Gap Analysis and CCD Document Specification

Bridging the Gaps

CCD document specification gap analysis

In a previous post on CCD, C-CDA, and CDA, we compared HL7 v2 messaging to CCD development. This week’s article is about the biggest roadblock with CCD document specification: gap analysis.

What is Gap Analysis?

Simply put, gap analysis is about understanding the differences in the data between two systems. The output of a gap analysis process is a list of all the differences between two systems charted in a requirements document. With HL7 v2 messaging, many organizations create their own gap analysis templates and include items such as field mapping tables, the development work involved with bridging a gap, and an issue tracker. To fill in the template, they do a spec cross-walk, look at messages with text or HL7 editors, run queries using messaging tools, and manually document their findings. Some use Caristix software to automate this process.

What about the CCD Document Specification and Gap Analysis?

You’ll need to apply the same process with CCD document specifications and messages. The manual gap analysis process can be onerous with HL7 v2.x messaging. That doesn’t change with CCD.

Gap Analysis Questions

With CCD document specifications, you’ll need to answer the following questions during the gap analysis process:

  • Built into the standard is the ability for both source and destination systems to handle all tags. How does each system handle extra tags built for special needs?
  • Are the systems using the same version of the standard? The standard is evolving, so systems might be on different versions.
  • Are there any differences between the format or structure in each system? If so, what are they? 
  • Are there any optional data elements that are required in one system?
  • Do both systems use the same content? They may use the same code sets, but they may be using slightly different sets of constraints. For instance, take LOINC or SNOMED. It’s all well and good to say these are specified in the standard, but these are vast data sets. Is there a perfect match in all fields/tags? You need to check during gap analysis.
  • What about data attributes like length or optionality?
  • Is there any custom information that must be documented or explained?
  • Is the data semantically consistent? In other words, does the data mean the same thing in both systems?

Why You Need to Do the Gap Analysis

The gap analysis is a critical requirements document. Without one, you won’t uncover your systems’ unique needs before development, so testing and validation will drag on. Every single difference or customization will require extra time, money, and effort to troubleshoot and resolve. The result cascades into extended go-lives, more expensive maintenance, and unhappy end-users.

Our two cents: do the gap analysis. It’ll save time, money, and headaches down the road.