3.0Capability Specifications

System-to-System (e.g., EHR System-to-Lab System)

Y

Y

Y

Y

Y [3]

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

System-to-HIE

Y

Y

Y

Y

Y [4]

Y

Y

N

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

HIE-to-HIE

N

N

Y [5]

Y

Y [6]

N

Y

N

N

N

Y [7]

Y

Y

N

N

Y [8]

N

N

N

N

N

N

N

Y

Y

Portable Media

N

N

Y

Y

Y [9]

N

N

N

N

N

Y

N [10]

Y

N

N

Y

N

N

N

N

N

N

N

N

Y

System-to-System (e.g., EHR System-to-Lab System)

Y

Y

Y

Y

Y

Y

Y

Y

Y

System-to-HIE

Y

Y

Y

Y

Y

Y

Y

Y

Y

HIE-to-HIE

Y

Y

Y

Y

Y

Y

Y

Y

Portable Media

Y

Y

Y

Access Control

Request Access Control

HITSP/SC108

HITSP/TP20, HITSP/TP30, HITSP/C19, HITSP/T17

Knowledge and Vocabulary

Request Medical Knowledge

Respond Medical Knowledge

Request Value-Set

Respond Value-Set

HITSP/SC111

HITSP/T81, HITSP/T66

HITSP/T17

Patient Identification Management

Request Patient Identification

HITSP/SC110

HITSP/T23, HITSP/TP22, HITSP/T24

HITSP/SC108, HITSP/SC109, HITSP/T17

Query for Existing Data

Request Existing Patient Data

Respond Existing Patient Data

HITSP/SC113

HITSP/TP21

HITSP/SC108, HITSP/SC110, HITSP/SC109, HITSP/T17

Security Audit

Send Security Audit Event

HITSP/SC109

HITSP/T15, HITSP/T16

Healthcare Document Management

Send Documents (dynamically choose method)

Send Documents Directly

Send Documents through email

Publish Documents through Media

Send Documents through Share

Publish Documents through Share

Receive Documents (dynamically choose method)

Receive Documents Directly

Receive Documents through email

Consume Documents through Media

Receive Documents through Share

Consume Documents through Share

HITSP/SC112

HITSP/TP13, HITSP/T31, HITSP/T33, HITSP/T29

HITSP/SC108, HITSP/SC110, HITSP/SC109, HITSP/T17, HITSP/T64

Emergency Message Distribution Element

Send Emergency Message Distribution Element

HITSP/SC116

HITSP/T63

HITSP/SC108, HITSP/SC109, HITSP/T17

Administrative Transport to Health Plan

Request Administrative Response to Health Plan

Respond to Administrative Response to Health Plan

HITSP/SC114

HITSP/T85

HITSP/SC108, HITSP/SC110, HITSP/SC109, HITSP/T17

HL7 Messaging

Request HL7 Message

Respond to HL7 Message

HITSP/SC115

HL7 v2.x MLLP

HITSP/SC108, HITSP/SC109, HITSP/T17

Appropriate protocols, patient identification methodology, consent, Security and Privacy procedures are agreed to by all relevant participants in Business Agreements that address relevant statutory, regulatory, and policy requirements for security and privacy. Security and Privacy policies, procedures and practices are implemented to support appropriate levels of consumer/patient privacy and security. Legal and governance issues regarding data access authorizations, data ownership, and data use are in effect. Organizations handling data address statutory, regulatory, and policy requirements (e.g., HIPAA policy compliance) in their policy, agreements, and/or processes.

Pre-Condition

This specification provides the needed capabilities that organizations could use to address relevant statutory, regulatory, and policy requirements. These capabilities use established standards for trust management, risk assessment and cross-jurisdiction information exchange.

Assumption

Unless precluded by statute, the consumer shall be informed of the existence and unavailability of the document per statute. Consumer escalation procedures should be available, at minimum, by reference

Assumption

There is no regulatory roadblock to the transmission of personal health information between systems and that all exchanges between systems are properly handled by the appropriate business rules by the system provider.

Assumption

Process and places where portable media would be created or read in healthcare delivery organization is consistent with policy restrictions (e.g., to protect from malicious data or unauthorized release of Individual Identifiable Health Information). It is assumed the import/export to and from portable media to be restricted to specific locations and/or staff

Assumption

Network infrastructures enable secure, appropriate, and accurate information exchange across data sources and systems to view the data. This includes, but is not limited to: methods to: identify and authenticate users; identify and determine providers of care; enforce data access authorization policies correctly match consumers/patients across systems. To identify and determine health insurers; identify and determine pharmacy benefits managers (NOTE: Pharmacy benefit information obtained through NCPDP transactions); identify data sources including but not limited to provider EHR systems

Pre-Condition

Support the technical measures to ensure Security and Privacy of consumer/patient health information

Pre-Condition

Support the technical measures to ensure Security and Privacy of consumer/patient health information

Pre-Condition

Security and Privacy policies, procedures and practices are commonly implemented to support acceptable levels of consumer/patient privacy and security Legal and governance issues regarding data access authorizations, data ownership, and data use are in effect

Pre-Condition

A users access or disclosure of PHR information is successfully logged

Post-Condition

Access and disclosure logs for PHR are available for Consumer review

Post-Condition

Health Information Exchange (HIE) can serve as intermediary for data in many implementation variants.

Assumption

Appropriate patient consent is obtained and recorded for treatment, payment and healthcare operations.

Pre-condition

Either (1) Providers cant limit a consumers access to clinical information directly related to that consumer, or; (2) The specification, interoperability requirements, and policy considerations of such restrictions are outside the scope of this document

Assumption

A userfriendly error message is displayed in the event of retrieval failure

Post-Condition

Policies exist authorizing registries to exchange information

Pre-condition

Augmentation of electronic data with manual input or query to other systems require appropriate authorizations

Assumption

Electronic Health Record (EHR)

Electronic Health Record (EHR) Hospital & EHR LTC

Pharmacy Systems

Pharmacy Systems Hospital and Pharmacy Systems External

Clinical Decision Support and Other Clinical or Admin Data Sources

Health Care Entities (for LTC)

Health Information Exchange (HIE)

PBM/Payers System

Health Information Exchange (HIE) can serve as intermediary for data in many implementation variants. The various alternative options are not shown

Assumption

Patient consent for treatment, payment and healthcare operations

Pre-condition

Entities have pre-established a business relationship to exchange information

Pre-condition

Authentication service to authenticate requestors and/or data submissions from various locations

Pre-condition

Security and privacy policies, procedures and practices are commonly implemented to support acceptable levels of consumer/patient security and privacy

