The article The recordTarget element provides an overview of the recordTarget XML sub-element of the ClinicalDocument root element of all CDA documents.

As explained in detail in that article, the recordTarget element is part of the CDA Header, and represents the patient that is the subject of the CDA document.

Usually Only One recordTarget Per CDA Document
In the vast majority of cases, a CDA document will only have one recordTarget element.

Even situations that might seem to require multiple patients to be listed – such as the summary of a group therapy session – really only should have one recordTarget element. If there is a record being maintained for the entire group, then the group as a whole would have an identifier and that single entity/identifier (“the group”) would be captured in the recordTarget element. If, on the other hand, the record was destined for the clinical record of a specific member of the group, that specific patient would be captured in the single recordTarget element for the CDA document.

There Are Some Exceptions
There are, however, situations, where a single CDA document might be intended for filing in multiple clinical records. The case of conjoined twins would be an example.

However, in nearly all other circumstances, the use of multiple recordTarget elements is NOT recommended. Typically, even in situations that appear to warrant the use of multiple recordTarget entries, there is a single primary patient that is the focus of the CDA document – and other parties can be listed in specific contexts via related clinical act statements within the document.

Potential Interpretation Issues
Even if a situation warrants the use of a CDA document with multiple recordTarget elements, there is the question about how likely a recipient of such a CDA document will be to correctly interpret it. Thus, the use of multiple recordTarget elements should practically be limited to CDA implementation guides (e.g. in areas of population reporting, etc.) that explicitly indicate that this should be done, and when/how it should be done for specific document templates.

Multiple recordTarget Elements in C-CDA
C-CDA documents, the use of multiple recordTarget elements is formally allowed, but it should be limited to very specific use cases such as conjoined twins.

Other CDA PRO Know Articles Referenced In This Article