HealthShare Foundation Basics

Version 2012.2
31 August 2012

InterSystems Corporation 1 Memorial Drive Cambridge MA 02142 www.intersystems.com

HealthShare Foundation Basics
HealthShare Foundation Version 2012.2 31 August 2012
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 Table of Contents
About This Book .................................................................................................................................... 1
1 Introduction to HealthShare Foundation ......................................................................................... 3
1.1 IHE Support in HealthShare Foundation .................................................................................... 4
2 IHE Use Cases in HealthShare Foundation ..................................................................................... 5
2.1 Performing PIX and PDQ Queries Against an EMPI ................................................................ 5
2.1.1 Perform a Deterministic Query Against an EMPI (PIXv3) ............................................. 6
2.1.2 Perform a Probabilistic Query Against an EMPI (PDQv3) ............................................. 7
2.2 Adding or Updating Demographic Data Held in an EMPI (PIX Add) ....................................... 9
2.2.1 PIX Add Message Trace ................................................................................................. 10
2.2.2 PIX Add Procedure ........................................................................................................ 10
2.2.3 PIX Add Components and Settings ................................................................................ 11
2.2.4 PIX Add Example .......................................................................................................... 11
2.3 Querying an XDS Registry and Retrieving a Document from a Repository ........................... 12
2.3.1 XDS Query Message Trace ............................................................................................ 12
2.3.2 XDS Query Procedure ................................................................................................... 13
2.3.3 XDS Query Components and Settings ........................................................................... 14
2.3.4 XDS Retrieve Message Trace ........................................................................................ 14
2.3.5 XDS Retrieve Document Set Procedure ........................................................................ 14
2.3.6 XDS Retrieve Components and Settings ....................................................................... 15
2.3.7 XDS Query and Retrieve Example ................................................................................ 15
2.4 Providing and Registering Documents to an XDS Document Repository ............................... 16
2.4.1 Provide and Register a CDA Document ......................................................................... 16
2.4.2 Provide and Register a Non-CDA Document ................................................................ 20
2.5 Querying and Retrieving a Document from another Affinity Domain (XCA) ........................ 24
2.5.1 XCA Query Message Trace ........................................................................................... 24
2.5.2 XCA Query Procedure ................................................................................................... 26
2.5.3 XCA Query Components and Settings .......................................................................... 28
2.5.4 XCA Retrieve Message Trace ........................................................................................ 29
2.5.5 XCA Retrieve Procedure ................................................................................................ 30
2.5.6 XCA Retrieve Components and Settings ....................................................................... 31
2.5.7 XCA Query and Retrieve Example ................................................................................ 32
2.6 Generating a CCD Document from an HL7 Message .............................................................. 33
2.6.1 HL7 to CCD Provide and Register Message Trace ........................................................ 33
2.6.2 HL7 to CCD Provide and Register Procedure ............................................................... 34
2.6.3 HL7 to CCD Provide and Register Components and Settings ....................................... 35
2.6.4 Example Transformer Business Operation to Generate a CCD Document from an HL7
Message ................................................................................................................................... 35
2.7 Generating a CCD Document by Querying an Internal Database ........................................... 36
2.8 Receiving a CCD Document and Converting it to an Internal Format ..................................... 36
3 Registry Settings for IHE Communication .................................................................................... 37
3.1 Sample Service Registry Entries for IHE ................................................................................. 37
3.2 OID Registry Entries for IHE ................................................................................................... 38
3.3 Configuration Registry Entries for IHE ................................................................................... 39
4 SDA Documents ................................................................................................................................ 41
4.1 The Basic XML Structure of an SDA Document ..................................................................... 41

HealthShare Foundation Basics                                                                                                                                             iii

 4.2 The Patient in SDA ................................................................................................................... 42
4.3 Encounters in SDA ................................................................................................................... 43
4.4 For More Information on SDA ................................................................................................. 43
5 Auditing ............................................................................................................................................. 45
5.1 Basic Auditing .......................................................................................................................... 45
5.2 ATNA Auditing ......................................................................................................................... 45

iv                                                                                                                                             HealthShare Foundation Basics

 List of Tables
Table 2–1: Components and Settings Used in a PIX Query ................................................................... 7
Table 2–2: Components and Settings Used in a PDQ Query ................................................................. 9
Table 2–3: Components and Settings Used in a PIX Add ..................................................................... 11
Table 2–4: Components and Settings Used in XDS Query ................................................................... 14
Table 2–5: Components and Settings Used in XDS Retrieve ................................................................ 15
Table 2–6: Components and Settings Used in Provide and Register of a CDA Document .................. 18
Table 2–7: Components and Settings Used in Provide and Register of a non-CDA Document ........... 22
Table 2–8: Components and Settings Used in XCA Query ................................................................... 28
Table 2–9: Components and Settings Used in XCA Retrieve ............................................................... 31
Table 2–10: Components and Settings Used in Transformation of HL7 to CCD followed by a Provide
and Register ........................................................................................................................................... 35
Table 4–1: Properties in HS.SDA3.Patient ............................................................................................ 42
Table 4–2: Properties in HS.SDA3.Encounter ...................................................................................... 43

HealthShare Foundation Basics                                                                                                                                             v

About This Book
This book describes how to use HealthShare Foundation. It is divided into the following chapters:
• “ Introduction to HealthShare Foundation” describes what HealthShare Foundation is and lists the IHE profiles and
actors supported by the product.
• “ HealthShare Foundation Use Cases ” describes the use cases that HealthShare Foundation can solve.
• “ Registry Settings for IHE Communication” describes how to configure the HealthShare Foundation registries to
enable communication with other systems.
• “ SDA Documents ” describes the XML format used in HealthShare Foundation to represent patient records.
• “ Auditing” describes how to configure auditing in HealthShare Foundation.

This book also contains a complete table of contents.

For more information on HealthShare Foundation, see the following books:
• InterSystems Supported Platforms lists the platforms on which HealthShare Foundation is supported.
• HealthShare Foundation Administration Guide describes how to administer HealthShare.
• HealthShare Foundation Release Notes lists new features in the product.
• HealthShare Foundation Installation and Migration Guide describes how to install or upgrade HealthShare Foundation.
(Not yet completed.)

For general information, see Using InterSystems Documentation.

HealthShare Foundation Basics                                                                                                                                             1

1
Introduction to HealthShare Foundation
Integrating the Healthcare Enterprise (IHE) is an emerging international standard for communication between healthcare
entities. IHE provides a common standard for healthcare applications to interoperate. HealthShare Foundation provides
Ensemble-based tools that perform IHE transactions with other systems. HealthShare Foundation supports a variety of IHE
profiles and actors.
IHE transactions are based on Integration Profiles that use a complex set of XML messages whose structure is laid out in
Technical Framework documents that run hundreds of pages long. HealthShare foundation allows you to perform IHE
queries and send and receive IHE documents simply by constructing Ensemble messages, without requiring in-depth
knowledge of the underlying IHE technology in use.
HealthShare Foundation includes:
• a set of Ensemble business hosts that you can add to a production to perform IHE transactions
• a trace business operation that can help you diagnose problems by reporting the status of a transaction at each stage of
the transaction
• a set of Ensemble messages for initiating transactions and receiving results
• a set of XSL transformations that
– translate Ensemble messages into IHE messages
– translate IHE messages into Ensemble messages
– construct IHE messages from other IHE messages
– construct CCD documents from your data (via SDA, a documented, internal XML representation of patient data)
– construct CCD documents from HL7
– parse CCD documents into SDA, so you can integrate received CCD data into your database

• a utility (Caché class) that can set up a sample production for you
• a Test service, which is a simple Ensemble message router
• a set of registries to store:
– assigning authorities
– OIDs (of assigning authorities, home communities, coding systems, repositories, devices, facilities, etc.)
– configuration options
– internet addresses of services
– SAML credentials

HealthShare Foundation Basics                                                                                                                                             3

Introduction to HealthShare Foundation

1.1 IHE Support in HealthShare Foundation

HealthShare Foundation supports the following IHE profiles and actors:

Profile Description Supported Actors Supported Transactions ITI #

ATNA Audit Trail and Node Authentication Secure Application Record Audit Event ITI-20
Retrieve Document Set ITI-43
XCA Cross-Community Access Initiating Gateway
Cross Gateway Retrieve ITI-39
Initiating Gateway Patient Discovery ITI-55
XCPD Cross-Community Patient Discovery
Request
Registry Stored Query ITI-18
Document Consumer
Cross-Enterprise Document Retrieve Document Set ITI-43
XDS.b
Sharing, version b
Provide and Register
Document Source ITI-41
Document Set-b

Patient Demographics Query for Patient Demographics

PDQv3 Consumer Query ITI-47
HL7 version 3

Patient Identifier Cross Reference Consumer PIX Query ITI-45

PIXv3
for HL7 version 3 Patient Identity Source Patient Identity Feed ITI-44

InterSystems’ official IHE integration statement for the full line of HealthShare products can be found online at
www.intersystems.com/healthshare/ihe.

Note: Throughout this document, the following terms are used interchangeably:
• XDS.b/XDS
• PIXv3/PIX
• PDQv3/PDQ

4                                                                                                                                             HealthShare Foundation Basics

2
IHE Use Cases in HealthShare Foundation
This chapter details how HealthShare Foundation handles several IHE transaction scenarios:
• PIX/PDQ
– Perform a deterministic query against an EMPI
– Perform a probabilistic query against an EMPI
– Add or update demographic data held in an EMPI

• XDS
– Query the Affinity Domain’s registry and retrieve a document from a repository
– Provide and register a document (CDA or other) to a repository in the Affinity Domain

• XCA
– Query the registry in another Affinity Domain and retrieve a document from a repository

• CCD
– Generate a CCD document from an HL7 message and provide and register it to a repository.
– Generate a CCD document by querying an internal database
– Receive a CCD document (via a registry or point-to-point) and convert it to an internal format

Each use case is described and the messages are traced through the product. A table lists the components and settings
employed in each use case, and examples provide instructions on creating messages for input.

