leveraging ihe to build rhio interoperability
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Leveraging IHE to buildRHIO InteroperabilityLeveraging IHE to buildRHIO Interoperability
Charles ParisotGE Healthcare
IHE IT Infrastructure Technical Committee co-chair
http://ihe.univ-rennes1.fr/data/editable/organization/PCC_WS_2005/Interoperability_Workshop_IHE%20for%20a%20RHIO-3.ppt
June 28-29, 2005 Interoperability Strategy Workshop2
W W W . I H E . N E TW W W . I H E . N E T
Providers and VendorsProviders and Vendors
Working Together to DeliverWorking Together to Deliver
Interoperable Health Information SystemsInteroperable Health Information Systems
in the Enterprisein the Enterprise
and Across Care Settingsand Across Care Settings
June 28-29, 2005 Interoperability Strategy Workshop3
Lab Results Document Content
Format of the Document Content and associated coded vocabulary
For Display Document
Format of the Document Content
Selected IHE Integration Profiles for RHIOsSelected IHE Integration Profiles for RHIOsWhat is available and is added in 2005What is available and is added in 2005
Consistent TimeCoordinate time across
networked systems
Audit Trail & Node Authentication
Centralized privacy audit trail and node to node authentication
to create a secured domain.
Patient Demographics Query
Cross-Enterprise Document Sharing
Registration, distribution and access across health enterprises of clinical documents forming a patient electronic health record
Notification of Document Availability
Notification of a remote provider/ health enterprise
Imaging Information Sharing
Format of the Document Content and associated coded vocabulary
Medical Summary Document Content
Format of the Document Contentand associated coded vocabulary
Cross-enterprise User Authentication
Authentication & Auditing: Basis for Access Control
Document Digital Signature
Attesting “true-copy and origin
Patient Identifier Cross-referencing
Map patient identifiers across independent identification
domains
June 28-29, 2005 Interoperability Strategy Workshop4
HIMSS 2005 – HIMSS 2005 – Show-Wide InteroperabilityShow-Wide InteroperabilityVendor System
Ambulatory Showcase BoothAmbulatory Showcase Booth
HomeHome
PCP
MultispecialtyMultispecialtyClinicClinic
Diag Center
Cross-enterprise Showcase BoothCross-enterprise Showcase Booth
Cardiology
RadiologyIT
Infrastructure
In-Patient/Out-patient
Vendor BoothVendor Booth
Vendor BoothVendor Booth
Vendor BoothVendor Booth
Vendor BoothVendor Booth
Vendor BoothVendor Booth
Vendor BoothVendor Booth
Vendor BoothVendor Booth
HL7 BoothHL7 Booth
HIMSS “RHIO” withCross-enterprise
doc sharing (17 vendors)
June 28-29, 2005 Interoperability Strategy Workshop5
HIMSS 2005 InteroperabilityHIMSS 2005 InteroperabilityShow Case VendorsShow Case Vendors
Leadership LevelLeadership Level
CapMed/SanDiskCapMed/SanDiskEclipsysEclipsysGE HealthcareGE HealthcareIDXIDXInterSystemsInterSystemsKryptiqKryptiqQuovadx/CareScienceQuovadx/CareScienceSiemensSiemensWebMDWebMD
Participant LevelParticipant LevelAllscriptsAllscripts
Cedara Cedara
CernerCerner
Dictaphone Dictaphone
Eastman KodakEastman Kodak
EclipsysEclipsys
EmageonEmageon
EpicEpic
ETIAMETIAM
INFINITT Tech.INFINITT Tech.