Pre-condition

Medication has been dispensed to a patient, or the reason why it was not is provided to the prescribing clinician

Post-condition

HITSP/SC114 Administrative Transport to Health Plan

The Administrative Transport to Health Plan service collaboration provides the transport mechanism for conducting administrative transactions with health plans

HITSP/T40 Patient Health Plan Eligibility Verification

The Patient Health Plan Eligibility Verification Transaction is intended to provide the status of a health plan covering the individual, along with details regarding patient liability for deductible, co-pay and co-insurance amounts for a defined base set of generic benefits or services. The base set of benefits includes, but is not limited to, coverage status and patient liability for medical, chiropractic, dental, hospital inpatient, hospital outpatient, emergency, physician office visit, pharmacy and vision services that are included in the patients generic health plan benefit

HITSP/T42 Medication Dispensing Status

This Medication Dispensing Status Transaction provides a medication prescriber the dispensing status of an ordered prescription (dispensed, partially dispensed, not dispensed). This Transaction is used for original prescriptions, refills and renewals. It uses the NCPDP SCRIPT Standard Implementation Guide Version 10.1 RXFILL message to provide the status

HITSP/TP43 Medication Orders

The Medication Orders Transaction Package is used to define transactions between prescribers (who write prescriptions) and dispensers (who fill prescriptions). It is used for new prescriptions, refill requests, prescription change requests and prescription cancellations. Orders/prescriptions may occur in many different real world settings, such as inpatient, long term care and ambulatory settings

HITSP/TP46 Medication Formulary and Benefits Information

The Medication Formulary and Benefits Information Transaction Package addresses two tasks. The first task is to perform an eligibility check for a specific patients pharmacy benefits. The second task is to obtain the medication formulary and benefit information

Medication Order Prescriber

1

R

Medication Order Request (HITSP/TP43)

CAP117-[201]

Medication Dispensing Status Receiver

2

O*

Medication Dispensing Status Query (HITSP/T42)

R

Medication Order Filler

3

R

Medication Order Request (HITSP/TP43)

R

Eligibility Information Receiver

4

R

Patient Generic Health Plan Eligibility Verification (HITSP/T40)

R

Medication Formulary and Benefits Retriever

5

R

Medication Formulary and Benefits Request (HITSP/TP46)

R

Request Administrative Transport to Health Plan

6

R

Administrative Transport (HITSP/SC114)

R

Respond to Administrative Request to Health Plan

7

R

Administrative Transport (HITSP/SC114)

R

CAP117-[201]

The NCPDP transaction method shall be used

Electronic Health Record (EHR)

Electronic Health Record (EHR) Hospital

Electronic Health Record (EHR) Hospital and EHR LTC

Pharmacy Systems

Pharmacy Systems Hospital and Pharmacy Systems External

Clinical Decision Support and Other Clinical or Admin Data Sources

Health Information Exchange (HIE)

PBM/Payers System

Health Information Exchange (HIE) can serve as intermediary for data in many implementation variants. The various alternative options are not shown

Assumption

Patient consent for treatment, payment and healthcare operations

Pre-condition

Entities have pre-established a business relationship to exchange information

Pre-condition

Authentication service to authenticate requestors and/or data submissions from various locations

Pre-condition

Security and privacy policies, procedures and practices are commonly implemented to support acceptable levels of consumer/patient security and privacy

Pre-condition

Medication has been dispensed to a patient, or the reason why it was not is provided to the prescribing clinician

Post-Condition

HITSP/TP43 Medication Orders

The HITSP Medication Orders Transaction Package is used to define transactions between prescribers (who write prescriptions) and dispensers (who fill prescriptions). It is used for new prescriptions, refill requests, prescription change requests and prescription cancellations. Orders/prescriptions may occur in many different real world settings, such as inpatient, long term care and ambulatory settings

HITSP/T42 Medication Dispensing Status

The HITSP Medication Dispensing StatusTransaction provides a medication prescriber the dispensing status of an ordered prescription (dispensed, partially dispensed, not dispensed). This Transaction is used for original prescriptions, refills and renewals. It uses the NCPDP SCRIPT Standard Implementation Guide Version 10.1 RXFILL message to provide the status

HITSP/T40 Patient Health Plan Eligibility Verification

The HITSP Patient Health Plan Eligibility Verification Transaction is intended to provide the status of a health plan covering the individual, along with details regarding patient liability for deductible, co-pay and co-insurance amounts for a defined base set of generic benefits or services. The base set of benefits includes, but is not limited to, coverage status and patient liability for medical, chiropractic, dental, hospital inpatient, hospital outpatient, emergency, physician office visit, pharmacy and vision services that are included in the patients generic health plan benefit

HITSP/TP46 Medication Formulary and Benefits Information

The HITSP Medication Formulary and Benefits Information Transaction Package addresses two tasks. The first task is to perform an eligibility check for a specific patients pharmacy benefits. The second task is to obtain the medication formulary and benefit information

HITSP/SC114 Administrative Transport to Health Plan

TheHITSP Administrative Transport to Health Plan Service Collaboration provides the transport mechanism for conducting administrative transactions with health plans

HITSP/SC115 HL7 Messaging

The HITSP HL7 Messaging Service Collaboration provides the Capability to send and receive HL7 messages. The Service Collaboration applies the necessary Security and Privacy constructs

Medication Order Prescriber

1

R

Medication Order Request (HITSP/TP43)

CAP118-[201]

Medication Dispensing Status Receiver

2

R

Medication Dispensing Status Query (HITSP/T42)

R

Medication Order Filler

3

R

Medication Order Request (HITSP/TP43)

R

Eligibility Information Receiver

4

R

Patient Generic Health Plan Eligibility Verification (HITSP/T40)

R

Medication Formulary and Benefits Retriever

5

R

Medication Formulary and Benefits Request (HITSP/TP46)

R

Request Administrative Transport to Health Plan

6

R

Administrative Transport to Health Plan (HITSP/SC114)

R

Respond to Administrative Request to Health Plan

7

R

Administrative Transport to Health Plan (HITSP/SC114)

R

Request HL7 Message

8

R

HL7 Messaging (HITSP/SC115)

R

Respond to HL7 Message

9

R

HL7 Messaging (HITSP/SC115)

R

CAP118-[201]

The HL7 transaction method shall be used within the hospital, and the NCPDP transaction method shall be used when communicating with external systems

Electronic Health Record (EHR) Systems

Personal Health Record (PHR) Systems

Public Health Information System

Health Information Exchange (HIE) / Regional Health Information Organizations (RHIO)

