QED-PCC-CP-0027

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Change Proposal QED-PCC-CP-0027

Official Change Proposal Template is a WORD document found at ftp://ftp.ihe.net/Document_templates/IHE_Change_Proposal-Template-V10.doc

The Change Proposal Template that you use is dependent on the committee.

Tracking Information

Domain
Patient Care Coordination
Change Proposal Number
QED-PCC-CP-0027
Status
In process
Last Updated
Kboone 15:05, 21 May 2008 (CDT)
Assigned
Unassigned

Change Proposal Summary

Title
Add Clinical Data Source Actor to QED
Submission Date
14:52, 21 May 2008 (CDT)
Profile Affected
QED
TF Version
2023
Volume and Section

Rationale

The QED Profile specifies a number of specific Data Repositories that can be queried for specific acts, such as Problems, Medications, Allergies et cetera. In development of the CM Profile we have discovered that there is a potential need for the Care Manager to query for additional information from a Clinical Data Source actor. The QED profile very nearly supports that capability, and could be slightly extended to fully support it, providing a mechanism by which the Care Manager can query for additional information without having to issue more than one query. This would require the addition of a new actor to QED, the Clinical Data Source, which would be a composite of the other six Data Source actors of the QED profile, and a new transaction (PCC-12) which would support the query of a Clinical Data Source.

Content

Note: Modify the Actors/Transaction section of the QED profile in PCC-TF Volume I as follows:


Actors/Transaction

There are seveneight actors in this profile, the Clinical Data Consumer, and fiveseven different types of repositories of clinical data, including vitals, problems and allergies, diagnostic results, medications, immunizations and, professional services and a Clinical Data Repository.

Query for Existing Data Actor Diagram

The table below lists the transactions for each actor directly involved in the Query for Existing Data Profile. In order to claim support of this Integration Profile, an implementation must perform the required transactions (labeled 'R'). Transactions labeled 'O' are optional. A complete list of options defined by this Integration Profile and that implementations may choose to support is listed below under Options.

Actor Name Optionality Transaction
Query for Existing Data Actors and Transactions
Clinical Data Consumer Query Vital Signs O1 PCC-1
Query Problems and Allergies O1 PCC-2
Query Diagnostic Data O1 PCC-3
Query Medications O1 PCC-4
Query Immunizations O1 PCC-5
Query Professional Services O1 PCC-6
Query Clinical Data O PCC-12
Vital Signs Data Repository Query Vital Signs R PCC-1
Problems and Allergies Data Repository Query Problems and Allergies R PCC-2
Diagnostic Data Repository Query Diagnosic Data R PCC-3
Medications Data Repository Query Medications R PCC-4
Immunizations Data Repository Query Immunizations R PCC-5
Professional Services Data Repository Query Professional Services R PCC-6
Clinical Data Repository Query Clinical Data R PCC-12

Note 1: The Actor shall support at least one of these transactions.

Options

Actor Option
Query for Existing Data Options
Vital Signs Data Repository None Defined
Problems and Allergies Data Repository
Diagnostic Data Repository
Medications Data Repository
Immunizations Data Repository
Professional Services Data Repository
Clinical Data Repository
Clinical Data Consumer Vital Signs Option (1)
Problems and Allergies Option (1)
Diagnostic Data Option (1)
Medications Option (1)
Immunizations Option (1)
Professional Services Option (1)
Clinical Query Option (1)

(1) At least one of these options shall be supported by a Clinical Data Consumer Actor


Note: Add the following option description to the QED profile

Clinical Query Option

A Clinical Data Consumer that implements the Clinical Query Option implements the Query Clinical Data transaction.


Note: Add the following transaction to Volume II

Query Clinical Data

This section corresponds to Transaction PCC-12 of the IHE Patient Care Coordination Technical Framework. Transaction Query Clinical Data is used by the Clinical Data Consumer and Clinical Data Repository Actors.

Transaction Query Clinical Data uses the same pattern as transaction PCC-1. Therefore, the Referenced Standards and Interaction Diagrams sections of that transaction also serve to document the standards and interactions used in this transaction. Information specific to this transaction is described in futher detail below in the section Domain Content.

Use Case Roles

Clinical Data Consumer   Clinical Data Repository
Usecase.png
Query Clinical
Actor
Clinical Data Consumer
Role
Requests a list of clinical data for a given patient matching a minimal set of selection criteria from the Clinical Data Repository.
Cooresponding HL7 Version 3 Application Roles
Care Record Query Placer (QUPC_AR004030UV)
Query by Parameter Placer (QUQI_AR000001UV01)
Actor
Clinical Data Repository
Role
Returns clinical data entries for a given patient matching the selection criteria supplied by the Clinical Data Consumer.
Cooresponding HL7 Version 3 Application Roles
Care Record Query Fulfiller (QUPC_AR004040UV)
Query by Parameter Fulfiller (QUQI_AR000002UV01)


Domain Content

This section lists the requirements specific to the Query Clinical Data transaction.


Note: Implementors of a Clinical Data Repository Actor, or a Clinical Data Consumer Actor shall publish an HL7 Conformance Profile that indicates the vocabularies and code sets that they support for this transaction.


Get Care Record Profile Query
careProvisionCode

A Clinical Data Consumer may specify the values from the vocabularies specified for the careProvisionCode attribute used in the PCC-1, PCC-2, PCC-3, PCC-4, PCC-5 or PCC-6 transactions.

