Main features

The CCC System (version 2.5 – updated June 2012) is a free empirically developed system consisting of standardized coded nursing terminology and an information model designed for documenting the “essence of care” in electronic health record (EHR) systems. It is a concept-oriented terminology described as follows:

  • Free standardized nursing terminology with coded concepts structured for the electronic storage, processing, retrieval and analyses of clinical nursing practice data.
  • The information model is also designed for documentation of nursing plans of care (POCs) following the six steps of the Nursing Process for Professional Nursing Practice (ANA, 2015).
  • Framework electronically links diagnoses, interventions and outcomes to each other and to other health-related terminologies: SNOMED CT, LOINC, ICNP, etc.

Fast facts

Features and characteristics of the CCC System (version 2.5):

  • Requires no licensing fee
  • Consists of atomic level-concepts/data elements
  • Designed as open architecture
  • Designed for use in electronic health record (EHR) and healthcare information technology (HIT) systems
  • Tested and applicable in all healthcare settings
  • Conforms to Cimino’s “desiderata” criteria for a standardized vocabulary for HITs
  • Mapped (updated) to SNOMED CT, LOINC and ICNP
  • Free mapping of the CCC System to SNOMED CT, LOINC and 3MMM. Visit the contact page to learn how to access these password-protected files 

Electronic healthcare standards

The CCC System has also been formally accepted by the recognized electronic healthcare standards organizations:

  • Formally recognized in 1991 and reaffirmed in 1998 and 2006 by the ANA as a nursing terminology/classification critical for representing clinical nursing practice in computer-based clinical information systems (CISs).
  • Recognized in October 2006 as the first nursing terminology named by Secretary Michael Leavitt, U.S. Department of Health and Human Services (HHS), and was recognized in 2007 as an interoperable healthcare standard within the Healthcare Information Technology Standards Panel’s (HITSP) interoperability specification for electronic healthcare records (EHRs), biosurveillance and consumer empowerment as presented to the meeting of the American Health Information Community (AHIC), a Federal Advisory Data Standards Organization (SDO) to the Office of the National Coordinator for Healthcare Information Technology (ONC).
  • Registered as HL7 languages/terminologies promoting interoperability.
  • Integrated in Metathesaurus of Unified Medical Language System (UMLS) of the National Library of Medicine (NLM).
  • Integrated in and mapped to SNOMED CT and previously SNOMED RT.
  • Integrated the CCC nursing diagnoses and outcomes in Clinical LOINC (Logical Observations, Identifiers, Names and Codes).
  • Indexed in CINAHL (Cumulative Index for Nursing and Allied Health Literature).
  • Listed in American National Informatics Standards Technical Board (HITSB) of Inventory of Healthcare Standards Library (2000).
  • Conforms to criteria for “Integration of a Reference Terminology Model for Nurses (ISO-18104) Standard” approved by the International Organization for Standardization (ISO) Technical Committee (TC) 215 Working Group 3-Concept Representation, in October 2003 in Oslo, Norway.
  • Adapted by ABC Codes for complementary and alternative medicine (CAM) and selected for billing coded concepts (initial version 1996).
  • Formed the basis for the original and mapped to the International Classification of Nursing Practice (ICNP) developed by the International Council of Nurses (ICN) (1992).
  • Partnered (SabaCare Inc.) with ICN to harmonize the International Classification of Nursing Practice (ICNP) and Clinical Care Classification (CCC) System.