MedcomSoft MedcomSoft
MediNotesMediNotes
MedCommonsMedCommons
MidMarkMidMark
Mortara Instrument, IncMortara Instrument, IncNational Institute National Institute ofof Standards & TechnologyStandards & Technology
NextGenNextGen
NovellNovell
Open TextOpen Text
SentillionSentillion
Supporter LevelSupporter LevelAccessPtAccessPt AGFAAGFA dbMotiondbMotion Dinmar – OacisDinmar – OacisEMCEMC HealthvisionHealthvision HealthrampHealthramp McKessonMcKesson
Valco Data SystemsValco Data Systems
June 28-29, 2005 Interoperability Strategy Workshop6
IHE North America Vendors (2004-2005)IHE North America Vendors (2004-2005)
• Agfa HealthCare • Allscripts • Camtronics Medical
Systems • Cedara Software Corp. • Cerner Corporation • Dictaphone Corporation • Dynamic Imaging, LLC • Eastman Kodak Company • Eclipsys • Emageon • Epic Systems
Corporation • ETIAM • FujiFilm Medical
Systems, USA, Inc. • GE Healthcare • Heartlab, Inc • Hitachi Medical
Corporation
• Hologic • IDX Systems Corp. • INFINITT Technology • InSite One, Inc. • Intelerad Medical
Systems • InterSystems
Corporation • Konica-Minolta Medical
Imaging, USA, Inc. • Kryptiq • Marotech • McKesson Information
Solutions • MedCommons Inc. • MedCon, Inc. • Merge eFilm • Mortara Instrument,
Inc. • Novell, Inc. • Philips Medical
Systems
• QRS Diagnostic • Quovadx • St. Jude Medical A.B. • Sectra Imtec A.B. • St. Jude Medical A.B. • Sectra Imtec A.B. • Sentillion • Siemens Medical
Solutions • Stentor • Swissray International,
Inc. • Tiani Medgraph A.G. • Tiani Spirit Gmbh • Toshiba Medical
Systems Company • Vital Images • WebMD Practice
Services
June 28-29, 2005 Interoperability Strategy Workshop7
community
Clinical Encounter
Clinical IT System Index of patients records(Document-level)
Temporary Aggregate Patient History
4-Patient data presented to
Physician
Sharing SystemSharing System
3-Records3-RecordsReturnedReturned
Referenceto records
Clinic Record Specialist Record
Hospital Record
2-Referenceto Records for Inquiry
At HIMSS in 2005 : IHE-XDSAt HIMSS in 2005 : IHE-XDS
June 28-29, 2005 Interoperability Strategy Workshop8
community
Clinical Encounter
Clinical IT System Index of patients records(Document-level)
Temporary Aggregate Patient History
3-Records3-RecordsReturnedReturned
Referenceto records
Laboratory Results Specialist Record
Hospital Record
2-Referenceto Records for Inquiry
At HIMSS in 2005 : IHE-XDSAt HIMSS in 2005 : IHE-XDS
Sharing SystemSharing System
Shared prototype content:• Medical Summaries (Pre-CCR)• Discharge Summaries (CDA-R1)• Lab Results (HL7)• Other (PDF)
June 28-29, 2005 Interoperability Strategy Workshop9
community
Clinical Encounter
Clinical IT System Index of patients records(Document-level)
1-Patient Authorized
Inquiry
Temporary Aggregate Patient History
3-Records3-RecordsReturnedReturned
Referenceto records
Laboratory Results Specialist Record
Hospital Record
2-Referenceto Records for Inquiry
Demo a RHIO with IHE at HIMSS 2006 ?Demo a RHIO with IHE at HIMSS 2006 ?
Sharing SystemSharing System
Secured Sharing of:• Medical Summaries• Images & reports• ECG Reports• PDFs• Lab Results ?+ Notif of Doc Avail.
June 28-29, 2005 Interoperability Strategy Workshop10
Document Life Cycle ManagementDocument Life Cycle Management
A two-way relationship between Original and Addendum
Document
Addendum
Document 1(Approved)
Addendum
ReplacementDocument
Replacement
Document 1(Deprecated)
Document 2(transform)
Transform
Document 1(Approved)
A two-way relationship between Original and Replacement Document.
A two-way relationship between Original and Transform (alternative format with same scope or DSG).
