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

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

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

Human-Readable Output:
Data Formats:
 XML (primarily); PNGs and PDFs also occur
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

Meets Meaningful Use and Patient Access Standards:
First Normative Release:
Date Required in Health IT:
Health API and EHR Support:
Regulatory Basis:
HITECH Act / Meaningful Use Rule
Cures Act / Anti-Information Blocking Rule / TEFCA
Supported by Particle's API:

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!

1. Natively SOAP, but Particle supports an easier RESTful API.