1. RFD Profile Examine Security Compare to XDS Node Security

2. Agenda RFD Actors and Transactions RFD Actors and Transactions Examples of RFD Form Filler Examples of RFD Form Filler XDS Community XDS Community RFD World RFD World

3. RFD Profile and XForms Form Manager B Form Receiver C Form Filler A Form Archiver D Domain Standard, e.g. ODM, ICSR XForms “package” defining screen handling and carrying an instance of the domain standard

4. RFD Profile and XForms Form Manager B Form Receiver C Form Filler A Form Archiver D Form Manager – Form Receiver pairing is a statically defined business relationship based upon the domain, e.g., clinical trials, drug safety, public health, that can be embedded within the XForms Form Filler – Form Archiver(s) pairing is a dynamic, Form Filler defined business relationship that cannot be embedded within the XForm Form Archiver D D

7. XDS Affinity Domain Patient Identity Feed Patient Identity Feed Patient Identity Cross-reference Manager Patient Identity Cross-reference Manager XDS Registry XDS Registry Multiple XDS Repositories Multiple XDS Repositories Multiple Document Sources and Consumers Multiple Document Sources and Consumers Node Security via TLS Node Security via TLS

8. Community Clinic Lab Info. System PACS Teaching Hospital PACS ED Application EHR System Physician Office EHR System XDS Affinity Domain A87631 PACS L-716 Affinity Domain Patient Identity Source M8354673993 Retrieve Document Provide & Register Docs Register (using Pt ID)Query Document (using Pt Id) Patient Identity Feed Document Registry 14355 M8354673993 L-716 A87631 Patient Identity Feed PIX Query PIX Query Patient Identity Feed Patient Identity XRef Mgr Patient Identity Feed PDQ Query to Acquire Affinity Domain Patient ID M8354673993 A87631 L-716 M8354673993 XDS Document Repository XDS Document Repository ATNA Audit record repository CT Time server

9. Community Clinic Lab Info. System PACS Teaching Hospital PACS ED Application EHR System Physician Office EHR SystemXDS PACS Document Registry 14355 M8354673993 L-716 A87631 Patient Identity XRef Mgr M8354673993 A87631 L-716 XDS Document Repository XDS Document Repository CN-1 CN-3 CN-2 CN-4 CN-5 Retrieve Document Register (using Pt ID)Query Document (using Pt Id) Provide & Register Docs Each Consumer / Source Node has its own Private Certificate, plus Public Certs for each Infrastructure Node Infrastructure Nodes have their own Private Certificates, plus Public Certs for all nodes in the Community

10. Community Clinic Lab Info. System PACS Teaching Hospital PACS ED Application EHR System Physician Office EHR SystemXDS PACS Document Registry 14355 M8354673993 L-716 A87631 Patient Identity XRef Mgr M8354673993 A87631 L-716 XDS Document Repository XDS Document Repository CN-1 CN-3 CN-2 CN-4 CN-5 Retrieve Document Register (using Pt ID)Query Document (using Pt Id) Provide & Register Docs Each Consumer / Source Node has its own Private Certificate, plus Public Certs for each Infrastructure Node Infrastructure Nodes have their own Private Certificates, plus Public Certs for all nodes in the Community We can add more end user devices without necessarily having to add additional certificates

11. XDS Security Reviewed Nodes have Certificates Nodes have Certificates Multiple end-user devices can share one Secure Node Multiple end-user devices can share one Secure Node TLS with Mutual Verification of Certificates means no rogue Nodes TLS with Mutual Verification of Certificates means no rogue Nodes

12. Community Clinic Lab Info. System PACS Teaching Hospital PACS ED Application EHR System Physician Office EHR System RFD World PACS Document Registry 14355 M8354673993 L-716 A87631 Patient Identity XRef Mgr M8354673993 A87631 L-716 XDS Document Repository XDS Document Repository CN-1 CN-3 CN-2 CN-4 CN-5 Retrieve Document Register (using Pt ID)Query Document (using Pt Id) Provide & Register Docs Start with an XDS Affinity Domain Shrink the view of the Affinity Domain so we can focus on one EHR App

13. PA CS ED Appli cation EHR System RFD World 14355 M8354673993 L-716 A87631 Patient Identity XRef Mgr M8354673993 A87631 L-716 XDS Affinity Domain Clinical Trials Sponsor Federal or State Agency Disease Registry Drug Safety Data Collection Agency Paired Form Manager / Form Receiver Physician Office CN-1 A robust Form Filler Notice these are outside the Affinity Domain….could be anywhere in the world

14. PA CS ED Appli cation EHR System RFD World 14355 M8354673993 L-716 A87631 Patient Identity XRef Mgr M8354673993 A87631 L-716 XDS Affinity Domain Clinical Trials Sponsor Federal or State Agency Disease Registry Drug Safety Data Collection Agency Paired Form Manager / Form Receiver Physician Office CN-1 Hundreds of Form Fillers at one EHR site

15. RFD Security RFD and XDS are independent RFD and XDS are independent XDS was only used in the slides to illustrate Node SecurityXDS was only used in the slides to illustrate Node Security Every end-user device may be a Form Filler Every end-user device may be a Form Filler RFD transactions cannot be funneled thru one Secure Node RFD transactions cannot be funneled thru one Secure Node How do we handle Security ? How do we handle Security ? We cannot depend on every device having a Private CertWe cannot depend on every device having a Private Cert We cannot ask every Form Manager or Form Receiver to have all certificates from all Form FillersWe cannot ask every Form Manager or Form Receiver to have all certificates from all Form Fillers