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Electronic Health Information (EHI) Export

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Table of Contents

This document provides detailed information about the Electronic Health Information (EHI) export formats used by the certified health IT product for single patient and patient population export. The format complies with the ONC certification criterion §170.315(b)(10).

Single patient export is implemented using the  HL7 Consolidated Clinical Document Architecture (C-CDA) standard, whereas Population-Level Batch Export is implemented using AWS HealthLake FHIR-based batch export

Single Patient Export #

Product Information #

Product Name: Legend EHR, LLC
Version: 5.3
Export Type: Continuity of Care Document (CCD) – C-CDA R2.1

Export Format Structure and Syntax #

The export format is based on the HL7 Consolidated Clinical Document Architecture (C-CDA) Release 2.1, July 2017. The exported document follows XML syntax and complies with the CDA schema definitions as defined in the HL7 implementation guides.

Each exported file includes the following key sections:

  • Patient Demographics
  • Author and Custodian Information
  • Problems List
  • Allergies and Intolerances
  • Medications
  • Encounters and Diagnoses
  • Procedures
  • Vital Signs
  • Social History
  • Results

Example CCD (C-CDA R2.1) Export #

Below is a representative example of a Continuity of Care Document (CCD) generated by the
system. This XML structure follows the HL7 CDA namespace and schema definitions:

<?xml version=”1.0″ encoding=”UTF-8″ standalone=”yes”?>
<ClinicalDocument xmlns=”urn:hl7-org:v3″ xmlns:xsi=”http://www.w3.org/2001/XMLSchema-instance” xsi:schemaLocation=”urn:hl7-org:v3 CDA.xsd”>
<realmCode code=”US”/>
<typeId root=”2.16.840.1.113883.1.3″ extension=”POCD_HD000040″/>
<templateId root=”2.16.840.1.113883.10.20.22.1.2″/>
<id root=”2.25.79597816765834076003231149380744084217″/>
<code code=”34133-9″ codeSystem=”2.16.840.1.113883.6.1″ codeSystemName=”LOINC” displayName=”Summarization of Episode Note”/>
<title>Continuity of Care Document (CCD)</title>
<effectiveTime value=”20251010113135+0000″/>
<confidentialityCode code=”N” codeSystem=”2.16.840.1.113883.5.25″/>
<languageCode code=”en-US”/>
…
</ClinicalDocument>

Validation and Compliance #

The generated CCDA documents have been validated using the official ONC CDA Validator against the ‘Consolidated CDA (C-CDA DSTU Release 2.1) (July 2017)’ standard. All exports conform to the required template and schema constraints.

Public Accessibility #

This document serves as the publicly available documentation describing the export format of the EHI data. It is intended to be linked via a publicly accessible hyperlink on the Certified Health IT Product List (CHPL) without preconditions or login requirements.

Versioning and Maintenance #

The product team maintains this documentation to ensure it reflects the current export format for the single patient export. Any structural or version changes to the export implementation will be reflected in future updates to this documentation.

Patient Population Export #

Product Information #

  • Product Name: Legend EHR, LLC
  • Version: 5.3
  • Population Export Type: AWS HealthLake Bulk FHIR Export

Population-Level Batch Export (AWS HealthLake) #

For population-level data export, the system utilizes AWS HealthLake’s bulk export capabilities in compliance with the FHIR standard (FHIR R4). The export produces data in NDJSON (Newline Delimited JSON) format, with each line representing a complete FHIR resource.

Export Structure: #

  • Format: FHIR R4 Resources in NDJSON format
  • Compression: GZIP compressed bundles
  • Resource Types: Patient, Observation, Condition, Medication, Encounter, Procedure, etc.
  • Metadata: Export manifest with file checksums and resource counts

Key Features: #

  • Scalable export for entire patient populations
  • Incremental export support (delta changes)
  • Compressed output for efficient data transfer
  • FHIR-standard compliance for interoperability

Example AWS HealthLake Batch Export – Population Level #

File Structure:

text
export-2024-01-15/
├── Patient-1.ndjson.gz
├── Observation-1.ndjson.gz
├── Condition-1.ndjson.gz
├── Medication-1.ndjson.gz
└── export_manifest.json
Sample FHIR Resource (Patient.ndjson):
json
{“resourceType”:”Patient”,”id”:”patient-123″,”meta”:{“versionId”:”1″,”lastUpdated”:”2024-01-15T10:30:00Z”},”identifier”:[{“system”:”http://hospital.org/patient“,”value”:”12345″}],”name”:[{“use”:”official”,”family”:”Smith”,”given”:[“John”]}],”gender”:”male”,”birthDate”:”1980-05-15″}
{“resourceType”:”Patient”,”id”:”patient-124″,”meta”:{“versionId”:”1″,”lastUpdated”:”2024-01-15T10:31:00Z”},”identifier”:[{“system”:”http://hospital.org/patient“,”value”:”12346″}],”name”:[{“use”:”official”,”family”:”Doe”,”given”:[“Jane”]}],”gender”:”female”,”birthDate”:”1975-08-22″}
Export Manifest Example:
json
{
  “transactionTime”: “2024-01-15T10:00:00Z”,
  “requiresAccessToken”: false,
  “output”: [
    {
      “type”: “Patient”,
    },
    {
      “type”: “Observation”,
    }
  ],
  “error”: []
}

Validation and Compliance #

FHIR Export: Validated against FHIR R4 specification and AWS HealthLake compliance requirements

Public Accessibility #

This document serves as the publicly available documentation describing export format of the EHI data for patient population. It is intended to be linked via a publicly accessible hyperlink on the Certified Health IT Product List (CHPL) without preconditions or login requirements.

Versioning and Maintenance #

The product team maintains this documentation to ensure it reflects the current export formats. Any structural or version changes to export implementation will be reflected in future updates to this documentation.

Last Updated: January 2024
Export Format Versions: FHIR R4
Supported Standards: FHIR R4, ONC §170.315(b)(10)

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