To the IHE Community,
As part of IHE Canada’s continuing work on the XDS profile and its related specifications, the ITI working committee co-chairs are proposing the creation of a new white paper that will address an issue that has been under discussion for some time: how to align XDS with the Infoway EHRS Blueprint, in particular in its relationship to the EHR Index and the Shared Health Record Repository.
The objective of this white paper is to document the differences and similarities between both approaches and define possible avenues for alignment between these specifications. Given the current state of many EHR projects across the country, XDS-I will naturally be an important aspect of the document, but the intent is to provide a broader vision on how to leverage XDS for other clinical domains as well. This will be a high-level position paper and will not attempt to establish a definite solution to the problem.
We are looking for volunteers to help us write and/or review this white paper. We will be using the IHE XDS Implementation Google group to exchange information and draft material, so if you are interested and available, please make sure to join the group first. Our intention is to have a first version of the document prepared within the next 3-4 weeks.
To further describe what is the current intent of this work, we have drafted an initial Table of Contents, subject to change, which is included below.
Further information regarding conference call schedules will be forthcoming very soon.
As usual, we would appreciate very much if one of the member organizations could offer their phone/web meeting facilities for this work.
José Mussi – Michael Nusbaum
ITI Working Committee Co-Chairs
Draft Table of Contents:
1. Executive Summary
2. Introduction and Background
a. Why is it important that we address this problem?
3. Current State Summary
a. Infoway and the EHRS Blueprint
b. IHE XDS profile
c. IHE XDS-I Profile
d. Diagnostic Imaging Repository (DI-r) Projects in Canada
e. EHRS Blueprint EHR Index
f. EHRS Shared Health Record Repository (SHRR)
4. Challenges and Opportunities
5. Guiding Principles
6. Alternatives for Aligning XDS with the EHRS Blueprint
g. Level 1 - XDS-I for Radiology Only with separate EHR Index
i. Co-existence of EHR Index and XDS Registry and XDS Repository
h. Level 2 - XDS Registry as the basis for EHR Index
i. Define EHR Index as a superset of XDS (single index)
ii. XDS transactions used for Radiology (based on XDS-I)
iii. HL7 v3 messages used for SHR and Other Domain Repositories
i. Level 3 - EHR Index as an extension of an XDS Registry
i. XDS repository is a component of the SHR
ii. Single EHR index for all domains based on XDS registry (possibly extending current definition)
iii. Support of both XDS transactions and HL7 v3 (TBD) messages for all domains
j. Summary of Alternatives versus Principles
1. XDS Metadata Schema versus an EHR Metadata Schema for EHR Index
2. Messaging (XDS transactions vs. HL7 v3)
3. XDS Repository for SHRR
4. Patient identification - ECID v. XDS Affinity Domain Patient Identifier
5. Patient Eligibility in XDS - not required in Canada
8. Next Steps
a. Infoway iEHR Technical Project
b. IHE Canada extensions to XDS
c. IHE ITI profile work
d. Standards Collaborative
Appendix A - Standards and Specifications
a. IHE XDS Profile
i. Document Sharing Paradigm
iv. Metadata Schema
b. EHR Index
i. Data Locating Services
ii. EHRS Blueprint
iii. HL7 v3 Control Act Schema