Laboratory Information Systems

Emergency Communications System

Immunization Information System

Clinical Decision Support System

Quality Measure Processing Entity

Systems store patient data as an encounter. A patient has one to many encounters linked into episodes of care. Each encounter holds documents. Each document holds data. This is analogous to each encounter being a report holding many paper document sections and each document section containing many data elements. An episode of care contains many reports on the same incident. The file folder also contains incident information on the same topic (e.g., patient). We assume data are communicated in both document and message forms

Assumption

Ability to identify and request corrections to errors is available

Pre-Condition

Ability to apply notes, corrections and comments on original entries is available

Pre-Condition

Appropriate standards are developed, approved, and widely adopted supporting data content and structure, allowing universal access by compliant systems

Pre-Condition

Core datasets are defined and adhered to

Pre-Condition

Method to query other organizations for data and matching to the consumer is available

Pre-Condition

If physical media is used for the transport, when the media is read the consent directives stored on the portable media need to be enforced by the portable media importer. The validity of these content directives may need to be checked

Post-Condition

HITSP/C28 Emergency Care Summary Document Using IHE Emergency Department Encounter Summary (EDES)

The HITSP Emergency Care Summary Document Using IHE Emergency Department Encounter Summary (EDES) Component is the collection of data from multiple sources (such as physicians, nurses, technologists, etc.) recording the assessments and care delivered by the ED team in response to an ED visit. It is a summary of the patients current health status and care tendered in the ED between arrival and ED departure. This Component specifies the use of the IHE Emergency Department Encounter Summary (EDES), Technical Framework Supplement, Volume I, Revision 3.0, 2007-2008

HITSP/C32 Summary Documents Using HL7 Continuity of Care Document (CCD)

The HITSP Summary Documents Using HL7 Continuity of Care Document (CCD) Component describes the document content summarizing a consumer's medical status for the purpose of information exchange. The content may include administrative (e.g., registration, demographics, insurance, etc.) and clinical (problem list, medication list, allergies, test results, etc) information. This Component defines content in order to enable interoperability between participating systems such as Personal Health Record Systems (PHRs), Electronic Health Record Systems (EHRs), Practice Management Applications and others

HITSP/C39 Encounter Message

The HITSP Encounter Message Component supports the process of sending patient encounter data (excluding laboratory, radiology) from a Biosurveillance Message Sender to a Biosurveillance Message Receiver

HITSP/C48 Encounter Document Using IHE Medical Summary (XDS-MS)

The HITSP Encounter Document Using IHE Medical Summary (XDS-MS) Component supports the process of sending patient encounter data (excluding laboratory and radiology) in a document sharing functional flow scenario. Patient encounter data are captured as part of the normal process of care performed by healthcare providers, such as hospitals, emergency departments and outpatient clinics

HITSP/C74 Remote Monitoring Observation Document

The HITSP Remote Monitoring Observation Document Component describes the document content to convey medical information collected by remote monitoring management systems from monitorng devices and/or device intermediaries for the purpose of information exchange. The content may include administrative (e.g., registration, demographics, insurance, etc.) and clinical (results, vital signs, etc) information. This specification defines content in order to promote interoperability between participating systems. Such systems may include Remote Monitoring Management Systems, Personal Health Record Systems (PHRs), Electronic Health Record Systems (EHRs), Health Information Exchange infrastructure services and other persons and systems as identified and permitted

HITSP/C75 Healthcare Associated Infection (HAI) Report

The HITSP Healthcare Associated Infection (HAI) Report Component specifies a standard for electronic submission of Healthcare Associated Infection (HAI) Reports to the National Healthcare Safety Network (NHSN) of the Centers for Disease Control and Prevention (CDC). HITSP has adopted the HL7 Implementation Guide for CDA Release 2: NHSN Healthcare Associated Infection (HAI) Reports, Release 1 for this construct

HITSP/C78 Immunization Document

The HITSP Immunization Document Component defines the immunization data content to be exchanged between healthcare entities such as immunization information systems, electronic medical records systems, personal healthcare record systems and other stakeholders. It is based upon the IHE Patient Care Coordination (PCC) Technical Framework Supplement 2008-2009, Immunization Content (IC), Trial Implementation Version 1.0

HITSP/C80 Clinical Document and Message Terminology

The HITSP Clinical Document and Message Terminology Component defines the vocabularies and terminologies utilized by HITSP specifications for Clinical Documents and Messages used to support the interoperable transmission of information

HITSP/C83 CDA Content Modules

The HITSP CDA Content Modules Component defines the content modules for document based HITSP constructs utilizing clinical information. These Content modules are based on IHE PCC Technical Framework Volume II, Release 4. That technical framework contains specifications for document sections that are consistent with all implementation guides for clinical documents currently selected for HITSP constructs

HITSP/C84 Consult and History & Physical Note

The HITSP Consult and History & Physical Note Component supports two types of commonly used clinical notes, a consult note, and a history and physical note. It is intended for use to support the exchange of information from a consulting provider to a referring provider; and may also be used to provide background information from a referring provider to a consulting provider (e.g., prior reports)

HITSP/SC112 Healthcare Document Management

The HITSP Healthcare Document Management Service Collaboration provides the ability to share healthcare documents using a set of topologies, such as Media, e-Mail, Point-to-Point, Shared within a Health Information Exchange, and Shared within a larger community (made up of potentially diverse Health Information Exchanges)

Content Creator

1

R

Creator-Registration Subset (see Section 3.4.1.5.1)(HITSP/C32)

CAP119-[201]

Creator-Registration-Coded Subset (see Section 3.4.1.5.2)(HITSP/C32)

CAP119-[201]

Creator-Medication and Immunization History Subset (see Section 3.4.1.5.3)(HITSP/C32)

CAP119-[201]

Creator-Medication and Immunization History Coded Subset (see Section 3.4.1.5.4)(HITSP/C32)

CAP119-[201]

Creator-Conditions and Allergy Subset (see Section 3.4.1.5.5)(HITSP/C32)

CAP119-[201]

Creator-Conditions and Allergy -Coded Subset (see Section 3.4.1.5.6)(HITSP/C32)

CAP119-[201]

Creator-Laboratory Section Subset (see Section 3.4.1.5.7)(HITSP/C32)

CAP119-[201]

Creator-Laboratory Section -Coded Subset (see Section 3.4.1.5.8)(HITSP/C32)

CAP119-[201]

Creator-Medication and Allergies Subset (See Section 3.4.1.5.9) (HITSP/C32)

CAP119-[201]

Encounter Document Using IHE Medical Summary (XDS-MS) Component(HITSP/C48)

CAP119 -201]

