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Sept 13-15, 2004IHE Interoperability Worshop 1 Integrating the Healthcare Enterprise XDS Cross-Enterprise Document Sharing Integration Profile Standards.

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Presentation on theme: "Sept 13-15, 2004IHE Interoperability Worshop 1 Integrating the Healthcare Enterprise XDS Cross-Enterprise Document Sharing Integration Profile Standards."— Presentation transcript:

1 Sept 13-15, 2004IHE Interoperability Worshop 1 Integrating the Healthcare Enterprise XDS Cross-Enterprise Document Sharing Integration Profile Standards &Transactions & Implementation Bill Majurski – NIST IHE IT Infrastructure Technical Committee http://www.sanita.forumpa.it/documenti/0/100/150/150/IHE_XDS_1.ppt

2 Sept 13-15, 2004IHE Interoperability Worshop 2Introduction Registry Standard Things XDS adds to the Registry Standard Structure of Actors and Transactions Implementation High-level focus – minimal XML

3 Sept 13-15, 2004IHE Interoperability Worshop 3 Registry Standard ebXML Registry OASIS Standard  OASIS (Organization for the Advancement of Structured Information Standards) is a not-for-profit, international consortium that drives the development, convergence, and adoption of e-business standards  http://www.oasis-open.org Adopted by ISO Specifically a Document Registry Focus on business documents

4 Sept 13-15, 2004IHE Interoperability Worshop 4 ebXML Registry Component Standards ebRIM – Registry Information Model  Metadata Data about documents Defines basis for searches ebRS – Registry Services  Interfaces  Protocols  Actions/verbs  Query language

5 Sept 13-15, 2004IHE Interoperability Worshop 5 ebXML Registry defines Integrated Registry & Repository Registry holds Metadata Repository holds Documents

6 Sept 13-15, 2004IHE Interoperability Worshop 6 Metadata Building Blocks Large collection of small objects Document (ExtrinsicObject) Association – Link between two objects External Link – URI – link to web resource Classification Scheme – Taxonomies Classification – Link to term in taxonomy RegistryPackage – Bundle of objects

7 Sept 13-15, 2004IHE Interoperability Worshop 7 Common Registry Object Attributes Id – object identifier (UUID) Name – label only – not used in identification Description – f ree text objectType Status – submitted/approved/deprecated … Slots – name/value pairs External Identifiers – primary search indexes

8 Sept 13-15, 2004IHE Interoperability Worshop 8 Common Registry Object Attribute Size Limitations Name – 128 chars Description – 256 chars Slots  name – 128 chars  value – 128 chars External Identifiers – 64 chars External Link (URI) – 256 chars

9 Sept 13-15, 2004IHE Interoperability Worshop 9 General Document Registry Operations Submit metadata and documents Update metadata and documents Query metadata Retrieve Documents

10 Sept 13-15, 2004IHE Interoperability Worshop 10 How does XDS relate to ebXML Registry? Applies Constrains Extends Reconfigures Integrates

11 Sept 13-15, 2004IHE Interoperability Worshop 11 ebXML Registry -> XDS Reconfigures:  Registry and repository as separate actors Benefits:  Repository may already be part of another product/system.  Common registry for many repositories

12 Sept 13-15, 2004IHE Interoperability Worshop 12 ebXML Registry -> XDS Constrains:  Metadata design Benefits:  Establishes mandatory metadata  Relevant to medical documents  Restriction on how documents may relate  Defines reasonable space for queries

13 Sept 13-15, 2004IHE Interoperability Worshop 13 ebXML Registry -> XDS Extends:  Metadata submission to registry guaranteed atomic Benefits:  Simpler registry client  Well defined responsibilities

14 Sept 13-15, 2004IHE Interoperability Worshop 14 ebXML Registry -> XDS Integrates:  With other IHE profiles Benefits:  Integrate once – at specification level

15 Sept 13-15, 2004IHE Interoperability Worshop 15 ebXML Registry -> XDS Extends:  By introducing the Submission Set (record of what was submitted together) Benefits:  Related by medical event, parameters of the submission, support for transactions

16 Sept 13-15, 2004IHE Interoperability Worshop 16 ebXML Registry -> XDS Extends:  By introducing the Folder with constraints on its contents Benefits:  Restricted content, standard parameters

17 Sept 13-15, 2004IHE Interoperability Worshop 17 ebXML Registry -> XDS Extends:  By introducing new terminology Benefits:  Terms now exist to describe subtle issues in standard  New terms to describe how XDS deploys and integrates ebXML Registry