TimeAddendum to a registered document
Replacing a registered document by a new document
Registering an alternate form or a signature for a registered document
Time
June 28-29, 2005 Interoperability Strategy Workshop11
Local & Regional RHIOs Infrastructure and Local & Regional RHIOs Infrastructure and InteroperabilityInteroperability
• Cross-Enterprise Document Sharing (XDS) minimizes clinical data management by the infrastructure. Transparency = Ease of Evolution
• XDS works with other IHE Integration Profiles: patient Id mgt, security, etc. Flexibility of RHIO configuration
• With introduction of new Integration Profiles, IHE ready to build regional health networks linking interoperable EHRs. Major milestone for 2006 RHIO projects
• Goal is to offer a consistent, standards-based and functional for EHRs and other ancillary systems.
June 28-29, 2005 Interoperability Strategy Workshop12
Creating a Health Information Network with IHECreating a Health Information Network with IHE
CareDelivery IT system
CareDelivery IT system
CareDelivery IT system
Tier 1 EHRsand Ancillaries
June 28-29, 2005 Interoperability Strategy Workshop13
Creating a Health Information Network with IHECreating a Health Information Network with IHE
CareDelivery IT system
CareDelivery IT system
XDS Document Registry
DocumentEntries
CareDelivery IT system
Tier 2 Community HINWhat and Where ?
XDSDocument Repository
XDSDocument Repository
XDSDocument Repository
June 28-29, 2005 Interoperability Strategy Workshop14
Creating a Health Information Network with IHECreating a Health Information Network with IHE
CareDelivery IT system
CareDelivery IT system
XDS Document Registry
C-HIN Patient Identity Source
DocumentEntries
PDQ Consumer
CareDelivery IT system
Tier 2 Community HIN
Patient Demo Supplier
Patient Id X-Ref Mgr
XDSDocument Repository
XDSDocument Repository
XDSDocument Repository
Patient Id X-Ref Mgr
Who, What and Where ?Who, What and Where ?
June 28-29, 2005 Interoperability Strategy Workshop15
Creating a Health Information Network with IHECreating a Health Information Network with IHE
CareDelivery IT system
CareDelivery IT system
XDS Document Registry
C-HIN Patient Identity Source
DocumentEntries
PDQ Consumer
CareDelivery IT system
Tier 2 Community HIN
Patient Demo Supplier
Patient Id X-Ref Mgr
XDSDocument Repository
XDSDocument Repository
XDSDocument Repository
Patient Id X-Ref Mgr
Time Server
Who, What When and Where ?
June 28-29, 2005 Interoperability Strategy Workshop16
Creating a Health Information Network with IHECreating a Health Information Network with IHE
CareDelivery IT system
CareDelivery IT system
XDS Document Registry
C-HIN Patient Identity Source
DocumentEntries
PDQ Consumer
CareDelivery IT system
Tier 2 Community HIN
Patient Demo Supplier
Patient Id X-Ref Mgr
XDSDocument Repository
XDSDocument Repository
XDSDocument Repository
Patient Id X-Ref Mgr
Time Server
Who, What When and Where ?Trusted !
June 28-29, 2005 Interoperability Strategy Workshop17
Secured Node
Document Consumer
Retrieve Document
Query Documents
Patient Identity Source
Patient Identity
Feed
Document Source
Document Registry
Document Repository
Provide&RegisterDocument Set
RegisterDocument Set
Secured Node
Secured Node
Secured Node
Secured Node
Secured Node
ATNA creates a secured domain:• User Accountability (Audit trail)
• Node-to-Node Access Control
• Node-level user authentication
• User access control provided by node
BUT Registry/repository based User-Level Access Control and policy agreements is beyond XDS.
