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Cross Domain Patient Identity Management

Cross Domain Patient Identity Management. Eric Heflin Dir of Standards and Interoperability/Medicity. Audience/Scope. Audience Senior Healthcare IT Technical Executives Implementation Architects Implementers seeking an overview Scope

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Cross Domain Patient Identity Management

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  1. Cross Domain Patient Identity Management Eric Heflin Dir of Standards and Interoperability/Medicity

  2. Audience/Scope • Audience • Senior Healthcare IT Technical Executives • Implementation Architects • Implementers seeking an overview • Scope • Broad context and guidance about the use of IHE standard profiles for patient identity management

  3. Definitions • Patient Identifier: A value controlled and assigned by a single assigning authority (hospital, group of related practices, national health authority, etc.). • Assigning authority: • XDS Affinity Domain: <get from Charles> • <why did we group these together, perhaps have a diagram showing the interplay between the profiles>

  4. What Problem is Being Solved? • Problem statements: • How can we accommodate exchange of health information across organizational boundaries requiring identification of the same patient in different systems with different IDs using a standards-based approach? • Assurance that health information is about the correct patient via correct identification of the patient of interest <wordsmith>

  5. IHE Approach • IHE has created several mechanisms, or “profiles”, designed to solve this problem • PIX, PIXv3, PDQ, PDQv3, XCPD, PAM

  6. PIX Definition • PIX = Patient Identifier Cross Referencing • Definition: Allows a patient identifier assigned by one assigning authority to establish and maintain an identifier relationship assigned by another assigning authority • Status: “Final Text” • <review wiki page def text>

  7. PIX v2 vs. PIX v3 • Identical purpose, different underlying standards • HL7 v2 messaging is used for PIX v2 • HL7 v3 messaging is used for PIX v3

  8. PIX Use Case • Use case <pull from the Wiki> • <get content from Charles, may have in ppt format> • <TF vol 1, section 5>

  9. PIX Transaction Diagram • Insert transaction diagram from ITI TF

  10. PIX Actors • List each PIX actor • List each PIX transaction

  11. PIX Options • List and define each PIX option

  12. PIX Workflow(s) • List one or more typical workflows • Should be a less technical diagram, like the appendix, not a UML sequence diagram

  13. PIX Security and Privacy • Describe how security and privacy are implemented for this profile

  14. PDQ • PDQ = Patient Demographic Query • PDQ is designed to allow for a query across domains using, as the name implies, demographic information • Status: Final Text? • Other topics…

  15. PDQ Use Case • Use case

  16. PDQ Transaction Diagram • Insert transaction diagram from ITI TF

  17. PDQ • List and define each PDQ actor • List each PDQ transaction

  18. PDQ Options • List and define each PDQ option

  19. PDQ Workflow(s) • List one or more typical workflows

  20. PDQ Security and Privacy • Describe how security and privacy are implemented for this profile

  21. PDQ Typical Architecture • Simplistic architectural diagram

  22. XCPD • <covered by karen, sync up with her> • XCPD = Cross Community Patient Discovery • XCDP is designed … • XCPD is different than PDQ in the following ways… • Async, optimized, reverse query, etc. • Used for the Nationwide Health Information Network Exchange 2010 Patient Discovery Production Specification

  23. XCPD Maturity • Relatively new profile, just entering first year of “Trial Implementation” status • Deployed by NHIN Exchange participants • Will be demonstrated for the firs time at the 2011 IHE Connectathon?

  24. XCPD Use Case • Use case

  25. XCPD Transaction Diagram • Insert transaction diagram from ITI TF

  26. XCPD Actors • List and define each XCPD actor • List each XCPD transaction

  27. XCPD Options • List and define each XCPD option

  28. XCPD Workflow(s) • List one or more typical workflows

  29. XCPD Security and Privacy • Describe how security and privacy are implemented for this profile

  30. Typical XCPD Architecture • Simplistic diagram

  31. Patient Administration • Repeat the above for PAM

  32. References • For more information on this topic, please see: • IHE content

  33. Other topics??

  34. IHE ITI Integration Profile XDS: Clinical Information Sharing in RHIO IHE Technical Webinar A87631 14355 M8354673993 US Exam System Query Document Physician Office Query Document Retrieve Document Retrieve Document Register Provide & Register Register Provide & Register PACS L-716 In order to publish or query clinical documents in XDS Affinity Domain (XAD), applications need to look-up XAD Patient ID using their local patient information, e.g., Patient ID in local domain and demographics Lab Info. System Community Clinic XAD Patient Identity Source Patient Identity Feed ED Application Document Registry PACS Document Repository EHR System Document Repository Register Query Document Provide & Register Retrieve Document Teaching Hospital XDS Clinical Affinity Domain

  35. Look-Up XDS Affinity Domain Patient ID with Local PIX Service IHE Technical Webinar A87631 A87631 14355 14355 M8354673993 M8354673993 M8354673993 L-716 L-716 XAD Patient Identity Source Patient Identity Feed Patient Identity Feed Patient Identity Feed Patient Identity Feed US Exam System ED Application Patient Identity Feed Physician Office Patient Identity Feed Document Registry PACS Document Repository PIX Query PIX Query EHR System Document Repository Register Query Document PACS Provide & Register Retrieve Document Lab Info. System Community Clinic Teaching Hospital XDS Clinical Affinity Domain