2.1 Performing PIX and PDQ Queries Against an EMPI

HealthShare Foundation can perform both probabilistic and deterministic queries against an external EMPI (Enterprise
Master Patient Index).
• Deterministic queries use the PIXv3 profile.
• Probabilistic queries use the PDQv3 profile.

HealthShare Foundation Basics                                                                                                                                             5

IHE Use Cases in HealthShare Foundation

2.1.1 Perform a Deterministic Query Against an EMPI (PIXv3)

HealthShare Foundation supports deterministic queries against an EMPI via the IHE “PIXv3” profile. A PIX query provides
an MRN (Medical Record Number) and assigning authority and receives back the name and MPI ID of a single patient.
This section includes:
• PIX query message trace
• PIX query procedure
• PIX query components
• PIX query example

2.1.1.1 PIX Query Message Trace

Below is an annotated PIX query message trace.
The test service shown in the diagram is a simple message router. Trace operations is a utility that makes intermediate
processing steps visible. The numbers in the diagram match the steps in the procedure below.

2.1.1.2 PIX Query Procedure

1. You provide a Patient Search Request message containing an MRN and assigning authority to the HealthShare PIX
Consumer.
2. The HealthShare PIX Consumer transforms the message into an IHE “PIXv3_QueryRequest” using the transformation
specified in the TransformPatientSearchToPIX setting.
3. The HealthShare PIX Consumer then forwards the PIX request to the service named in the ServiceName setting. This
setting is typically PIXv3.Manager, and it refers to a service registry entry pointing to the location of the PIX manager
actor endpoint in another system.
4. The PIX manager on the other system returns a PIX response message that contains the name and MPI ID for a single
patient if there is a match.

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 Performing PIX and PDQ Queries Against an EMPI

5. The HealthShare PIX Consumer transforms the response into a Patient Search Response message using the transfor-
mation specified in the TransformPIXToPatientSearch.
6. The HealthShare PIX Consumer returns the Patient Search Response message, which contains the name and MPI ID
of the patient, if found. If no patient is found, the response message indicates a <ResultsCount> of zero. If there is
an error, the PIX Consumer returns null.

2.1.1.3 PIX Query Components and Settings

Table 2–1: Components and Settings Used in a PIX Query

Business Hosts PIX Consumer: HS.IHE.PIXv3.Consumer.Operations

Production Settings TransformPatientSearchToPIX in the PIX Consumer

ServiceName in the PIX Consumer

TransformPIXToPatientSearch in the PIX Consumer

Ensemble Messages HS.Message.PatientSearchRequest

HS.Message.PatientSearchResponse
XSL Transformations IHE/PIX/Version1/PatientSearchToPRPAIN201309UV.xsl

IHE/PIX/Version1/PRPAIN201310UVToPatientSearchResponse.xsl

Service Registry Entries PIXv3.Manager

External IHE Actor Endpoint PIX manager

2.1.1.4 PIX Query Example

The method below generates a PIX query:
ClassMethod PIXQuery()
{
/// Create Patient Search Request message
Set obj=##class(HS.Message.PatientSearchRequest).%New()

//Provide the Patient MRN

Set obj.AssigningAuthority="EXTERNAL" //refers to an Assigning Authority entry in the OID Registry

Set obj.MRN="1111222"

// Send to the routing service (or directly to HS.IHE.PIXv3.Consumer.Operations)

Do ##class(HS.Test.Service).SendSync(obj,.pr)

quit
}

2.1.2 Perform a Probabilistic Query Against an EMPI (PDQv3)

HealthShare Foundation supports probabilistic queries against an EMPI via the IHE “PDQv3” profile. A PDQ query provides
a partial set of patient demographics and receives back full demographics for one or more MPI IDs (patients) that match
the provided demographics.
This section includes:
• PDQ query message trace
• PDQ query procedure
• PDQ query components

HealthShare Foundation Basics                                                                                                                                             7

IHE Use Cases in HealthShare Foundation

• PDQ query example

2.1.2.1 PDQ Query Message Trace

Below is an annotated PDQ message trace.
The test service shown in the diagram is a simple message router. Trace operations is a utility that makes intermediate
processing steps visible in the trace. The numbers in the diagram match the steps in the procedure below.

2.1.2.2 PDQ Query Procedure

1. You provide a Patient Search Request message containing partial demographics to the HealthShare PDQ Consumer.
2. The HealthShare PDQ Consumer transforms the message into an IHE “PDQv3_QueryRequest” using the transformation
specified in the TransformPatientSearchToPDQ setting.
3. The HealthShare PDQ Consumer then forwards the PDQ request to the PDQ supplier endpoint on another system that
is named in the ServiceName setting.
4. The PDQ supplier on the other system returns a PDQ response message that contains the complete demographics for
all patients that match the supplied partial demographics.
5. The HealthShare PDQ Consumer transforms the response into a Patient Search Response message using the transfor-
mation specified in the TransformPDQToPatientSearch setting.
6. The HealthShare PDQ Consumer returns the Patient Search Response message, which contains the full demographics
and MPI IDs of the matching patients. If no patient is found, the response message indicates a <ResultsCount> of
zero. If there is an error, the PDQ Consumer returns null.

8                                                                                                                                             HealthShare Foundation Basics

 Adding or Updating Demographic Data Held in an EMPI (PIX Add)

2.1.2.3 PDQ Query Components and Settings

Table 2–2: Components and Settings Used in a PDQ Query

Business Hosts PDQ Consumer: HS.IHE.PDQv3.Consumer.Operations

Production Settings TransformPatientSearchToPDQ in the PDQ Consumer

ServiceName in the PDQ Consumer

TransformPDQToPatientSearch in the PDQ Consumer

Ensemble Messages HS.Message.PatientSearchRequest

HS.Message.PatientSearchResponse
XSL Transformations IHE/PDQ/Version1/PatientSearchToPRPAIN201305UV.xsl

IHE/PDQ/Version1/PRPAIN201306UVToPatientSearchResponse.xsl

Service Registry Entries PDQv3.Supplier

External IHE Actor Endpoint PDQ Supplier

2.1.2.4 PDQ Query Example

The method below generates a PDQ query:
ClassMethod PDQQuery()
{
// Create Patient Search Request message
Set obj=##class(HS.Message.PatientSearchRequest).%New()

// Provide patient demographics

Set obj.FirstName="James"
Set obj.LastName="Smith"

// Required only for HS.Test.Service to distinguish between PIX/PDQ

Do obj.AdditionalInfo.SetAt(1,"PDQ")

// Send to the routing service (or directly to HS.IHE.PDQv3.Consumer.Operations)

Do ##class(HS.Test.Service).SendSync(obj,.sr)

quit
}

2.2 Adding or Updating Demographic Data Held in an

EMPI (PIX Add)
HealthShare Foundation can add a patient or update the demographic data held for a patient in an external EMPI via an
IHE “PIXv3_PatientAddRequest ” transaction.
This section includes:
• PIX add message trace
• PIX add procedure
• PIX add components
• PIX add example

HealthShare Foundation Basics                                                                                                                                             9

IHE Use Cases in HealthShare Foundation

2.2.1 PIX Add Message Trace

Below is an annotated PIX add message trace that returns the MPIID.
The test service shown in the diagram is a simple message router. Trace operations is a utility that makes intermediate
processing steps visible in the trace. The numbers in the diagram match the steps in the procedure below.

2.2.2 PIX Add Procedure

1. You provide an Add Update Hub Request message that contains the necessary demographic data to the HealthShare
PIX Source.
2. The HealthShare PIX Source transforms the message into an IHE “PIXv3_PatientAddRequest” using the transformation
specified in the TransformAddUpdateHubToPIX setting.
3. The HealthShare PIX Source then forwards the PIX request to the PIX manager endpoint on another system that is
named in the ServiceName setting.
4. The PIX manager on the other system returns an acknowledgement or error.
5. If the OperationToLocateMPIID setting in the HealthShare PIX Source contains a value (typically
HS.IHE.PIXv3.Consumer.Operations), then it sends a patient search request to the named operation, and that oper-
ation performs a PIX query to get the MPIID of the patient.
6. The HealthShare PIX Source returns an Add Update Hub Response message. Depending on the setting in step 5, this
response message may contain the MPIID. If there is an error, the HealthShare PIX Source returns null.

10                                                                                                                                           HealthShare Foundation Basics

 Adding or Updating Demographic Data Held in an EMPI (PIX Add)

2.2.3 PIX Add Components and Settings

Table 2–3: Components and Settings Used in a PIX Add

Business Hosts PIX Source: HS.IHE.PIXv3.Source.Operations

PIX Consumer: HS.IHE.PIXv3.Consumer.Operations
• if returning the MPI ID

Production Settings TransformAddUpdateHubToPIX in PIX Source

ServiceName in PIX Source

OperationToLocateMPIID in PIX Source

Ensemble Messages HS.Message.AddUpdateHubRequest

HS.Message.AddUpdateHubResponse
HS.Message.PatientSearchRequest (if PIX)
HS.Message.PatientSearchResponse (if PIX)
XSL Transformations IHE/PIX/Version1/AddUpdateHubRequestToPRPAIN201301UV.xsl

Service Registry Entries PIXv3.Manager

External IHE Actor Endpoint PIX manager

2.2.4 PIX Add Example

The method below generates a PIX add:
ClassMethod PIXADD()
{
// Create AddUpdateHub Message
Set obj=##class(HS.Message.AddUpdateHubRequest).%New()

// Name, sex, DOB

Set obj.FirstName="James"
Set obj.LastName="Smith"
Set obj.Sex="M"
Set obj.DOB=obj.DOBDisplayToLogical("2000-09-30")

// Patient ID
Set obj.MRN="1111222"
Set obj.AssigningAuthority="EXTERNAL" // refers to an Assigning Authority entry in the OID Registry