User-level Access Control is
provided by XUA
Security for XDSSecurity for XDSLeverages IHE Audit Trail & Node Authentication
A formal Security and Privacy profile is provided for XDS
June 28-29, 2005 Interoperability Strategy Workshop18
Cross-Enterprise User AuthenticationCross-Enterprise User Authentication
Transaction DiagramTransaction Diagram
IdentityProvider
2 Request Assertion (of who this user is)
1 XD
S Retrieve
3 Req
uest U
ser ID
4 User
Iden
tity
5 Authentication Assertion
RecordAuditableEvent
ATNAAudit
Repository
XDS Repository
June 28-29, 2005 Interoperability Strategy Workshop19
Is it possible to federate Is it possible to federate multiple XDS-based HIN ? multiple XDS-based HIN ?
CareDelivery IT system
CareDelivery IT system
XDS Document Registry
C-HIN Patient Identity Source
DocumentEntries
PDQ Consum
er
CareDelivery IT system
Tier 2 Community HIN
Patient Demo Supplier
Patient Id X-Ref Mgr
XDSDocument Repository
XDSDocument Repository
XDSDocument Repository
Patient Id X-Ref Mgr
Time Server
Who, What When and Where ?Trusted !
CareDelivery IT system
CareDelivery IT system
XDS Document Registry
C-HIN Patient Identity Source
DocumentEntries
PDQ Consum
er
CareDelivery IT system
Tier 2 Community HIN
Patient Demo Supplier
Patient Id X-Ref Mgr
XDSDocument Repository
XDSDocument Repository
XDSDocument Repository
Patient Id X-Ref Mgr
Time Server
Who, What When and Where ?Trusted !
CareDelivery IT system
CareDelivery IT system
XDS Document Registry
C-HIN Patient Identity Source
DocumentEntries
PDQ Consum
er
CareDelivery IT system
Tier 2 Community HIN
Patient Demo Supplier
Patient Id X-Ref Mgr
XDSDocument Repository
XDSDocument Repository
XDSDocument Repository
Patient Id X-Ref Mgr
Time Server
Who, What When and Where ?Trusted !
CareDelivery IT system
CareDelivery IT system
XDS Document Registry
C-HIN Patient Identity Source
DocumentEntries
PDQ Consum
er
CareDelivery IT system
Tier 2 Community HIN
Patient Demo Supplier
Patient Id X-Ref Mgr
XDSDocument Repository
XDSDocument Repository
XDSDocument Repository
Patient Id X-Ref Mgr
Time Server
Who, What When and Where ?Trusted !
CareDelivery IT system
CareDelivery IT system
XDS Document Registry
C-HIN Patient Identity Source
DocumentEntries
PDQ Consum
er
CareDelivery IT system
Tier 2 Community HIN
Patient Demo Supplier
Patient Id X-Ref Mgr
XDSDocument Repository
XDSDocument Repository
XDSDocument Repository
Patient Id X-Ref Mgr
Time Server
Who, What When and Where ?Trusted !
Tier2 Community-HINse.g. XDS Affinity Domain
June 28-29, 2005 Interoperability Strategy Workshop20
Federating Tier 2 Health Information NetworksFederating Tier 2 Health Information NetworksOn IHE Roadmap for 2006-2007: X-Registry FederationOn IHE Roadmap for 2006-2007: X-Registry Federation
(Addressed by ebXML Registry 3.0)(Addressed by ebXML Registry 3.0)
Patient / Registry Locator Service
Managed Identification
Federated Identification
T2 C-HIN Be.g. XDS Affinity Domain
T2 C-HIN De.g. XDS Affinity Domain
RG
RG
What are the document registries where a patient has information ?What are the document registries where a patient has information ?
