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hello my name is betty and ill be covering some background information about clinical document exchange and then ill talk about the responder role well talk a little bit about what clinical document exchange is and how it works well discuss patient consent and how the practice records this for the practice as a whole and for individuals clinical document exchange is sometimes referred to as care summary exchange or continuity of care document ccd this allows different healthcare organizations to exchange clinical documents its a system of standards for how these documents are shared there are three steps that make up clinical clinical document exchange the first step is patient discovery through pcc ehr the user at the practice will query a third party to see if they have records on a specific patient in step two well locate the documents if the patient exists in the third party system well take a look to see what documents are available for that patient in step three well retr