Medical Document Binding to XDS, XDM and XDR

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Medical Document Binding to XDS, XDM and XDR

This binding defines a transformation that generates metadata for the XDSDocumentEntry element of appropriate transactions from the XDS, XDM and XDR profiles given a medical document and information from other sources. The medical document refers to the document being stored in a repository that will be referenced in the registry. The other sources of information include the configuration of the Document Source actor, the Affinity Domain, the site or facility, local agreements, other documents in the registry/repository, and this Content Profile.

XDSDocumentEntry Metadata

XDSDocumentEntry Attribute Optional? Source Type Source/ Value
authorSpecialty
This metadata element should be based on a detailed defined classification system for healthcare providers such as those found in SNOMED-CT, or the HIPPA Healthcare Provider Taxonomy.
R2 CADDS  
authorInstitution R2 SA /ClinicalDocument/author
/assignedAuthor
/representedOrganization/name
authorPerson
The author can be formatted using the following XPath expression, where $person in the expression below represents the author.
concat(
  $person/id/@extension,"^",
  $person/assignedPerson/name/family,"^",
  $person/assignedPerson/name/given,"^",
  $person/assignedPerson/name/middle,"^",
  $person/assignedPerson/name/suffix,"^",
  $person/assignedPerson/name/prefix,"^",
  $person/assignedPerson/name/degree,"^^&",
  $person/id/@root,"&ISO"
)
R2 SAT $person <= /ClinicalDocument/author
classCode
Derived from a mapping of /ClinicalDocument/code/@code to an Affinity Domain specified coded value to use and coding system. Affinity Domains are encouraged to use the appropriate value for Type of Service, based on the LOINC Type of Service (see Page 53 of the LOINC User's Manual).
R CADT Must be consistent with /ClinicalDocument/code/@code
classCodeDisplayName
DisplayName of the classCode derived. Derived from a mapping of /ClinicalDocument/code/@code to the appropriate Display Name based on the Type of Service.
R CADT Must be Consitent with /ClinicalDocument/code/@code
confidentialityCode
Derived from a mapping of /ClinicalDocument/confidentialityCode/@code to an Affinity Domain specified coded value and coding system. When using the BPPC profile, the confidentialyCode may also be obtained from the <authorization> element.
R CADT /ClinicalDocument/confidentialityCode/@code

  -AND/OR-
/ClinicalDocument/authorization/
  consent[templateId/@root='1.3.6.1.4.1.19376.1.5.3.1.2.5']
  /code/@code

