Current development

The IHE ITI domain has selected the first work items to be developed in 2019, see https://trello.com/b/IH4FPDhN

Maintenance is a crucial ongoing activity for the quality and alignment of the ITI assets with the latest standard updates.

The other work items proposals assessed are available on the Planning assessed work items.

The other work items proposals received are available on the Under assessement by planning.

The item proposals are available on the ftp site

Mobile Care services Discovery (mCSD) - Rev.3.0 (Facilities and Hierarchies in FHIR work item)

FHIR does not have a good definition for facilities and has recommended using both Organization and Location to define a facility. There is also no defined way to handle multiple hierarchies for facilities. Furthermore there is a need to be clear on what data is provided for a facility instead of solely a Location or Organization.

In order to avoid multiple solutions that would not be compatible, this proposal suggests the following approaches:

• A larger CP for mCSD can be issued in order to clearly define how facilities are defined by using Location and Organization together.
• A whitepaper profiling how this can be achieved in a standard way.
• Any other option.

March 28, 2019 : Approved for public comments
April 27, 2019 : End of public comments
May 2, 2019 : Approved for Trial Implementation

Update core set of IHE-on-FHIR profiles to FHIR Release 4

Update to FHIR Release 4 for January/February publication: MHD, PDQm, QEDm, mCSD and Appendix Z. This is to meet a desire for ONC to include IHE on FHIR profiles in updated regulation.

Jan.8, 2019 : Approved for public comments
Feb.19, 2019 : End of public comments
Feb.27, 2019 : Approved for Trial implementation
March 6, 2019 : Published for Trial implementation

Patient Master Identity Registry (PMIR)

Patient Resource Identity Management (PRIM (formal PIMuF)) renamed (Nov.2019)
There is not, today, an IHE FHIR profile to support the operation of a client registry (CR) or enterprise master patient index (EMPI) solution.
The current PIXm profile is missing the FHIR equivalent of ITI-8. The FHIR standard has the needed capability. Extensions to the IHE PIXm profile are needed to support Connectathon testing of FHIR-based CR/EMPI solutions and the point of service (POS) solutions that make use of them.
The purpose of this work item is to update and extend the PIXm profile to support a FHIR-based Patient Identity Feed transaction. There is demand for such an IHE profile from organizations (e.g. the OpenHIE community) and jurisdictions (e.g. eHealth Ontario, Tanzania, Vietnam, Myanmar, the Philippines) that are leveraging FHIR-based IHE profiles and IHE Connectathons to operationalize large-scale (e.g. province-wide, nation-wide, etc.) interoperable digital health infrastructure. The profile development will be supported by members of the OpenHIE community.

May 3, 2019 : Approved for public comments
July 1, 2019 : Public comment review (Tcon)
November 15, 2019 : Approved for Trial Implementation

XCA Deferred Response Option

Query and retrieval of documents across communities may in some cases require much more time than synchronous web services allow. We identify two such cases. Further, the existing asynchronous mechanisms available in XCA may not be a good match for some systems.
The XCPD profile has a Deferred Response Option, while the XCA profile does not. When ITI was designing the deferred mechanism for XCPD, it proposed and partially designed a draft mechanism for XCA as well. The only reason it was not originally completed was that there was not yet a pressing need. We now have one, so we are proposing to add a Deferred Response option to XCA. The US Social Security Administration and a partnering Release Of Information vendor have indicated strong interest in solving this problem, and we believe others will have similar interest.
IHE ITI is an appropriate venue to solve this, so that the solution may be standardized and not left to individual implementers.

May 3, 2019 : Approved for public comments
July 1, 2019 : Public comment review (Tcon)
July 25, 2019 : Approved for Trial implementation

Add restfull feed to ATNA

Planning meeting (March 1, 2019): The scope changed into "Combining ATNA Feed with ATNA Query update in FHIR R4"

This proposal is in line with the work already carried out for example, for Mobile access to Health Documents (MHD) with XDS on FHIR, in searching and retrieving documents through RESTful capabilities. This work item consists of auditing the access to clinical documents from mobile applications implementing this kind of new profiles for mobile. This work could be achieved in using FHIR, which offers the ability to POST the AuditEvent resource that is suitable to manage the audit of an event.

May 3, 2019 : Approved for public comments
July 1, 2019 : Public comment review (Tcon)
July 25, 2019 : Approved for Trial implementation

Remainder ITI FHIR profiles to R4

Planning meeting (March 1, 2019): The profiles selected to be converted in FHIR R4 are mACM, PIXm, and NPFSm.

