1. Cross-Enterprise Document Networking (XDN) Problem – Legacy decommissioning produces large static collections of patient-related documents requiring long-term retention. – Hospitals want solutions for access to these documents without long term dependence on a vendor. Opportunity – Networked storage systems can store the documents. – Missing is a standard resource for managing the metadata. Solution – XDS registry provides such a metadata resource. – Add an optional URI slot (already present in XDM) to XDS Registry, pointing to each stored document.

2. XDN extends XDS.b by: Extending XDS.b Registry to – Allow XDS documents to be addressed as files or objects in network storage systems, using the URI slot already defined for the Cross-Enterprise Document Media Sharing (XDM) Profile. – Define a storage mapping resource enabling storage locations to be changed without updating registry entries for all documents. – Define repository behavior that includes the above mentioned externally referenced documents.

3. Patient Identity Source Document RegistryDocument Consumer Imaging Document Consumer Document Repository Document Source Imaging Document Source  Register Document Set–b [ITI-42] Registry Stored Query [ITI-18]   Patient Identity Feed [ITI-8]  Patient Identity Feed HL7v3 [ITI-44]  Retrieve Document Set [ITI-43]  Provide & Register Imaging Document Set – MTOM/XOP [RAD-68] Provide&Register Document Set – b [ITI-41]  Standard XDS.b and XDS.b-I  WADO Retrieve [RAD-55]  Retrieve Doc. Set [RAD-69]  DICOM Retrieves [RAD-16, 17, 27, 31, 45]

4. Patient Identity Source Networked Storage Document RegistryDocument Consumer Imaging Document Consumer Document Repository Document Source Imaging Document Source XDN Document Consumer  Register Document Set–b [ITI-42] Registry Stored Query [ITI-18]   Patient Identity Feed [ITI-8]  Patient Identity Feed HL7v3 [ITI-44]  Retrieve Document Set [ITI-43]  Provide & Register Imaging Document Set – MTOM/XOP [RAD-68] Provide&Register Document Set – b [ITI-41]  XDN Storage Broker  Retrieve XDN Storage Map  Retrieve Mapped XDN DICOM Instances  Direct Retrieve XDN Documents XDN Document Repository  Retrieve XDN Storage Map  Retrieve Mapped XDN Documents Store XDN Documents  Direct Retrieve XDN Documents  Brokered Retrieve XDN Instances   WADO Retrieve [RAD-55]  Retrieve Doc. Set [RAD-69]  DICOM Retrieve s [RAD-16, 17, 27, 31, 45] Standard XDS.b and XDS.b-I plus XDN

5. XDN Storage Broker Web server hosting the storage mapping table A broker providing http access to XDN Storage URIs in the Registry point to the broker. A client can directly access the URI at the Broker, or can use the storage mapping table and directly access the resource. A basic XDN Storage Broker, capable of accessing NAS-based storage, can be implemented by configuring an Apache Web server, and including a hand-crafted Storage Mapping Table.

6. Example XDN Storage Broker Apache httpd Web Server XDN Storage Mapping Table (XML) Apache configuration file XDN Storage (EMC Centera) XDN Storage (RESTful object storage) XDN Storage (NAS partitions) … Apache Module for Centera Apache Module for RESTful

7. XDN Storage Mapping Table docs11 CIFS //10.34.122.60/PACS/PACSARC001 1.2.840.26636366.2344.44.33.4 … URI in Registry: http://xdnstorage.ourhospital.org/xdn/docs11/20140504/2345671.pdf Root Resource Path