Set obj.Facility="EXTERNAL" // refers to a Facility entry in the OID Registry

// Address 1
Set addr=##class(HS.Types.Address).%New()
Set addr.City="Somewhere"
Set addr.State="SW"
Set addr.StreetLine="123 Money Street"
Set addr.Use="HP" // Primary Home address
Do obj.Addresses.Insert(addr)

// Address 2
Set addr=##class(HS.Types.Address).%New()
Set addr.City="Anywhere"
Set addr.StreetLine="456 Any Street"
Set addr.Use="WP" // Work Place address
Do obj.Addresses.Insert(addr)

//Telephone
Set tel=##class(HS.Types.Telecom).%New()
Set tel.PhoneCountryCode="1"
Set tel.PhoneAreaCode=705
Set tel.PhoneNumber=5551212

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IHE Use Cases in HealthShare Foundation

Set tel.Use="HP" // Primary Home phone

Set tel.Type="L" // Landline
Do obj.Telecoms.Insert(tel)

// Alternate ID
Set tIdent=##class(HS.Types.Identifier).%New()
Set tIdent.Root="Other.AA" // refers to an Assigning Authority entry in the OID Registry
Set tIdent.Extension="98754321"
Do obj.Identifiers.Insert(tIdent)

// Send to the routing service (or directly to HS.IHE.PIXv3.Source.Operations)

Do ##class(HS.Test.Service).SendSync(obj,.r)
Quit
}

2.3 Querying an XDS Registry and Retrieving a Document

from a Repository
HealthShare Foundation can query an XDS document registry requesting a list of documents for a patient via the IHE
“XDS.b Registry Stored Query” transaction. It can then retrieve one or more stored documents from an XDS repository
via the IHE “ XDS.b Retrieve Document Set” transaction.
IHE supports the idea of an Affinity Domain of healthcare systems that share a common IHE infrastructure. An Affinity
Domain might be a RHIO, an IDN, or some other organization. Each Affinity Domain has a single document registry, and
may have multiple document repositories. Use the XDS.b profile to query and retrieve documents only within your Affinity
Domain. To query and retrieve documents outside of an Affinity Domain as well, use the XCA profile instead.
This section includes:
• XDS Query:
– XDS query message trace
– XDS query procedure
– XDS query components

• XDS Retrieve:
– XDS retrieve message trace
– XDS retrieve procedure
– XDS retrieve components

• Example XDS query and retrieve

2.3.1 XDS Query Message Trace

Below is an annotated XDS query message trace.
The test service shown in the diagram is a simple message router. Trace operations is a utility that makes intermediate
processing steps visible in the trace. The numbers in the diagram match the steps in the procedure below.

12                                                                                                                                           HealthShare Foundation Basics

 Querying an XDS Registry and Retrieving a Document from a Repository

2.3.2 XDS Query Procedure

1. You provide an XDS.b Query Request message that contains an MPI ID and assigning authority to the HealthShare
Document Consumer. You can obtain the MPI ID through a PIX or PDQ query (described above). The query request
also specifies the document type and status (for example “approved” ), and may also include a list of filters.
2. The HealthShare Document Consumer transforms the Ensemble message into an IHE “XDSb_QueryRequest” message
using an internally-specified transform.
3. The HealthShare Document Consumer then forwards the query to the XDS document registry endpoint on another
system that is named in the XDSbRegistryServiceName setting.
4. The XDS document registry on the other system returns a list of available documents along with their metadata and
locations.
5. The HealthShare Document Consumer extracts the document metadata from the response using the transformation
specified in the TransformToMetadata setting. It then constructs an XDS.b Query Response message.
6. The HealthShare Document Consumer returns the XDS.b Query Response message, which contains both the original
XDS document registry response and the extracted metadata.

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IHE Use Cases in HealthShare Foundation

2.3.3 XDS Query Components and Settings

Table 2–4: Components and Settings Used in XDS Query

Business Hosts Document Consumer: HS.IHE.XDSb.Consumer.Operations

Production Settings XDSbRegistryServiceName in the Document Consumer

TransformToMetadata in the Document Consumer

Ensemble Messages HS.Message.IHE.XDSb.QueryRequest

HS.Message.IHE.XDSb.QueryResponse
XSL Transformations QueryRequestToXDSbQuery.xsl

MessageToMetadata.xsl

Service Registry Entries XDSb.Registry

External IHE Actor Endpoint XDS Document Registry

2.3.4 XDS Retrieve Message Trace

Below is an annotated XDS retrieve message trace.
The test service shown in the diagram is a simple message router. Trace operations is a utility that makes intermediate
processing steps visible in the trace. The numbers in the diagram match the steps in the procedure below.

2.3.5 XDS Retrieve Document Set Procedure

1. Take the query response (above) and construct an HS.Message.IHE.XDSb.RetrieveRequest message that contains
the document unique ID and repository unique ID (OID) for one or more of the documents listed in the query. Each

14                                                                                                                                           HealthShare Foundation Basics

 Querying an XDS Registry and Retrieving a Document from a Repository

retrieve request can go to only one repository, so if the query response refers to multiple repositories, you must split
these out into separate retrieve requests, one for each repository.
Send the XDS.b Retrieve Request to the HealthShare Document Consumer.
2. The HealthShare Document Consumer transforms the Ensemble message into an IHE “ XDSb_RetrieveRequest”
message using an internally-specified transform.
3. The HealthShare Document Consumer then forwards the request to the XDS document repository endpoint on another
system that is indicated by the <RepositoryUniqueID> value in the message. This value is an OID. In order to
translate the OID into a URL, the following setup is required:
• An OID registry entry of type “Repository” for the OID.
• A service registry entry that provides the URL of the repository:
– The service registry entry must include the OID registry code in the Repository field. This ties the OID and
service registry entries together.

Note: If there is a value in the XDSbRepositoryServiceName setting in the HealthShare Document Consumer, then
the message will go to the repository specified there rather than to the repository specified in the message.
This is useful for testing purposes, but this setting should be blank in a production application.

4. The XDS document repository on the other system responds by providing the requested document(s) as MIME encoded
MTOM attachments.
5. The HealthShare Document Consumer separates out the attachments and translates them.
6. The HealthShare Document Consumer returns the MTOM attachments in an XML message of the “RetrieveDocu-
mentSetResponse” variety.

2.3.6 XDS Retrieve Components and Settings

Table 2–5: Components and Settings Used in XDS Retrieve

Business Hosts Document Consumer: HS.IHE.XDSb.Consumer.Operations

Production Settings XDSbRepositoryServiceName in the Document Consumer

• For testing purposes only

Ensemble Messages HS.Message.IHE.XDSb.RetrieveRequest

HS.Message.XMLMessage:
• RetrieveDocumentSetResponse

XSL Transformations RetrieveRequestToXDSbRetrieve.xsl

Service Registry Entries XDSb.Repository (or the repository specified in the message)
External IHE Actor Endpoint XDS Document Repository

2.3.7 XDS Query and Retrieve Example

Below is a sample XDS query and retrieve:

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IHE Use Cases in HealthShare Foundation

ClassMethod XDSbQueryRetrieve()
{
// Create the XDSb Query Request message
Set o=##class(HS.Message.IHE.XDSb.QueryRequest).%New()

// Add the MPI ID, document status and type

Do o.AddPatientId("100000002^^^&1.3.6.1.4.1.21367.2010.1.2.300&ISO")
Do o.AddStatusValues("Approved")
Do o.AddDocumentType(3)

// Optionally insert other query parameters

// Do QueryRequest.Parameters.Insert(##class(HS.Message.IHE.XDSb.QueryItem).CodedValue(
// "$XDSDocumentEntryFormatCode",code,scheme))

// Send the message to the test service (or directly to HS.IHE.XDSb.Consumer.Operations)

Write ##class(HS.Test.Service).SendSync(o,.pr)

Break

/// XDSbRetrieve ///

// Assumes you are using the response from the previous query.
// Currently this is limited to retrieval from a single repository,
// so if the query response contains multiple repositories, they should
// be split out into separate retrieve requests.

// Create the XDSb Retrieve Request message

Set obj=##class(HS.Message.IHE.XDSb.RetrieveRequest).%New()

// Use the results of the query to populate the message

Set obj.Documents=pr.Documents

// Send the message to the test service (or directly to HS.IHE.XDSb.Consumer.Operations)

Write ##class(HS.Test.Service).SendSync(obj,.rr)

Quit
}

2.4 Providing and Registering Documents to an XDS

Document Repository
HealthShare Foundation can provide and register a document to an XDS repository via the IHE “XDS.b Provide and
Register Document Set” transaction. If the document uses the Clinical Document Architecture (CDA), then HealthShare
Foundation can extract the document metadata directly from the document. For all other kinds of documents, for example
PDF files, you must provide the document metadata in the Ensemble message.
This section describes how to:
• Provide and register a CDA document to an XDS repository
• Provide and register a non-CDA document to an XDS repository

2.4.1 Provide and Register a CDA Document

HealthShare Foundation can provide and register a CDA document to a document repository within the Affinity Domain
via the IHE “ XDS.b Provide and Register Document Set ” transaction (PnR). HealthShare foundation can extract the
metadata from the document itself.
If an MPI ID is not included in the Provide and Register, then a PIX Query is automatically performed. The PIX query uses
the extracted MRN to get the MPI ID of the patient.
If the CDA is replacing another document (<ReplacementContext> is specified in the Provide and Register), then an
XDS query is performed to get the unique ID of the document to be replaced.
This section includes:

16                                                                                                                                           HealthShare Foundation Basics

 Providing and Registering Documents to an XDS Document Repository

• CDA provide and register message trace

• CDA provide and register procedure
• CDA provide and register components
• CDA provide and register example

2.4.1.1 CDA Provide and Register Message Trace

Below is an annotated XDS provide and register message trace for a CDA document, showing both the optional search
request and replacement query.
The test service shown in the diagram is a simple message router. Trace operations is a utility that makes intermediate
processing steps visible in the trace. The numbers in the diagram match the steps in the procedure below.