A Clinical Data Consumer Actor may make requests using other codes to obtain information about clinical data, but Clinical Data Repositories are not required to support these codes.

Additional codes for Clinical may be found in SNOMED CT (2.16.840.1.113883.6.96), CPT-4 (2.16.840.1.113883.6.12), ICD-9-CM procedure codes (2.16.840.1.113883.6.104), LOINC (2.16.840.1.113883.6.1), and in other controlled vocabularies.

careProvisionReason

The <value> element of the <careProvisionReason> element may contain a value identifying a the reason for the procedure or visit.

A Clinical Data Repository Actor that chooses to honor this query parameter shall return only those results that were for the indicated reason. Should the Clinical Data Repository Data Repository Actor not support the use of the <careProvisionReason> element, it shall indicate this by raising the appropriate alert as decribed in the expected actions recorded in PCC-1.

Get Care Record Profile Response

A Clinical Data Repository Actor shall respond to a query request by returning clinical statements matching the query parameter returned within <pertinentInformation3> data elements.

The clinical statements that are returned for codes specified in the table above in the section on careProvisionCode shall conform to the templates shown above. All clinical statements returned shall specify the author or authors of the statement in an <author> element, and may indicate the informants in <informant> elements.

A Clinical Data Repository Actor may respond to query requests using other codes to return information about specific procedure or visit. These entries conform to one of the template identifiers shown above.

WSDL Declarations

The following WSDL naming conventions SHALL apply for this transaction:

WSDL Definitions for PCC-6
WSDL Item Value
wsdl:definitions/@name ClinicalDataSource
Get Care Record Profile Query QUPC_IN043100UV_Message
Get Care Record Profile Response QUPC_IN043200UV_Message
General Query Activate Continue / Cancel QUQI_IN000003UV01_Messsage
portType ClinicalDataSource_PortType
Query Operation ClinicalDataSource_QUPC_IN043100UV
Continue Operation ClinicalDataSource_QUQI_IN000003UV01_Continue
Cancel Operation ClinicalDataSource_QUQI_IN000003UV01_Cancel
SOAP 1.1 binding ClinicalDataSource_Binding_Soap11
SOAP 1.1 port ClinicalDataSource_Port_Soap11
SOAP 1.2 binding ClinicalDataSource_Binding_Soap12
SOAP 1.2 port ClinicalDataSource_Port_Soap12

The following WSDL snippets specify the Port Type and Binding definitions, according to the requirements specified in ITI TF-2: Appendix V. A full WSDL example for the Clinical Data Source actor implementing the QED profile can be found at ftp://ftp.ihe.net/Patient_Care_Coordination/yr3_2007-2008/resources/Query.zip. For a general description of the WSDLs for QED see the Appendix of the same name in this volume.

Port Type
<portType name="ClinicalDataSource_PortType">
 <operation name="ClinicalDataSource_QUPC_IN043100UV">
   <input message="tns:QUPC_IN043100UV_Message"
     wsaw:Action="urn:hl7-org:v3:QUPC_IN043100UV"/>
   <output message="tns:QUPC_IN043200UV_Message" 
     wsaw:Action="urn:hl7-org:v3:QUPC_IN043200UV "/>
 </operation>
 <operation name="ClinicalDataSource_QUQI_IN000003UV01_Continue">
   <input message="tns:QUQI_IN000003UV01_Message"
     wsaw:Action="urn:hl7-org:v3:QUQI_IN000003UV01"/>
   <output message="tns:QUPC_IN043200UV_Message" 
     wsaw:Action="urn:hl7-org:v3:QUPC_IN043200UV "/>
 </operation>
 <operation name="ClinicalDataSource_QUQI_IN000003UV01_Cancel">
   <input message="tns:QUQI_IN000003UV01_Message"
     wsaw:Action="urn:hl7-org:v3:QUQI_IN000003UV01"/>
   <output message="tns:QUPC_IN043200UV_Message" 
     wsaw:Action="urn:hl7-org:v3:QUPC_IN043200UV "/>
 </operation>
</portType>
Port Types for PCC-6
Bindings
<binding name="ClinicalDataSource_Binding_Soap12" 
   type="ClinicalDataSource_PortType">
 <wsoap12:binding style="document"
   transport="http://schemas.xmlsoap.org/soap/http"/>
 <operation name="ClinicalDataSource_QUPC_IN043100UV">
   <wsoap12:operation soapAction="urn:hl7-org:v3:QUPC_IN043100UV"/>
   <input>
     <wsoap12:body use="literal"/>
   </input>
   <output>
     <wsoap12:body use="literal"/>
   </output>
 </operation>
</binding>
SOAP 1.2 Binding for PCC-6 
<binding name="ClinicalDataSource_Binding_Soap11" 
   type="ClinicalDataSource_PortType">
 <wsoap11:binding style="document"
   transport="http://schemas.xmlsoap.org/soap/http"/>
 <operation name="ClinicalDataSource_QUPC_IN043100UV">
   <wsoap11:operation soapAction="urn:hl7-org:v3:QUPC_IN043100UV"/>
   <input>
     <wsoap11:body use="literal"/>
   </input>
   <output>
     <wsoap11:body use="literal"/>
   </output>
 </operation>
</binding>
SOAP 1.1 Binding for PCC-6

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