Structured Family History Creator-Structured Family History subset (see Section 3.4.1.5.10)(HITSP/C48)

CAP119-[201]

Emergency Department Encounter(HITSP/C28)

CAP119-[201], [202]

Consult and History & Physical Note(HITSP/C84)

CAP119-[201]

Structured Family History Content Creator (See Section 3.4.1.5.11)(HITSP/C84)

CAP119-[201]

Remote Monitoring Observation Document(HITSP/C74)

CAP119-[201]

Adverse Event Reports: CDC Healthcare Associated Infection Reporting (HITSP/C75)

CAP119-[201]

Clinical Document and Message Terminology(HITSP/C80)

R

CDA Content Modules (HITSP/C83)

R

Content Consumer

2

R

Consumer-Document Display)(HITSP/C32)

R

Consumer-Document Import (HITSP/C32)

CAP119-[203]

Consumer-Registration Discrete Data Import (HITSP/C32)

CAP119-[203]

Consumer-Medication and Immunization History Discrete Data Import Subset (see Section 3.4.1.5.12)(HITSP/C32)

O

Consumer-Conditions and Allergy Discrete Data Import Subset (see Section 3.4.1.5.13)(HITSP/C32)

O

Consumer-Medication and Allergies Information Import Subset (See Section 3.4.1.5.14)(HITSP/C32)

O

Structured Family History Consumer-Document Import Subset (see Section3.4.1.5.15)(HITSP/C32)

O

Structured Family History Consumer-Document Discrete Data Import (see Section 3.4.1.5.16)(HITSP/C32)

O

Consumer-Document Display (HITSP/C28)

R

Consumer-Document Import (HITSP/C28)

CAP119-[203]

Consumer-Document Discrete Data Import HITSP/C28)

CAP119-[203]

Consumer-Document Display (HITSP/C48)

R

Consumer-Document Import (HITSP/C48)

CAP119-[203]

Consumer-Document Discrete Data Import(HITSP/C48)

CAP119-[203]

Structured Family History Consumer-Document Import (see Section 3.4.1.5.17)(HITSP/C48)

O

Structured Family History Consumer-Document Discrete Data Import Subset (See Section 3.4.1.5.18)(HITSP/C48)

O

Consumer-Document Display(HITSP/C84)

R

Consumer-Document Import(HITSP/C84)

CAP119-[203]

Consumer-Document Discrete Data Import(HITSP/C84)

CAP119-[203]

Structured Family History Consumer-Document Import Subset (see Section 3.4.1.5.19)(HITSP/C84)

O

Structured Family History Consumer-Document Discrete Data Import Subset (see Section 3.4.1.5.20)(HITSP/C84)

O

Consumer-Document Display (HITSP/C74)

R

Consumer-Document Import (HITSP/C74)

CAP119-[203]

Consumer-Document Discrete Data Import (HITSP/C74)

CAP119-[203]

Consumer-Document Display (HITSP/C78)

R

Consumer-Document Import (HITSP/C78)

CAP119-[203]

Consumer-Document Discrete Data Import (HITSP/C78)

CAP119-[203]

Clinical Document and Message Terminology(HITSP/C80)

R

CDA Content Modules(IHTSP/C83)

R

Send Documents

3

CAP119-[101], [102]

Healthcare Document Management (HITSP/SC112)

R

Receive Documents

4

CAP119-[101]

Healthcare Document Management (HITSP/SC112)

R

CAP119-[101]

An implementation shall choose amongst one of the interfaces defined in HITSP/SC112 Healthcare Document Management. This choice is dependent on the topology chosen (See Table 3-1 Information Exchange Topologies Mapped to Capabilities above), the physical limitations, policies and processes of the implementation

CAP119-[102]

The EHR System may optionally choose to implement a Document Repository or use an external repository for the Send Documents through Share option of HITSP/SC112 Healthcare Document Management

CAP119-[201]

Shall support either at least one of the subsets of the HITSP/C32 Summary Documents Using HL7 Continuity of Care Document (CCD), HITSP/C37 Lab Report Document, the entire document or at least one of the subsets of HITSP/C48 Encounter Document Using IHE Medical Summary (XDS-MS), HITSP/C28 Emergency Department Encounter, the entire document or at least one of the subsets of HITSP/C84 Consult and History & Physical Note, HITSP/C74 Remote Monitoring Observation Document, HITSP/C75 Adverse Event Reports: CDC Healthcare Associated Infection Reporting Document, or any combination of the these constructs

CAP119-[202]

Shall be supported if the EHR is used by an emergency department

CAP119-[203]

The Content Consumer should minimally Display the content received in the specified CDA document (i.e. HITSP/C32, HITSP/C28, HITSP/C48, HITSP/C74, HITSP/C78, and HITSP/C84). Optionally, the Content Consumer may support one or both of the following functions:

Consumer-Document Import [Requires the Content Consumer to have the ability to import the CDA document into the patient record as a whole and display it as requested]

Consumer-Discrete Data Import [Requires the Content Consumer to have the ability to import the discrete data from one or more of the data section entries in a structured form into the patient record. Coded values shall be maintained.]

The specific data sections which have been described in HITSP documents which can be optionally supported have been identified as Discrete Data Import subsets.

Advance Directive

R2

Comments

R2

Healthcare Provider

R2

Information Source

R2

Insurance Provider

R2

Language Spoken

R2

Person Information

R

Pregnancy

R2

Support

R2

Comments

R2

Healthcare Provider

R2

Immunization

R2

Information Source

R2

Medications Prescription and Non-Prescription

R2

Person Information

R

Allergies and Drug Sensitivity

R2

Comments

R2

Condition

R2

Healthcare Provider

R2

Information Source

R2

Person Information

R

Comments

R2

Healthcare Provider

R2

Information Source

R2

Person Information

R

Result

R2

Person Information

R

Medications Prescription and Non-Prescription

R

Allergies and Drug Sensitivity

R

Healthcare Provider

R2

Insurance Provider

R2

Information Source

R2

Conditions

R2

Comments

R2

Family History

R

Allergies and Adverse Reactions

R

Active Problems

R

History of Past Illness

R

Diagnostic Results

R

Family History

R

Allergies and Adverse Reactions

R

Active Problems

R

History of Past Illness

R

Diagnostic Results

R

Electronic Health Record (EHR) Systems

Personal Health Record (PHR) Systems

Patient Identifier Service

Public Health Information System

Health Information Exchange (HIE)

Immunization Information System (IIS)

