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September, 2005 What IHE Delivers1
IT Infrastructure Planning CommitteeKaren Witting – Ready Computing
XDS & XCA: On-Demand Documents
On-Demand Documents Introduction
Supports sources of healthcare data which can provide most recent or dynamic views of healthcare dataEnables a new type of Document Entry, which provides access to a service to generate dynamic data rather than a single document containing historical data.The new source of data is similar to a static query with no arguments: each defined service always generates the same set of data the data will contain the most recent clinical data available
Supported as part of the XDS and XCA profilesCurrently supported through a supplement which is Trial Implementation
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Profile updatesCommon to XDS and XCA Defined on-demand DocumentEntry Query: enhanced to support returning new type of Document
Entry Retrieve: enhanced to support return of on-demand/dynamic
document New On-Demand Document option
XDS only New transaction enables registration of on-demand Document
Entries (ITI-61) New Actor – On-Demand Document Source. Initiates new
transaction and responds to retrieve requests.
Document Entry types
Document Entry types defined Stable Document Entry – metadata about a specific and already
existing set of healthcare content formed into a document.
On-Demand Document Entry – metadata describing a type of healthcare content that could be created if requested.
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Static vs On-Demand DocumentEntry
Static DocumentEntry On-Demand DocumentEntry
Original DocumentEntry used in XDS and XCA.
New type of DocumentEntry created for support of on-demand documents.
Represents a specific set of existing clinical data formatted in a document
Defines a collection of clinical data that hasn’t been created yet
Represents a document which presents a point in time view of the clinical data
Used to create an updated view of the defined clinical data
Created based on clinical events Created once for each patient and clinical data collection type
uniqueID used to retrieve the document represented which contains a point in time view of the data
uniqueID used to retrieve a new document containing the most recent clinical information
uniqueID is the identifier of the document retrieved
uniqueID is never an identifier of any document, retrieved documents have a different identifier
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Static vs On-Demand DocumentEntry
Static DocumentEntry On-Demand DocumentEntry
Future retrieve requests using the same uniqueID will always return exactly the same document
Future retrieve requests using the same uniqueID will rarely return the same document, only if the clinical data has not changed since the last request
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Static vs On-Demand DocumentEntry
Static DocumentEntry On-Demand DocumentEntry<ExtrinsicObject objectType= "urn:uuid:7edca82f-054d-47f2-a032-9b2a5b5186c1>
<ExtrinsicObject objectType= "urn:uuid:34268e47-fdf5-41a6-ba33-82133c465248>
creationTime, hash, size metadata required
creationTime, hash, size not supported – would have no meaning
repositoryUniqueId refers to a Document Repository Actor
repositoryUniqueId refers to a On-Demand Document Source Actor
serviceStartTime, serviceStopTime represents the actual service time of data in the document
Not applicable for most On-Demand Documents
Query parameter<Slot name="$XDSDocumentEntryType"><ValueList><Value> ('urn:uuid:7edca82f-054d-47f2-a032-9b2a5b5186c1') </Value> <ValueList> </Slot>
Query parameter<Slot name="$XDSDocumentEntryType"><ValueList><Value> ('urn:uuid:34268e47-fdf5-41a6-ba33-82133c465248') </Value> <ValueList> </Slot>
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Query Transactions
XDS (ITI-18) and XCA (ITI-38) Query transactions updated to support:
New DocumentEntryType query parameter<Slot name="$XDSDocumentEntryType"><ValueList><Value> ('urn:uuid:7edca82f-054d-47f2-a032-9b2a5b5186c1‘, 'urn:uuid:34268e47-fdf5-41a6-ba33-82133c465248') </Value> <ValueList> </Slot>
Static only – defaultNew ExtrinsicObject ObjectType in return list.
