201801 IHE-on-FHIR

IHE-on-FHIR

Submitting WG/Project/Implementer Group

Driven by IHE International in coordination with IHE-Connectathon

Justification

To support engagement at FHIR Connectathon on the IHE Profiles that leverage FHIR.

Shall not duplicate more focused and dedicate tracks. These other tracks are encouraged and every effort will be made to coordinate IHE engagement with them:

• 201801 Care Plan
• 201801 Medical Device and Implantables Tracking using UDI
• 201801 Provider Directory
• 201801 Patient Track
• 201801 Apps for Imaging Research

Also not intended to be testing non-FHIR based IHE profiles. Testing will leverage IHE-Connectathon tools, but will not be considered as comprehensive as IHE-Connectathon

Zulip thread for refinement

https://chat.fhir.org/#narrow/stream/ihe/topic/January.20Connectathon.20-.20IHE-on-FHIR

Proposed Track Lead

See Connectathon_Track_Lead_Responsibilities

1. Steve Moore (MooreS@mir.wustl.edu)
2. John Moehrke (JohnMoehrke@gmail.com) -- skype id = johnmoehrke

Roles

This track will be further refined based on the IHE Profiles that leverage FHIR, not including those more dedicated tracks, and the participation. The wiki reference above gives a full list of IHE profiles that leverage FHIR. This is a short list that excludes the tracks already proposed for January, 2018:

• Mobile Alert Communication Management (mACM)
  • The Mobile Alert Communication Management (mACM) Profile provides the infrastructural components needed to send short, unstructured text alerts to human recipients and can record the outcomes of any human interactions upon receipt of the alert. The mACM Profile also allows for a feedback mechanism to determine the status of an alert through the use of alert statuses.
• Mobile Access to Health Documents (MHD)
  • The Mobile access to Health Documents (MHD) Profile defines one standardized interface to health documents (a.k.a. an Application Programming Interface (API)) for use by mobile devices so that deployment of mobile applications is more consistent and reusable. MHD it enables simplified access by mobile devices to an XDS (or a similar) document management environment containing health information.
• Mobile Cross-Enterprise Document Data Element Extraction (mXDE)
  • The Mobile Cross-Enterprise Document Data Element Extraction (mXDE) Profile provides the means to access data elements extracted from shared structured documents. This is intended to support data provenance.
• Non-patient File Sharing (NPFSm)
  • The Non-patient File Sharing (NPFSm) Profile defines how to enable the sharing of non-patient files that are created, consumed and updated by many different systems involved in a wide variety of data sharing workflows (eg. domain policies sharing, stylesheets management, etc.)
• Patient Demographics Query for Mobile
  • The Patient Demographics for Mobile (PDQm) Profile provides a transaction for mobile and lightweight browser based applications to query a patient demographics supplier for a list of patients based on user-defined search criteria and retrieve a patient’s demographic information.
• Patient Identifier Cross-reference for Mobile
  • The Patient Identifier Cross-reference for Mobile (PIXm) Profile provides a transaction for mobile and lightweight browser based applications to query a Patient Identifier Cross-reference Manager for a list of patient identifiers based on the patient identifier in a different domain and retrieve a patient’s cross-domain identifiers information into the application.

IHE will provide experienced IHE-Connectathon staff with tooling used at IHE Connectation.

Alert Reporter

• The IHE Alert Reporter actor originates the alert (an alarm, either physiological or technical, or an advisory). May also query the Alert Aggregator for the status of the alert.
• During the Connectathon, it will be required to submit alerts to the Alert Aggregator; the FHIR resource is CommunicationRequest. As an optional step, it can retrieve status information from the Alert Aggregator.

Alert Aggregator

• This actor receives alerts from the Alert Reporter and collects status events related to the dissemination of the alert.
• During the Connectathon, the Alert Aggregator will receive alert requests from the Alert Reporter. It will have to simulate sending out actual alerts and creating status information for an Alert Aggregator to retrieve.

Document Recipient

• The IHE Document Recipient actor receives a set of documents. It is similar to a Document Repository but is only tasked with receiving documents. It will provide documents to other systems through transactions or operations using other interfaces.
• During the Connectathon, the Document Recipient will be expected to accept documents and metadata from a Document Source.

Document Responder

• The IHE Document Responder is a single actor that supports both the Document Registry and Document Repository functionality.
• During the Connectathon, the Document Responder will be expected to support search and retrieve operations from a Document Consumer. The Document Responder can use existing documents or perhaps accept new documents as grouped with a Document Recipient.

Document Source

• The IHE Document Source actor produces and publishes documents. In this context, it publishes documents with metadata by sending data to a Document Recipient.
• During the Connectathon, the Document Source will be required to submit documents for specified patients to a Document Recipient.

Document Consumer

• The IHE Document Consumer actor queries for document metadata meeting certain criteria, and may retrieve selected documents. In this context, it communicates with a Document Responder.

Patient Demographics Supplier

• The IHE Patient Demographics Supplier provides a searchable repository of patient demographic information.
• During the Connectathon, the Patient Demographics Supplier will be expected to host a set of patients with defined demographics (Patient resource) and to respond to search requests and retrieve requests. Searchable parameters are listed below.