18 Sept 13-15, 2004IHE Interoperability Worshop 18 New Terms XDS Document XDS Repository Submission Request XDS Registry Submission Request XDS Submission Set XDS Folder XDS Registry Adaptor Function

19 Sept 13-15, 2004IHE Interoperability Worshop 19 What does XDS Not Change? Messages – all messages conform to standard Protocols - unchanged Information Model – restricted but unaltered

20 Sept 13-15, 2004IHE Interoperability Worshop 20 Document Source Document Consumer Document Registry Patient Identity Source XDS Actors Document Repository

21 Sept 13-15, 2004IHE Interoperability Worshop 21 Document Source Document Consumer Document Registry Patient Identity Source XDS Actors and Transactions Document Repository Patient Identity Feed Query Registry Register Document Set Retrieve Document Provide & Register Document Set

22 Sept 13-15, 2004IHE Interoperability Worshop 22 Document Source Actor Transactions  Provide & Register Document Set

23 Sept 13-15, 2004IHE Interoperability Worshop 23 Provide & Register Document Set Transaction Document Source has responsibility for generating metadata Send Repository Submission Request containing metadata and documents to repository Status returned

24 Sept 13-15, 2004IHE Interoperability Worshop 24 Repository Submission Request Metadata Document 1 Document 2 Repository Submission Request Submission Set

25 Sept 13-15, 2004IHE Interoperability Worshop 25 Document Source Document Consumer Document Registry Patient Identity Source Document Repository Actor Document Repository Patient Identity Feed Query Registry Register Document Set Retrieve Document Provide & Register Document Set

26 Sept 13-15, 2004IHE Interoperability Worshop 26 Document Repository Actor Transactions  Provide & Register Document Set  Register Document Set  Retrieve Document

27 Sept 13-15, 2004IHE Interoperability Worshop 27 Provide & Register Document Set Transaction Documents stored in repository Knows location of the cross-enterprise registry Invoke Register Document Set Transaction Success means documents accepted by repository and metadata accepted by registry

28 Sept 13-15, 2004IHE Interoperability Worshop 28 Register Document Set Transaction Compute  Document address (URI) within repository  Document size  Document hash Metadata amended to include URI, size, hash Reject submission if document ID already present in repository with different size/hash (optional) Passes metadata to registry

29 Sept 13-15, 2004IHE Interoperability Worshop 29 Retrieve Document Transaction Documents retrievable via HTTP GET request Uses URI generated by Document Repository in Register Document Set Transaction Exact byte stream is returned

30 Sept 13-15, 2004IHE Interoperability Worshop 30 Document Source Document Consumer Document Registry Patient Identity Source Document Consumer Actor Document Repository Patient Identity Feed Query Registry Register Document Set Retrieve Document Provide & Register Document Set

31 Sept 13-15, 2004IHE Interoperability Worshop 31 Document Consumer Actor Transactions  Query Registry  Retrieve Document

32 Sept 13-15, 2004IHE Interoperability Worshop 32 Query Registry Transaction SQL query language ebRIM defines information model for queries ebRIM defines subset of SQL that applies Return is by reference or by value

33 Sept 13-15, 2004IHE Interoperability Worshop 33 Simple SQL Query Select all documents for patient ID 12345.34.259373 SELECT * FROM ExtrinsicObject doc, ExternalIdentifier patID WHERE doc.objectType=XDSDocumentEntry AND patID.identificationScheme=XDSPatientID AND patID.registryObject=doc.id AND patID.value=‘12345.34.259373’ AND doc.status=‘Approved’ XDSDocumentEntry and XDSPatientID are coded as UUIDs

34 Sept 13-15, 2004IHE Interoperability Worshop 34 XDS Query Keys Doc-level

35 Sept 13-15, 2004IHE Interoperability Worshop 35 Retrieve Document Transaction Query Registry Transaction  Can return metadata including document URI Retrieve Document via HTTP GET  Returns exact byte stream that was delivered to Repository in Provide & Register Document Set Transaction  Not related to IHE RID Profile

36 Sept 13-15, 2004IHE Interoperability Worshop 36 Document Source Document Consumer Document Registry Patient Identity Source Document Registry Actor Document Repository Patient Identity Feed Query Registry Register Document Set Retrieve Document Provide & Register Document Set

37 Sept 13-15, 2004IHE Interoperability Worshop 37 Document Registry Actor ebXML Registry XDS Registry Actor Structure ebXML Registry Function Registry Adaptor Function Document Repository Actor

38 Sept 13-15, 2004IHE Interoperability Worshop 38 Document Registry Actor Transactions  Register Document Set  Query Registry  Patient Identity Feed

