federation karen witting. goals of “federation” show a vision for support of cross xds affinity...
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Federation
Karen Witting
Goals of “Federation”
• Show a vision for support of cross XDS Affinity Domain communication
• Show cooperation between IHE and Connecting for Health
Community
• a coupling of facilities/enterprises for the purpose of sharing patient-relevant medical information
• Examples: XDS Affinity Domain, RHIO, Sub-network Organization (SNO)
• Communities can be hierarchically part of a larger community
Communicating across Communities• Finding the community
– Focus of prior discussion
• Communicating with the community– Minimal focus so far
SNO
XDS AD XDS AD
RLSOther
XDS AD SNO
Patient-Data Existence Locator
• Privacy/security of entity outside a community of significant concern
• Multiple such entities being consistent
• Support for such a locator within a community for patients of interest referencing external communities
Patient-Data-Existence Locator
Patient-Data-Locator (e.g. XDS Registry)
Data Repository (e.g. XDS Doc Repository)
Patient-Data-Locator (e.g. XDS Registry)
Data Repository (e.g. XDS Doc Repository)
Data Repository (e.g. XDS Doc Repository) Data Repository
(e.g. XDS Doc Repository) Data Repository (e.g. XDS Doc Repository) Data Repository
(e.g. XDS Doc Repository)
Data Repository (e.g. XDS Doc Repository) Data Repository
(e.g. XDS Doc Repository)
Data Requesters (e.g. XDS Doc Consumer)
Data Source (e.g. XDS Doc Source)
Data Source (e.g. XDS Doc Source)
Distributed, patient indexed
Patient-Data-Existence Locator Patient-Data-Locator (e.g. XDS Registry)
Data Repository (e.g. XDS Doc Repository)
Patient-Data-Locator (e.g. XDS Registry)
Data Repository (e.g. XDS Doc Repository)
Data Repository (e.g. XDS Doc Repository) Data Repository
(e.g. XDS Doc Repository) Data Repository (e.g. XDS Doc Repository) Data Repository
(e.g. XDS Doc Repository)
Data Repository (e.g. XDS Doc Repository) Data Repository
(e.g. XDS Doc Repository)
Data Requesters (e.g. XDS Doc Consumer)
Data Source (e.g. XDS Doc Source)
Data Source (e.g. XDS Doc Source)
Locator of selected patients controlled by community
Patient-Data Locator(e.g. XDS Registry)
Data Repository(e.g. XDS Repository)
Patient-Data Existence Locator
Patient-Data Locator(e.g. XDS Registry)
Federation
Service
Data Repository(e.g. XDS Repository)
Data Requester(e.g. XDS Doc Consumer)
Data Source(e.g. XDS Doc Source)
Data Source(e.g. XDS Doc Source)
FederationService
Selected patient-data locations saved within community
Mechanism to support creation of this line
Profile
Finding Likely Relevant Communities
• Search by attributes– Most people have data in one or few communities– Proper selection of attributes will facilitating successful search in most
cases– Precision is not as critical as ease of creation & use– All data is public, no security needed– Searches will be infrequent, setup activities rather than frequent or
ongoing• Define schema for defining attributes: participating organizations,
cities serviced, medical specialty, etc.• Communities required to provided attributes as described in schema• Supports creation of search engines both within and outside of
communities. Special purpose search engines.• Result of search is a list of hostnames, community is defined by a
registered hostname.
Patient-Data Locator(e.g. XDS Registry)
Data Repository(e.g. XDS Repository)
Patient-Data Existence Locator
Patient-Data Locator(e.g. XDS Registry) Federation
Service
Data Repository(e.g. XDS Repository)
Data Requester(e.g. XDS Doc Consumer)
Data Source(e.g. XDS Doc Source)
Data Source(e.g. XDS Doc Source)
FederationService
Get Attributes Transaction
Search EngineNon-XDS CommunityFederation
Service
Search Engine
Search
Communicating with Communities
• URL is not enough– Protocol: XDS, CfH, other?– Coding systems– Document format– Authorization/Authentication mechanisms
• Get Capabilities transaction– Define structure for defining capabilities– Require all communities to supply the information
• Get Capabilities query may mean communication between that pair of communities is not possible: query return should include alternate mechanism like phone # or records dept, FAX, other
Patient-Data Locator(e.g. XDS Registry)
Data Repository(e.g. XDS Repository)
Patient-Data Existence Locator
Patient-Data Locator(e.g. XDS Registry) Federation
Service
Data Repository(e.g. XDS Repository)
Data Requester(e.g. XDS Doc Consumer)
Data Source(e.g. XDS Doc Source)
Data Source(e.g. XDS Doc Source)
FederationService
Get Capabilities Transaction
Search EngineNon-XDS CommunityFederation
Service
Sear
ch
Patient-Data Existence Locator
Patient-Data Locator(e.g. XDS Registry)
FederationServiceData Repository
(e.g. XDS Repository)
Data Requester(e.g. XDS Doc Consumer)
Data Source(e.g. XDS Doc Source)
Get Capabilities Transaction
Search Engine
Connecting for Health Community
Inter-SNOBridge
RLS
CfHAdapter
OtherMaybe XDS
Conclusion
• Patient data held only within communities which have a relationship with the patient.
