HITSP Emergency Responder Electronic Health Record Interoperability Specification

December 18, 2008

Version 2.0

HITSP Emergency Responder Electronic Health Record Interoperability Specification

HITSP/IS04

Healthcare Information Technology Standards Panel (HITSP) logo

Submitted to:

Healthcare Information Technology Standards Panel

Submitted by:

Provider Perspective Technical Committee
(Formerly Care Delivery Technical Committee)

Document Change History

Version Number	Description of Change	Name of Author	Date Published
1.0	Review Copy	Care Delivery Technical Committee	July 20, 2007
1.0.1	Review Copy	Care Delivery Technical Committee	December 5, 2007
1.1	Released for Implementation	Care Delivery Technical Committee	December 13, 2007
1.1.1	Review Copy	Provider Perspective Technical Committee	August 1, 2008
1.2	Released for Implementation	Provider Perspective Technical Committee	August 20, 2008
	Template Updated to V2.4	Project Team	July 31, 2008
1.2.1	Review Copy	Provider Perspective Technical Committee	September 26, 2008
1.2.2	Review Copy	Provider Perspective Technical Committee	December 10, 2008
2.0	Released for Implementation	Provider Perspective Technical Committee	December 18, 2008

Table of Contents

1.0 Introduction. 6

1.1 Interoperability Specification Overview. 6

1.2 Interoperability Specification Document Map. 7

1.2.1 List of Constructs. 8

1.3 Copyright Permissions. 11

1.4 Reference Documents. 11

2.0 Requirements. 13

2.1 Use Case Synopsis. 13

2.1.1 The Emergency Communications System Actor and Functions. 15

2.2 Use Case Requirements. 16

2.2.1 Mapping of Use Case Actions to Information Exchange Requirements. 18

2.2.2 Data and Information Exchange Requirements. 19

2.2.3 Identification of Business Actors, Mapped to Requirements. 26

2.2.4 High-Level Diagrams. 34

3.1 Scope of Design. 38

3.1.1 Assumptions. 38

3.1.2 Constraints. 39

3.1.3 Pre-conditions. 39

3.1.4 Post-conditions. 40

3.1.5 Process Triggers. 41

3.2 Detailed Design. 41

3.2.1 Technical Actor Role Descriptions. 41

3.2.2 Construct Requirements. 44

3.2.3 Mapping of Business Actors to Technical Actors and Constructs with Optionality. 52

3.2.4 Construct Dependencies. 66

3.2.5 Additional Constraints on Required Constructs. 66

4.0 Standards Selection. 67

4.1 Standards. 68

4.1.1 Regulatory Guidance. 68

4.1.2 Selected Standards. 68

4.1.3 Informative Reference Standards. 73

4.2 Gaps Where There Are No Standards. 73

4.3 Standard Overlaps. 76

5.0 Conformance. 78

5.1 Conformance Criteria. 78

5.2 Conformance Scoping, Subsetting and Options. 78

5.3 Test Methods. 78

6.0 Appendix. 80

6.1 Description of Standards. 80

6.2 Use Case to Information Exchange and Data Requirements. 90

6.3 Use Case Sequence Diagrams. 111

6.3.1 On-Site Care Scenario Perspective Business Sequence Diagram.. 111

6.3.2 Emergency Care Scenario Perspective Business Sequence Diagram.. 115

6.3.3 Definitive Care Scenario Diagram.. 117

6.4 Mapping of Constructs to Information Exchange and Data Requirements. 119

6.5 Emergency Contact Resolution. 129

6.6 ER-EHR Acronyms. 129

7.0 Document Updates. 131

7.1 December 5, 2007. 131

7.2 December 13, 2007. 131

7.3 September 26, 2008. 131

7.4 December 10, 2008. 131

7.4.1 Global Changes. 132

7.5 December 18, 2008. 132

Figures and Tables

Figure 1-1 Interoperability Specification Document Map. 8

Figure 2-1 Legend for Component Diagrams. 34

Figure 2-2 On-Site Care Component Data Flow Diagram.. 35

Figure 2-3 Emergency Care Component Data Flow Diagram.. 36

Figure 2-4 Definitive Care Component Data Flow Diagram.. 37

Figure 3-1 On-Site Care Detailed Design Diagram Part 1 and Part 2. 47

Figure 3-2 Emergency Care Detailed Design Diagram Part 1 and Part 2. 49

Figure 3-3 Definitive Care Detailed Design Diagram.. 51

Figure 6-1 On-Site Care Scenario Business Sequence Diagram.. 112

Figure 6-2 Emergency Care Scenario Perspective Business Sequence Diagram Part 1 and 2. 116

Figure 6-3 Definitive Care Scenario Perspective . 118

Table 1-1 List of Constructs. 9

Table 1-2 Reference Documents. 11

Table 2-1 Data Element and Information Requirements (DR) 19

Table 2-2 Information Exchange Requirements (IER) 23

Table 2-3 Business Actors. 28

Table 3-1 Assumptions. 38

Table 3-2 Constraints. 39

Table 3-3 Pre-conditions. 39

Table 3-4 Post-conditions. 41

Table 3-5 Process Triggers. 41

Table 3-6 Technical Actor Role Descriptions. 42

Table 3-7 Business-Technical Actor Mapping to Transaction and/or Content 53

Table 3-8 Implementation Conditions/Constraints. 63

Table 3-9 Creator Registration Subset Content Modules. 63

Table 3-10 Creator Medication and Immunization History Subset Content Modules. 64

Table 3-11 Creator Conditions and Allergy Subset Content Modules. 64

Table 3-12 Creator Laboratory Subset Content Modules. 65

Table 3-13 Construct Dependencies. 66

Table 3-14 Additional Constraints on Required Constructs. 66

Table 4-1 Regulatory Guidance. 68

Table 4-2 Selected Standards Linked to HITSP Constructs. 69

Table 4-3 Informative Reference Standards. 73

Table 4-4 Use Case Requirements and Associated Standards Gaps. 75

Table 4-5 Use Case Requirements and Associated Standard Overlaps. 77

Table 6-1 Description of Standards. 80

Table 6-2 Description of Candidate Standards. 89

Table 6-3 Mapping of Use Case Actions to Information Exchange Requirements. 90

Table 6-4 Mapping of HITSP Constructs to Requirements. 119

Table 6-5 Mapping of Requirements to HITSP Constructs. 123