Laboratory Information Systems

Emergency Communications System

Systems store patient data as an encounter. A patient has one to many encounters linked into episodes of care. Each encounter holds documents. Each document holds data. This is analogous to each encounter being a report holding many paper document sections and each document section containing many data pieces. An episode of care contains many reports on the same incident. The file folder also contains incident information on the same topic (e.g., patient). We assume data are communicated in both document and message forms

Assumption

Ability to identify and request corrections to errors is available

Pre-Condition

Ability to apply notes, corrections and comments on original entries is available

Pre-Condition

Appropriate standards are developed, approved, and widely adopted supporting data content and structure, allowing universal access by compliant systems

Pre-Condition

Core datasets are defined and adhered to

Pre-Condition

Method to query other organizations for data and matching to the consumer is available

Pre-Condition

If physical media is used for the transport, when the media is read the consent directives stored on the portable media need to be enforced by the portable media importer. The validity of these content directives may need to be checked

Post-Condition

HITSP/C62 Unstructured Document

The HITSP Unstructured Document Component is provided for the capture and storage of patient identifiable, unstructured document content, such as text, PDF, and images rendered in PDF. It is based on the Cross-Enterprise Sharing of Scanned Documents (XDS-SD) profile from the Integrating the Healthcare Enterprise (IHE) IT Infrastructure Technical Framework (ITI-TF)

HITSP/SC112 Healthcare Document Management

The HITSP Healthcare Document Management Service Collaboration provides the ability to share healthcare documents using a set of topologies, such as Media, e-Mail, Point-to-Point, Shared within a Health Information Exchange, and Shared within a larger community (made up of potentially diverse Health Information Exchanges)

Content Creator

1

R

Unstructured Document(HITSP/C62)

R

Content Consumer

2

R

Consumer-Document Display (HITSP/C62)

R

Consumer-Document Import(HITSP/C62)

CAP120-[201]

Send Documents

3

CAP120-[101],[102]

Healthcare Document Management (HITSP/SC112)

R

Receive Documents

4

CAP120-[101]

Healthcare Document Management (HITSP/SC112)

R

CAP120-[101]

An implementation shall choose amongst one of the interfaces defined HITSP/SC112 Healthcare Document Management. This choice is dependent on the topology chosen (See Table 3-1 Information Exchange Topologies Mapped to Capabilities above), the physical limitations, policies and processes of the implementation

CAP120-[102]

The EHR System may optionally choose to implement a Document Repository or use an external repository for the Send Documents through Share option of HITSP/SC112 Healthcare Document Management

CAP120-[201]

The Content Consumer should minimally Display the content received in the specified CDA document (i.e. HITSP/C62). Optionally, the Content Consumer may the following function:

Consumer-Document Import [Requires the Content Consumer to have the ability to import the CDA document into the patient record as a whole and display it as requested]

Electronic Health Record System

Health Information Exchange(HIE)

No Applicable Constraints

HITSP/SC112 Healthcare Document Management

The HITSP Healthcare Document Management Service Collaboration provides the ability to share healthcare documents using a set of topologies, such as Media, e-Mail, Point-to-Point, Shared within a Health Information Exchange, and Shared within a larger community (made up of potentially diverse Health Information Exchanges)

HITSP/SC115 HL7 Messaging

The HITSP HL7 Messaging Service Collaboration provides the Capability to send and receive HL7 messages. The Service Collaboration applies the necessary Security and Privacy constructs

HITSP/T67 Clinical Referral Request Transport

The HITSP Clinical Referral Request Transport Transaction will be used to transport the provider to provider (clinical) referral request interaction. It is based on the IHE Document-based Referral Request (DRR) profile which is used to bundle a referral request document with other relevant clinical documents of interest and optionally to send a trigger message to the receiving provider system

Receive Documents

1

R

Healthcare Document Management (HITSP/SC112)

R

Referral Dispatcher

2

R

Convey/Request Referral (HITSP/T67)

R

Referral Requestor

3

R

Convey/Request Referral (HITSP/T67)

R

Request HL7 Message

4

R

HL7 Messaging (HITSP/SC115)

R

Respond to HL7 Message

5

R

HL7 Messaging (HITSP/SC115)

R

Send Documents

6

CAP121-[101], [102]

Healthcare Document Management (HITSP/SC112)

R

CAP121-[101]

An implementation shall choose amongst one of the interfaces defined in HITSP/SC112 Healthcare Document Management. This choice is dependent on the topology chosen (See Table 3-1 Information Exchange Topologies Mapped to Capabilities above), the physical limitations, policies and processes of the implementation

CAP121-[102]

The EHR System may optionally choose to implement a Document Repository or use an external repository for the Send Documents through Share option of HTISP/SC112 Healthcare Document Management

Clinical Information System

Laboratory Information System

Radiology Information System

Personal Health Record (PHR) Service Provider

Knowledge Resource System

Electronic Health Record (EHR) System

Health Information Exchange (HIE) (Knowledge Resource System)

Quality Measure Processing Entity

Performance Measurement Information Resource (Knowledge Resource System)

The context-specific parameters regarding the request for medical knowledge may include consumer knowledge level, preferred language, consumer demographics (gender, age), document type (laboratory results, radiology reports). If these parameters are known, these could be used to tailor the response and the medical knowledge returned

Assumption

A userfriendly error message is displayed in the event of query failure

Post-Condition

Automatic request: Based upon predefined parameters, the requesting system may initiate, a request for medical knowledge from the Knowledge Resource

Process Trigger

Manual request: The user may initiate a request for medical knowledge from the Knowledge Resource

Process Trigger

HITSP/SC111 Knowledge and Vocabulary

The HITSP Knowledge and Vocabulary Service Collaboration provides the ability to retrieve medical knowledge and terminology

Request Medical Knowledge

1

R

Knowledge and Vocabulary (HITSP/SC111)

R

Respond Medical Knowledge

2

R

Knowledge and Vocabulary (HITSP/SC111)

R

Request Value Set

3

R

Knowledge and Vocabulary (HITSP/SC111)

R

Respond Value Set

4

O

Knowledge and Vocabulary (HITSP/SC111)

R

No Applicable Condition Codes

Electronic Health Record (EHR) System

Immunization Information System (IIS)

Quality Measure Processing Entity

No Applicable Constraints

HITSP/C19 Entity Identity Assertion

The HITSP Entity Identity Assertion Component ensures that an entity is the person or application that claims the identity provided

HITSP/SC113 Query for Existing Data

The HITSP Query for Existing Data Service Collaboration provides the Capability to query and retrieve data from another clinical system, and the Capability to respond to same queries. It applies the necessary Security and Privacy constructs and supports all the queries found in HITSP/TP21

HITSP/TP21- Query for Existing Data

The HITSP Query for Existing Data Transaction Package supports retrieval of patient level quality data from source repositories to compile the required patient level data submission