Tier 3 HINe.g. State Level
June 28-29, 2005 Interoperability Strategy Workshop21
Federating Tier 2 Health Information NetworksFederating Tier 2 Health Information NetworksOn IHE Roadmap for 2006-2007: X-Registry FederationOn IHE Roadmap for 2006-2007: X-Registry Federation
Patient / Registry Locator Service
T2 C-HIN A e.g. IDN
Tier 3 HINe.g. State Level
Managed Identification
Federated Identification
T2 C-HIN Be.g. XDS Affinity Domain
T2 C-HIN Ce.g. IDN
T2 C-HIN De.g. XDS Affinity Domain
RG +AdaptRG +Adapt RG
RG
Integrating existing IDNs: Integrating existing IDNs: Adaptor + RegistryAdaptor + Registry
June 28-29, 2005 Interoperability Strategy Workshop22
Federating Tier 3 Health Information NetworksFederating Tier 3 Health Information NetworksOn IHE Roadmap for 2006-2007: X-Registry CommunicationOn IHE Roadmap for 2006-2007: X-Registry Communication
Patient / Registry
Locator Service
T1-RHIO A e.g. IDN
e.g. State HIN
T1-RHIO Be.g. XDS Affinity Domain
T1-RHIO Ce.g. IDN
T1-RHIO De.g. XDS Affinity Domain
RGRG RG
RG
Patient / Registry
Locator Service
T1-RHIO A e.g. IDN
e.g. State HIN
T1-RHIO Be.g. XDS Affinity Domain
T1-RHIO Ce.g. IDN
T1-RHIO De.g. XDS Affinity Domain
RGRG RG
RG
Patient / Registry Locator Service
Patient / Registry Locator Service
Patient /
Registry
Locator
Service
T1-RHIO A e.g. IDN
e.g. State HIN
T1-RHIO Be.g. XDS Affinity Domain
T1-RHIO Ce.g. IDN
T1-RHIO De.g. XDS Affinity Domain
RGRG RG
RG
Patient /
Registry
Locator
Service
T1-RHIO A e.g. IDN
e.g. State HIN
T1-RHIO Be.g. XDS Affinity Domain
T1-RHIO Ce.g. IDN
T1-RHIO De.g. XDS Affinity Domain
RGRG RG
RG
Patient /
Registry
Locator
Service
T1-RHIO A e.g. IDN
e.g. State HIN
T1-RHIO Be.g. XDS Affinity Domain
T1-RHIO Ce.g. IDN
T1-RHIO De.g. XDS Affinity Domain
RGRG RG
RG
Nation-Wide Health Info network (Tier 4)
June 28-29, 2005 Interoperability Strategy Workshop23
IHE: RHIOs’ Interoperability PartnerIHE: RHIOs’ Interoperability Partner• IHE offers a solid technical foundation to establish
interoperability for RHIOs.
• Standards-based, open, multi-vendor, provider-led.
• Yearly progress, validation testing built in, backed by a proven process. Implementation by many vendors.
• IHE welcomes RHIOs’ technical architects’ active involvement.
• The IHE Technical Framework accelerates RHIOs pilot development (e.g. XDS Affinity Domain).
• This is being applied: Norway, Italy, then Canada, soon USA, France, ?
June 28-29, 2005 Interoperability Strategy Workshop24
Clinical EncounterClinical Encounter ClinicalClinicalIT SystemIT System 1-Expression of a 1-Expression of a
need for additional need for additional informationinformation
Index of patients records(Document-level)
Temporary Aggregate Patient History
3-Documents3-DocumentsReturnedReturned
DocumentRepositories
4-Patient data 4-Patient data presented to presented to
PhysicianPhysician
3-Reference3-Referenceto Docs from to Docs from
InquiryInquiry2- Inquiry 2- Inquiry for Docs for Docs
Clinicians access XDS ServicesClinicians access XDS Servicesthrough their clinical IT system (EHRs)through their clinical IT system (EHRs)
June 28-29, 2005 Interoperability Strategy Workshop25
Sharing Radiology Reports and Images with XDSSharing Radiology Reports and Images with XDSin a Regional Health Information Networkin a Regional Health Information Network
Radiology Enterprise A
Radiology Enterprise B
Physician Office
Regional Health Regional Health Information Information NetworkNetwork
PACS B
PACS A
Radiology-to-radiology
Radiology-to-Physicians
June 28-29, 2005 Interoperability Strategy Workshop26
Sharing Radiology Reports and ImagesSharing Radiology Reports and Imagesin a Regional Health Information Networkin a Regional Health Information Network
