xdm / xdr point-to-point transmission of documents iti planning committee
TRANSCRIPT
XDM / XDR Point-to-Point Transmission of
Documents
ITI Planning CommitteeITI Planning Committee
IT Infrastructure Planning CommitteeIT Infrastructure Planning Committee
Point-to-Point Transmission of Documents
• XDS is the base– XDM = exchange of XDS metadata and
documents on Media– XDR = exchange of XDS metadata and
documents over reliable protocols
IT Infrastructure Planning CommitteeIT Infrastructure Planning Committee
XDM
• XDM – Media Interchange (email, CD, etc.)– Documents and XDS Metadata shared via media – Options
• USB• CD-R• ZIP over email
– Imposes File/Directory structure on the media– Transport Multiple XDS Submission Sets
• Each Submission Set has Metadata describing documents
– Documents• Protocol structure of XDS imposed on file/directory organization
IT Infrastructure Planning CommitteeIT Infrastructure Planning Committee
• XDM – Media Interchange (email, CD, etc.)– Uses
• Release of documents to patient• Manual (in pocket or email) transfer of documents
– Local display after receipt
– Index.htm file required to support display
– These are manual operations!
– Works with XDS• XDS Query/Retrieve can feed XDM transmission• Point-to-point transfer via XDM can feed XDS submission
XDM
IT Infrastructure Planning CommitteeIT Infrastructure Planning Committee
Health Information Exchange
Generally more than two trading partners,
e.g.PhysicianOffice
e.g. A Hospital
Discharge summary +Lab report
Write
Read
InterchangeMedia
Discharge summary + Lab
report
Read
e.g. Home
XDM
IT Infrastructure Planning CommitteeIT Infrastructure Planning Committee
• XDR – Reliable Interchange– Single Submission Set per transfer– Optionally identify intended recipients– More like XDS than XDM
• Reliable asynchronous point-to-point transmission of XDS content (metadata and documents) over reliable communications
• A new profile but really just documents how to use Provide and Register transaction [ITI-15] (same as XDS) to perform point-to-point transfers.
XDR
IT Infrastructure Planning CommitteeIT Infrastructure Planning Committee
• XDR – Reliable InterchangeReliable transfer comes from ebMS Messaging
Services Specification v2.0Online vs. Offline
• Online = over direct TCP connection• Offline = over SMTP
Works with XDS• XDS Query/Retrieve can feed XDR transmission• Point-to-point transfer via XDR can feed XDS submission
XDR
IT Infrastructure Planning CommitteeIT Infrastructure Planning Committee
Health Information Exchange
Send to Switch Send to
e.g. A SpecialistOffice
e.g. A Clinic
A referral summary + lab report A referral summary +
lab report
Two specific trading partners,
XDR
IT Infrastructure Planning CommitteeIT Infrastructure Planning Committee
Combining XDM / XDR
Specialist, Radio or LabGP / PCP Doctor
A
Care Facility Hospital Acute
Care / ED
Patient Transfer
Personal Health Record (PHR)to ED/Primary Care EMR
Acute Care DischargeAcute Care Dischargeto Extended Care Facility (ECF)to Extended Care Facility (ECF)
Remote advice
Consulting to referring physicians
Hospital-doctor communication
IT Infrastructure Planning CommitteeIT Infrastructure Planning Committee
Flexible Infrastructure
Health Information Exchange
Publish
PullStructuredobjects
Pull
Send to Switch Send to
Write ReadInterchangeMedia
XDS
XDR
XDM
IT Infrastructure Planning CommitteeIT Infrastructure Planning Committee
• Complementary to sharing documents (XDS), point-to-point communication of documents
• Both transports: secured mail & media (CD…)• As XDS, “document content agnostic”• Maximal re-use of XDS objects & meta-data• Compatible with exchange of images (PDI…)• All XDS “content profiles” apply
Point-to-Point Transmission of Documents
IT Infrastructure Planning CommitteeIT Infrastructure Planning Committee
• Interchange of patient centered documents• Transmission of results, discharge letters or patient
referrals (not the "workflow" itself but all the medical information associated with - e.g. reports, results, images, signals…)
• Personal Health Record medical information (history, etc), snapshots of clinical information (medication list, immunization records, etc), current observations from home care medical devices (e.g. blood pressure, blood sugar level, etc).
Point-to-Point Transmission of Documents