Request Existing Patient Data

1

R

Query for Existing Data (HITSP/SC113)

CAP123-[201]

Respond to Existing Patient Data

2

R

Query for Existing Data (HITSP/SC113)

R

CAP123-[201]

Shall be applied where identity assertion is required by the jurisdiction or information sharing agreements

Repository

Electronic Health Record (EHR) System

The Laboratory has registered the laboratory result document in the Repository, and the Repository has notified the Locator Service of the document location

Pre-Condition

Result is received and is viewable or can be processed

Post-Condition

HITSP/C44 Secure Web Connection

The HITSP Secure Web Connection Component provides the Capability to access documents through a secure web browser

HITSP/SC108 Access Control

The HITSP Access Control Service Collaboration provides the mechanism for security authorizations which control the enforcement of security policies including: role-based access control, entity based access control, context based access control, and the execution of consent directives

HITSP/SC109 Security Audit

The HITSP Security Audit Service Collaboration describes the mechanism to record security relevant events in support of policy, regulation, or risk analysis. It also provides the mechanism to determine the record format to support analytical reports that are needed

HITSP/T17 Secured Communication Channel

The HITSP Secured Communication Channel Transaction provides the mechanisms to ensure the authenticity, integrity, and confidentiality of transmissions, and the mutual trust between communicating parties. Its objectives include providing: mutual node authentication to assure each node of the others identity; transmission integrity to guard against improper information modification or destruction while in transit; and transmission confidentiality to ensure that information in transit is not disclosed to unauthorized individuals, entities, or processes

HITSP/T18 View Laboratory Results from a Web Application

The HITSP View Laboratory Results from a Web Application Transaction allows a user to view a laboratory report through a secure browser. This Transaction uses the HITSP/C44 Secure Web Connection Component. It may not define all functions, constructs and standards necessary to implement a conforming system in a real world environment. In particular, an implementer must provide the technical infrastructure and security framework necessary to support operations in accordance with law, regulation, best practices and business agreements

Web Server

1

R

View Laboratory Results (HITSP/T18)

Secure Web Connection (HITSP/C44)

R

R

Node

2

R

Secured Communication Channel (HITSP/T17)

R

Request access control decision

3

R

Access Control (HITSP/SC108)

R

Send Security Audit Event

4

R

Security Audit (HITSP/SC109)

R

No Applicable Condition Codes

Genetic Clinical Decision Support System

Electronic Health Record (EHR) System

No Applicable Constraints

HITSP/C90 Clinical Genomic Decision Support

The HITSP Family History Decision Support for Genetic Risk Analysis Component is used to communicate genetic and family history information from healthcare IT applications to a clinical decision support system that provides an assessment of genetic risk of disease for a patient. It uses the HL7 Version 3 Standard: Clinical Genomics; Pedigree, Release 1 to support the communication of genetic and family history information to the clinical decision support system, and to support the communication of risk information from that system back to the originator

HITSP/SC112 Healthcare Document Management

The HITSP Healthcare Document Management Service Collaboration provides the ability to share healthcare documents using a set of topologies, such as Media, e-Mail, Point-to-Point, Shared within a Health Information Exchange, and Shared within a larger community (made up of potentially diverse Health Information Exchanges)

Content Creator

1

CAP125-[101]

Content Creator-Family History (HITSP/C90)

R

Content Consumer

2

R

Content Consumer Genetic Risk Analysis (HITSP/C90)

CAP125-[101]

Send Documents

3

CAP125-[102], [103]

Healthcare Document Management (HITSP/SC112)

R

Receive Documents

4

CAP125-[102]

Healthcare Document Management (HITSP/SC112)

R

CAP125-[101]

Shall be supported if this system is being used to provide genetic counseling

CAP125-[102]

An implementation shall choose amongst one of the interfaces defined in HITSP/SC112 Healthcare Document Management. This choice is dependent on the topology chosen (See Table 3-1 Information Exchange Topologies Mapped to Capabilities above), the physical limitations, policies and processes of the implementation

CAP125-[103]

The EHR System may optionally choose to implement a Document Repository or use an external repository for the Send Documents through Share option of HITSP/SC112 Healthcare Document Management

Electronic Health Record (EHR) System

Infrastructure Services

Laboratory Information System

Health Information Exchange (HIE)

Public Health Information System

Clinical Information System

Diagnostic Imaging Information System

Laboratory results are only sent to the prescribing physician; all others receive notification, due to HIPAA regulation

Assumption

An order for a laboratory test has been created and accepted by the performing laboratory

Pre-condition

The order contains an electronic address of all authorized electronic recipients

Pre-condition

Result is received and is viewable or can be processed

Post-condition

HITSP/C35 Lab Result Terminology

The HITSP Lab Result Terminology Component defines the vocabulary for either message-based or document-based laboratory results reporting

HITSP/C36 Lab Result Message

The HITSP Lab Result Message Component describes the use of a constrained Health Level Seven (HL7) Version 2.5.1 ORU Unsolicited Observation Message for electronic laboratory results reporting

HITSP/C87 Anonymize Public Health Case Reporting Data

The HITSP Anonymize Public Health Case Reporting Data Component provides specific instructions for anonymizing data that was created as part of routine clinical care data delivery in preparation for repurposing data for public health case reporting. This construct defines the Component specification that provides the ability to anonymize patient identifiable information. Anonymization, according to the International Organization for Standardization (ISO), is the process that removes the association between the identifying data set and the data subject

HITSP/SC115 HL7 Messaging

The HITSP HL7 Messaging Service Collaboration provides the Capability to send and receive HL7 messages. The Service Collaboration applies the necessary Security and Privacy constructs

HITSP/T14 Send Laboratory Result Message

The HITSP Send Laboratory Result Message Transaction supports: Transmission of complete, preliminary, final and updated laboratory results to the EHR system (local or remote) of the ordering clinician; and transmission of complete, preliminary, final and updated laboratory results (or notification of the availability of laboratory results) to the EHR system (local or remote) or other clinical data system of designated providers of care (with respect to a specific patient)

HITSP/T24 Pseudonymize

The HITSP Pseudonymize Transaction describes a framework for including Pseudonymization Services where the use of dummy or pseudo references to specific patients or providers is required. Pseudo-identifiers are intended to allow accessibility to clinical information, while safeguarding any information that may compromise the privacy of the individual patient or provider. Using pseudo-identifiers can assist in compliance with HIPAA regulations regarding suppression of patient identification information

Content Creator

1

R

Lab Result Terminology (HITSP/C35)

