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XDM / XDR Point-to-Point Transmission of Documents IHE IT Infrastructure Webinar Series INTEGRATING THE HEALTHCARE ENTERPRISE.

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Presentation on theme: "XDM / XDR Point-to-Point Transmission of Documents IHE IT Infrastructure Webinar Series INTEGRATING THE HEALTHCARE ENTERPRISE."— Presentation transcript:

1 XDM / XDR Point-to-Point Transmission of Documents IHE IT Infrastructure Webinar Series INTEGRATING THE HEALTHCARE ENTERPRISE

2 IT Infrastructure Planning Committee Contents Introduction XDM XDR Summary References

3 IT Infrastructure Planning Committee Introduction Point-to-Point Transmission of Documents refers to: – –Cross-Enterprise Document Media Interchange (XDM) – –Cross-Enterprise Document Reliable Interchange (XDR) Based on XDS – –XDM = exchange of XDS metadata and documents on media – –XDR = exchange of XDS metadata and documents over reliable protocols – –Maximal re-use of XDS objects & meta-data As with XDS both are document content agnostic – –All XDS content profiles apply (e.g., XDS-MS, XD-Lab, XPHR, etc.) When to use – –When document sharing infrastructure not in place – –Where XDS is not desirable or available to one of the participants – –Complementary to sharing documents via XDS

4 IT Infrastructure Planning Committee XDM Cross-Enterprise Document Media Interchange (XDM) Documents and metadata shared using standard media types (e.g., , CD, USB) Intended to be easy to implement using: – –Existing clients – –CD burners – –USB ports Meant for person-to-person communication – –In pocket media – –Send via Imposes common file and directory structure

5 IT Infrastructure Planning Committee XDM Supports transfer of data about multiple patients within one exchange – –Multiple submission sets Requires recipient to support human intervention to control importing of data – –Manual operation Works with XDS – –XDS Query/Retrieve can feed XDM transmission – –Point-to-point transfer via XDM can feed XDS submission

6 IT Infrastructure Planning Committee XDM Use Cases – –Physician to Patient to Specialist Test result and referral information given to patient on CD-R to be taken to specialist of his choice. – –Patient Visiting ED Patient maintains copy of his EHR at home and brings a memory stick with him to the ED. – –Physician to Physician Primary physician s zip file attachment about his patient to specialist

7 IT Infrastructure Planning Committee XDM Actors & Transaction Options

8 IT Infrastructure Planning Committee XDM Exchange of Health Information Physician Office Hospital Discharge summary +Lab report Write Read Interchange Media Discharge summary + Lab report Read Home XDM

9 IT Infrastructure Planning Committee XDM Standards – –DICOM PS 3.10 Media Storage and File Format for Data Interchange (DICOM file format). – –DICOM PS 3.12 Media Formats and Physical Media for Data Interchange, Annex F - 120mm CD-R media, Annex R - USB Connected Removable Devices, Annex V - ZIP File Over Media, and Annex W - Media. – –XHTML 1.0 The Extensible HyperText Markup Language (Second Edition). A Reformulation of HTML 4 in XML 1.0. W3C Recommendation 26 January 2000, revised 1 August – –XHTML Basic. W3C Recommendation 19 December – –MDN: RFC 3798 Message Disposition Notification. editor.org/rfc/rfc3798.txt

10 IT Infrastructure Planning Committee XDM Security & Privacy – –The Portable Media Importer shall check the hash value and size as found in the XDS metadata to detect corruption within the metadata or media. – –Basic Patient Privacy Enforcement Option – –In the case of physical media, encryption of the CD-R or USB shall not be used. – –In the case the media used is the ZIP file over , the transaction shall be secured by S/MIME (see IHE ATNA) and comply with the security process as defined in the DICOM Part 15 Appendix (Secure Use of ZIP File Media over ) – –Portable Media Importers/Exporters that import/export media shall generate one or more ATNA Import/Export events into the audit trail to describe the media event.

11 IT Infrastructure Planning Committee Cross-Enterprise Document Reliable Interchange (XDR) Documents and metadata shared using a reliable messaging system Permits interchange between EHRs, PHRs, and other health IT systems in the absence of XDS infrastructure Allows for automatic transfer of documents for a single patient (one submission set) Supports the reuse of the Provide and Register Document set (ITI-41) with web services as transport XDR

12 IT Infrastructure Planning Committee More like XDS than XDM – –Direct transfer between source and consumer – –No registry or repository actors involved Optionally identify intended recipients Works with XDS – –XDS Query/Retrieve can feed XDR transmission – –Point-to-point transfer via XDR can feed XDS submission XDR

13 IT Infrastructure Planning Committee Use Cases Primary Physician to Specialist Referral information for patient sent to specialist ahead of visit Hospital to Long-term Care Patient summary information sent to long-term care facility upon patient transfer from hospital Physician to Physician Patient MRI test results sent from physician in specialized care facility to another specialist for consultation XDR

14 IT Infrastructure Planning Committee Actors & Transaction Options XDR

15 IT Infrastructure Planning Committee Send Existing Reliable Messaging System Receive A referral summary XDR Specialist Office Physician Office XDR Exchange of Health Information

16 IT Infrastructure Planning Committee Standards – –ebRIM - OASIS/ebXML Registry Information Model v3.0 – –ebRS- OASIS/ebXML Registry Services Specifications v3.0 – –Appendix V - ITI TF-2x:Appendix V Web Services for IHE Transactions. Contains references to all Web Services standards and requirements of use – –MTOM - SOAP Message Transmission Optimization Mechanism – –XOP - XML-binary Optimized Packaging XDR

17 IT Infrastructure Planning Committee Security & Privacy Basic Patient Privacy Enforcement Option Relevant XDS Affinity Domain security considerations are discussed in the XDS Security Considerations Section (see ITI TF-1: 10.7) XDR

18 IT Infrastructure Planning Committee Summary Health Document Exchange Options - Flexible Infrastructure Publish Query/Retrieve Send to Existing Reliable Messaging System Send to Write Read Interchange Media XDS XDR XDM M A L-716 XDS INFRASTRUCTURE Query/Retrieve

19 IT Infrastructure Planning Committee **** Update **** Summary Specialist, Radio or Lab GP / PCP Doctor A Care Facility Hospital Acute Care / ED Patient Transfer Personal Health Record (PHR) to ED/Primary Care EMR Acute Care Discharge to Extended Care Facility (ECF) Remote advice Consulting to referring physicians Hospital-doctor communication Combining XDM / XDR

20 IT Infrastructure Planning Committee 20 References To learn more about IHE… – –IHE web site: IHE official material Frequently Asked Questions Technical Framework documents – –Integration Profiles – –See Volume 1 of each for Use cases Vendor Products Integration Statements – –IHE IT Infrastructure Wiki: IHE committee pages Implementation Notes Ongoing committee work


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