Cross-enterprise Document Query - XDQ

1. Proposed Workitem: Adding on-demand queries to XDS

• Proposal Editor: Vassil Peytchev
• Editor: Vassil Peytchev
• Date: N/A (Wiki keeps history)
• Version: N/A (Wiki keeps history)
• Domain: IT Infrastructure

2. The Problem

The existing XDS framework addresses several common healthcare workflows, while providing a relatively simple set of interactions between actors. The current XDS framework, however, doesn't provide a mechanism for on-demand query for a patient summary. The reliance on creating documents at fixed points of the care delivery process is not sufficient to cover all use cases when a patient summary is needed at the point of care.

3. Key Use Case

How it works with current XDS

Person A moves to a new area due to accepting a job with company B. Person A visits their PCP for the first time, and provides initial information, including a drug allergy. That night, Person A is in an accident, and unconscious is admitted in the ER. Even though the ER staff knows the patient's PCP from records contained on his person, their query to the regional registry returns no existing documents, as the initial visit summary is not ready to be published. The drug allergy remains unknown ,and the patient is harmed.

How it should work

Person A moves to a new area due to accepting a job with company B. Person A visits their PCP for the first time, and provides initial information, including a drug allergy. That night, Person A is in an accident, and unconscious is admitted in the ER. The ER staff finds the patient's PCP from records contained on his person, and issues a direct query to the PCP's EMR system. The response of the query is a CCD document, which contains the current clinical summary of the patient, including the drug interaction. Using this information, the ER staff avoids a dangerous situation.

4. Standards & Systems

Document Source, Document Consumer, Document Repository, Document Registry

ebXML Registry, existing XDS transactions

5. Discussion

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<Why IHE would be a good venue to solve the problem and what you think IHE should do to solve it.>

<What might the IHE technical approach be? Existing Actors? New Transactions? Additional Profiles?>

<What are some of the risks or open issues to be addressed?>

<This is the brief proposal. Try to keep it to 1 or at most 2 pages>

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