ArticleJournal of the American Medical Informatics Association : JAMIA
Are Meaningful Use Stage 2 certified EHRs ready for interoperability? Findings from the SMART C-CDA Collaborative.
Article in Journal of the American Medical Informatics Association : JAMIA. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 2 of them syntheses that pooled it.
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Who cites it
42 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The Impact of Electronic Health Record Interoperability on Safety and Quality of Care in High-Income Countries: Systematic Review.Journal of medical Internet research · 2022Pooled it
- Clinical information modeling processes for semantic interoperability of electronic health records: systematic review and inductive analysis.Journal of the American Medical Informatics Association : JAMIA · 2015Pooled it
- Registry Forge: an open-source end-to-end pipeline for patient-directed SMART on FHIR registries.JAMIA open · 2026Article
- Deconstructing the Interoperability Stack: A Comparative Technical Analysis of HL7 v2, CDA, and the FHIR Resource Framework.Computational and structural biotechnology journal · 2026Review
- Gaps and Similarities in Research Use LOINC Codes Utilized in Korean University Hospitals: Towards Semantic Interoperability for Patient Care.Journal of Korean medical science · 2025Article
- A machine learning approach to leveraging electronic health records for enhanced omics analysis.Nature machine intelligence · 2025Article
- The standard problem.Journal of the American Medical Informatics Association : JAMIA · 2023Article
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- Standard Document Development for Health Information Exchange in Korea.Applied clinical informatics · 2022Article
- Adoption of clinical risk prediction tools is limited by a lack of integration with electronic health records.BMJ health & care informatics · 2021Article
- Transitions from One Electronic Health Record to Another: Challenges, Pitfalls, and Recommendations.Applied clinical informatics · 2020Article
- Applying Bidirectional Transformations to the Design of Interoperable EMR Systems.Journal of healthcare informatics research · 2020Article
- A step closer to nationwide electronic health record-based chronic disease surveillance: characterizing asthma prevalence and emergency department utilization from 100 million patient records through a novel multisite collaboration.Journal of the American Medical Informatics Association : JAMIA · 2020Article
- Adapting a System-Theoretic Hazard Analysis Method for the Analysis of an eHealth Interoperability Conformance Profile.AMIA Joint Summits on Translational Science proceedings. AMIA Joint Summits on Translational Science · 2020Article
- Article
- Health systems' use of enterprise health information exchange vs single electronic health record vendor environments and unplanned readmissions.Journal of the American Medical Informatics Association : JAMIA · 2019Article
- One-Way and Round-Trip Analysis Demonstrates Surprising Limitations of Standards-Based Terminology Maps.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2019Article
- Lessons Learned in Creating Interoperable Fast Healthcare Interoperability Resources Profiles for Large-Scale Public Health Programs.Applied clinical informatics · 2019Article
- Forecasting the Maturation of Electronic Health Record Functions Among US Hospitals: Retrospective Analysis and Predictive Model.Journal of medical Internet research · 2018Article
- Vendor of choice and the effectiveness of policies to promote health information exchange.BMC health services research · 2018Article
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
BACKGROUND AND
objectiveUpgrades to electronic health record (EHR) systems scheduled to be introduced in the USA in 2014 will advance document interoperability between care providers. Specifically, the second stage of the federal incentive program for EHR adoption, known as Meaningful Use, requires use of the Consolidated Clinical Document Architecture (C-CDA) for document exchange. In an effort to examine and improve C-CDA based exchange, the SMART (Substitutable Medical Applications and Reusable Technology) C-CDA Collaborative brought together a group of certified EHR and other health information technology vendors. MATERIALS AND
methodsWe examined the machine-readable content of collected samples for semantic correctness and consistency. This included parsing with the open-source BlueButton.js tool, testing with a validator used in EHR certification, scoring with an automated open-source tool, and manual inspection. We also conducted group and individual review sessions with participating vendors to understand their interpretation of C-CDA specifications and requirements.
resultsWe contacted 107 health information technology organizations and collected 91 C-CDA sample documents from 21 distinct technologies. Manual and automated document inspection led to 615 observations of errors and data expression variation across represented technologies. Based upon our analysis and vendor discussions, we identified 11 specific areas that represent relevant barriers to the interoperability of C-CDA documents.
conclusionsWe identified errors and permissible heterogeneity in C-CDA documents that will limit semantic interoperability. Our findings also point to several practical opportunities to improve C-CDA document quality and exchange in the coming years.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.