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Plan-to-Plan Personal Health Record

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Wiki page supporting collaborative work on CDA for the Plan-to-Plan Personal Health Record (P2PPHR)

Upcoming Ballot

On Saturday, December 6, 2009, on behalf of the Structured Documents Work Group, HL7 posted the second round CCD ballot for the Plan-to-Plan PHR Portability standard. The last day to signup for the ballot is Monday Dec 29th. The last day to submit comments is Monday, January 5th.

As background, in 2006, America’s Health Insurance Plans (AHIP) and the Blue Cross and Blue Shield Association (BCBSA) worked together to identify the core information to include in PHRs, and also developed and pilot tested draft standards to enable consumers to transfer PHR data when they change coverage. This will help ensure that PHRs will be portable from health insurer to health insurer as consumers requested. The industry model PHR is expected to be a private, secure web-based tool maintained or sponsored by an insurer that contains a consumer’s claims, administrative and when available clinical information. PHRs enable individual patients and their designated caregivers to view and manage health information and play a greater role in their own health care.

The ballot, for which comments are due on January 5, 2009, reflects the formal implementation guide standard of HL7 for the data payload to transfer core information in PHRs – as defined in 2006 and further refined in 2007. The HL7 Structured Documents Working Group (SDWG) is offering an opportunity for industry comment on the HL7 Implementation Guide for CDA Release 2: Plan-to-plan Personal Health Record (PHR) Data Transfer, Release 1 (2nd Informative Ballot). This Implementation Guide standard is a constraint on the HL7/ASTM Continuity of Care Document, itself a constraint on the Clinical Document Architecture (CDA) Release 2. In addition to constraining CCD, this Implementation Guide standard illustrates how to use the specification to send a broad range of data pertinent to the personal health record.

The goal of the Plan-to-Plan Personal Health Record (PHR) Data Transfer Project is to create an HL7 implementation guide that will provide for PHR portability between Health Plans. The project is limited in scope to the payor stakeholder community in the U.S. Many updates, additions and improvements have been made to the draft ballot as a result of the May, 2008 ballot. These include:

  • Addition of fields related to insurance coverage
  • Addition of an appendix listing all required, required if known data elements, including those from the base specifications (CDA, CCD, HITSP C32)
  • Harmonization of requirements with HITSP C32

Below are several files and links to assist you in review of the ballot and understanding the background on this proposed new CCD implementation guide standard from HL7:

1. HL7 Ballot files and links:

  • HL7 Ballot P2P_PHR_BallotCoverLetter.Jan2009 – cover letter from the Structured Documents Work Group that provides background on this second round ballot of the CCD implementation guide to support Plan to Plan PHR portability.
  • HL7 Ballot P2P PHR CDA_IG.Jan2009 – the zip file of the CCD implementation guide that is being balloted.
  • Announcement document can be downloaded from this link:
  • Ballot pool signup is available until a week from ballot closing, Monday, December 29th. This is also the closing date for enrollment in Paid Participation for non-members - as posted in the announcements section of the Ballot Desktop.

2. Background on the portability PHR portability project:

3. 2008 Industry Presentations and information on the PHR portability implementation guides & operating rules:

If you have additional questions, please contact Lenel James @ 312.297.5962 or

Updates to Ballot Package

  • May 2008

Sample File of P2PPHR (zip) - This updated zip file includes a sample file with an example link of problem to a specifc encounter and a new CDA stylesheet.