National Extensions Process

Scope of National Extensions

National Extensions to the IHE Technical Framework address specific local healthcare needs and facilitate local implementation of the IHE Technical Framework.

They may add requirements to the Technical Framework generally or to specific Transactions, Actors or Integration Profiles. Since systems must still comply with the original Technical Framework, National Extensions may not relax or introduce conflicting requirements.

For example, it is appropriate for National Extensions to:

• Require support of character sets and national languages
• Provide translation of IHE concepts, codes or data fields from English into other national languages
• Extend institutional information and financial transactions to conform to national health system payment structures and specific local care practices
• Extend patient or provider information to reflect policies regarding privacy and confidentiality (Can someone provide an example of supporting privacy policies by extending patient/provider information?)
• (It has been suggested that it can also include a list of Profiles which are "invalid" in that country. Is that appropriate? If so, is the National Extension the best place to communicate that?)

Developing National Extensions

IHE National Committees are responsible for drafting National Extensions. Typically this happens after identifying a specific local healthcare need or implementation issue during the review, selection and promotion of Integration Profiles within their country.

Currently, a National Extension applies to the Technical Framework to which it is appended. National Extension documents are submitted to the Technical Committee of the relevant IHE Domain for review.

The National Committee and the Domain Technical Committee collaborate to resolve any outstanding issues in the draft.

Once the draft is approved by both the National Committee and Domain Technical Committee, it is incorporated and published as part of the Domain Technical Framework according to the maintenance and publication process of the Domain Technical Committee.

The overall process is intended to be very similar to that for Change Proposals.

When a National Committee would like to submit an extension to multiple Technical Frameworks, they may wish to identify the target Domains, submit the extension to the IHE Domain Coordination Committee and request a joint review of the extension. In this case the affected Technical Committees would work out a plan for a joint review.

Testing National Extensions

The National Extension shall be written with sufficient detail to allow for accurate development and testing.

It is appropriate for Regional Connectathons to include testing of compliance with published National Extensions. It is not appropriate to “fail” systems for not complying with National Extensions that were not approved and published a reasonable time before the Connectathon, as this is unfair to vendors who have implemented their systems in good faith according to the published Technical Framework.

The National Committee should consider organizing sponsorship for tool and test plan development necessary for Connectathon testing of the National Extension.

The National Committee should also consider providing staff to support verification of compliance to the National Extension at the Regional IHE Connectathons.

National Extension Document

National Extensions shall include concise descriptions of the local needs they address. They shall identify the transactions, actors, integration profiles and sections of the Technical Framework to which they apply.

It is highly recommended that National Committees review other existing National Extensions before drafting their own to get a feel for the types of issues addressed, document format and wording. In fact National Committees may find it useful to use a National Extension from another country with similar interests as an initial template.

(Since we are pointing them to existing Extensions as templates, do we need to include a template here?)

The basic outline of a submittal shall include:

X.0 National Extension for IHE <National Initiative>

This section includes extensions and restrictions to effectively support the regional practice of healthcare in <National Initiative>. These extensions shall be used in conjunction with the IHE Technical Framework to which they are attached.

X.1 Comments

This national extension document was authored by IHE <National Initiative> under the sponsorship and supervision of <sponsoring Organisation(s)>, who welcome comments on this document. Comments should be directed to: <National Initiative Representative>.

X.2 Scope

The extensions, restrictions and translations specified impact the following IHE Integration Profiles:

• <Applicable Integration Profiles>

X.3 Technical Requirements

<Technical Requirements

• Include technical detail equivalent to that contained in the Technical Framework
• identify the transactions, actors, integration profiles and sections of the Technical Framework to which they apply

>