2.4.1.2 CDA Provide and Register Procedure

1. You provide a Provide and Register Request with minimal metadata to the HealthShare Document Source.
The minimum required document metadata includes the <MIMEType>, <FormatCode>, and the file contents in
<BodyCharacter>. When you open the file to include in <BodyCharacter>, be sure to open it as the correct file
type, for example, open a CDA document in XML format as a text file.

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IHE Use Cases in HealthShare Foundation

When a new Provide and Register Request is created, it automatically generates a document unique ID.
2. The HealthShare Document Source extracts the document metadata from the CDA and uses it to build a complete IHE
“ ProvideAndRegisterDocumentSetRequest ”:
a. If an MPI ID is not included in the Provide and Register request, the HealthShare Document Source extracts the
MRN and assigning authority from the CDA and performs a PIX query using the procedure described earlier.
b. If the Provide and Register indicates that this document should replace an existing document, the Document Source
performs an XDS query to get the ID of the document to be replaced in the repository. The Provide and Register
may include a variety of conditions for the replacement context, but the MPI ID and default entry status of
“approved” are included by default if not specified.
c. Using the XSL transformation specified in the DocumentTransform setting, the Document Source extracts additional
metadata from the CDA and uses it to populate the Provide and Register request.

3. The HealthShare Document Source forwards the Provide and Register request to the XDS document repository endpoint
on another system that is named in the XDSbRepositoryServiceName setting. The Provide and Register contains both
the extracted document metadata and the document itself (the contents of <BodyCharacter>) as an MTOM attachment.

Note: Because the HealthShare Document Source uses the XDSbRepositoryServiceName setting to determine where
to send documents, if you post documents to more than one repository, then you must have a separate document
source operation for each repository. Use a message router to determine which document source operation
to send the document to, based on whatever criteria you use to determine the appropriate repository for a
particular document.

4. The document repository on the other system stores the document and updates the Affinity Domain’s document registry
with the document metadata provided in the request.
5. The document repository on the other system responds with a success (or failure) message.
6. The HealthShare Document Source returns an XML message of the “RegistryResponse ” variety, indicating success
or failure. If the transaction fails before the document is sent to the registry, the HealthShare Document Source returns
null.

2.4.1.3 CDA Provide and Register Components and Settings

Table 2–6: Components and Settings Used in Provide and Register of a CDA Document

Business Hosts Document Source: HS.IHE.XDSb.DocumentSource.Operations

PIX Consumer: HS.IHE.PIXv3.Consumer.Operations
• if needed to get MPI ID

Document Consumer: HS.IHE.XDSb.Consumer.Operations

• if <Replacement Context> is specified in the message

Production Settings DocumentTransform in the Document Source

XDSbRepositoryServiceName in the Document Source

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 Providing and Registering Documents to an XDS Document Repository

Ensemble Messages HS.Message.IHE.XDSb.ProvideAndRegisterRequest

HS.Message.XMLMessage:
• RegistryResponse

HS.Message.PatientSearchRequest (if PIX)

HS.Message.PatientSearchResponse (if PIX)
HS.Message.IHE.XDSb.QueryRequest (if replacement)
HS.Message.IHE.XDSb.QueryResponse (if replacement)
Minimum Document Metadata Open the file as the correct type, for example, open an XML as a text file.
<MIMEType> — usually text/xml

<FormatCode> — indicating the document type

<BodyCharacter> — containing the file contents

XSL Transformations IHE/XDSb/Version1/DocumentToProvideAndRegister.xsl

Service Registry Entries XDSb.Repository

PIXv3.Manager (if PIX)
XDSb.Registry (if replacement)
External IHE Actor Endpoint XDS Document Repository
PIX Manager (if PIX)
XDS Document Registry (if replacement)

2.4.1.4 CDA Provide and Register Example

The method below opens a CDA file and provides the minimum metadata required to provide and register the document:
ClassMethod CDAPnR()
{
///Provide and Register a CDA document

//Create the Provide and Register message, which automatically assigns a document unique ID
Set tMessage=##class(HS.Message.IHE.XDSb.ProvideAndRegisterRequest).%New()

// Identify the message source

Set tMessage.SourceOID="1.3.6.1.4.1.21367.1"

// Create a document instance to hold the document metadata

Set tDocument = ##class(HS.Message.IHE.XDSb.Document).%New()

// Open the document file and insert it into <BodyCharacter> (for non-CDA, this is <Body>).
// The document will become an MTOM attachment in the outbound message.
// In this case, we are providing a CCD in XML, so open the file as a text file.
Set tFile = ##class(%File).%New()
Set tFile.Name="C:\wtemp\testccd.xml"
Do tFile.Open("R")
Do tFile.Rewind()
Do tDocument.BodyCharacter.CopyFrom(tFile)
Kill tFile

// Set the required minimum document metadata. For CDA, the <MIMEType> is "text/xml"
Set tDocument.MimeType="text/xml"
Set tDocument.FormatCode=##class(HS.IHE.XDSb.Types.CodedValue).%New(
"2.16.840.1.113883.10.20.1","HITSP","HL7 CCD Document")

// This is optional and controls replacement. If you specify a ReplacementContext,

// then an XDS.B query is performed to obtain the document unique ID
// of documents that match the context.
//

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IHE Use Cases in HealthShare Foundation

// In the case below, it is looking for documents that match the specified format code.
// You may include other context items as well.
// HealthShare Foundation automatically adds the Patient ID and the Status of "approved"
// to the context.
Set tContext = ##class(HS.Message.IHE.XDSb.QueryItem).CodedValue(
"$XDSDocumentEntryFormatCode","2.16.840.1.113883.10.20.1","HITSP")

Do tDocument.ReplacementContext.Insert(tContext)

/// Insert the document metadata into the message

Do tMessage.Documents.Insert(tDocument)

/// Send to the routing service (or directly to HS.IHE.XDSb.DocumentSource.Operations)

Write ##class(HS.Test.Service).SendSync(tMessage,.rr)

quit
}

2.4.2 Provide and Register a Non-CDA Document

HealthShare Foundation can provide and register any kind of document to a document repository within the Affinity Domain
via the IHE “ XDS.bProvide and Register Document Set ” transaction (PnR). You must provide HealthShare Foundation
with the document metadata.
If the CDA is replacing another document (<ReplacementContext> is specified in the Provide and Register), then an
XDS query is performed to get the unique ID of the document to be replaced.
This section includes:
• Non-CDA provide and register message trace
• Non-CDA provide and register procedure
• Non-CDA provide and register components
• Non-CDA provide and register example

2.4.2.1 Non-CDA Provide and Register Message Trace

Below is an annotated XDS provide and register message trace for a non-CDA document, that includes the query request
for replacement context.
The test service shown in the diagram is a simple message router. Trace operations is a utility that makes intermediate
processing steps visible in the trace. The numbers in the diagram match the steps in the procedure below.

20                                                                                                                                           HealthShare Foundation Basics

 Providing and Registering Documents to an XDS Document Repository

2.4.2.2 Provide and Register a Non-CDA Document Procedure

HealthShare Foundation can provide and register any clinical document (for example a PDF) to a document repository
within the Affinity Domain via the IHE “XDS.b Provide and Register Document Set ” transaction (PnR).
1. You provide a Provide and Register Request with complete document metadata to the HealthShare Document Source.
You must include the MPI ID of the patient in <SourcePatientId> in the message. If you only have the MRN,
perform a PIX query to get the MPI ID before creating the message.
The minimum required document metadata includes the <MIMEType>, <FormatCode>, <Body>,
<SourcePatientInfo>, and author information. When you open the file to include in <Body>, be sure to open it
as the correct file type, for example open a PDF file as a binary.
When a new Provide and Register Request is created, it automatically generates a document unique ID.
2. If the Provide and Register indicates that this document should replace an existing document, the Document Source
performs an XDS Query to get the ID of the document to be replaced in the repository. The Provide and Register may
include a variety of conditions for the replacement context, but the MPI ID and default entry status of “approved” are
included by default if not specified.
3. The HealthShare Document Source transforms the Ensemble message into an IHE “ ProvideAndRegisterDocumentSe-
tRequest” using the XSL transformation specified in the DocumentTransform setting.
4. The HealthShare Document Source forwards the Provide and Register request to XDS document repository endpoint
on another system that is named in the XDSbRepositoryServiceName setting. The Provide and Register contains both
the document metadata and the document itself (the contents of <Body>) as an MTOM attachment.
5. The XDS document repository on the other system stores the document and updates the Affinity Domain’s XDS doc-
ument registry with the document metadata provided in the request.
6. The XDS document repository on the other system responds with a success (or failure) message.

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IHE Use Cases in HealthShare Foundation

7. The HealthShare Document Source returns an XML message of the “RegistryResponse ” variety, indicating success
or failure. If the transaction fails before the document is sent to the registry, the HealthShare Document Source returns
null.

2.4.2.3 Non-CDA Provide and Register Components and Settings

Table 2–7: Components and Settings Used in Provide and Register of a non-CDA Document

Business Hosts Document Source: HS.IHE.XDSb.DocumentSource.Operations

Document Consumer: HS.IHE.XDSb.Consumer.Operations
• if <Replacement Context> is specified in the message

Production Settings XDSbRepositoryServiceName in the Document Source

Ensemble Messages HS.Message.IHE.XDSb.ProvideAndRegisterRequest

HS.Message.XMLMessage:
• RegistryResponse

HS.Message.IHE.XDSb.QueryRequest (if replacement)

HS.Message.IHE.XDSb.QueryResponse (if replacement)
Minimum Document Metadata Open the file as the correct type, for example, open a PDF as a binary.