• Patient data indexing done within communities for selected patients
• Transactions needed to allow indexing of external communities containing patient data for patients of interest
• Suggest:1. Defining and sharing attributes for communities2. Defining and sharing capabilities for communities3. Supporting storing references to external communities within
XDS registry4. Consider “Federation service” actor and transactions it supports.
Focus Bottom Up
1. Agree on vision2. Build profile to connect “Federation
Service” to internal actors – rename to Cross Community Bridge
3. Build collecting references of patients of interest
4. 2009 timeframe – build capabilities & attributes support
Two approaches to linking multiple communities
• Hierarchical grouping of communities
• Peer-to-peer community communication
SNO
XDS AD XDS AD
RLS/PIX+Other
Transactions to RLS/PIX+:•Update provide demographics and reference for a “domain”
•Query given demographics return a list of references
These transactions also used in peer-to-peer
XDS Registry
RLS/PIX+
XDS Registry
CrossCommunity
Bridge
DataRepository
DocumentConsumer
Query Demo
(2)
1. Precondition: The IHE-RLS is primed with data2. Query (existing transaction)3. Query RLS/PIX+ (new transaction – alternate could configure static list to query)4. Query each registry in list (existing transaction)5. Return consolidated results6. Document Retrieve (existing)7. Document Retrieve (existing)
(4)
(3)
(5)
XDS Repository
(7)
(6)
XDS Registry
XDS Repository
(7)
(4)
XDS RegistryRLS/PIX+
XDS Registry
CrossCommunity
Bridge
DataRepository
CrossCommunity
Searcher
CrossCommunity
Bridge
Find New
Search Engine
(1)
(2)
1. Find New (attributes + demographics)2. Search by attributes3. Get Capabilities4. Query PDQ/Registry5. Update RLS/PIX+6. Notify caller: found new
(3)
(4)(5)
(6)
PDQ
CrossCommunity
Bridge
XDS Registry
RLS/PIX+
XDS Registry
CrossCommunity
Bridge
DataRepository
CrossCommunityRequestor
CrossCommunity
Bridge
Query External
(1)
1. Query External (query info, identical except for expected return timeframe?)2. Query RLS/PIX+3. Query registries4. Return consolidated results5. Retrieve External (url/webservice retrieve)6. Retrieve7. Return transformed data
(3)
(2)
(4)
XDS Repository
(7)
(6)
(5)
XDS Registry
XDS Repository
(6)
(3)
Cross Community Transactions
Cross CommunitySearcher
Cross CommunityBridge
Cross CommunityConsumer
Cross CommunityBridge
Find New
Query External
Cross CommunityBridge
Cross CommunityBridge
Get Capabilities
Cross CommunityBridge
Search EngineSearch by Attributes
Etc….
?? RLS/PIX+Query RLS
Update RLS
Cross Community Transactions
Cross CommunitySearcher
Cross CommunityConsumer
Find New
Query External
Get Capabilities
Search Engine
Search by Attributes
Etc….
Cross CommunityBridge
RLS/PIX+Query RLS
Update RLS
Find New Transaction
• Search for patient data in a community which has not previously been located.– Request includes attributes and patient demographics
– Bridge executes search transaction
– Bridge checks capabilities
– Bridge executes PDQ query for patient
– Bridge queries non-local registry
– Bridge updates local RLS/PIX+ with a new reference
Query External Communities
• Pull information from references external communities– Query specifying patient demographics and
query parameters– Bridge pulls external reference list from
RLS/PIX+– Bridge queries referenced XDS Registries– Bridge consolidates/translates results– Bridge returns results to caller
Other Thoughts
• Async vs. Sync vs mixed– Give me whatever you get in 30 seconds and
hold the rest until I ask for more– Agreed that async is needed
• Technology, Technology, where is the standards to build on?