XCC Cross Community Connection

1. Proposed Profile: Cross Community Connection (XCC)

• Proposal Editor: Tony Mallia (Anthony.Mallia@va.gov)
• Profile Editor: TBA
• Date: N/A (Wiki keeps history)
• Version: N/A (Wiki keeps history)
• Domain: IT Infrastructure

2. The Problem

The Cross Community Access Profile (XCA) provides a solution for communities who do not share a common Clinical Affinity Domain to exchange information. Although it does not require collaborating communities to be clinical affinity domains, the profile supports that architecture if chosen.

Within XCA some needed functions were described as informative particularly in Appendix E. These functions and others needed to establish the conditions for successful implementation of XCA and other transaction profiles are missing in a formal profile.

3. Key Use Case

There are a number of Use Cases required to complete the management of Cross Community Connections:

1. Registration of a Community and its XCG (Cross Community Gateway) with a Community Registry.
2. Merging and splitting of communities.
3. Permitting and revoking communication between an XCG and other XCGs as part of security administration.
4. Registration of person identity and personal authorization and revocation of personal identity disclosure across lateral communities including identity arbitration as part of Privacy administration
5. Changing of identifying demographics and merging and unmerging of personal identities.
6. HIPAA Privacy accounting of disclosure
7. HIPAA Privacy Permitted access without personal disclosure authorization.

4. Standards & Systems

IHE ITI Profiles including:

• Person Identity Feed
• PIX
• XCA
• XUA
• Other IHE ITI profiles for Transactions such as Lab and Pharmacy
• Basic Patient Privacy Consents (BPPC)

• WS-TRUST

5. Discussion

The forum of IHE has been beneficial to the constraining of other standards for adoption by the NHIN HITSP process. Movement of XCA towards an architecturally agnostic approach for a community has accelerated the possibility of IHE ITI Profile acceptance within major NHIN participants.

The profile would fit within the existing structure of IHE and was suggested during revue of the XCA profile.

The profile will have impacts on XCA and other IHE ITI Profiles such as transactions for Labs and Pharmacy. The profile will define the constraints if any on these other profiles without (hopefully) requiring any changes to them.

This proposal is intended to be submitted along with a white paper which will scope out some of the potential behavior in the profile.