Patient Demographics Consumer

• The IHE Patient Demographics Consumer searches for patients, retrieves demographic information and makes use of that information in some manner not defined by IHE.
• During the Connectathon, the Patient Demographics Consumer will be expected to exhibit patient searches using several different search criteria and to read individual Patient resources hosted by the Patient Demographics Supplier.

Patient Identifier Cross-reference Manager

• The IHE Patient Identifier Cross-reference Manager provides cross-referencing of patient identifiers across Patient Identifier Domains.
• During the Connectathon, the Patient Identifier Cross-reference Manager will be expected to host a set of patients with defined demographics (Patient resource) and to respond to Patient GET requests by a stated sourceIdentifier (not a FHIR resource).

Patient Identifier Cross-reference Consumer

• The IHE Patient Identifier Cross-reference Consumer has a patient identifier in one identifier domain (not a Patient resource identifier), retrieves an identifier from a different domain from the Cross-reference Manager, and makes use of that information in some manner not defined by IHE.
• During the Connectathon, the Patient Identifier Cross-reference Consumer will be expected to GET Patient resources for specific patients based on identifiers provided as test data. These are not traditional FHIR GET operations on a Patient resource.

Scenarios

Scenario (mACM) Crisis Response

In response to a crisis or emergency situation, such as the 2014 and 2015 outbreaks of Ebola in western Africa, it is critical to communicate to health workers across organizational and national boundaries, and to verify receipt of such alerts. Such alerts are commonly issued in the OASIS Common Alerting Protocol (CAP) format. For this testing, the CAP format is a nice to have but not required.

Action: The Alert Reporter submits an alert to the Alert Aggregator. The FHIR resource is CommunicationRequest.

Precondition:

Success Criteria: Alert Aggregator will have to demonstrate through logs or simulated alert being sent out the back end.

Bonus point: Alert Reporter requests status information (Communication resource) from the Alert Aggregator.

Scenario (MHD) Publication of New Documents

Action: Document Source publishes new documents by sending them to a Document Recipient

Precondition: Actors have agreed on patient identifier domains. A Patient resource exists somewhere that is referenced by the new documents. This Patient resource can live within the Document Source, the Document Recipient or in some other system.

Success Criteria: There are several ways to determine success. If the Document Recipient is coupled with a Document Responder, we have tools that can query the Document Responder and locate the documents. Also, a Document Consumer actor can directly discover and retrieve documents from a Document Responder. If nothing else, we will have to check log entries at the Document Recipient.

Bonus point: Integrate the document workflow with PDQm or PIXm scenarios to manage patient identities and demographics.

Scenario (MHD) Discovery and Retrieval of Existing Documents

Action: Document Consumer discovers documents and retrieves them from a Document Responder.

Precondition: Document Responder has pre-defined documents or is coupled with a Document Recipient and has received documents during the event. We will need to coordinate metadata values.

Success Criteria: Document Consumer will have to demonstrate that it was able to retrieve one or more documents for specified patients.

Bonus point: Integrate the document workflow with PDQm or PIXm scenarios to manage patient identities and demographics. Also integrate directly with submission of documents to a Document Recipient.

Scenario (PDQm) Patient Demographics Query for Lightweight Applications

The PDQm Profile supports all of the use cases of PDQ while keeping the technology as lightweight as possible. Example uses include:

• Mobile devices used by physicians (for example: a mobile app for electronic patient charts) which need to establish patient context by scanning a bracelet,
• Web based EHR/EMR applications which wish to provide dynamic updates of patient demographic information such as a non-postback search, additional demographic detail, etc.
• A document source/consumer wishing to perform an operation in the IHE Mobile access to Health Documents (MHD) Profile, where patient ID in the appropriate patient ID domain needs to be resolved by the source/consumer,
• A health portal securely exposing demographics data to browser based plugins,
• Medical devices which need to access patient demographic information.

Action: Patient Demographic Consumer queries a Patient Demographics Supplier by Patient ID (MRN) and/or patient demographics.

Precondition: Patient Demographics Supplier will need to have demographic data pre-loaded.

Success Criteria: Patient Demographics Consumer will need to show user interface or logs that indicate success.

Bonus point: Integrate directly with submission of documents to a Document Recipient or for retrieval of a document. A different bonus point awarded for an application that scans a barcode on a bracelet and performs a PDQm query.

Scenario (PIXm) Patient Identifier Cross-reference for Lightweight Applications

A patient is known by one identifier in a mobile care system (ambulance setting). That same patient is known by a different identifier in the hospital system where allergies are stored. The operator in the mobile care system needs to use the first patient identifier to determine the hospital patient identifier to complete a search for allergies.

Action: Patient Identifier Cross-reference Consumer submits cross reference request to Patient Identifier Cross Reference Manager (Mobile Patient Identifier Cross-reference Query [ITI-83])

Precondition: Patient Identifier Cross Reference Manager needs to be seeded with patient information from at least two different Patient Identifier domains.

Success Criteria: Patient Identifier Cross-reference Consumer will need to show user interface or logs that indicate success.

Bonus point: Integrate directly with submission of documents to a Document Recipient or for retrieval of a document.

Security and Privacy Considerations

unknown at this time