Continuity of Care Document (CCD)

What is a Continuity of Care Document?

The CCD is a specific document type within the HL7 Consolidated Clinical Document Architecture (C-CDA) R2.1 standard — the current version governing clinical document exchange in US healthcare. A CCD is structured around standardized sections: allergies, medications, problem list, procedures, results, vital signs, immunizations, plan of care, and social history. The Transition of Care (ToC) summary is a CCD variant specifically required under Meaningful Use/Promoting Interoperability regulations — it must be transmitted electronically within 24–72 hours of an inpatient discharge or care transition. While C-CDA remains the dominant document exchange standard, FHIR APIs are increasingly supplementing it for more granular, resource-level data access. Common C-CDA quality failures include incomplete medication lists (omitted medications lead to reconciliation errors at the receiving facility), locally coded entries that are unmapped to standard terminologies (SNOMED CT, RxNorm, LOINC), and problem lists that have not been updated to reflect current diagnoses. Incomplete or inaccurate CCDs at care transitions are a documented contributor to medication errors and duplicative testing.

Why It Matters for Healthcare Analytics

CCD quality directly affects both regulatory compliance and patient safety. MIPS PI measures require successful transmission of ToC summaries at transitions — failures reduce PI scores. Clinically, a CCD with an incomplete medication list or outdated problem list at a skilled nursing facility or specialist handoff is a primary driver of adverse drug events and preventable readmissions.

How Vizier Tracks CCDs

Upload your EHR exchange logs, then ask "What percentage of our discharges had a compliant ToC summary transmitted within 24 hours?" — Vizier calculates ToC transmission compliance by provider and discharge destination, flagging documentation gaps that affect both MIPS PI scores and care transition quality.