  36. Look-Up XDS Affinity Domain Patient ID with Affinity Domain PIX Service IHE Technical Webinar A87631 A87631 A87631 14355 14355 14355 M8354673993 M8354673993 M8354673993 L-716 L-716 L-716 Patient Identity Feed Patient Identity Feed XAD Patient Identity Source US Exam System ED Application Physician Office Patient Identity Feed Patient Identity Feed Document Registry PACS Document Repository PIX Query PIX Query EHR System Document Repository Query Document Register PACS Provide & Register Retrieve Document Lab Info. System Community Clinic Teaching Hospital XDS Clinical Affinity Domain

  37. Query Affinity Domain PDQ Service for XDS Affinity Domain Patient ID IHE Technical Webinar Patient Demographics Supplier A87631 14355 M8354673993 L-716 XAD Patient Identity Source US Exam System ED Application Physician Office Patient Identity Feed Document Registry PACS Document Repository PDQ Query to Acquire XAD Patient ID PDQ Query to Acquire XAD Patient ID EHR System Document Repository Query Document Register PACS Provide & Register Retrieve Document Lab Info. System Community Clinic Teaching Hospital XDS Clinical Affinity Domain

  38. IHE IT Infrastructure Integration Profiles Provide a Solid Foundation for EHR Management IHE Technical Webinar Cross-enterprise Patient Health Information Management Architectural Principles: • A Patient Information Source administers patient records (demographics) and manages a Patient Identification Domain to identify these patient records on that domain • Patient ID is assigned / maintained within a managed Patient Identification Domain • Search patient records (in a patient information source) → PDQ Integration Profile • Look-up Patient ID in federated domains → PIX Integration Profile • Locate healthcare information (documents or services) → XDS Integration Profile

  39. IHE PIX / PDQ Profiles Implementation Considerations Administration and Service Functions PIX Notification Service PIX Query Service Patient Identity Feed Service HL7 HL7 PDQ Service Enhanced PDQ Service Master Patient ID Domain Patient Identity Source MPI Service Service defined in IHE Technical Framework Service out of IHE scope IHE Technical Webinar

  40. IHE ITI Integration Profile XDS: Clinical Information Sharing in RHIO IHE Technical Webinar A87631 14355 M8354673993 US Exam System Query Document Physician Office Query Document Retrieve Document Retrieve Document Register Provide & Register Register Provide & Register PACS L-716 In order to publish or query clinical documents in XDS Affinity Domain (XAD), applications need to look-up XAD Patient ID using their local patient information, e.g., Patient ID in local domain and demographics Lab Info. System Community Clinic XAD Patient Identity Source Patient Identity Feed ED Application Document Registry PACS Document Repository EHR System Document Repository Register Query Document Provide & Register Retrieve Document Teaching Hospital XDS Clinical Affinity Domain

  41. Look-Up XDS Affinity Domain Patient ID with Local PIX Service IHE Technical Webinar A87631 A87631 14355 14355 M8354673993 M8354673993 M8354673993 L-716 L-716 XAD Patient Identity Source Patient Identity Feed Patient Identity Feed Patient Identity Feed Patient Identity Feed US Exam System ED Application Patient Identity Feed Physician Office Patient Identity Feed Document Registry PACS Document Repository PIX Query PIX Query EHR System Document Repository Register Query Document PACS Provide & Register Retrieve Document Lab Info. System Community Clinic Teaching Hospital XDS Clinical Affinity Domain

  42. Look-Up XDS Affinity Domain Patient ID with Affinity Domain PIX Service IHE Technical Webinar A87631 A87631 A87631 14355 14355 14355 M8354673993 M8354673993 M8354673993 L-716 L-716 L-716 Patient Identity Feed Patient Identity Feed XAD Patient Identity Source US Exam System ED Application Physician Office Patient Identity Feed Patient Identity Feed Document Registry PACS Document Repository PIX Query PIX Query EHR System Document Repository Query Document Register PACS Provide & Register Retrieve Document Lab Info. System Community Clinic Teaching Hospital XDS Clinical Affinity Domain

  43. Query Affinity Domain PDQ Service for XDS Affinity Domain Patient ID IHE Technical Webinar Patient Demographics Supplier A87631 14355 M8354673993 L-716 XAD Patient Identity Source US Exam System ED Application Physician Office Patient Identity Feed Document Registry PACS Document Repository PDQ Query to Acquire XAD Patient ID PDQ Query to Acquire XAD Patient ID EHR System Document Repository Query Document Register PACS Provide & Register Retrieve Document Lab Info. System Community Clinic Teaching Hospital XDS Clinical Affinity Domain

  44. IHE IT Infrastructure Integration Profiles Provide a Solid Foundation for EHR Management IHE Technical Webinar Cross-enterprise Patient Health Information Management Architectural Principles: • A Patient Information Source administers patient records (demographics) and manages a Patient Identification Domain to identify these patient records on that domain • Patient ID is assigned / maintained within a managed Patient Identification Domain • Search patient records (in a patient information source) → PDQ Integration Profile • Look-up Patient ID in federated domains → PIX Integration Profile • Locate healthcare information (documents or services) → XDS Integration Profile

  45. IHE PIX / PDQ Profiles Implementation Considerations Administration and Service Functions PIX Notification Service PIX Query Service Patient Identity Feed Service HL7 HL7 PDQ Service Enhanced PDQ Service Master Patient ID Domain Patient Identity Source MPI Service Service defined in IHE Technical Framework Service out of IHE scope IHE Technical Webinar

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