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'''Cross-Enterprise Document Sharing (XDS)''' facilitates the registration, distribution and access across health enterprises of patient electronic health records.
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==Summary==
Cross-Enterprise Document Sharing (XDS) is focused on providing a standards-based specification for managing the sharing of documents between any healthcare enterprise, ranging from a private physician office to a clinic to an acute care in-patient facility and personal health record systems.  This is managed through federated document repositories and a document registry to create a longitudinal record of information about a patient within a given clinical affinity domain. These are distinct entities with separate responsibilities:
* A [[Document Repository]] is responsible for storing documents in a transparent, secure, reliable and persistent manner and responding to document retrieval requests.
* A [[Document Registry]] is responsible for storing information about those documents so that the documents of interest for the care of a patient may be easily found, selected and retrieved irrespective of the repository where they are actually stored.
* Documents are provided by one or more [[Document Source]]s 
* They are then accessed by one or more [[Document Consumer]]s

==Benefits==

'''Facilitates management of the Electronic Health Record'''
* facilitates the registration, distribution and access across health enterprises of patient electronic health records. 
* focused on providing a standards-based specification for managing the sharing of documents between any healthcare enterprise, ranging from a private physician office to a clinic to an acute care in-patient facility.

==Details==

The '''''Cross-Enterprise Document Sharing (XDS) Integration Profile''''':
* assumes that the enterprises belong to one or more XDS Affinity Domains. An XDS Affinity Domain is a group of healthcare enterprises that have agreed to work together using a common set of policies and share a common infrastructure.
Examples of XDS Affinity Domains include:
::*Community of Care supported by a regional health information organizations in order to serve all patients in a given region.
::*Nationwide EHR
::*Specialized or Disease-oriented Care
:::*Cardiology Specialists and an Acute Cardiology Center
:::*Oncology network
:::*Diabetes network
::*Federation of enterprises
:::*A regional federation made up of several local hospitals and healthcare providers
::*Government sponsored facilities (e.g., VA or Military)
::*Insurance Provider Supported Communities
* The concept of a document in XDS is not limited to textual information. As XDS is document content neutral, any type of clinical information without regard to content and representation is supported. This makes the XDS IHE Integration Profile equally able to handle documents containing simple text, formatted text (e.g., HL7 CDA Release 1), images (e.g., DICOM) or structured and vocabulary coded clinical information (e.g., CDA Release 2, CCR, CEN ENV 13606, DICOM SR). In order to ensure the necessary interoperability between the document sources and the document consumers, the XDS Affinity Domain must adopt policies concerning document format, structure and content.

==Systems Affected==

Systems involved in this profile are:

* Enterprise-wide information systems that manage a patient’s Electronic Health Record, such as a Hospital Information System.


'''Actors & Transactions:'''

[[Image:XDS-Actor-Transaction.jpg]]

==Specification==

'''Profile Status:''' [[Comments| Final Text]]  

'''Documents:''' 
[http://www.ihe.net/Technical_Framework/index.cfm#IT IHE IT Infrastructure Technical Framework Version 2 or later]
:* Vol. 1 - Section 10 
:* Vol. 2 - Sections 3.14, 3.15, 3.16, 3.17, 3.8

'''Underlying Standards:'''
:* ebMS OASIS/ebXML Messaging Services Specifications v2.1
:* ebRIM OASIS/ebXML Registry Information Model v2.1
:* ebRS OASIS/ebXML Registry Services Specifications v2.1
:* HTTP HyperText Transfer Protocol HTTP/1.1 (IETF RFC2616)
:* CDA HL7 Clinical Document Architecture (ANSI/HL7 CDA R1-2000)
:* MIME Multipurpose Internet Message Extensions (RFC 2045 to RFC 2049)
:* SMTP Simple Mail Transfer Protocol (RFC2821)
:* MIME Multipart/Related Content-type (RFC2387)
:* ISO/IEC 9075 Database Language SQL
:* [http://www.hl7.org HL7 Version 2.5]
:* [http://www.hl7.org HL7 Version 2.3.1 Chapter 2 – Control, Chapter 3 – Patient Administration]

==See Also==
Related Profiles:  

* [[Patient Identity Cross Referencing]]
* [[Patient Demographics Query]]
* [[Audit Trail and Node Authentication]]
* [[Consistent Time]]

The [[XDS FAQ]] answers typical questions about what the Profile does.

[[XDS Purchasing]] describes considerations when purchasing equipment to deploy this Profile.

[[XDS Implementation]] provides additional information about implementing this Profile in software.

===References===

[http://tinyurl.com/wwxds Where in the World is CDA and XDS?]

[http://www.e-health-media.com/comment_and_analysis/266/the_xds_factor The XDS Factor]

[http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_028946.html From Regional Healthcare Information Organizations to a National Healthcare Information Infrastructure]

[http://www.diagnosticimaging.com/pacsweb/newsupdate/showArticle.jhtml?articleID=189601278 Cross-enterprise image sharing sees breakthrough]

[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=17108551 Medical Data GRIDs as approach towards secure cross enterprise document sharing (based on IHE XDS).]

[http://www.healthimaging.com/content/view/4240/68/ IHE Update: Bigger, Better Events, New Standards & Guides]

[http://www.europacs.net/Extended%20abstracts/Integration%20of%20PACS%20RIS%20and%20EPR/Raimund%20Vogel%20Full_Paper_DistEHR_RVo_EuroPACS2006.pdf Architecture for a Distributed National Electronic Health Record System in Austria]

[http://www.srdc.metu.edu.tr/webpage/projects/saphire/publications/April24SaphireEchallenges.doc SAPHIRE: A semantic Web service based Clinical guideline deployment infrastructure exploiting IHE XDS (Turkey)]

[[Image:XDS-Worldwide.png|center|frame|XDS is in use Worldwide]]



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