As explained in the article What is MU2?, the US government EHR (Electronic Health Record) Incentive Programs regulations define the EHR “Meaningful Use” (MU) critieria that doctors and hospitals need to meet. The current 2014 Edition of MU defines Stage Two (MU2) requirements, which prominently feature C-CDA documents for data exchange objectives. Refer also to the article What is the role of C-CDA in MU2?, for more information.

Software products are tested and certified to support MU2 requirements, under a certification program of the US government that is executed via authorized testing bodies. In support of those tests, the US government maintains an online testing tool called TTT – which stands for Transport Test Tool.

TTT covers a few different MU2 technologies, including the validation of C-CDA documents. Follow the link to the TTT tool and then click on the link on that page titled “Message and CCDA document validators”, to go to the C-CDA validation portion of TTT.

C-CDA Validation
Validation of a C-CDA document takes place at different levels with increasing speficity.

Since every C-CDA document is also an XML file, XML syntax validation is the first level of C-CDA validation. There are many online XML validation tools, such as this one, for XML validation, as well as many software packages and libraries.

To specifically validate the CDA syntax of a C-CDA file, XML Schema tools are used. to CDA is XML Schema validation via XSD files. The CDA PRO Learn session titled XML Schema provides an overview of XML Schema and its use in CDA. There are a variety of tools and software packages that automate the process of validating an XML file, relative to a defined XML Schema.

To more specifically validate a C-CDA document, requires a “rules engine” that can validate the rules that are defined for CDA templates (in this case, C-CDA templates) that are asserted as “being conformed to” in the document.

There are at least two different technology frameworks/engines for this C-CDA template rule validation. The one used by the TTT Validator (and by CDA PRO tools) is based on an open-source library called MDHT (Model Driven Health Tools).

Using the TTT Validator for Validating C-CDA Documents
The user interface for the C-CDA validation portion of the TTT Validator requires that one of the seven MU2 document types be selected, as shown:

Note that there are ten options above, even though we have indicated that there are seven MU2 document types. The last option above allows the TTT C-CDA validator to be used for validating generic C-CDA documents, irrespective of MU2. In addition, the Transition of Care scenarios are separated into “Referral Summary” and “Receive” – although from a technical standpoint there is no difference between them in terms of the C-CDA requirements.

In addition to selecting a document type, the user interface has a button for uploading the C-CDA file to be validated, and a button to begin the validation, as highlighted here:

Additional Information
Refer to the article Interpreting TTT C-CDA validation results for more information about the TTT C-CDA Validation output.

Other articles in this MU2 C-CDA Certificaton category of CDA PRO Know, address additional aspects of the the TTT C-CDA Validator.

Other CDA PRO Know Articles Referenced In This Article

Related CDA PRO Learn Sessions