Query for Existing Data

Introduction

This is a draft of the Query for Dynamic Clinical Data Profile (QCD) supplement to the Patient Care Coordination Technical Framework. This draft is a work in progress, not the official supplement or profile.

Profile Abstract

The Query for Dynamic Clinical Data Profile (QCD) supports dynamic queries for Clinical Data. A wide variety of systems often need access to dynamic clinical information stored and maintained in an EMR system or other clinical data repository. This profile makes the information widely available to other systems in the enterprise to support provision of better clinical care. The information made available by this profile can be used to support clinical care, quality reporting, financial transactions, public health reporting, clinical trials, drug interaction checking, and patient qualification for various protocols.

Glossary

Clinical Data Repository

A Clinical Data Repository (CDR) is a database of clinical information on patients, often optimized for access by individual patients.

Issue Log

Open Issues

1. One WSDL or two?
   HL7 and IHE specifications for Web Services would indicate that the formal contract defining the behavior of the service be described in a single Web Services Definition. However, a WSDL that conforms to HL7 specifications is overly complex for engineering use. I would recommend supplying one WSDL that is the formal contract, and a second WSDL for engineering use, to simplify the creation of client proxies.
2. Should Accept and Application Acknowledgements be supported?
   The web service responds to queries with results. This is a very simple request/response message exchange pattern (MEP), which obviates the need to support application or accept acknowledgements. If the request succeeds, then the response serves as an application level acknowledgement. So, I have decided to not use either of these.
3. Following the HL7 Shoulds in naming?
   The HL7 Web Services profile provides guidance about how to name various components of the service description. No rationale for this guidance is provided, and the names are not easily understood by application developers. Therefore, I have followed the spirit but not the letter for this guidance, using the human readable names derived from the HL7 Ballot materials, instead of the interation identifiers. Note however, that the names of the Elements carried in the soap:Body conform to the "Shall" requirements, in that they do use the HL7 interaction identifiers for the name of the message element.

Volume I

Add the following bullet to the list of profiles

• Query for Dynamic Clinical Data - {{{3}}}

Dependencies

Add the following row(s) to the list of dependencies

Integration Profile	Dependency	Dependency Type	Purpose
Query for Dynamic Clinical Data

Profile Name

The Query for Dynamic Clinical Data Profile (QCD) has a one paragraph description.

And then some more introductory text.

Use Cases

Use Case Name 1

One or more paragraphs describing a clinical scenario.

Use Case Name 2

One or more paragraphs describing a clinical scenario.

Use Case Name 3

One or more paragraphs describing a clinical scenario.

Actors/Transaction

There are two actors in this profile, the Content Creator and the Content Consumer. Content is created by a Content Creator and is to be consumed by a Content Consumer. The sharing or transmission of content from one actor to the other is addressed by the appropriate use of IHE profiles described below, and is out of scope of this profile. A Document Source or a Portable Media Creator may embody the Content Creator Actor. A Document Consumer, a Document Recipient or a Portable Media Importer may embody the Content Consumer Actor. The sharing or transmission of content or updates from one actor to the other is addressed by the use of appropriate IHE profiles described by section 3.7 Content Bindings with XDS, XDM and XDR found in the Patient Care Coordination Technical Framework

Query for Dynamic Clinical Data Actor Diagram

Options

Query for Dynamic Clinical Data Options

Actor	Option	Section
Content Consumer	View Option (1) Document Import Option (1) Section Import Option (1) Discrete Data Import Option (1)	PCC TF-1: 2.13.1 PCC TF-1: 2.13.2 PCC TF-1: 2.13.3 PCC TF-1: 2.13.4
Content Creator	Referral Option (1) Discharge Summary Option (1)	PCC TF-1: 2.13.5 PCC TF-1: 2.13.6

Note ¹: The Actor shall support at least one of these options.

Process Flow

Query for Dynamic Clinical Data Process Flow

More text about process flow

Actor Definitions

Actor

Definition

Transaction Definitions

Transaction

Definition

Volume II

Query for Dynamic Clinical Data Content

Standards

CDAR2

Clinical Document Architecture, Release 2, 2005 HL7

CRS

Implementation Guide for CDA Release 2 – Level 1 and 2 – Care Record Summary (US realm), 2006, HL7.

CCD

ASTM/HL7 Continuity of Care Document (Draft)

SNOMED

Systemized Nomenclature for Medicine