Cross Community (XC) Profiles

pigeoneggtrainsNetworking and Communications

Oct 24, 2013 (3 years and 11 months ago)

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Cross Community (XC)

Profiles

Karen Witting

Outline


Vision


as described in 2006 IHE White
Paper on Cross Community Exchange


Existing


what has been implemented
today


First steps


plan for 2007 and 2008

Regional Network B

Acute Care

(Inpatient)

PCPs and Clinics


(Ambulatory)

Long Term Care

Other Specialized Care

or Diagnostics Services

Document Registry

Document

Repository

Longitudinal Record

as used

across
-
encounters

Regional Network C

Acute Care

(Inpatient)

PCPs and Clinics


(Ambulatory)

Long Term Care

Other Specialized Care

or Diagnostics Services

Document Registry

Document

Repository

Longitudinal Record

as used

across
-
encounters

Regional Network A

Acute Care

(Inpatient)

PCPs and Clinics


(Ambulatory)

Long Term Care

Other Specialized Care

or Diagnostics Services

Document Registry

Document

Repository

Longitudinal Record

as used

across
-
encounters

Hierarchical Exchange

From Cross Community Information Exchange White Paper


Cross Community
Bridge

Which community holds

records for a patient ?

Cross

Community

Bridge

Cross

Community

Bridge

Community

Locator service


Each region notifies Community
Location Service when new
patient is registered or first data is
stored.


Cross Community Bridges query
Community Locator Service
(future)


Cross
-
Community Bridges query
and retrieve records (2007 &
future)


IHE Transactions

(future)

National Network A

Non
-
IHE
National
EHR

Cross Community
Bridge

Cross

Community

Bridge

Cross

Community

Bridge

Community

Search

Service


National or Regional
Networks not required to be
IHE
-
based


Mapping to & from IHE
Transactions performed by
X
-
Community bridges


Mapping practical as most
European projects use
variants of structured
document sharing


National Network C

IHE based Sub
-
Networks

XDS Affinity Domain (NHIN sub
-
network)

Integrated

Delivery

Network

Community

Locator service

Non
-
IHE Sub
-
Net

IHE Transactions

(future)

What communities have

specific attributres?

National or Regional
Network B

Acute Care

(Inpatient)

PCPs and Clinics


(Ambulatory)

Long Term Care

Other Specialized Care

or Diagnostics Services

Document Registry

Document

Repository

Longitudinal Record

as used

across
-
encounters

Lateral Exchange and non
-
IHE Domains

From Cross Community Information Exchange White Paper

Acute Care

(Inpatient)

PCPs and Clinics


(Ambulatory)

Long Term Care

Other Specialized Care

or Diagnostics Services

Document Registry

Document

Repository

Longitudinal Record

as used

across
-
encounters

Acute Care

(Inpatient)

PCPs and Clinics


(Ambulatory)

Long Term Care

Other Specialized Care

or Diagnostics Services

Document Registry

Document

Repository

Longitudinal Record

as used

across
-
encounters

Common

PIX Server

XDS Registry

Cross

Community

Bridge

Document

Consumer

Meta
-
Community using existing IHE Profiles

XDS Registry

XDS Repository

Patient Identity

Source

Patient Identity

Source

Patient Identity

Source

(1)

(1)

(1)

(3)

(2)

XDS Registry

(4)

(4)

(4)

(5)

XDS Repository

XDS Repository

(6)

(6)

(6)

Meta
-
Community

Community A

Community B

Community C

Cross Community White Paper


Cross Community Access


2007 profile


Cross Community Location Service


2008
profile

Cross Community Access


Sharing of documents beyond the XDS Affinity Domain
(community) boundary.


Scoped to document sharing between XDS Affinity
Domains. Future goal to define sharing with other types
of communities.


Two purposes:


Encapsulate cross community interactions in one actor


Cross
Community Bridge (XC Bridge)


Define a query which returns data from external communities


Cross Community Query (XC Query)


The XC query is the first instance of an interaction that the
XC Bridge mediates

Meta
-
community

XDS community C

XDS community A

XDS community B

XDS Registry

XC

Bridge

XC Locator Service

or

Any other service

or configuration

XDS Registry

XC

Bridge

XDS

Repository

XC

Consumer

XC

Bridge

Use of the Cross Community Access profile in a Meta
-
community

XDS Repository

XDS Registry

XDS Repository

(3)

XC Bridge (local)

XC Consumer

XC Query

XB Query

XB Retrieve

XC Bridge (remote)

XC Retrieve

Draft Transaction Diagram

Cross Community Access

Technical Solution


Cross Community Bridge


A new actor which supports all inter
-
community communications.
Encapsulates in one actor all activities required to communicate outside
the community.


Every community would have one cross community bridge which would
interact with actors within the community and remote cross community
bridges.


Cross Community Consumer


Initiator of a request for information beyond the community.


Technical Issues:


Need for asynchronous transactions in the cross community environment


Interaction with existing XDS actors


Reliable identification of the patient

Cross Community (XC)

Location Service


Service to save, update, remove, query patient
record references


Record references might me:


To documents (internal and external)


To XDS registry (internal and external)


To “XC Bridge” definition TBD


To “Fine grained data repository” definition TBD

i.e. MUST BE EXTENSIBLE


Record references indexed by patient demographics


Patient ids could be one element of demographics but service
must talk using demographics as a common patient id cannot
be assumed.

Draft Transaction Diagram

XC Location
Consumer

XC Location Service

(PIX+/RLS/RLUS)

Add

Update

Merge

Remove

Query

XC Location

Feed