Cross Enterprise Workflow

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Cross Enterprise Document Workflow (XDW) coordinates human and applications mediated workflows across multiple organizations.


The Cross-Enterprise Document Workflow (XDW) profile enables participants in a multi-organizational environment to manage and track the tasks related to patient-centric workflows as the systems hosting workflow management applications coordinate their activities for the health professionals and patients they support.

XDW builds upon the sharing of health documents provided by other IHE profiles such as XDS, adding the means to associate documents conveying clinical facts to a patient-specific workflow. XDW provides a common interoperability infrastructure upon which a wide range of specific workflow definitions may be supported. It is designed to support the complexity of health services delivery with flexibility to adapt as workflows evolve.



XDW provides a common, workflow-independent interoperability infrastructure that:

  • provides a platform upon which a wide range of specific workflows can be defined with minimal specification and application implementation efforts on the workflow definition (e.g., Medical Referrals Workflow, Prescriptions Workflow, Home Care Workflow);
  • benefits many clinical and non-clinical domains by avoiding different competing approaches to workflow management;
  • increases the consistency of workflow interoperability, and enables the development of interoperable workflow management applications where workflow-specific customization is minimized;
  • facilitates the integration of multi-organizational workflows with the variety of existing workflow management systems used within the participating organizations;
  • offers the necessary flexibility to support a large variety of different healthcare workflows by not being overly constrained.


XDW supports a broad range of workflows that are:

  • patient-centric;
  • based on business/clinical needs that are defined externally to the XDW Profile. Such workflow definitions have to be known only by the applications within the participating systems, not by the XDW infrastructure (flexibility);
  • executed in loosely connected, distributed environments, where centralized workflow management systems are not desired, or in many instances, possible.

The XDW Workflow Architecture (see figure below) builds upon the sharing of XDW Documents between “edge” applications using Document Sharing infrastructure. XDW supports the management of Workflow according to Workflow Definitions established between participating applications.

XDW architecture.PNG

Systems Affected

Systems involved in this profile are any health IT System within an orgnaization that needs to engage into patient centric workflows with other health organizations. This includes a wide range of systems such as enterprise-wide and departmental information systems that manage the various patient’s worklfows, in particular those engage in care coordination activities with the objective to ensure continuity of care, as well as those supporting home health.

Actors & Transactions The systems participating into XDW Workflows simply need to create XDW Workflow Documents, consume and update them.

XDW Actors.PNG

To do so they are using the transactions defined in existing IHE document sharing profiles such as XDS, XDM and XDR. No Metadata extensions are required simply a specialisation of some metadata attributes (e.g. Document Class=XDW Document).


Profile Status: Final Text


IHE IT Infrastructure Technical Framework Version 13 or later

Additional Supplements: Trial Implementation

Underlying Standards:

  • OASIS Web Services – Human Task (WS-HumanTask) Specification Version 1.1
  • HL7 CDA Release 2.0 and Reference Information Model

See Also

Related Profiles

The XDW profile depends on other IHE profiles:

Consumer Information

The Profile FAQ Template answers typical questions about what the Profile does.

Implementer Information

The Profile Implementation Template provides additional information about implementing this Profile in software.

Reference Articles

<List References (good and bad) (with link if possible) to Journal Articles that mention IHE's work (and hopefully include some analysis). Go ahead, Google: IHE <Profile Name> abstract or Google: IHE <Profile Name> and under the "more" select "Scholar". You might be surprised. >

This page is based on the Profile Overview Template