System Directory for Document Sharing (SDDS) Profile Proposal for 2010/2011 presented to the IT Infrastructure Planning Committee Vassil Peytchev, Epic October 18, 2010

The Problem What problem is this profile proposal hoping to address? In an XCA environment, an Initiating Gateway needs to know what Responding Gateways are available for querying about a patient. In an XDS affinity domain, a Document Consumer needs to know what repositories correspond to any possible Repository Unique ID that may be returned as a result of a Stored Query. Identify any existing IHE profile gaps/overlaps that this proposal will improve upon Currently, the XDS-b and XCA profiles do not specify how the participants in the document exchange know about the existence and web services end points of the document repositories, the document registry, and the various responding gateways. This proposal adds the transactions needed to automate some of this setup.

Market Readiness What is the market readiness for this IHE profile proposal? In the US, the NHIN project includes a UDDI based server, which provides information about the participating gateways. Also in the US, the Health Direct Project (FKA NHIN Direct) also expects UDDI based directories to provide information about web services used in point-to-point exchanges. The ability to change/add/remove repositories within an XDS affinity domain without disrupting the other participants is important for the practical implementation of XDS.b

Risks and Other Comments What is the risk of this proposal not being undertaken this cycle? A delay in the undertaking of this proposal may cause multiple mutually incompatible solutions to this problem to be developed in order to meet the aggressive timelines of various XCA and XDS implementations. Other relevant comments The HPD profile (currently in trial implementation) provides a mechanism to link individual providers and provider organizations to entries in the System Directory for Document Sharing

Use Case - XCA In an XCA environment, a large healthcare organization participates as a community of its own. When a patient is admitted in a hospital for the first time, he indicates that he had previously received care in Arizona. Based on this information, the Initiating Gateway for the healthcare organization will query only the Responding Gateways that are associated with Arizona communities. The information about which Responding Gateways are to be queried can be dynamically obtained (via a query to the directory server) or passively maintained (via updates from the directory server).

Use Case - XDS A new organization (A) joins an XDS Affinity Domain with its own repository. It registers several existing documents in the Affinity Domain’s Registry. A patient is scheduled for an appointment in Organization B. As part of the scheduling process, a stored query is sent to the Document Registry. The results of the query contain entries from A’s repository. Since there is a directory server in the Affinity Domain, the Document Consumer in B can associate the Repository Unique ID of A with the corresponding web services end point, which will allow for documents from A to be retrieved. The information about associating A’s Repository Unique ID with a web services end-point can be dynamically obtained (via a query to the directory server) or passively maintained (via updates from the directory server).

Proposed Standards & Systems What standards and/or systems should be considered in addressing this proposal? This proposal will be a new profile and it will introduce additional actors, and several new transactions. The NHIN specifications for UDDI server will be used as a starting point

Discussion What level of effort do you foresee in developing this profile? medium effort Is there someone who is willing to act as profile editor? Vassil Peytchev, Epic, vassil@epic.com