IHE Profile - Cross Enterprise Document Sharing

A patient record constructed as a collection of clinical documents and organized by a document registry is a key component of an electronic health record (EHR). The challenge is to make these documents available to any healthcare professional, regardless of their organizational affiliation, enabling them to make quality healthcare decisions. The goal of this project is to develop a standards-based registry prototype that will allow healthcare professionals to find and access all pertinent documents of clinical information regarding a patient regardless of the healthcare organization that creates and manage the documents.

The use of document registries for sharing clinical information intra-organizationally presents unique challenges. Standardized metadata, interfaces and formats are required for interoperability and interchange. The strict adherence to security and privacy policies related to healthcare information must be supported by the technology. Document registries, an emerging technology for indexing documents on a network, provide solutions to many of these challenges. A number of industrial and international standards organizations support current document registry standards.

NIST is collaborating with industry to define standardized approaches to clinical document registries, and to build prototypes to show their feasibility. We are collaborating on the project Integrating the Healthcare Enterprise (IHE) that is sponsored by the Radiological Society of North America (RSNA), Healthcare Information and Management Systems Society (HIMSS), and the American College of Cardiology (ACC). NIST is the primary author of the IHE Profile: Cross-Enterprise Document Sharing (XDS). This profile tailors an ebXML registry to the healthcare environment. NIST has also developed a reference implementation for the XDS profile and web-based test suite, allowing vendors to determine conformance to the XDS profile. The test suite was used by HIMSS industry vendors to validate interoperability of their products as part of their participation in a multi-vendor demonstration at the 2005 HIMSS Annual Conference. Additionally at this conference, NIST provided a central clinical document registry based on the XDS profile, to showcase the integration of multiple vendors demonstrating the concept of an Electronic Health Record (EHR) based on XDS.

NIST has established an Open Source project based on our work with IHE. The project, called iheos (which stands for IHE Open Source) is hosted on Source Forge. The goal is to develop a complete implementation of XDS and all its components. NIST is seeding the project with the code from its XDS reference implementation.

Downloads

IHE Open Source Project: XDS software (html file)

Message Maker Prototype (html file)

Healthcare Standards Landscape (html file)

Healthcare Information Standards and Testing, A Concept Paper (pdf file)

Conformance Testing and Certification Framework, White Paper (pdf file)

What is This Thing Called Conformance, White Paper (html file)

Principles for Writing Conformance Criteria (pdf file)

Building HL7 EHR-S Conformance Criteria, Slide presentation (html file)