R

O

Lab Result Message (HITSP/C36)

R

CAP126-[101]

Pseudonymization Request (HITSP/T24)

R

CAP126-[102]

Anonymize (HITSP/C87)

R

Content Consumer

2

R

Laboratory Result General Laboratory Subset (See Section3.11.2.5.1)(HITSP/C36)

R

Laboratory Result Microbiology Subset (See section 3.11.2.5.2)(HITSP/C36)

R

Laboratory Result Terminology General Laboratory Subset (See section 3.11.2.5.1)(HITSP/C35)

R

Laboratory Result Terminology Microbiology Subset (See section 3.11.2.5.2)(HITSP/C35)

R

Laboratory Result Message Sender

3

R

Send Lab Result Message (HITSP/T14)

R

Lab Result Terminology (HITSP/C35)

R

Lab Result Message (HITSP/C36)

R

Laboratory Result Message Receiver

4

R

Send Lab Result Message (HITSP/T14)

R

Lab Result Terminology (HITSP/C35)

R

Lab Result Message (HITSP/C36)

R

Request HL7 Message

5

R

HL7 Messaging (HITSP/SC115)

R

Respond to HL7 Message

6

R

HL7 Messaging (HITSP/SC115)

R

CAP126-[101]

Shall be applied where pseudonymization is required by the jurisdiction or information sharing agreements or selected by PHR

CAP126-[102]

Shall be applied where anonymization is required by the jurisdiction or information sharing agreements or selected by PHR

Electronic Health Record (EHR) System

Laboratory Information System

Health Information Exchange (HIE)

Infrastructure Services

Public Health Information System

Clinical Information System

Diagnostic Imaging Information System

Personal Health Record (PHR) System

Emergency Communications System

No Applicable Constraints

HITSP/C25 Anonymize

The HITSP Anonymize Component provides specific instruction for anonymizing data that are prepared for repurposing data created as part of routine clinical care delivery. This construct defines the Component specification that provides the ability to anonymize patient identifiable information

HITSP/C35 Lab Result Terminology

The HITSP Lab Result Terminology Component defines the vocabulary for either message-based or document-based laboratory results reporting

HITSP/C37 Lab Report Document

The HITSP Lab Report Document Component prescribes the use of the standard Clinical Document Architecture Release 2 (CDA R2), as in the HL7 V3 2006 normative edition profiled by IHE LAB TF-3 for: transmission of complete, preliminary, final and updated laboratory results to the EHR system (local or remote) of the ordering clinician; transmission of complete, preliminary, final and updated (or notification) to the EHR system (local or remote) or other clinical data system of designated providers of care (with respect to a specific patient); transmission of laboratory result data from electronically enabled healthcare delivery and public health systems in standardized and anonymized format to authorized Public Health Agencies with less than one day lag time

HITSP/C87 Anonymize Public Health Case Reporting Data

The HITSP Anonymize Public Health Case Reporting Data Component provides specific instructions for anonymizing data that was created as part of routine clinical care data delivery in preparation for repurposing data for public health case reporting. This construct defines the Component specification that provides the ability to anonymize patient identifiable information. Anonymization, according to the International Organization for Standardization (ISO), is the process that removes the association between the identifying data set and the data subject

HITSP/SC111 Knowledge and Vocabulary

The HITSP Knowledge and Vocabulary Service Collaboration provides the ability to retrieve medical knowledge and terminology

HITSP/SC112 Healthcare Document Management

The HITSP Healthcare Document Management Service Collaboration provides the ability to share healthcare documents using a set of topologies, such as Media, e-Mail, Point-to-Point, Shared within a Health Information Exchange, and Shared within a larger community (made up of potentially diverse Health Information Exchanges)

Content Consumer

1

R

Consumer-Document Display Subset(See section 3.12.2.5.1) (HITSP/C37)

R

Consumer-Document Import Subset(See section 3.12.2.5.2) (HITSP/C37)

R

Consumer-Lab Report Discrete Data General Laboratory Import Subset(See section 3.12.2.5.3) (HITSP/C37)

R

Consumer-Lab Report Discrete Data Microbiology Import Subset (See section 3.12.2.5.4)(HITSP/C37)

CAP127 [201]

Laboratory Result Terminology General Laboratory Subset (See section3.12.2.5.5)(HITSP/C35)

R

Laboratory Result Terminology Microbiology Subset (See section 3.12.2.5.6)(HITSP/C35)

R

Content Creator

2

R

Lab Report Document (HITSP/C37)

R

Anonymize (HITSP/C25)

R

R

Anonymize ( HITSP/ C87)

R

Send Documents

3

CAP127-[101], [102]

Healthcare Document Management (HITSP/SC112)

R

Receive Documents

4

CAP127-[101]

Healthcare Document Management (HITSP/SC112)

R

Request Value Set

5

R

Knowledge and Vocabulary (HITSP/SC111)

R

CAP127-[101]

An implementation shall choose amongst one of the interfaces defined in HITSP/SC112 Healthcare Document Management. This choice is dependent on the topology chosen (See Table 3-1 Information Exchange Topologies Mapped to Capabilities above), the physical limitations, policies and processes of the implementation

CAP127-[102]

The EHR System may optionally choose to implement a Document Repository or use an external repository for the Send Documents through Share option of HTISP/SC112 Healthcare Document Management

CAP127-[201]

If an implementation claims to manage microbiology data, it must support this subset

Electronic Health Record (EHR) System

Laboratory Information Systems

Infrastructure Services

Health Information Exchange (HIE)

Public Health Information System

Clinical Information System

Diagnostic Imaging Information System

Personal Health Record (PHR) System

Emergency Communications System

No Applicable Constraints

HITSP/SC111 Knowledge and Vocabulary

The HITSP Knowledge and Vocabulary Service Collaboration provides the ability to retrieve medical knowledge and terminology

HITSP/SC112 Healthcare Document Management

The HITSP Healthcare Document Management Service Collaboration provides the ability to share healthcare documents using a set of topologies, such as Media, e-Mail, Point-to-Point, Shared within a Health Information Exchange, and Shared within a larger community (made up of potentially diverse Health Information Exchanges)

HITSP/TP89 - Sharing Imaging Results

The Sharing Imaging Results Transaction Package supports the process of sharing medical imaging results data. Imaging results data are captured as part of the normal process of care performed by healthcare providers. This data can be made available through document sharing for both clinical care and public health purposes

Imaging Document Consumer

1

R

Retrieve Images [RAD-16] (HITSP/TP89)

CAP128- [201]

WADO Retrieve [RAD-55] (HITSP/TP89)

CAP128- [201]

