North West Genomics Testing Workflow (GTW)
0.0.1 - ci-build flag

DRAFT Implementation Guide

This is for collaboration and discussion purposes and is subject to change.

North West Genomics Testing Workflow (GTW) - Local Development build (v0.0.1) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Health Information Exchange (HIE)

Reference Standards

Health Documents Sharing

Clinical Compositions (FHIR Documents and CDA)

These are formats for clinical documents (equivalent to PDF, html, png, etc), used with Health Document Sharing

Clinical Data Sharing

The health document approaches above can be considered the summary and clinical data sharing is the detailed record.

Health Document Sharing

References

Overview

Is based on federating the referenced standards via Scatter-Gather

Document Consumer MHDIntermediaryRegional Integration Engine (RIE)Master Patient IndexMPIDocument Registry XDSIron IslandsDocument Registry XDSWesterlandsClinical Data Source QEDmWesterosDocument Responder MHDNational Record LocatorFind Document References [ITI-67]Retrieve patient's document pointers (GET)List of FHIR DocumentReference (UKCore)opt[Identify Systems with Records]Used to identify which systems have documents for the patientPatient Demographics Query [ITI-78]List of FHIR Patient (includes MRN from providers)Registry Stored Query [ITI-18]List of DocumentEntryRegistry Stored Query [ITI-18]List of DocumentEntryQuery Existing Data [PCC-44]HL7 IPA Finding and Retrieving Patient Information (DocumentReference)List of FHIR DocumentReferenceTransformandAggregateList of FHIR DocumentReference (UKCore + IHE UK metadata)

Health Document Sharing - Federated


  1. Document Consumer makes a call to the Intermediary. This is an updated version of Cross-Community Access (XCA) with ITI-67 used in place of ITI-18.
  2. The Intermediary calls National Record Locator to find nationally held record references.
  3. The Intermediary optionally calls the Master Patient Index. This is similar to the use of Cross-Community Patient Discovery (XCPD) with XDS.b but uses ITI-78 in place of HL7 v3 ITI-55 or HL7 v2 PDQ ITI-21
  4. The Intermediary calls systems within the region using either IHE XDS or IHE QEDm/HL7 IPA api standards to find XDS DocumentEntry or FHIR DocumentReference.
  5. The Intermediary transforms XDS DocumentEntry to FHIR DocumentReference, performs de-duplication and aggregates them into a single list.
  6. The list of FHIR DocumentReference is returned to the Document Consumer

Clinical Data Sharing

References

Overview

Like Health Document Sharing is based on federating the referenced standards via Scatter-Gather

Clinical Data Consumer QEDmIntermediaryRegional Integration Engine (RIE)Master Patient IndexMPIClinical Data Source QEDmPykeClinical Data Source QEDmLannisportClinical Data Source QEDmWesterosQuery Existing Data [PCC-44]HL7 IPA Finding and Retrieving Patient Informationopt[Identify Systems with Records]Used to identify which systems have documents for the patientPatient Demographics Query [ITI-78]List of FHIR Patient (includes MRN from providers)Query Existing Data [PCC-44]HL7 IPA Finding and Retrieving Patient InformationList of FHIR {resource}Query Existing Data [PCC-44]HL7 IPA Finding and Retrieving Patient InformationList of FHIR {resource}Query Existing Data [PCC-44]HL7 IPA Finding and Retrieving Patient InformationList of FHIR {resource}TransformandAggregateList of FHIR {Resource}

Health Document Sharing - Federated


  1. Clinical Data Consumer makes a call to the Intermediary. This is Query Existing Data [PCC-44]/HL7 IPA Finding and Retrieving Patient Information - these are expected to merge, the FHIR {resource} queried will vary.
  2. The Intermediary optionally calls the Master Patient Index. This is similar to the use of Cross-Community Patient Discovery (XCPD) with XDS.b but uses ITI-78 in place of HL7 v3 ITI-55 or HL7 v2 PDQ ITI-21
  3. The Intermediary calls systems within the region using Query Existing Data [PCC-44]/HL7 IPA Finding and Retrieving Patient Information to find FHIR {resource}
  4. The Intermediary Performs de-duplication of the FHIR {resource}’s and aggregates them into a single list.
  5. The list of FHIR {resource} is returned to the Clinical Data Consumer