creationTime R SA /ClinicalDocument/effectiveTime
eventCodeList
These values express a collection of keywords that may be relevant to the consumer of the documents in the registry.
O
CADT  
eventCodeDisplayNameList
These are the display names for the collection of keywords described above.
R
(if event
Code is valued)
CADT  
formatCode
The format code shall be the OID associated with the template identifier used to identify the content module that the document conforms to. See PCC TF-2:5.1.2 for a list of values that can be used as format codes.
R FM /ClinicalDocument/templateId
healthcareFacilityTypeCode
A fixed value assigned to the Document Source and configured form a set of Affinity Domain defined values.
R
O Must be concistent with /clinicalDocument/code
healthcareFacility
TypeCodeDisplay
Name
R O Must be concistent with /clinicalDocument/code
intendedRecipient
The intendedRecipient can be formatted using the following XPath expression, where $person in the expression below represents the intendedRecipient.
concat(
  $person/id/@extension,"^",
  $person/assignedPerson/name/family,"^",
  $person/assignedPerson/name/given,"^",
  $person/assignedPerson/name/middle,"^",
  $person/assignedPerson/name/suffix,"^",
  $person/assignedPerson/name/prefix,"^",
  $person/assignedPerson/name/degree,"^^&",
  $person/id/@root,"&ISO"
)
R2 SAT $person <= /ClinicalDocument/intendedRecipient
languageCode R SA /ClinicalDocument/languageCode
legalAuthenticator
The legalAuthenticator can be formatted using the following XPath expression, where $person in the expression below represents the legalAuthenticator.
concat(
  $person/id/@extension,"^",
  $person/assignedPerson/name/family,"^",
  $person/assignedPerson/name/given,"^",
  $person/assignedPerson/name/middle,"^",
  $person/assignedPerson/name/suffix,"^",
  $person/assignedPerson/name/prefix,"^",
  $person/assignedPerson/name/degree,"^^&",
  $person/id/@root,"&ISO"
)
O SAT $person <= /ClinicalDocument/
legalAuthenticator
mimeType R FM text/xml
parentDocumentRelationship R
(when applicable)
SA /ClinicalDocument/relatedDocument/@typeCode
parentDocumentId
The parentDocumentId can be formatted using the following XPath expression, where $docID in the expression below represents the identifier.
concat($docID/@root,"^", $docID/@extension)
R
(when parent
Document
Relationship is present)
SAT $docID <= /ClinicalDocument/
relatedDocument/parentDocument/
id
patientId
The patientId can be formatted using the following XPath expression, where $patID in the expression below represents the appropriate identifier.
concat($patID/@extension,"^^^&", $patID/@root, "&ISO")
R SAT $patID <= /ClinicalDocument/recordTarget/
patientRole/id
practiceSettingCode
This elements should be based on a coarse classification system for the class of specialty practice. Recommend the use of the classification system for Practice Setting, such as that described by the Subject Matter Domain in LOINC.
R
CAD  
practiceSettingCodeDisplayName
This element shall contain the display names associated with the codes described above.
R CAD  
serviceStartTime R2 SA /ClinicalDocument/documentationOf/
serviceEvent/effectiveTime/low/
@value
serviceStopTime R2 SA /ClinicalDocument/documentationOf/
serviceEvent/effectiveTime/high/
@value
sourcePatientId R DS  
sourcePatientInfo R DS  
Title O SA /ClinicalDocument/title
typeCode R
SA /ClinicalDocument/code/@code
typeCodeDisplay
Name
R SA /ClinicalDocument/code/@displayName
uniqueId
The uniqueId can be formatted using the following XPath expression, where $docID in the expression below represents the identifier.
concat($docID/@root,"^", $docID/@extension)
R SAT $docID <= /ClinicalDocument/id

XDSSubmissionSet Metadata

XDSSubmissionSet Attribute Optional? Source Type Source/ Value
authorDepartment
This metadata element should be based on a detailed defined classification system for healthcare providers such as those found in SNOMED-CT, or the HIPPA Healthcare Provider Taxonomy.
R2 CAD  
authorInstitution R2 SA /ClinicalDocument/author/assignedAuthor
/representedOrganization/name
authorPerson

The author can be formatted using the following XPath expression, where $person in the expression below represents the author.

concat(
  $person/id/@extension,"^", 
  $person/assignedPerson/name/family,"^",
  $person/assignedPerson/name/given,"^",
  $person/assignedPerson/name/middle,"^",
  $person/assignedPerson/name/suffix,"^",
  $person/assignedPerson/name/prefix,"^",
  $person/assignedPerson/name/degree,"^^&",
  $person/id/@root,"&ISO"
)
R2 SAT $person <= /ClinicalDocument/author
comments R2   string(//section[@code='42349-1']/text)
This is the reason for referral if present.
contentTypeCode R CAD  
contentTypeCodeDisplayName R CAD  
patientId

The patientId can be formatted using the following XPath expression, where $patID in the expression below represents the appropriate identifier.

concat($patID/@extension,"^^^&", $patID/@root, "&ISO")
R SAT $patID <= /ClinicalDocument/recordTarget
/patientRole/id
sourceId R DS  
submissionTime R DS  
uniqueId R    

Use of XDS Submission Set

This content format uses the XDS Submission Set to create a package of information to send from one provider to another. All documents referenced by the Medical Summary in this Package must be in the submission set.

Use of XDS Folders

No specific requirements identified.

Configuration

This Medical Summary Content Profile requires that Content Creators and Content Consumers using these documents be configured with institution and other specific attributes or parameters. Implementers should be aware of these requirements to make such attributes easily configurable. There shall be a mechanism for the publishing and distribution of style sheets used to view medication summaries (See PCC TF-2: 5.4.1.1.2.1).