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Retrieve Transactions
XDS (ITI-43) and XCA (ITI-39) Retrieve transactions updated to support retrieve of an On-Demand Document:
NewDocumentUniqueId element in response contains uniqueID of document created in response to the retrieve of a On-Demand DocumentEntry NewRepositoryUniqueId used to identify the Document Repository containing the newly created document
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XCA new option
Actor Options Vol. & SectionInitiating Gateway XDS Affinity Domain Option ITI TF-1: 18.2.1
Asynchronous Web Services Exchange
ITI TF-1: 18.2.2
On-Demand Documents ITI TF-1: 18.2.4
Responding Gateway On-Demand Documents ITI TF-1:18.2.4Persistence of Retrieved Documents
ITI TF-1: 18.2.5
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XDS new option
Actor Options Vol. & SectionDocument Registry Patient Identity Feed (Note 1) ITI TF-2a: 3.8
Patient Identity Feed HL7v3 (Note 1) ITI TF-2b: 3.44
On-Demand Documents ITI TF-1: 10.2.6
Document Consumer Basic Patient Privacy Enforcement ITI TF-2a: 3.18.4.1.3.5ITI TF-2b: 3.43.4.1.3.1
Basic Patient Privacy Proof ITI TF-2a: 3.18.4.1.3.6
On-Demand Documents ITI TF-1: 10.2.6
On-Demand Document Source
Persistence of Retrieved Documents
ITI TF-1: 10.2.7
Basic Patient Privacy Enforcement
ITI TF-2b: 3.61.4.1.4.1
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Persistence of Retrieved Documents
Adds the requirement that documents created in response to a retrieve of an on-demand entry uniqueID will be persisted and available for later retrieval through the newUniqueID returned in the retrieve transaction.XDS The persistence must include a ITI-41 Provide and Register transaction
submitting the Stable DocumentEntry reflecting the new document to the same Document Registry where the On-Demand Document is registered.
XCA The persistence is internal to the Responding Gateway and need only
reflect the registration of the Stable DocumentEntry in response to query requests and the return of the identical document upon a retrieve request specifying the newUniqueID.
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XDS On-Demand Documents Actors/Transactions
Document Source
Document Consumer with On-Demand
Documents Option
Document Registry with On-Demand
Documents Option
Document Repository
Registry Stored Query [ITI-18]
Patient Identity Source
On-Demand Document
Source
Register On-Demand Document Entry [ITI-61]
Retrieve Document
Set [ITI-43]
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XCA workflow example – with persistenceCommunity A
InitiatingCommunity B
Initiating
Create On-Demand Entry # 5
XCA Query
Community D Responding
On-Demand Entry uniqueID=5
Reuse On-Demand Entry # 5On-Demand Entry uniqueID=5
XCA Query
Community C Initiating
XCA Retrieve # 5 Create and save Stable Entry # 6
Reuse # 6
XCA Retrieve # 5
XCA Query
uniqueID=5 & 6Return On-Demand
Entry # and Stable # 6
XCA Retrieve # 5
Returns # 6
Returns # 6
Create and save Stable # 7Returns # 7
Returns # 7 Reuse # 7
XCA Query for id=7 Return Stable # 7
No new data available XCA Retrieve # 5
New data available
No new data available
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XCA workflow example – no persistenceCommunity A
InitiatingCommunity B
Initiating
Create On-Demand Entry # 5
XCA Query
Community D Responding
On-Demand Entry uniqueID=5
Reuse On-Demand Entry # 5On-Demand Entry uniqueID=5
XCA Query
Community C Initiating
XCA Retrieve # 5 New document uniqueID=6
XCA Retrieve # 5
XCA Query
uniqueID=5Reuse On-Demand
Entry # 5
XCA Retrieve # 5
Returns # 6
Returns # 7
Returns # 8
Returns # 9
XCA Query for id=9 Return no document found
No new data available XCA Retrieve # 5
New data available
No new data available
New document uniqueID=7
New document uniqueID=8
New document uniqueID=9
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XDS On-Demand WorkflowOn-Demand
Document Source with Persistence
Document Consumer A
Save On-Demand Entry # 5
Document Registry
Register new Stable Entry #6
On-Demand Entry uniqueID=5
XDS Stored Query
Document Consumer B
XDS Retrieve # 5
Save Stable Entry # 6
XCA Retrieve # 5
XDS Stored Query
uniqueID=5 & 6Return all matching,
On-Demand Entry # 5 and Stable # 6
XDS Retrieve # 5
Returns # 6
Returns # 6
Save Stable Entry # 7Returns # 7
Returns # 7
XDS Stored Query for id=7Return Stable #
7
XDS Retrieve # 5
Return all matching, only #5
New data available
Register new Stable Entry #7
Register new On-Demand Entry #5
No new data available
No new data available
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CompatibilityOn-Demand is an option in XDS and XCA and is designed so that Actors not implementing the option are not effected.Query Transaction The new parameter is ignored by a Document Registry/Responding
Gateway not supporting the option. A Document Consumer not supporting the new option will never specify the
new parameter and thus will never receive the new DocumentEntry type
Retrieve Transaction A Document Consumer/Initiating Gateway not supporting the new option will
never receive an On-Demand DocumentEntry and therefor will never initiate a retrieve request for an on-demand DocumentEntry.
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More Information
IHE Web site: www.ihe.net IHE official materialTechnical Framework documents
IHE Wiki site: wiki.ihe.net IHE committee pages Implementation Notes Ongoing committee work
IHE ITI technical committee mailing list http://www.ihe.net/IT_infra/committeesAt the bottom of the page is a place to join the mailing list
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