There are some ITI Profiles that are using FHIR, but are not using the current version of FHIR. FHIR R4 has been released for use December 2018. The priority set of profiles have been converted to R4, so this proposal is requesting that a project be undertaken to convert the remainder to R4. Those that are not to be converted to R4 should be retired.

ITI should consider if PCC or QRPH need assistance at converting their profiles as well. This given that we did help PCC with QEDm.

July 25, 2019 : Approved for public comments
September 14, 2019 : Public comments deadline
November 12, 2019 : NPFSm is renamed NPFS and approved for Trial Implementation
November 13, 2019 : mACM and PIXm are approved for Trial Implementation

Internet User Authorization (IUA) update

Since its initial publication in 2015, IUA started out with a few incompatibilities with base standards. Additionally, since then, OAuth 2.0 and related authentication frameworks (OpenID Connect, SMARTonFHIR) have matured. IUA still fills a void within these specifications and thus deserves an update. This work item replaces CPs that have been opened over years.

July 25, 2019 : Approved for current development

Mobile Health Document Sharing (MHDS)

Mobile access to Health Documents-Health Information Exchange (MHD-HIE) renamed in Nov. 2019.
Given that MHD has not included a central repository and deferred this responsibility to XDS Registry/Repository or XCA Responding Gateway. MHD has received positive implementation. Patient Identity Management profile now exists using FHIR. Audit Logging now exists using FHIR. There is interest in building a HIE completely upon FHIR technology.

July 25, 2019 : Approved for current development
Jan.7, 2020 : Approved for 1st Public Comment

Sharing Valuesets, Codes and Maps (SVCM)

Mobile Sharing Value Sets (SVS using FHIR) renamed in Nov. 2019.
Terminologies stored in value sets are most useful when they are widely shared and standardized across geography and disciplines to add clarity and pecificity. The IHE ITI Sharing Value Sets (SVS) profile currently solves that problem, however a FHIR-based approach to Sharing Value Sets would allow simpler, and more standardized use of FHIR terminology tools, including the FHIR Terminology Service and Value Sets.

July 25, 2019: Approved for current development
Feb, 2020: Volume 1 to be approved

Survey of network interfaces form (SNIF) - White paper

Configuration management of system-to-system interfaces that enable IHE profiles is burdensome within the healthcare enterprise. Interfaces are often manually configured, requiring trained integrators to: gather configuration properties, configure and test interoperability. The human element introduces the opportunity for errors, often typographical, that can be difficult to identify and correct. The increasing adoption of secure connectivity protocols complicates connectivity by adding additional connectivity properties, such as logging, and certificates.

This profile provides a consistent method to catalogue configuration properties for human and machine consumption during installation, upgrade and repair. This profile is a content profile that specifies properties and actors to create a “plug and play” like connectivity of interoperable systems.

November 14, 2019 : Approved for current development

ATNA Tool

November 14, 2019 : Approved for current development

Maintenance of ITI Profiles Published in 2018 and earlier

In Fall 2018, the IT Infrastructure Domain counts 25 Final Text Profiles, 19 Trial Implementation Profiles, and 7 additional Trial Implementation Supplements that modify existing FT profiles. More new TI supplements are published every year than are moved to Final Text. This growing list of documents has to be maintained with a yearly significant list of change proposals by a finite number of ITI Technical committee members.

The 2018-19 cycle (on Sept.7) begins with 101 assigned CPs, 7 completed CPs in 2 CP ballots, and 9 completed CPs awaiting a future ballot.33 CPs are currently assigned to someone who is no longer active on the ITI Technical Committee. Key expertise has been lost due to contributors who cannot be involved anymore in ITI development (for example, the work on CPs enabling XDS-MU to go to Final Text).

The staggered publication is also an important element to be considered. In scheduling republication of approx. 4 documents per quarter, rather than doing all republications once a year, the publication workload would be better managed.

This situation is becoming critical and the audience for this proposal knows the value of ITI Technical Framework documentation to the other IHE domains and to the healthcare IT community.

The ITI Planning and Technical Committees should explicitly identify maintenance as a work item to evaluate against other work item proposals for new profiles and set aside Technical Committee resources to improve quality in existing documentation.

See Also

• Return to ITI Planning Committee
• Return to IT Infrastructure domain page

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