CCD specification describes a historical summary that can span several encounters.
Its clinical content includes medications, allergies and intolerances, health problems, results, social history and vital signs. It can also include procedures, immunizations, encounters, equipment and treatment plans. The detail available depends on the source record and what the sender includes. A section that says information is unknown is different from an affirmative finding that the patient has none.
The summary does not necessarily contain every progress note, original report or event in the full chart. If you need the narrative explaining a medication change, request that note or the relevant discharge record rather than assume the summary carries the explanation.
CCD, C-CDA and other clinical records
CDA means Clinical Document Architecture, HL7’s underlying standard for clinical documents. Consolidated CDA, usually written C-CDA or CCDA, defines a family of document templates using that architecture. A CCD is one document type in that family. Calling a file “a C-CDA” identifies the broader format; it does not tell you which kind of clinical document it contains. HL7’s C-CDA guide lists the document types.
A discharge summary focuses on a particular hospital or other facility stay and the transition afterward. It can explain the hospital course, discharge diagnoses and follow-up plan. HL7 defines Discharge Summary separately from CCD, so receiving a CCD after discharge does not establish that you have the discharge summary or all discharge instructions.
A care plan centers on concerns, goals and planned interventions. The C-CDA Care Plan specification describes that purpose. A CCD can contain plan information, but its overall role is to summarize the patient’s history. For the pharmacy’s role in exchanging care-planning information, see our pharmacist eCare Plan overview.
A personal medication record serves a narrower purpose: it gives the patient a usable medication list. It does not replace the broader clinical summary. Our personal medication record guide covers that patient-facing record.
FHIR is another HL7 standard for representing and exchanging health information, including through APIs. It is not a different name for a CCD file. A system may support both; ask which document or data exchange the receiving workflow actually accepts.
How to get and open a CCD
Ask the sending practice or hospital whether its patient portal or records-export function can provide a CCD. The download may be an XML file or a package containing the file and display resources. XML carries structured content that compatible software can process; a document viewer or stylesheet can turn it into a readable clinical summary.
For example, PCC’s export instructions describe a chart export that includes a CCD and a way to view it in a browser. That is one product’s export process; use the sender’s instructions for the files you receive. A PDF or printed view may be useful to read, but it is not interchangeable with the structured XML when another system expects an importable CCD.
If a file opens as markup or fails to import, ask the sender or your approved software support team for a supported viewer or readable copy. Use your organization’s approved tools for patient information rather than upload a real record to an unfamiliar online converter.
Opening, importing and reconciling are separate capabilities. Opening displays the document; importing brings supported data into a system; reconciliation compares sources and resolves differences. Before importing into a patient chart, confirm the patient match and how the software handles duplicates, source dates and conflicting entries. ONC’s reconciliation guidance describes displaying sources and modification dates, then allowing a user to review and validate the combined information.
A medication entry needs its context
Read the medication name, strength, directions, status and start or stop dates together with the surrounding narrative. The date the CCD was generated is not necessarily the date the medication was last reviewed.
In structured data, HL7 also distinguishes a clinician’s intended regimen from recorded actual use. The Medication Activity field called moodCode can use INT for intent and EVN for an event. HL7’s Medication Activity definition explains that distinction. A reader-friendly view may express it in words rather than show the code.
Even a recorded event describes what the source documented at that time. An “active” label or an absent stop date does not independently confirm that the patient is taking the medicine now. If an imported status conflicts with the dates or instructions, review the original entry and its meaning in the sending system before changing the current list.
An example: two records disagree after discharge
Consider a fictional pharmacy review on October 6. A primary-care CCD generated on October 1 lists a maintenance medicine as active, with an April start date and no stop date. A hospital discharge medication list dated October 4 says to stop that same medicine. The patient says they are still taking it because it remains in their weekly organizer.
The CCD establishes what the primary-care record reported before the hospital discharge. The discharge list reports a later instruction. The patient’s account describes current use that differs from that instruction. Choosing whichever file arrived last would miss the actual discrepancy.
The pharmacist can confirm that both entries refer to the same medicine and regimen, review the discharge context, and contact the discharging or responsible clinician if the intended plan remains unclear. The patient’s report belongs in that discussion; a dispensing record may add evidence about supply, but does not establish what was taken.
Once the discrepancy is resolved through the pharmacy’s clinical process, update the appropriate medication record and explain the agreed plan to the patient. If clarification is still pending, keep that specific question visible for the person following up rather than silently turn the imported entry into a confirmed current medication.
