Sharing Documents and IHE XDS

Abstract

IHE XDS (cross-enterprise document sharing) can be used to share documents between different organizations using a common portal. The XDS registry holds document metadata, which can be searched to retrieve appropriate documents stored in XDS repositories. The local specifi cations for metadata are defi ned in an affi nity domain. The metadata includes information about each document, the patient, author, event and technical data. A number of related specifi cations have been defi ned as extensions. Keywords XDS • Source • Repository • Registry • Consumer • Patient Identity Source • Metadata • Affi nity Domain • PIX (patient identifi er cross-referencing) • PDQ (patient demographics query) • Submission set • Direct project • HISP (health information service provider) • DSUB (document metadata subscription) • ATNA (audit trail and node authentication) • BPPC (basic patient privacy consent) Sharing Documents When patient records are fragmented across multiple care providers it is hard for anyone to grasp the whole picture. Approximately 75 % of Medicare spending pays for care for benefi ciaries who have fi ve or more chronic conditions and see an average of 14 different physicians each year. [ 1 ] Fragmentation of the patient's health record leads to errors, duplication of work and waste. The case for sharing records across provider organizations is strong, although there is a danger of information overload [ 2 ]. Integrating the Health Enterprise (IHE) Cross-Enterprise Document Sharing (XDS) enables healthcare documents to be shared over a wide area network, between hospitals, primary care providers and social services. It is part of the IHE IT Infrastructure Technical Framework Integration Profi les (ITI-TF-1) [ 3 ]. Rather than having one big database at the center, IHE XDS offers a distributed collaborative approach to sharing clinical documents held by different healthcare organisations. It is based on standardized metadata.