IT Infrastructure Plans Karen Witting – IBM IT Infrastructure Technical Committee co-chair

IHE IT Infrastructure – Schedule for 2007 Development Schedule Planning Committee decision:January 2007 Issue Public Comment version: June 2007 Public Comment Due:July 2007 Issue Trial Implementation version: August 2007 IHE Connectathon: January 2008 HIMSS Demo: February 2008 Face-to-face ITI Technical committee to prepare 2007 work itemsto prepare 2007 work items held in RSNA headquarters Chicagoheld in RSNA headquarters Chicago March Resolve significant technical issues May Prepare public comment version July Prepare trial implementation version

IHE IT Infrastructure – Plan for 2007 New Supplements For 2007New Supplements For 2007 Web Services for XDS – Roberto RuggeriWeb Services for XDS – Roberto Ruggeri Cross Enterprise User Authentication (XUA) – John MoehrkeCross Enterprise User Authentication (XUA) – John Moehrke Cross Community Access (XCA) – Karen WittingCross Community Access (XCA) – Karen Witting Significant updates to existing last years profilesSignificant updates to existing last years profiles PIX/PDQ HL7 V3 transactions updated to support latest V3 specificationPIX/PDQ HL7 V3 transactions updated to support latest V3 specification RFD updated for latest level of XForms specificationRFD updated for latest level of XForms specification White Papers for 2007White Papers for 2007 Configuration ManagementConfiguration Management Security Risk ManagementSecurity Risk Management Web Services RoadmapWeb Services Roadmap Aggregate DataAggregate Data Meeting Privacy Principles using IHE ProfilesMeeting Privacy Principles using IHE Profiles Change Proposal (CP) work for all profilesChange Proposal (CP) work for all profiles

Web Services for XDS Value Proposition Bring XDS in line with current Web Services standards –Builds on the WS adoption of XDS Stored Query. –Easier to develop and manage Align use of ebXML Reg/Rep standard to version 3.0 –Stored Query transaction introduced in 2006 is based on 3.0 –Original transactions are based on ebXML Reg/Rep 2.1 Lay the foundation for security, federation, reliable messaging work (XUA, XC…)

Web Services for XDS Technical Solution Defines optional Web Services based versions of the existing transactions: –Updated Provide & Register on-line transaction based on SOAP/MTOM –New Document Retrieve using SOAP/MTOM Updates Web Services specification to use SOAP 1.2 Updates metadata format to use ebXML Reg/Rep 3.0 for Provide & Register, Register, and Retrieve New WSDL contracts for all the new Web Services XDS transactions Integrates WS for PIX/PDQ HL7 v3 for the Patient Identity Feed

Cross-Enterprise User Authentication Value Proposition Extend User Identity to Affinity Domain –Users include Providers, Patients, Clerical, etc –Must supports cross-enterprise transactions, can be used inside enterprise –Distributed or Centralized. Provide information necessary so that receiving actors can make Access Control decisions –Does not include Access Control mechanism Provide information necessary so that receiving actors can produce detailed and accurate Security Audit Trail

Cross-Enterprise User Authentication Technical Solution Initial scope to XDS-Stored Query and XDS- Retrieve (WS) Relies on Web Services profiling work in progress Leverage WS-I Basic Security Profile 1.1 Use SAML Assertions Leverage IHE PWP Profile –Update PWP to include user attributes needed Define grouping behavior with EUA and ATNA

Cross Community Access Value Proposition Sharing of documents beyond the XDS Affinity Domain (community) boundary. Part of a larger vision for regional and national sharing – 2006 whitepaper on Cross Community Information Exchange –Cross Community Access (2007) –Cross Community Location (2008) Scoped to document sharing between XDS Affinity Domains. Future goal to define sharing with other types of communities.

Regional Network B Acute Care (Inpatient) PCPs and Clinics (Ambulatory) Long Term Care Other Specialized Care or Diagnostics Services Document Registry Document Repository Longitudinal Record as used across-encounters Regional Network C Acute Care (Inpatient) PCPs and Clinics (Ambulatory) Long Term Care Other Specialized Care or Diagnostics Services Document Registry Document Repository Longitudinal Record as used across-encounters Regional Network A Acute Care (Inpatient) PCPs and Clinics (Ambulatory) Long Term Care Other Specialized Care or Diagnostics Services Document Registry Document Repository Longitudinal Record as used across-encounters Hierarchical Exchange From Cross Community Information Exchange White Paper Cross Community Bridge Which community holds records for a patient ? Cross Community Bridge Bridge Community Locator service  Each region notifies Community Location Service when new patient is registered or first data is stored.  Cross Community Bridges query Community Locator Service (future)  Cross-Community Bridges query and retrieve records (2007 & future) IHE Transactions (future)

National Network A Non-IHE National EHR Cross Community Bridge Cross Community Bridge Bridge CommunitySearchService  National or Regional Networks not required to be IHE-based  Mapping to & from IHE Transactions performed by X-Community bridges  Mapping practical as most European projects use variants of structured document sharing National Network C IHE based Sub-Networks XDS Affinity Domain (NHIN sub-network) IntegratedDeliveryNetwork Community Locator service Non-IHE Sub-Net IHE Transactions (future) What communities have specific attributres? National or Regional Network B Acute Care (Inpatient) PCPs and Clinics (Ambulatory) Long Term Care Other Specialized Care or Diagnostics Services Document Registry Document Repository Longitudinal Record as used across-encounters Lateral Exchange and non-IHE Domains From Cross Community Information Exchange White Paper Acute Care (Inpatient) PCPs and Clinics (Ambulatory) Long Term Care Other Specialized Care or Diagnostics Services Document Registry Document Repository Longitudinal Record as used across-encounters Acute Care (Inpatient) PCPs and Clinics (Ambulatory) Long Term Care Other Specialized Care or Diagnostics Services Document Registry Document Repository Longitudinal Record as used across-encounters

Cross Community Access Technical Solution Cross Community Bridge –A new actor which supports all inter-community communications. Encapsulates in one actor all activities required to communicate outside the community. –Every community would have one cross community bridge which would interact with actors within the community and remote cross community bridges. Cross Community Consumer –Initiator of a request for information beyond the community. Technical Issues: –Need for asynchronous transactions in the cross community environment –Interaction with existing XDS actors –Reliable identification of the patient

White Papers Security Risk management Cookbook for the security section of IHE profiles. Publish final text. how to run a risk assessment for interoperability specifications (IHE Profiles). Web Services Roadmap – June 2006 Web Services standards are in rapid evolution and states of adoption. Provide across IHE a solid stepwise and pragmatic plan for staged adoption. Access to Aggregate Data – June 2006 Requirements & standards evaluation for an infrastructure for surveillance/notification for quality mgt, public health and research. Complementary to IHE-XDS working in both distributed and centralized repositories architectures. Configuration Management – August 2006 Establish the general principles of intra-enterprise and cross- enterprise systems configuration for interoperability Requirements & standards evaluation for a configuration infrastructure Meeting Privacy Principles using IHE Profiles Shows how the IHE Profiles address data protection principles (e.g. OECD Data protection principles) when used in a proper policy environment.