39 Sept 13-15, 2004IHE Interoperability Worshop 39 Register Document Set Transaction Receives metadata from Repository Actor Validates metadata Stores metadata in registry as atomic operation

40 Sept 13-15, 2004IHE Interoperability Worshop 40 Registry Submission Request Metadata Registry Submission Request Submission Set

41 Sept 13-15, 2004IHE Interoperability Worshop 41 Document Availability Management Availability Status Visible to a Document Source Approved Available for Patient Care Deprecated Obsolete Deleted Submitted Registration in progress Availability Status Visible to a Document Consumer Registry Status attribute: Life Cycle Status indicator

42 Sept 13-15, 2004IHE Interoperability Worshop 42 Registry Adaptor Function Validate Metadata Valid patient ID Required attributes Valid coded values

43 Sept 13-15, 2004IHE Interoperability Worshop 43 Registry Adaptor Function (Cont) Validate Metadata (Cont) Submission Set semantics  Example – all new documents for same patient Folder semantics  Example – all documents for same patient Document Resubmission Implement resubmission semantics

44 Sept 13-15, 2004IHE Interoperability Worshop 44 Registry Adaptor Function (Cont) XDS Submission is atomic ebXML Registry submission is not Use Status Attribute as control  Submitted – submission in progress  Approved – submission complete - available to query

45 Sept 13-15, 2004IHE Interoperability Worshop 45 Registry Adaptor Function (Cont) Use two registry operations to store metadata Submit – store data, set status to submitted Approve – change status to Approved

46 Sept 13-15, 2004IHE Interoperability Worshop 46 Query Registry Transaction Process SQL query against registry contents Return list of  Objects formatted in XML  Object references Remember to search for Approved objects

47 Sept 13-15, 2004IHE Interoperability Worshop 47 Simple SQL Query Select all documents for patient ID 12345.34.259373 SELECT * FROM ExtrinsicObject doc, ExternalIdentifier patID WHERE doc.objectType=XDSDocumentEntry AND patID.identificationScheme=XDSPatientID AND patID.registryObject=doc.id AND patID.value=‘12345.34.259373’ AND doc.status=‘Approved’ XDSDocumentEntry and XDSPatientID are coded as UUIDs

48 Sept 13-15, 2004IHE Interoperability Worshop 48 Patient Identity Feed Transaction Notification on  Patient registration  Updated Patient Information From Patient Identity Source (ADT) Registry Adaptor Function maintains list of valid patient IDs

49 Sept 13-15, 2004IHE Interoperability Worshop 49 Primary XDS Concepts Submission Request Submission Set Document Folder Document Life Cycle Management

50 Sept 13-15, 2004IHE Interoperability Worshop 50 Document Source Document Consumer Document Registry Patient Identity Source Submission Requests Document Repository Repository Submission Request Registry Submission Request

51 Sept 13-15, 2004IHE Interoperability Worshop 51Document Real document vs. metadata Attributes Relationships between documents  Replace  Append  Transform

52 Sept 13-15, 2004IHE Interoperability Worshop 52 Document in Registry ExtrinsicObject object  With objectType of XDSDocumentEntry

53 Sept 13-15, 2004IHE Interoperability Worshop 53Folder ‘Directory’ metaphor  But, a document can reside in multiple Folders Single patient Attributes

54 Sept 13-15, 2004IHE Interoperability Worshop 54 Folder in Registry RegistryPackage object Classified as XDSFolder Contains document objects

55 Sept 13-15, 2004IHE Interoperability Worshop 55 Submission Set Collection of documents & Folders Permanent label of what was submitted together Attributes Documents included by  Value (same patient)  Reference (any patient)

56 Sept 13-15, 2004IHE Interoperability Worshop 56 Submission Set in Registry RegistryPackage object Classified as XDSSubmissionSet RegistryPackage ‘contains’  Documents (XDSDocumentEntry object)  Folders (XDSFolder object)

57 Sept 13-15, 2004IHE Interoperability Worshop 57 XDS Query Keys Submis- sion Set AndFolder

58 Sept 13-15, 2004IHE Interoperability Worshop 58 Document Resubmission Given multiple:  Providers involved with a patient (Document Sources)  Repositories Single Registry Document resubmission will happen!

59 Sept 13-15, 2004IHE Interoperability Worshop 59 Document Resubmission (Cont) Key Attributes: XDSDocumentEntry.uniqueID  Unique document ID  Assigned by Document Source XDSDocumentEntry.hash  Hash code of contents of document  Computed by Document Repository ebXML Registry document id (UUID)  Assigned by Document Source  Internal to Registry

60 Sept 13-15, 2004IHE Interoperability Worshop 60 Document Resubmission (Cont) Document submitted twice… Document altered slightly  Different hash code Submitted by different office  Assigned different document id Detection of duplicate is beyond XDS!

