FHIR® vs. C-CDA®: What Are These Two Formats and How Do They Compare?

January 26, 2022

Particle Health Team

A high-level overview of the two common formats for exchanging medical records.

Your test results, visit notes, and vital signs are all clinical documents. FHIR® and C-CDA® are the two primary data formats used to electronically share these medical records.

FHIR® vs. C-CDA® Basics

	C-CDA	FHIR
Full Name:	Consolidated Clinical Document Architecture	Fast Healthcare Interoperability Resources
Exchanges Full Patient Records:	Yes	Yes
Easy Extraction of Specific Data Points:	No - specialized parsing needed to extract individual data points.	Yes - easy to search and separate every aspect of patient encounters.
Best for Organizations That:	• Require a quick implementation time. • Prefer to receive all individual data files. • Already use a CDA-compatible system.	• Have well-defined use cases. • Know which specific data elements (like medications) they need. • Previously worked with healthcare data (especially JSON-based FHIR).

FHIR® vs. C-CDA® Tech Specs

	C-CDA	FHIR
Human-Readable Output:	Yes	Yes
Data Formats:	XML (primarily); PNGs and PDFs also occur	JSON
Particle API Paradigm:	Downloadable via REST¹	Follows REST FHIR R4 Spec
Developer Ease of Use:	Easy to implement, but harder to parse.	More intensive to implement, but easier to parse.
Forward Compatible:	Being phased out - Particle can transform into FHIR format.	Largely codified as new standard.
Particle Stores Data For:	2 days	30 days

FHIR® vs. C-CDA® History

	C-CDA	FHIR
Meets Meaningful Use and Patient Access Standards:	Yes	Yes
First Normative Release:	2011	2019
Date Required in Health IT:	2014	2022
Health API and EHR Support:	Universal	Sometimes
Regulatory Basis:	HITECH Act / Meaningful Use Rule	Cures Act / Anti-Information Blocking Rule / TEFCA
Supported by Particle's API:	Yes	Yes

FHIR® vs. C-CDA® Similarities

Both FHIR® and C-CDA®:

Assist with Cures Act anti-information blocking compliance, although C-CDA® is a less comprehensive solution.
Are developed by Health Level 7 (HL7®), the standards development organization dedicated to digital health interoperability.
Evolve by consensus via HL7®.
Support structured and unstructured data.
Combine information into standardized document types.
Are open source. ❤️

Example C-CDA® Document

CCDA summary of care example — Beginning of a C-CDA Summary of Care XML document (using synthetic data, of course).

Example FHIR® Resource

FHIR medication resource example — Beginning of a FHIR medication resource (with synthetic data).

To sum up, C-CDA® is a markup standard that creates large bundles of patient data. FHIR® includes additional API elements that allow for unbundling of patient data.

Particle’s tools - including our API, industry-leading record locator 🌎, and stunningly reliable document converter ✨ - add additional functionality to both data formats.

These formats are enabling long-sought interoperability goals, pulling together data from smart devices to labs to hospitals. Explore them both to get the healthcare data you need!

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^{1. Natively SOAP, but Particle supports an easier RESTful API.↩}

About the author

Particle Health Team

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