Note: See the class refer- <MIMEType> — for example, application/pdf

ence for the Provide • See iana.org for a complete list of MIME types.
and Register request
message for com-
plete document meta- <FormatCode> — indicating document type
data details. <Body> — containing the file contents

<SourcePatientInfo> — patient demographics as HL7 segments

<Author...> (...Institution, ...Role, ...Person, ...Specialty)

XSL Transformations IHE/XDSb/Version1/DocumentToProvideAndRegister.xsl

Service Registry Entries XDSb.Repository

XDSb.Registry (if replacement)
External IHE Actor Endpoints XDS Document Repository
XDS Document Registry (if replacement)

2.4.2.4 Provide and Register a non-CDA Document Example

The COS code below (which can be incorporated into a method) generates an XDS provide and register for a PDF document
(in two boxes):
// Create the message, which automatically assigns a document unique ID
Set tMessage=##class(HS.Message.IHE.XDSb.ProvideAndRegisterRequest).%New()

// Provide the Patient ID and document source. Use a PIX query to obtain the
// Patient ID if you have only the MRN.
Set tMessage.PatientId="100000001^^^&1.3.6.1.4.1.21367.2010.1.2.300&ISO"
Set tMessage.SourceOID="1.3.6.1.4.1.21367.1"

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 Providing and Registering Documents to an XDS Document Repository

// Create a document instance to hold the document metadata

Set tDocument = ##class(HS.Message.IHE.XDSb.Document).%New()

// Open the document file and insert it into "Body" (for CDA, this is "CharacterBody").
// The document will become an MTOM attachment in the outbound message.
// In this case, we are providing a PDF, so open the file as a binary.
Set tFile = ##class(%Stream.FileBinary).%New()
Set tFile.Filename="C:\wtemp\testdoc.pdf"
Do tFile.Rewind()
Do tDocument.Body.CopyFrom(tFile)
Kill tFile

// Set the "MIMEType", for a PDF, this is "application/pdf".

// See http://www.iana.org/assignments/media-types/index.html for a list of valid types.
Set tDocument.MimeType="application/pdf"

/// Enter the document metadata

Set tDocument.CreationTime="20110510102615-0400"
Set tDocument.LanguageCode="en-CA"

Set tDocument.ClassCode=##class(HS.IHE.XDSb.Types.CodedValue).%New(
"Pathology Procedure","Connect-a-thon classCodes","Pathology Procedure")
Set tDocument.FormatCode=##class(HS.IHE.XDSb.Types.CodedValue).%New(
"PDF","Connect-a-thon formatCodes","PDF")
Set tDocument.HealthcareFacilityTypeCode=##class(HS.IHE.XDSb.Types.CodedValue).%New(
"Outpatient","Connect-a-thon healthcareFacilityTypeCodes","Outpatient")
Set tDocument.PracticeSettingCode=##class(HS.IHE.XDSb.Types.CodedValue).%New(
"General Medicine","Connect-a-thon practiceSettingCodes","General Medicine")
Set tDocument.TypeCode=##class(HS.IHE.XDSb.Types.CodedValue).%New(
"18768-2","2.16.840.1.113883.6.1","CELL COUNTS+DIFFERENTIAL STUDIES")
Do tDocument.EventCodeList.Insert(##class(HS.IHE.XDSb.Types.CodedValue).Create(
"1.3.6.1.4.1.21367.2006.7.106","Connect-a-thon eventCodeList","OPT-OUT"))
Do tDocument.EventCodeList.Insert(##class(HS.IHE.XDSb.Types.CodedValue).Create(
"1.3.6.1.4.1.21367.2006.7.108","Connect-a-thon eventCodeList","OPT-IN"))

// Patient demographics
Set tDocument.SourcePatientId="1111222^^^&1.3.6.1.4.1.21367.2010.1.2.310&ISO"
Do tDocument.SourcePatientInfo.Insert(##class(HS.IHE.XDSb.Types.SlotValue).%New(
"PID-3|1111222^^^&1.3.6.1.4.1.21367.2010.1.2.310&ISO"))
Do tDocument.SourcePatientInfo.Insert(##class(HS.IHE.XDSb.Types.SlotValue).%New(
"PID-5|Smith^James^"))
Do tDocument.SourcePatientInfo.Insert(##class(HS.IHE.XDSb.Types.SlotValue).%New(
"PID-7|20000930"))
Do tDocument.SourcePatientInfo.Insert(##class(HS.IHE.XDSb.Types.SlotValue).%New("PID-8|M"))
Do tDocument.SourcePatientInfo.Insert(##class(HS.IHE.XDSb.Types.SlotValue).%New(
"PID-11|123 Money Street^^Somewhere^SW^"))

// Document author
Set tAuthor= ##class(HS.IHE.XDSb.Types.Author).%New()
Set tAuthor.AuthorPerson="John Smith"
Do tAuthor.AuthorInstitution.Insert(##class(HS.IHE.XDSb.Types.SlotValue).%New("Johns Hopkins"))
Do tAuthor.AuthorRole.Insert(##class(HS.IHE.XDSb.Types.SlotValue).%New("Role"))
Do tAuthor.AuthorSpecialty.Insert(##class(HS.IHE.XDSb.Types.SlotValue).%New("Specialty"))
Do tDocument.Author.Insert(tAuthor)

// This is optional and controls replacement. If you specify a ReplacementContext, then an XDS.B
// query is performed to obtain the document unique ID of documents that match the context.
//
// In the case below, it is looking for documents that match the specified eventcode.
// You may include other context items as well.
// HealthShare Foundation automatically adds the Patient ID and the Status of
// "approved" to the context.
Set tContext = ##class(HS.Message.IHE.XDSb.QueryItem).CodedValue("$XDSDocumentEntryEventCodeList",
"1.3.6.1.4.1.21367.2006.7.106","Connect-a-thon eventCodeList")
Do tDocument.ReplacementContext.Insert(tContext)

// Insert the document metadata into the message

Do tMessage.Documents.Insert(tDocument)

// Send the message to the test service (or directly to HS.IHE.XDSb.DocumentSource.Operations)

Write ##class(HS.Test.Service).SendSync(tMessage,.rr)

Quit

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IHE Use Cases in HealthShare Foundation

2.5 Querying and Retrieving a Document from another

Affinity Domain (XCA)
IHE supports the idea of an Affinity Domain of healthcare systems that share a common IHE infrastructure. An Affinity
Domain might be a RHIO, an IDN, or some other organization. Each Affinity Domain has a single document registry, and
may have multiple document repositories.
HealthShare Foundation can query document registries in other Affinity Domains and request a list of documents for a
patient via the XCPD Cross-Gateway Patient Discovery transaction and the XCA Cross-Gateway Query transaction. It can
then retrieve one or more stored documents from the specified repositories via the XCA Retrieve Document Set transaction.
From the outside, XCA is essentially the same as XDS, except for the patient discovery. It uses the same Ensemble messaging
infrastructure as XDS, and you can set up HealthShare Foundation so that document queries search both the local repository
and other Affinity Domains.
This section includes:
• XCA Query:
– XCA query message trace
– XCA query procedure
– XCA query components

• XCA Retrieve:
– XCA retrieve message trace
– XCA retrieve procedure
– XCA retrieve components

• Example XCA query and retrieve

2.5.1 XCA Query Message Trace

Below is an annotated XCA Query message trace, illustrating the patient discovery (XCPD) and the document query.
The trace operations shown in the diagram is a utility that makes intermediate processing steps visible in the trace. The
numbers in the diagram match the steps in the procedure below. The first 3 steps and last 3 steps in the procedure appear
in a different session, and are basically identical to the steps in the XDS.b query transaction.

24                                                                                                                                           HealthShare Foundation Basics

 Querying and Retrieving a Document from another Affinity Domain (XCA)

HealthShare Foundation Basics                                                                                                                                           25

IHE Use Cases in HealthShare Foundation

2.5.2 XCA Query Procedure

An XCA query transaction in HealthShare Foundation begins with an XDS query request message. Rather than pointing
the XDS Document Consumer to a particular repository, the consumer points instead to the XCA Initiating Gateway, which
knows about both the local repository and the repositories in other Affinity Domains. The easiest way to set this up is to
create a service registry entry that contains the URL of the Initiating Gateway service and call it, for example, “XCA.IG.”
Then set the XDSbRegistryServiceName setting in your XCA Document Consumer to XCA.IG.
The full XCA query procedure is documented below. The first 3 steps and the last 3 steps occur in a separate session, and
are basically identical to an XDS.b query transaction. They are not shown in the diagram.
1. You provide an Ensemble XDSb.QueryRequest message that contains an MPI ID and assigning authority to the
XDS.b Document Consumer. The query request also specifies the document type and status (for example “approved”),
and may also include a list of filters.
You can obtain the MPI ID through a PIX or PDQ query (described above).
2. The document consumer transforms the Ensemble message into an IHE “XDSb_QueryRequest” message using an
internally-specified transform.
3. The document consumer then forwards the query to the XCA Initiating Gateway service that is indicated in the
XDSbRegistryServiceName setting. The rest of the procedure takes place in a new session until the document consumer
receives its response.
4. The XCA Initiating Gateway service forwards the message to the XCPD Initiating Gateway process named in the
XCPDInitiatingGatewayProcess setting.

