National Extensions Process

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National Extensions to the Technical Framework

Scope of National Extensions

National Extensions to the IHE Technical Framework address specific local healthcare needs and facilitate 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 implement according to the original Technical Framework in order to claim compliance, National Extensions may not relax 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 patient or provider information to reflect policies regarding privacy and confidentiality

• Extend institutional information and financial transactions to conform to national health system payment structures and support specific local care practices


Process for 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.

National Extension documents are submitted to the Technical Committee of the most relevant IHE Domain for review. It is the responsibility of this Technical Committee to contact all active IHE Domains to provide representation for the review. The Domain Representative Reviewers will provide a Domain-specific assessment on compatibility and impact of the proposed National Extension. The National Committee and the Domain Technical Committee collaborate to resolve any outstanding issues in the draft. Integration Profiles deemed incompatible with the National Extension would be listed in the National Extension until the incompatibility issues are resolved.

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.


National Extension Document

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

It is highly recommended that National Committees review 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 for another country with similar interests as an initial template.


The basic outline of a submittal shall include:


X.0 National Extensions for IHE <National Initiative>

The national extensions documented in this section shall be used in conjunction with the definitions of integration profiles, actors and transactions provided in volumes I-II of the IHE Technical Framework. This section includes extensions and restrictions to effectively support the regional practice of healthcare in <National Initiative>.


X.1 Comments

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


X.2 IHE-<National Initiative> Scope

The extensions, restrictions and translations specified have impact to IHE Integration Profiles as identified in this section.


X.2.1 Applicable Integration Profiles

The extensions, restrictions and translations specified apply to the following IHE Integration profiles:

· <Applicable Integration Profiles>


X.2.1 Incompatible Integration Profiles

The extensions, restrictions and translations specified are incompatible with the following IHE Integration profiles:

· <Applicable Integration Profiles>


X.3 Technical Requirements Additions <Technical Requirements identifying the precise transactions, actors, integration profiles and sections of the Technical Framework to which they apply. Including the technical detail equivalent to that contained in the Technical Framework. >


National Extension Testing

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 any 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.