61 Sept 13-15, 2004IHE Interoperability Worshop 61 Document Resubmission (Cont) Document submitted twice… Document altered slightly  Different hash code Document Id already present in Repository/Registry Submission is rejected!

62 Sept 13-15, 2004IHE Interoperability Worshop 62 Document Resubmission (Cont) Document submitted twice… Document is identical  Same hash code Document Id already present in Repository New UUID (internal registry ID) Submission is accepted!

63 Sept 13-15, 2004IHE Interoperability Worshop 63 Online/Offline & Protocols

64 Sept 13-15, 2004IHE Interoperability Worshop 64Online Direct network connection between all actors All Transactions Online ‘mode’ required in profile

65 Sept 13-15, 2004IHE Interoperability Worshop 65Offline Document Source connects to Document Repository via SMTP Remote, asynchronous submission via email Single transaction available  Provide & Register Document Set Transaction Offline ‘mode’ is optional in profile

66 Sept 13-15, 2004IHE Interoperability Worshop 66 Online Protocols SOAP Messages with Attachments  W3C Note 11 December 2000 MIME – Multipurpose Internet Message Extensions  RFC 2045 - Part One: Format of Internet Message Bodies  RFC 2046 - Part Two: Media Types  RFC 2047 - Part Three: Message Header Extensions for Non-ASCII Text  RFC 2048 - Part Four: Registration Procedures  RFC 2049 - Part Five: Conformance Criteria and Examples  RFC 2387 - The MIME Multipart/Related Content-type

67 Sept 13-15, 2004IHE Interoperability Worshop 67 Offline Protocol Uses ebXML Message Service Specification v2.0 (ebMS)

68 Sept 13-15, 2004IHE Interoperability Worshop 68 Implementation Scenarios

69 Sept 13-15, 2004IHE Interoperability Worshop 69 Document Submission Document Source Actor  Provide & Register Document Set  Online/Offline

70 Sept 13-15, 2004IHE Interoperability Worshop 70 Document Retrieval Document Consumer Actor  Query Registry Transaction  Retrieve Document Transaction

71 Sept 13-15, 2004IHE Interoperability Worshop 71 Clinical Information System Product already creates/stores documents Implement together Document Source Actor Document Repository Actor Required Transactions Register Document Set Retrieve Document

72 Sept 13-15, 2004IHE Interoperability Worshop 72 Replace Documents Replacement, Addendum, Transformation Document Consumer Actor  Query Registry Transaction  Needed to discover details of existing documents Document Source Actor  Provide & Register Document Set  Submit new documents and metadata

73 Sept 13-15, 2004IHE Interoperability Worshop 73 Place Existing Documents in a Folder Document Consumer Actor  Query Registry Transaction  Discover details of existing documents Document Source Actor  Provide & Register Document Set  Submit new Folder metadata

74 Sept 13-15, 2004IHE Interoperability Worshop 74 Provide XDS Registry Document Registry Actor Register Document Set Transaction Query Registry Transaction Patient Identity Feed Transaction Including ebXML Registry functionality Registry Adaptor functionality

75 Sept 13-15, 2004IHE Interoperability Worshop 75 Construct Registry given ebXML Registry Implementation Build Registry Adaptor Function as front end to ebXML Registry

76 Sept 13-15, 2004IHE Interoperability Worshop 76 Construct XDS Registry without ebXML Registry Implementation Build to two specifications:  ebXML Registry Standard (subset)  XDS Profile - Registry Adaptor Function

77 Sept 13-15, 2004IHE Interoperability Worshop 77 Implementation Resources Implementation guide  Clinical Coding  Example software  Example queries  Metadata cookbook (how-to)  Metadata Schema  Sample metadata submissions FAQ: http://www.connect-a-thon.net/bbhttp://www.connect-a-thon.net/bb Live registry with test data Testing

78 Sept 13-15, 2004IHE Interoperability Worshop 78Questions?

79 Sept 13-15, 2004IHE Interoperability Worshop 79 More information…. IHE Web sites: http://www.himss.org/IHE http://www.rsna.org/IHE http://www.acc.org/quality/ihe.htmhttp://www.acc.org/quality/ihe.htm. Technical Frameworks: ITI V1.0, RAD V5.5, LAB V1.0 Technical Framework Supplements - Trial Implementation May 2004: Radiology August 2004: Cardiology, IT Infrastructure 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

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