5. The XCA Initiating Gateway process transforms the message into an IHE “XCA_QueryRequest” message using an
internally-specified transform, and forwards it to the XCPD Initiating Gateway process to begin the patient discovery.
6. The XCPD Initiating Gateway process extracts the MPI ID from the request and constructs a Patient Search Request
message.
7. The XCPD Initiating Gateway process gets the patient’s demographics by sending the Patient Search Request to the
PDQ consumer named in the PDQv3Consumer setting.
8. The PDQ consumer returns the demographics.
9. The XCPD Initiating Gateway process confirms that the <Root> element of the <LivingSubjectID> returned
from the PDQ is the same as the assigning authority of the provided MPI ID.
10. The XCPD Initiating Gateway process checks the XCPDQueryServiceNames setting. This setting should contain a
comma-separated list of service registry entries that point to XCPD Responding Gateway endpoints in other Affinity
Domains.
11. The XCPD Initiating Gateway process sends one XCPD Patient Discovery Request to the XCPD Initiating Gateway
operation for each known XCPD Responding Gateway.
12. The XCPD Initiating Gateway operation forwards the discovery requests to the XCPD Responding Gateways in the
other Affinity Domains. It then returns XCPD Patient Discovery Responses from the XCPD Responding Gateways to
the XCPD Initiating Gateway process. Each response contains the MPI IDs and demographics of zero, one, or several
possible patients that match the provided demographics. These are exactly like PDQ responses.
13. The XCPD Initiating Gateway process transforms the responses and replaces the Home Community OIDs with Home
Community IDs from the OID registry.
14. The XCPD Initiating Gateway process extracts the MPI IDs and Home Communities (assigning authorities) for the
unique matches, discarding any that match multiple patients within a Home Community.

26                                                                                                                                           HealthShare Foundation Basics

 Querying and Retrieving a Document from another Affinity Domain (XCA)

15. The XCPD Initiating Gateway process returns an IHE “XCA_QueryResponse” message to the XCA Initiating Gateway
process that contains a list of MPI IDs and Home Community IDs, with at most a single entry for each Home Community.
16. The XCA Initiating Gateway process uses the Home Community IDs to get the Home Community OIDs. In order to
translate each OID into a URL, the following setup is required:
• An OID registry entry of type “HomeCommunity ” for each Home Community OID.
• A service registry entry for each Home Community that provides the URL of the XCA Responding Gateway actor
in that community:
– Each service registry entry must include the OID registry code in the HomeCommunity field. This ties the
OID and service registry entries together.
– Each service registry entry must include XCA.Query in the Device Function field. This indicates that it is the
“ XCA query device” for this community.

17. For each match returned by the XCPD Initiating Gateway process, the XCA Initiating Gateway process sends an
XCA_QueryRequest message to the XCA Initiating Gateway operation named in the XCAInitiatingGatewayOperation
setting.
If there is a value in the XDSbQueryServiceName field, which should point to the local XDS registry, then the XCA
Initiating Gateway process also sends an XDSb_QueryRequest to the XCA Initiating Gateway operation. This will
trigger a document search in the local XDS registry.
18. The XCA Initiating Gateway operation forwards the query requests to the XCA Responding Gateways (and possibly
the local registry). It then returns the query responses from the XCA Responding Gateways (and local registry) to the
XCA Initiating Gateway Process. Each response indicates the document metadata and location for each document
available for the patient.
19. The XCA Initiating Gateway Process combines the various responses.
20. The XCA Initiating Gateway Process returns an XML message of the “ XCA_QueryResponse” variety to the XCA
Initiating Gateway service.
21. The XCA Initiating Gateway service returns the combined responses to the XDS.b Document Consumer in the original
session in an XML message of the “XDSb_QueryResponse ” variety.
22. The document consumer extracts the document metadata from the response using the transformation specified in the
TransformToMetadata setting. It then constructs an HS.Message.IHE.XDSb.QueryResponse message.

23. The document consumer returns the XDS.b Query Response message, which contains both the original XCA and
XDS.b responses and the extracted metadata. This message can be used to initiate an XCA retrieve, as described in
the XCA Retrieve procedure.

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IHE Use Cases in HealthShare Foundation

2.5.3 XCA Query Components and Settings

Table 2–8: Components and Settings Used in XCA Query

Business Hosts XCA Document Consumer: HS.IHE.XDSb.Consumer.Operations

XCA Initiating Gateway Service: HS.IHE.XCA.InitiatingGateway.Services
XCA Initiating Gateway Process: HS.IHE.XCA.InitiatingGateway.Process
XCA Initiating Gateway Operation: HS.IHE.XCA.InitiatingGateway.Operations
XCPD Initiating Gateway Process: HS.IHE.XCPD.InitiatingGateway.Process
XCPD Initiating Gateway Operation: HS.IHE.XCPD.InitiatingGateway.Operation
PDQ Consumer: HS.IHE.PDQv3.Consumer.Operations
Production Settings XDSbRegistryServiceName in the XDS.b Document Consumer:

• Set to location of the XCA Initiating Gateway service.

XCPDInitiatingGatewayProcess in the XCA Initiating Gateway service

PDQv3Consumer in the XCPD Initiating Gateway process

Service Name in the PDQ Consumer operation

XCPDQueryServiceNames in the XCPD Initiating Gateway process:

• A comma-separated list of service registry entries pointing to XCPD Responding

Gateway endpoints on other systems.

XCAInitiatingGatewayOperation in the XCA Initiating Gateway process

XDSbQueryServiceName in the XCA Initiating Gateway process:

• A service registry entry with the URL of your local XDS.b registry. If you enter a
value here, then the XCA Initiating Gateway can be used for both XCA and
XDS.b queries.

TransformToMetadata in the XDS.b Document Consumer

28                                                                                                                                           HealthShare Foundation Basics

 Querying and Retrieving a Document from another Affinity Domain (XCA)

Ensemble Messages HS.Message.IHE.XDSb.QueryRequest

HS.Message.IHE.XDSb.QueryResponse
HS.Message.XMLMessage:
• XDSb_QueryRequest
• XDSb_QueryResponse
• XCA_QueryRequest
• XCA_QueryResponse
• XCPD_PatientDiscoveryRequest
• XCPD_PatientDiscoveryResponse

HS.Message.PatientSearchRequest (for PDQ query)

HS.Message.PatientSearchResponse (for PDQ query)
XSL Transformations QueryRequestToXDSbQuery.xsl in the XDS.b Document Consumer

IHE/PDQ/Version1/PatientSearchToPRPAIN201305UV.xsl in PDQ

IHE/PDQ/Version1/PRPAIN201306UVToPatientSearchResponse.xsl in PDQ

Message-To-Metadata.xsl in the XDS.b Document Consumer

Service Registry XCA.IG (or similar)

Entries
• points to the XCA Initiating Gateway service

PDQv3.Supplier (for PDQ query)

XCPD.RespondingGateway.1
XCPD.RespondingGateway.2
...etc:
• URLS of the various XCPD Responding Gateways in the Home Communities

An XCA.Query device entry for each Home Community that points to the URL of the
XCA Responding Gateway endpoint in that community. The OID registry code for
the community should appear in the HomeCommunity field, and XCA.Query should
appear in the Device Function field.
OID Registry Entries A HomeCommunity OID for each Home Community
External IHE Actor PDQ Supplier
Endpoints
XCPD Responding Gateway(s)
XCA Responding Gateway(s)

2.5.4 XCA Retrieve Message Trace

Below is an annotated XCA document retrieve message trace.

HealthShare Foundation Basics                                                                                                                                           29

IHE Use Cases in HealthShare Foundation

The trace operations shown in the diagram is a utility that makes intermediate processing steps visible in the trace. The
numbers in the diagram match the steps in the procedure below. The first 3 steps and last 3 steps in the procedure appear
in a different session, and are basically identical to the steps in the XDS.b retrieve transaction.

2.5.5 XCA Retrieve Procedure

The XCA retrieve procedure is documented below. The first 3 steps and the last 3 steps occur in a separate session, and
are basically identical to an XDS.b retrieve transaction. They are not shown in the diagram.
1. Take the XDS.b query response (above) and construct an HS.Message.IHE.XDSb.RetrieveRequest message that
contains the document unique ID and repository unique ID (OID) for one or more of the documents listed in the query
response.
Send the XDS.b Retrieve Request to the XDS.b Document Consumer.
2. The document consumer transforms the Ensemble message into an IHE “XDSb_RetrieveRequest” message using an
internally-specified transform.
3. The document consumer then forwards the request to the XCA Initiating Gateway service. This service is specified in
the XDSbRepositoryServiceName field. For XCA, this field should contain a service registry entry containing the URL
of the XCA Initiating Gateway service in your production. If you are using only XDS.b, this field is normally left
empty.

30                                                                                                                                           HealthShare Foundation Basics

 Querying and Retrieving a Document from another Affinity Domain (XCA)

The rest of the procedure takes place in a new session until the document consumer receives its response.
4. The XCA Initiating Gateway service forwards the request to the XCA Initiating Gateway process.
5. The request may contain documents from different Home Communities, possibly including the local community. The
XCA Initiating Gateway process separates them out. The <HomeCommunityId> in the message is specified as an
OID. In order to translate the OID into a URL, the following setup is required:
• An OID registry entry of type “HomeCommunity ” for each Home Community OID.
• A service registry entry for each non-local Home Community that provides the URL of the XCA Responding
Gateway actor in that community:
– Each service registry entry must include the OID registry code in the Home Community field. This ties the
OID and service registry entries together.
– Each service registry entry must include XCA.Retrieve in the Device Function field. This indicates that it
is the “XCA retrieve device ” for the Home Community.

• A service registry entry for the local Home Community that provides the URL of the XDS repository:
– This service registry entry must include the OID registry code in the Repository field. This ties the OID and
service registry entries together.
– This service registry entry must include XDSb.Retrieve in the Device Function field. This indicates that it
is the “XDS.b retrieve device ” for the local Home Community.

6. The XCA Initiating Gateway process constructs an XCA_RetrieveRequest for each community.
7. The XCA Initiating Gateway process sends the requests to the XCA Initiating Gateway operation.
8. The XCA Initiating Gateway operation forwards the requests to the appropriate XCA Responding Gateway endpoints
and returns their responses to the XCA Initiating Gateway process.
9. The XCA Initiating Gateway process combines the responses from the various Home Communities.
10. The XCA Initiating Gateway process constructs an XCA_QueryResponse message that contains a list of documents
in the message body, and a set of MIME-encoded MTOM attachments, one for each document.
11. The XCA Initiating Gateway process returns the query response to the XCA Initiating Gateway service.
12. The XCA Initiating Gateway service returns the combined responses to the XDS.b Document Consumer in the original
session in an XML message of the “XDSb_RetrieveResponse” variety.
13. The document consumer separates out the attachments and translates them.
14. The document consumer returns the list of documents and the MIME-encoded MTOM attachments in an XML message
of the “ XDSb_RetrieveResponse ” variety with a <DocType> of “RetrieveDocumentSetResponse ”.