Radiology Enterprise A
Radiology Enterprise B
Physician Office
Regional Health Regional Health Information Information NetworkNetwork
Cross-Cross-Enterprise Enterprise RegistryRegistry
Patient Id= 3547F45• Report 5/21/1998 : CT Head B• Study 5/21/1998 : CT Head B• Report 2/18/2005 : Chest Xray A• Study 2/18/2005 : Chest Xray A
PACS B
PACS A
June 28-29, 2005 Interoperability Strategy Workshop27
Physicians and Systems within a Regional Health Physicians and Systems within a Regional Health Network - Routine Imaging ReferralNetwork - Routine Imaging Referral
Radiology Enterprise A
Radiology Enterprise B
Physician Office
Regional Health Regional Health Information Information NetworkNetwork
Query for Query for Documents Documents
Register Imaging Register Imaging Information for Information for
sharingsharing
Priorimaging
Reports & Studies
Cross-Cross-Enterprise Enterprise RegistryRegistry
Register Imaging Register Imaging Information for Information for sharingsharing
Patient Id= 3547F45• Report 5/21/1998 : CT Head B• Study 5/21/1998 : CT Head B
June 28-29, 2005 Interoperability Strategy Workshop28
Physicians and Systems within a Regional Health Physicians and Systems within a Regional Health Network - Routine Imaging ReferralNetwork - Routine Imaging Referral
Radiology Enterprise A
Radiology Enterprise B
Physician Office
Regional Health Regional Health Information Information NetworkNetwork
Register Imaging Register Imaging Information for Information for
sharingsharing
Cross-Cross-Enterprise Enterprise RegistryRegistry
Notification of Notification of Doc AvailabilityDoc Availability
Register Imaging Register Imaging Information for Information for sharingsharing
June 28-29, 2005 Interoperability Strategy Workshop29
Physicians and Systems within a Regional Health Physicians and Systems within a Regional Health Network for a Routine Imaging ReferralNetwork for a Routine Imaging Referral
Radiology Enterprise A
Radiology Enterprise B
Physician Office
Prior Imaging Report & Study
Regional Health Regional Health Information Information NetworkNetwork
Query for Query for documents documents
Imaging Report Imaging Report & Study& Study
Cross-Cross-Enterprise Enterprise RegistryRegistry
Patient Id= 3547F45• Report 5/21/1998 : CT Head B• Study 5/21/1998 : CT Head B• Report 2/18/2005 : Chest Xray A• Study 2/18/2005 : Chest Xray A
Notification of Notification of Doc AvailabilityDoc Availability
June 28-29, 2005 Interoperability Strategy Workshop30
Regional Health Information Regional Health Information NetworkNetworkImages and reports Images and reports part of a sharedpart of a shared health record health record
Enterprise A
Enterprise B
Physician Office
Retrieve Prior Documents
Query for Query for Documents Documents
Regional Health Regional Health Information Information NetworkNetwork
Query for Query for documents documents
Retrieve Retrieve DocumentsDocuments
Register Documents Register Documents for sharingfor sharing
Retrieve Prior
Documents
Cross-Cross-Enterprise Enterprise RegistryRegistry
Register Documents Register Documents for sharingfor sharing
Notification of Notification of Doc AvailabilityDoc Availability
June 28-29, 2005 Interoperability Strategy Workshop31
oror
Lab Results Document Content
Format of the Document Content and associated coded vocabulary
For Display Document Content
Format of the Document Content
Requirements for care delivery IT system in a RHIORequirements for care delivery IT system in a RHIO(e.g. EHR, Lab, Imaging, etc.)(e.g. EHR, Lab, Imaging, etc.)
Consistent TimeCoordinate time across
networked systems
Audit Trail & Node Authentication
Centralized privacy audit trail and node to node authentication
to create a secured domain.
