Cross-enterprise Sharing of Scanned Documents

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Cross Enterprise Sharing of Scanned Documents (XDS-SD) associates structured, healthcare metadata with non-healthcare specific document formats to maintain the integrity of the patient health record as managed by the source system.


A variety of legacy paper, film, electronic and scanner outputted formats are used to store and exchange clinical documents. These formats are not designed for healthcare documentation, and furthermore, do not have a uniform mechanism to store healthcare metadata associated with the documents, including patient identifiers, demographics, encounter, order or service information. The association of structured, healthcare metadata with this kind of document is important to maintain the integrity of the patient health record as managed by the source system. It is necessary to provide a mechanism that allows such source metadata to be stored with the document.


This profile defines how to couple such information, represented within a structured HL7 CDA R2 header, with a PDF or plaintext formatted document containing clinical information. Furthermore, this profile defines elements of the CDA R2 header necessary to minimally annotate these documents. Such header elements include information regarding patient identity, patient demographics, scanner operator identity, scanning technology, scan time as well as best available authoring information. Portions of CDA R2 header, along with supplemental document registration information, are then used to populate XDS Document Entry metadata.

The content of this profile is intended for use in XDS, XDR and XDM. Content is created by a Content Creator and is to be consumed by a Content Consumer. The Content Creator can be embodied by a Document Source Actor or a Portable Media Creator, and the Content Consumer by a Document Consumer, a Document Recipient or a Portable Media Importer. Obligations imposed on the Content Creator and the Content Consumer by this profile are understood to be fulfilled by the software that creates the final document for submission and/or consumes profile conformant documents rather than any particular scanning technology.


Profile Status: Final Text

Documents: IHE IT Infrastructure Technical Framework Version 5 or later

CDA mapping to XDS Metadata:

Underlying Standards:

  • PDF RFC 3778, The application/pdf Media Type (informative)
  • PDF/A ISO 19005-1b. Document management - Electronic document file format for long-term preservation - Part 1: Use of PDF (PDF/A)
  • HL7 CDA Release 2.0 (denoted HL7 CDA R2, or just CDA, in subsequent text)
  • RFC 3066, Tags for the identification of languages

See Also

Related Profiles

This page is based on the Profile Template

Current: IT Infrastructure Technical Framework.