2.5.6 XCA Retrieve Components and Settings

Table 2–9: Components and Settings Used in XCA Retrieve

Business Hosts XCA Document Consumer: HS.IHE.XDSb.Consumer.Operations

XCA Initiating Gateway Service: HS.IHE.XCA.InitiatingGateway.Services
XCA Initiating Gateway Process: HS.IHE.XCA.InitiatingGateway.Process
XCA Initiating Gateway Operation: HS.IHE.XCA.InitiatingGateway.Operations

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IHE Use Cases in HealthShare Foundation

Production Settings XDSbRepositoryServiceName in the XCA Document Consumer

• Points to the local XCA Initiating Gateway service.

XCAInitiatingGatewayOperation in the XCA Initiating Gateway process

Ensemble Messages HS.Message.IHE.XDSb.RetrieveRequest

HS.Message.IHE.XDSb.QueryResponse
HS.Message.XMLMessage:
• XCA_RetrieveRequest
• XCA_RetrieveResponse
• XCA_QueryResponse
• XDSb_RetrieveResponse
• XDSb_RetrieveResponse (RetrieveDocumentSetResponse)

XSL Transformations RetrieveRequestToXDSbRetrieve.xsl in XCA Document Consumer

Message-To-Metadata.xsl in XCA Document Consumer

Service Registry XCA.IG (or similar)

Entries
• points to the local XCA Initiating Gateway service

An XCA.Retrieve device entry for each foreign Home Community that points to the
URL of the XCA Responding Gateway endpoint in that community. The OID registry
code for the community should appear in the HomeCommunity field, and XCA.Retrieve
should appear in the Device Function field.
A service registry entry for the local Home Community that provides the URL of the
XDS repository. This service registry entry must include the OID registry code in the
Repository field. This ties the OID and service registry entries together. This service
registry entry must include XDSb.Retrieve in the Device Function field. This indicates
that it is the “XDS.b retrieve device” for the local Home Community.

OID Registry Entries A HomeCommunity OID for the local and each foreign Home Community
A repository OID for the local XDS repository
External IHE Actor XCA Responding Gateway(s)
Endpoints XDS Repository (in the local Home Community)

2.5.7 XCA Query and Retrieve Example

The method below sends an Ensemble message that queries the document registry in each listed foreign Affinity Domain
and then retrieves whatever documents are found. The user must enter G after the break command to continue.
/// XCA Query and retrieve///
ClassMethod XCAQuery()
{

// Create an XDSb Query Request message

s o=##class(HS.Message.IHE.XDSb.QueryRequest).%New()

// Add the MPI ID, document status, type and creation date

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 Generating a CCD Document from an HL7 Message

Do o.AddPatientId("100000001^^^&1.3.6.1.4.1.21367.2010.1.2.300&ISO") //This is the format required

by IHE

Do o.AddStatusValues("Approved")

Do o.AddCreationFrom("20110510102615-0400")

Do o.AddDocumentType(1) // 1 is stable, 2 is on-demand, 3 is both

Do o.AdditionalInfo.SetAt(1,"XCA")

// Send the message to the test service (or directly to HS.IHE.XDSb.Consumer.Operations)

w ##class(HS.Test.Service).SendSync(o,.pr)

Break

/// XCA Retrieve ///

// Assumes you are using the response from the previous query.

// Create the XDSb Retrieve Request message

Set obj=##class(HS.Message.IHE.XDSb.RetrieveRequest).%New()

// Use the results of the query to populate the message

Set obj.Documents=pr.Documents

// Required only for HS.Test.Service to distinguish between XCA and XDS.b

Do obj.AdditionalInfo.SetAt(1,"XCA")
// Send the message to the test service (or directly to XCA Document Consumer)
Write ##class(HS.Test.Service).SendSync(obj,.rr)

Quit
}

2.6 Generating a CCD Document from an HL7 Message

HealthShare Foundation includes transformations that can accept an HL7 message, transform it into SDA (an internal rep-
resentation), and then transform it into a CCD, for example a C32 document. You can then provide and register the CCD
to an XDS document repository.
This section includes:
• HL7 to CCD provide and register message trace
• HL7 to CCD provide and register procedure
• HL7 to CCD provide and register components
• HL7 to CCD provide and register example

2.6.1 HL7 to CCD Provide and Register Message Trace

Below is an annotated message trace for an HL7 message transformed into a CCD followed by an XDS provide and register.
The provide and register includes a PIX search to get the MPI ID from the MRN extracted from the CCD.
The test service shown in the diagram is a simple message router. Trace operations is a utility that makes intermediate
processing steps visible in the trace. The numbers in the diagram match the steps in the procedure below.

HealthShare Foundation Basics                                                                                                                                           33

IHE Use Cases in HealthShare Foundation

2.6.2 HL7 to CCD Provide and Register Procedure

To set up HealthShare Foundation to convert HL7 into CCD:
1. Create an HL7 input service (for example, an HL7 file service). Set up the HL7 input service to forward HL7 messages
to some operation named in the TargetConfigNames setting.
2. Create the operation named in the previous step, and set it up to:
a. transform the HL7 message into SDA3.
b. transform the SDA into a CCD document, for example, a C32, C48, or other form.
c. package the CCD into a Provide and Register request.
d. send the Provide and Register request to the HealthShare Document Source.

3. The Document Source then follows the path laid out in the section “Provide and Register a CDA document ”.

34                                                                                                                                           HealthShare Foundation Basics

 Generating a CCD Document from an HL7 Message

2.6.3 HL7 to CCD Provide and Register Components and Settings

Table 2–10: Components and Settings Used in Transformation of HL7 to CCD followed by a Provide and Register

Business Hosts HL7 Service: EnsLib.HL7.Service.FileService (or similar)

HL7 to CCD Transformer: Custom Business Operation
Document Source: HS.IHE.XDSb.DocumentSource.Operations
PIX Consumer: HS.IHE.PIXv3.Consumer.Operations
Production Settings TargetConfigNames in the HL7 Service

Ensemble Messages HS.Message.IHE.XDSb.ProvideAndRegisterRequest

HS.Message.XMLMessage:
• RegistryResponse

HS.Message.PatientSearchRequest
HS.Message.PatientSearchResponse
XSL Transformations SDA3/SDA-to-C32v25.xsl

Service Registry Entries XDSb.Repository

PIXv3.Manager
External IHE Actor Endpoints XDS Document Repository
PIX Manager

2.6.4 Example Transformer Business Operation to Generate a CCD Document

from an HL7 Message
Below is a sample business operation that accepts an HL7 message and transforms it into a CCD:
Class Test.HL7Transformer Extends (Ens.BusinessOperation)
[ Inheritance = right, ProcedureBlock ]
{
Parameter INVOCATION = "Queue";

/// XDSb source operations component

Property XDSbSourceOperations As Ens.DataType.ConfigName
[ InitialExpression = "HS.IHE.XDSb.DocumentSource.Operations"];
Parameter SETTINGS As %String = "XDSbSourceOperations";

XData MessageMap
{
<MapItems>
<MapItem MessageType="EnsLib.HL7.Message">
<Method>ProcessHL7Message</Method>
</MapItem>
</MapItems>
}
/// Process an inbound HL7 v2.5 message
Method ProcessHL7Message(pRequest As EnsLib.HL7.Message,
Output pResponse As EnsLib.HL7.Message) As %Status
{
try {
// Convert the HL7 message to SDA3
set tSC = ##class(HS.Gateway.HL7.HL7ToSDA3).GetSDA(pRequest,.tSDA3)
Quit:$$$ISERR(tSC)

// Transform the SDA3 to a C32

Set tSC= tTransformer.Transform(tSDA3,"SDA3/SDA-to-C32v25.xsl",.tStream)

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IHE Use Cases in HealthShare Foundation

Quit:$$$ISERR(tSC)

// Create a Provide and Register

Set tRequest = ##class(HS.Message.IHE.XDSb.ProvideAndRegisterRequest).%New()
Set tDocument = ##class(HS.Message.IHE.XDSb.Document).%New()
Set tDocument.FormatCode=##class(HS.IHE.XDSb.Types.CodedValue).%New(
"2.16.840.1.113883.10.20.1","HITSP","HL7 CCD Document")
Set tDocument.MimeType="text/xml"

// Copy the C32 into the message

Do tDocument.BodyCharacter.CopyFrom(tStream)
Do tRequest.Documents.Insert(tDocument)

// Call the document source operation

Set tSC = ..SendRequestSync(..XDSbSourceOperations,tRequest,.tResponse)
Quit:$$$ISERR(tSC)
} Catch ex {
Set tSC= ex.AsStatus()
}
Quit tSC
}
}

2.7 Generating a CCD Document by Querying an Internal

Database
You can generate a CCD document using XSL transformations provided by HealthShare Foundation that transform SDA
into CCD, for example, HSF-home\CSP\xslt\SDA3\SDA-to-C37v23.xsl. You must write code to transform the query result
from your internal database into SDA.
See the chapter “SDA Documents ” for more details on the structure of the SDA.

2.8 Receiving a CCD Document and Converting it to an

Internal Format
If you receive a CCD document and wish to parse it and store its contents in an internal database, apply the provided
transformation from CCD to SDA, for example, HSF-home\CSP\xslt\SDA3\CDA-to-SDA.xsl, and then write code to transform
the SDA into your internal database format.
See the chapter “SDA Documents ” for more details on the structure of the SDA.