Patient Demographics Query
Cross-Enterprise Document Sharing
Registration, distribution and access across health enterprises of clinical
documents forming a patient electronic health record
Notification of Document Availability
Notification of a remote provider/ health enterprise
Imaging Information Sharing
Format of the Document Content and associated coded vocabulary
Medical Summary Document Content
Format of the Document Contentand associated coded vocabulary
Document Digital Signature
Attesting “true-copy and origin
Patient Identifier Cross-referencing
Map patient identifiers across independent identification
domains
Cross-enterprise User Authentication
Authentication & Auditing: Basis for Access Control
June 28-29, 2005 Interoperability Strategy Workshop32
IHE: Interoperability for RHIOs’IHE: Interoperability for RHIOs’
• By starting with a secured document sharing infrastructure, RHIOs have a a platform on which to build clinical content (more structure & coded terminology, specialized content).
• Solid SAML 2.0 authentication and document digital signature (need a PKI).
• Practical HL7 V3 approach with CDA-R2 and other content (e.g. imaging, CCR, legacy, PDF, etc.).
• Establishing a critical mass of products implementations, both in clinical applications and infrastructure for deployment in 2006.
• An architecture that caters to various RHIOs architectures: centralized, decentralized and mixed (operational decision).
June 28-29, 2005 Interoperability Strategy Workshop33
More information….More information….
• IHE Web sites: www.ihe.net• Technical Frameworks, Supplements
– Fill in relevant supplements and frameworks
• Non-Technical Brochures :• Calls for Participation
• IHE Fact Sheet and FAQ
• IHE Integration Profiles: Guidelines for Buyers
• IHE Connect-a-thon Results
• Vendor Products Integration Statements
June 28-29, 2005 Interoperability Strategy Workshop34
IHE Patient Id management IHE Patient Id management for RHIOsfor RHIOs
Use of PIX and PDQ Integration ProfilesUse of PIX and PDQ Integration Profiles
June 28-29, 2005 Interoperability Strategy Workshop35
Patient Identification ManagementPatient Identification ManagementPIX Cross Referencing (coexist with PDQ)PIX Cross Referencing (coexist with PDQ)
XDS Document Registry
XDSDocument
Repository
Patient Identity Source
Patient Patient Identification Identification
Domain CDomain C
Patient Patient Identification Identification Domain XADDomain XAD
Patient Patient Identification Identification Domain D2Domain D2
DocumentEntryDm=XADPid=Px
Patient Identity X-Ref Mgr
Patient Identity X-Ref Mgr
Patient Identity FeedDm=XAD, Pid=Px
Patient IDConsumer
Dm=CPid=Pc
XDS Document Source
XDS Doc
Dm=XADPid=Px
XDS Doc
Provide&Register Doc Set
Patient IDConsumer
XDS Document Consumer
Dm=D2Pid=Pd
Dm=XADPid=Px
Query Docs
June 28-29, 2005 Interoperability Strategy Workshop36
Patient Identification ManagementPatient Identification ManagementPDQ Discovery + Local mapping (coexist with PIX)PDQ Discovery + Local mapping (coexist with PIX)
XDS Document Registry
XDSDocument
Repository
Patient Identity Source
Patient Patient Identification Identification
Domain CDomain C
Patient Patient Identification Identification Domain XADDomain XAD
Patient Patient Identification Identification Domain D2Domain D2
DocumentEntryDm=XADPid=Px
Patient Demographics Supplier Patient Identity
FeedDm=XAD, Pid=Px
PatientDemoConsumer
XDS Document Source
XDS Doc
Dm=XADPid=Px
Demographics
XDS Doc
Provide&Register Doc Set
Patient DemoConsumer
XDS Document Consumer
Demographics
Dm=XADPid=Px
Query Docs
June 28-29, 2005 Interoperability Strategy Workshop37
W W W . I H E . N E TW W W . I H E . N E T
Providers and VendorsProviders and Vendors
Working Together to DeliverWorking Together to Deliver
Interoperable Health Information SystemsInteroperable Health Information Systems
in the Enterprisein the Enterprise
and Across Care Settingsand Across Care Settings
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