Medplum C-CDA Library

This library provides utilities for working with C-CDA (Consolidated Clinical Document Architecture) documents in the context of FHIR (Fast Healthcare Interoperability Resources).

Overview

The @medplum/ccda package enables seamless conversion between C-CDA and FHIR, leveraging the International Patient Summary (IPS) format as a bridge. This approach ensures standardized representation of clinical data and facilitates interoperability with various healthcare systems.

Key Features:

• C-CDA to FHIR: Convert a C-CDA document to a FHIR Composition bundle using the convertCcdaToFhir function.
• FHIR to C-CDA: Convert a FHIR Composition bundle to a C-CDA document using the convertFhirToCcda function.
• XML Parsing: Load a C-CDA document from an XML string using the convertXmlToCcda function.
• XML Serialization: Serialize a C-CDA document to an XML string using the convertCcdaToXml function.

Usage

import {
  convertCcdaToFhir,
  convertFhirToCcda,
  convertXmlToCcda,
  convertCcdaToXml,
} from '@medplum/ccda';

// Convert C-CDA to FHIR
const bundle = convertCcdaToFhir(ccda);

// Convert FHIR to C-CDA
const ccda = convertFhirToCcda(bundle);

// Load C-CDA from XML
const ccda = convertXmlToCcda(xml);

// Serialize C-CDA to XML
const xml = convertCcdaToXml(ccda);

Strategy and Alignment

This library is designed to elegantly integrate the following standards and specifications:

• FHIR R4: The underlying data model for representing healthcare resources.
• US Core: A set of FHIR profiles and extensions for US healthcare interoperability.
• USCDI: The United States Core Data for Interoperability, defining a standardized set of health data classes and elements.
• International Patient Summary (IPS): A FHIR-based standard for exchanging patient summaries.
• HL7 C-CDA: A widely used standard for clinical document exchange.
• C-CDA R2.1 for USCDI v3: A specific implementation of C-CDA aligned with the USCDI v3 standard.

By aligning with these standards, this library ensures that C-CDA documents can be effectively converted to and from FHIR, enabling interoperability with modern healthcare systems and applications.

FHIR Server Integration

In addition to the core conversion functions, Medplum provides FHIR server operations for seamless C-CDA import and export:

• Patient/{id}/$ccda-import: Imports a C-CDA document and updates the corresponding patient record.
• Patient/{id}/$ccda-export: Exports a patient's data as a C-CDA document.

These operations are documented in the Medplum FHIR server documentation.

Additional Notes

• This library is actively maintained and updated to support the latest versions of FHIR, US Core, and C-CDA standards.
• Contributions and feedback are welcome! Please submit issues or pull requests on GitHub.

Links:

• Medplum FHIR Server Documentation
• FHIR R4 Specification
• US Core Implementation Guide
• USCDI Website
• International Patient Summary Implementation Guide
• HL7 C-CDA Standard

About Medplum

Medplum is a healthcare platform that helps you quickly develop high-quality compliant applications. Medplum includes a FHIR server, React component library, and developer app.

License

Apache 2.0. Copyright © Medplum 2025