Home Forums Discussions Meaningful Use Creating and Transmitting CCD

Any comments or help would be appreciated.

I have tried to export a CCD from a patient's file for secure transmission to another email and Amazing Charts produces 2 files, one is an XSL stylesheet and the other is an XML document. If I try to view these in an XML viewer, I just get lines and lines of garbage. So, I figured that the file might be in a format that only an EMR can read correctly. So then I tried to import back into Amazing Charts the same file that it created. Low and behold, Amazing Charts cannot even read the file that it created. It gives me the following message when I try to import it back into AC:

The XML page cannot be displayed
Cannot view XML input using XSL style sheet. Please correct the error and then click the Refresh button, or try again later.
-------------------------------------------------------------------
System error: 2146697211.

What is up with this? The file that I tried to import back into AC has an XML extention, not and XSL extention. In fact, AC did not even list the file with the XSL extention on the list of importable files. Transmission of a patient's CCD is part of meaningful use. I would like to verify that the file that I am transmitting actually contains useful, readable data. What am I doing wrong, or what is wrong with Amazing Charts that I cannot get it to import and read data that it created?

Hello EyeGuy,

This is Stefan with Amazing Charts Product Support.

Currently Amazing Charts can export the CCD in 2 versions, 2.5 and 2.1. Development has notified me that 2.5 is the newer version that is also certified for Meaningful Use while 2.1 is not applicable to Meaningful Use. With the 2.5 version we now have an XML and XSL, which are required to view the document. The XSL is a style sheet and a pertinent part of the new CCD format as it allows you to view the document, likewise it will allow Amazing Charts to display the file natively. The reason you cannot see the file and you are getting that error is because it simply cannot reference the style sheet or XSL. As long as both thee XML and XSL remain in the same directory on the computer, you will be able to open the CCD.

I have been told that you are able to import this back into Amazing Charts as an Imported Item for a patient, if necessary, and the style sheet can be manually placed into the folder for the specific patients Imported Items, although tedious, it would be a solution for having a CCD available in Imported Items.

For the sake of having an easier to use and all-in-one CCD, you can export in the old format 2.1, which will not count for Meaningful Use, but it is solely an XML that can be viewed by itself. It is also easily imported to AC since it is just one file using the CCD importing tool from the Main screen.

The choice for either version is only available when using the "CCD" button from the Summary Sheet, or Right-Clicking the patient name from the list and choosing "Export CCD," both of which allow you to choose the version of CCD prior to exporting once you fill out a HIPAA release of records form.

As a final note, remember that Stage 1 of Meaningful Use is about Capability of providing said materials. With that said it is possible to perform the export to get credit for Meaningful Use, the transmitting of the file(s) can be done at your discretion.

Please let me know if this was helpful and if I can help you with anything else, I can always resource more info from the Dev team as well.

Thank you!

Stefan@AC

I did not understand a thing.

I cannot explain this answer either and I have a degree...it gave me a whopping headache...I was thinking about going to DC, but if this is the answer that I get I will just stay at the bar at the airport... Stefan...remember we are doctors, not computer linguists...we probably just got yelled at by some little old lady who didnt get her MEDCO rx on time..so take it easy on us please...if I come to DC I will buy you a drink...many drinks...so we can explain some of these little nuances to my scientific and yet very cynical brain....thanks for listening...todd

Hi everyone,

When you export a CCD for a patient, by default it gets exported to the ccd folder in the Amazing Charts folder on your computer (i.e. C:\Program Files\Amazing Charts\ccd\)

If you look in that folder, you will find several files that end with a .xml file extension. CCD_PatientId_1050.xml is an example file name. These are the actual CCD files themselves. As the extension implies, they are formatted using XML. If you open up any of these files in Notepad (or your favorite text editor of choice) you can see the XML format of the CCD. Believe me when I tell you that these are definitely not conducive to human readability, but you can certainly see all of the data (and how it is formatted.)

There will also be an additonal file - CCD.xsl - in that folder. This is the CCD Style Sheet, and it is what allows you to see the human readable form of any of the CCD files when opening them in an appropriate viewer. The easiest way to see the human readable version of any of the CCD files is to open one up in Internet Explorer. In Internet Explorer, it will display as a properly formatted, human readable report.

The caveat is that the style sheet (the CCD.xsl file) MUST be in the same folder on your computer as the CCD file (the file ending in .xml) that you are trying to view. That is what is causing the error you are seeing when you import the CCD back into Amazing Charts as an Imported Item. It successfully imports the .xml file, but it cannot find the style sheet when trying to display it. That is a bug in AC, and is something I will make sure we address in a future version. (Just as an FYI, that is the same error Internet Explorer would give you if you deleted the style sheet file in the ccd folder, or tried opening a CCD file from a different folder that didn't have the style sheet file in it.)

I hope this helped to clear up some of the confusion. If not, let me know, and I'll be happy to try and explain it further.

- Jeff Mathes, Software Engineering Manager

Thanks...Jeff...I will digest this...I really appreciate your time on this and now if you could just get all of the DECISION SUPPORT ANSWERS to be completed with just 1 click that would be a bloody miracle. That documentation looks really good with medical home patients, but it is really time consuming and is virtually worthless when doing charts in the patient visit....

Jeff: Great response! bug in ac! Got it. Seriously, your explanation made sense!
Thanks
tom