36                                                                                                                                           HealthShare Foundation Basics

3
Registry Settings for IHE Communication
In addition to configuring your Ensemble productions for IHE, you must create certain registry entries to facilitate IHE
communication. Entries must be made in the:
• Service Registry
• OID Registry
• Configuration Registry

See the HealthShare Foundation Administration Guide for details on how the create registry entries.

3.1 Sample Service Registry Entries for IHE

PIXv3.Consumer
Web address of the PIX consumer operation on your system, where PIX queries should be routed.
http://Your_Server:Port/csp/healthshare/Namespace/HS.IHE.PIXv3.Consumer.Operations.cls

PIXv3.Manager
Web address of the PIX manager endpoint on another system that you communicate with, where PIX queries
should be sent.
http://Other_Server:Port/csp/healthshare/Namespace/HS.IHE.PIXv3.Manager.Services.cls

PDQv3.Consumer
Web address of the PDQ consumer operation on your system, where PDQ queries should be routed.
http://Your_Server:Port/csp/healthshare/Namespace/HS.IHE.PIXv3.Consumer.Operations.cls

PDQv3.Supplier
Web address of the PDQ supplier endpoint on another system that you communicate with, where PDQ queries
should be sent.
http://Other_Server:Port/csp/healthshare/Namespace/HS.IHE.PDQv3.Supplier.Services.cls

HealthShare Foundation Basics                                                                                                                                           37

Registry Settings for IHE Communication

XDSb.Registry
Web address of the registry endpoint for your Affinity Domain, where XDS queries should be sent. There is only
a single registry within a given Affinity Domain.
http://Other_Server:Port/csp/healthshare/Namespace/HS.IHE.XDSb.Registry.Services.cls

XDSb.Repository
Web address of the repository endpoint on another system that you communicate with, where Provide and Register
requests should be sent. There may be more than one repository within an Affinity Domain, so you may have
multiple repository entries in your service registry.
http://Other_Server:Port/csp/healthshare/Namespace/HS.IHE.XDSb.Repository.Services.cls

XCA.Query
Web address of the XCA responding gateway service on your system, where inbound XCA queries should be
routed.
http://Your_Server:Port/csp/healthshare/Namespace/HS.IHE.XCA.RespondingGateway.Services.cls

XCA.Retrieve
Web address of the XCA responding gateway service on your system, where inbound XCA retrieve requests
should be routed.
http://Your_Server:Port/csp/healthshare/Namespace/HS.IHE.XCA.RespondingGateway.Services.cls

XCA.InitiatingGateway
Web address of the XCA initiating gateway service on your system, where outbound XCA queries should be
routed.
http://Your_Server:Port/csp/healthshare/Namespace/HS.IHE.XCA.InitiatingGateway.Services.cls

OtherSystem.XCPD.RespondingGateway
Web address of the XCPD responding gateway in a foreign system. There is a single responding gateway for each
foreign Affinity Domain. A separate entry is required for each Affinity Domain that may hold XCA documents.

OtherSystem.XCA.Query
(Optional) Web address of the XCA responding gateway in a foreign system where XCA queries should be for-
warded. Can be used in the XCAQueryServiceName setting in HS.IHE.XCA.RespondingGateway.Operations
if XCA queries are handled by a different system.

OtherSystem.XCA.Retrieve
(Optional) Web address of the XCA responding gateway in a foreign system where XCA retrieves should be for-
warded. Can be used in the XCARetrieveServiceName setting in HS.IHE.XCA.RespondingGateway.Operations
if XCA retrieves are handled by a different system.

3.2 OID Registry Entries for IHE

The following is the minimum set of OIDs required for IHE communication:
• A Facility OID for each facility.

38                                                                                                                                           HealthShare Foundation Basics

 Configuration Registry Entries for IHE

• An AssigningAuthority OID for the assigning authority associated with each facility (may be the same as the facility
OID).
• A HomeCommunity OID for the home community.
• An AssigningAuthority OID for the home community (may be the same as the home community OID).
• HomeCommunity OIDs for other communities.
• A Repository OID for each XDS repository.
• A Device OID for the PIXv3Manager device.
• A Device OID for the PIXv3Consumer device.
• Facility and AssigningAuthority OIDs for external facilities and assigning authorities.

3.3 Configuration Registry Entries for IHE

The following is the minimum set of configuration registry entries required for IHE communication:

Key Value
\IHE\AffinityDomain HomeCommunity
\IHE\HomeCommunity HomeCommunity

HealthShare Foundation Basics                                                                                                                                           39

4
SDA Documents
SDA (Summary Document Architecture) is an InterSystems format based on CDA (Clinical Document Architecture). This
is the format used to represent patient data in HealthShare Foundation.
Information in SDA format is represented by a Caché object that consists of instances of HS.SDA3.Patient,
HS.SDA3.Encounter, and other Caché classes. These classes are XML-enabled. You must convert your patient record query
result into the SDA XML format in order to use the provided transformations from SDA into the various CCD formats.

Note: This version of HealthShare Foundation is based on SDA3, but previous versions were based on SDA(2). This
section describes SDA3, which InterSystems strongly recommends that you use.

4.1 The Basic XML Structure of an SDA Document

The major sections in an SDA document are as follows:
<Container>
<Patient>
<Encounters>
<AdvanceDirectives>
<Alerts>
<Allergies>
<Appointments>
<Problems>
<Diagnoses>
<Documents>
<LabOrders>
<RadOrders>
<OtherOrders>
<Medications>
<Vaccinations>
<Observations>
<PhysicalExams>
<Procedures>
<FamilyHistories>
<IllnessHistories>
<SocialHistories>
<CustomObjects>
</Container>

The following rules apply to an SDA document:

1. There is a single <Patient>.
2. <Patient> is required and must be the first entry (after properties of the <Container> such as <Action> or <EventCode>).
3. All sections other than <Patient> are optional.
4. All sections other than patient may contain multiple entries, for example:

HealthShare Foundation Basics                                                                                                                                           41

SDA Documents

<Procedures>

<Procedure>
...
</Procedure>

<Procedure>
...
</Procedure>

</Procedures>

5. <Encounters>, if included, must appear directly after <Patient>.

6. All other sections may appear in any order.
7. Any entry may optionally reference an encounter number. In this case, <Encounters> must be included and must contain
an <Encounter> with that <EncounterNumber>.

4.2 The Patient in SDA

The HS.SDA3.Patient class represents the patient. This class contains properties that store information like the following:
• Demographic information and other basics, for example: name, a list of addresses, gender, marital status, race, religion,
and so on
• Patient numbers

The following table shows the properties of HS.SDA3.Patient. Some of these properties are simple (for example, strings),
some are complex objects which contain properties of their own, and some are lists of complex objects:
Table 4–1: Properties in HS.SDA3.Patient

Simple Property Complex Object List of Complex Objects

BirthTime Citizenship Addresses
DeathLocation ContactInfo Aliases
DeathTime DeathDeclaredBy PatientNumbers
InactiveMRNs FamilyDoctor PriorPatientNumbers
IsDead Gender OtherLanguages
MothersMaidenName MaritalStatus SupportContacts
MPIID Name
PrimaryLanguage
Race
Religion

42                                                                                                                                           HealthShare Foundation Basics

 Encounters in SDA

4.3 Encounters in SDA

An encounter encompasses all of the medical information related to a specific medical incident. The HS.SDA3.Encounter
class represents a medical encounter of a patient. Other sections in the SDA, representing orders, procedures, exams and
the like can refer to the encounter number, and thus be tied together.
The following table shows the properties of HS.SDA3.Encounter, some of which are simple (for example, strings), some
of which are complex objects (containing properties of their own), and some of which are lists of complex objects:
Table 4–2: Properties in HS.SDA3.Encounter

Simple Property Complex Object List of Complex Objects

AccountNumber AdmissionSource AttendingClinicians
AssignedBed AdmisssionType ConsultingClinicians
AssignedRoom AdmitReason HealthFunds
AssignedWard AdmittingClinician
EncounterMRN DischargeLocation
EncounterNumber HealthCareFacility
EncounterType ReferringClinician
EndTime
PreAdmissionNumber
PriorVisitNumber
VisitDescription
VisitStatus

4.4 For More Information on SDA

For complete details on the SDA model, see the class reference for HS.SDA3.Container and the other classes in the HS.SDA3
package.
To access the class reference for the SDA classes:
1. Go to the documentation home page by selecting Documentation from the HealthShare Foundation cube.
2. Select Class Reference from the list at the top of the documentation home page.
3. Using the drop-down list at the top of the left-hand pane, change to the HSLIB namespace.
4. Uncheck System Classes.
5. Drill down the hierarchy of package names to HS, then SDA3 and then to the class of interest.

To generate an XML schema document (XSD) for SDA, run the following utility in the HSLIB namespace:
Do ##Class(HS.SDA3.Container).ExportXMLSchema()

The utility will ask for a filename. Enter the name of the file and include the .xsd extension.

HealthShare Foundation Basics                                                                                                                                           43

5
Auditing
HealthShare Foundation offers all of the auditing capabilities of Caché and Ensemble. In addition, it can send audit messages
to an ATNA repository.

5.1 Basic Auditing

The HS.Audit.Consolidation.Service is an Ensemble business service that batches audit events and periodically updates the
Caché audit logs. To set up auditing, enable this business service in your HealthShare Foundation production.

5.2 ATNA Auditing

To add ATNA auditing:
1. Add one of the following business operations to your HealthShare Foundation production:
• HS.IHE.ATNA.SecureApplication.TCP.Operations

• HS.IHE.ATNA.SecureApplication.UDP.Operations

2. Configure the ATNA operation to communicate with your ATNA repository via TCP or UDP as appropriate.
3. Set AuditAlertOperations in the HS.Audit.Consolidation.Service to the name of the business operation you installed in
step 1.
4. Optionally edit the contents of the ExcludeUsers field in the HS.Audit.Consolidation.Service to control which events
are audited.

HealthShare Foundation Basics                                                                                                                                           45