Receive Documents

2

CAP128-[101]

Healthcare Document Management (HITSP/SC112)

R

Send Documents

3

CAP128-[101], [102]

Healthcare Document Management (HITSP/SC112)

R

Request Value Set

4

R

Knowledge and Vocabulary (HITSP/SC111)

R

Request Medical Knowledge

5

R

Knowledge and Vocabulary (HITSP/SC111)

R

Respond Medical Knowledge

6

R

Knowledge and Vocabulary (HITSP/SC111)

R

CAP128-[101]

An implementation shall choose amongst one of the interfaces defined in HITSP/SC112 Healthcare Document Management. This choice is dependent on the topology chosen (See Table 3-1 Information Exchange Topologies Mapped to Capabilities above), the physical limitations, policies and processes of the implementation

CAP128-[102]

The EHR System may optionally choose to implement a Document Repository or use an external repository for the Send Documents through Share option of HITSP/SC112 Healthcare Document Management

CAP128-[201]

System shall support at least one of these interfaces to communicate image content

Electronic Health Record (EHR) System

Health Information Exchange (HIE)

Quality Measure and Reporting Enterprise

Quality Measure Processing Entity

Pre-implementation certification/audit of the process (e.g., integrator/vendor certification)

Pre-condition

This specification will assume clearly defined measures as a Pre-condition. (See AQA for Heart Failure set of measures as an example of a clearly defined measure)

Pre-condition

The 'EHR' referenced may include any information system contained in any clinical and/or financial system supporting patient care and may be used for quality analysis; Augmentation is information that does not exist in an electronic form in the described systems

Assumptions

Claims data are available to CIS during compilation of historical and supplemental information retrieval

Assumptions

Clinical care documentation is available in an electronic format so that measure data can be provided in electronic form

Assumptions

Assume that there may be a statistician encoding the rules, and that the implementation of the mathematical formula is not specified in the Interoperability Specification and is left to product innovation

Assumptions

For each measure, wherever analyzed, the calculation algorithm is the same

Assumptions

Changes in measures can be tracked over time (NOTE: a likely solution is versioning)

Assumptions

Minimum dataset requirements for quality measurement are established

Pre-condition

There is policy surrounding sharing of this data, refuting data pre and post publication, and release of risk-adjusted public dissemination. Internal risk management policies surrounding public disclosures will be defined by organizational and public policy

Assumptions

Measures are available for quality improvement feedback and for measurement developer

Post-Conditions

An audit is performed to ensure the integrity and accuracy of the measurement and reporting program

Post-Conditions

The information recipient MAY further translate from the standard format to a local format at the system edge

Post-Conditions

Patient level data are ready for submission for measurement calculation

Trigger

HITPS/SC111 - Knowledge and Vocabulary

The HITSP Knowledge and Vocabulary Service Collaboration provides the ability to retrieve medical knowledge and terminology

HITSP/C105 Patient Level Quality Data Document Using HL7 Quality Reporting Document Architecture (QRDA)

The HITSP Patient Level Quality Data Document Using HL7 Quality Reporting Document Architecture Component supports the communication of patient level quality data for quality measurement in a document sharing environment. Patient encounter data are compiled from both the local systems and from longitudinal data available through a Health Information Exchange (HIE) prior to communicating the retrieved data described in this construct for analysis

HITSP/C25 Anonymize

The HITSP Anonymize Component provides specific instruction for anonymizing data that are prepared for repurposing data created as part of routine clinical care delivery. This construct defines the Component specification that provides the ability to anonymize patient identifiable information

HITSP/C34 Patient Level Quality Data Message

The HITSP Patient Level Quality Data Message Component supports the process of sending patient data from a Quality Message Sender to a Quality Message Receiver for further analysis and aggregation. Patient data are captured as part of the normal process of care performed by healthcare providers such as hospitals, emergency departments and outpatient clinics

HITSP/SC112 Healthcare Document Management

The HITSP Healthcare Document Management Service Collaboration provides the ability to share healthcare documents using a set of topologies, such as Media, e-Mail, Point-to-Point, Shared within a Health Information Exchange, and Shared within a larger community (made up of potentially diverse Health Information Exchanges)

HITSP/SC115 HL7 Messaging

The HL7 Messaging service collaboration provides the capability to send and receive HL7 messages. The Service Collaboration applies the necessary Security and Privacy constructs

HITSP/C26 - Nonrepudiation of Origin

The Nonrepudiation of Origin Component provides the mechanisms to support Nonrepudiation of Origin, which refers to both the proof of the integrity and origin of documents in a high-assurance manner, which can be verified by any party. This Component does not provide Nonrepudiation of Receipt

Request HL7 Message

1

CAP129-[103], [104]

HL7 Messaging (HITSP/SC115)

R

Respond to HL7 Message

2

CAP129-[103], [104]

HL7 Messaging (HITSP/SC115)

R

Content Creator

3

R

Patient Level Quality Data Message Component (HITSP/C34)

CAP129-[201]

R

Patient Level Quality Document Component (HITSP/C105)

CAP129-[201]

R

Anonymize (HITSP/C25)

CAP129-[202]

R

Nonrepudiation of Origin (HITSP/C26)

CAP129-[205]

Content Consumer

4

R

Patient Level Quality Data Message Component (HITSP/C34)

CAP129-[201]

R

Patient Level Quality Document Component (HITSP/C105)

CAP129-[201]

R

Nonrepudiation of Origin (HITSP/C26)

CAP129-[205]

Send Documents

5

CAP129-[101], [102]

Healthcare Document Management (HITSP/SC112)

R

Receive Documents

6

CAP129-[101]

[105]

Healthcare Document Management (HITSP/SC112)

CAP129-[204], [203]

CAP129-[101]

An implementation shall choose amongst one of the interfaces defined in HITSP/SC112 Healthcare Document Management. This choice is dependent on the topology chosen (See Table 3-1 Information Exchange Topologies Mapped to Capabilities above), the physical limitations, policies and processes of the implementation

CAP129-[102]

The EHR System may optionally choose to implement a Document Repository or use an external repository for the Send Documents through Share option of HTISP/SC112 Healthcare document Management

CAP129-[103]

Shall be applied for message-based functional flow

CAP129-[104]

System shall support at least one of these interfaces

CAP129-[105]

NAV may be required by implementation to support notification of document availability

CAP129-[201]

Shall support either HITSP Patient level Quality Message Component or HITSP Patient level Quality Document Component, or both

CAP129-[202]

Shall be applied wh ere anonymization is required by the jurisdiction or information sharing agreements

CAP129-[203]

Shall support Multi-Patient Stored Query

CAP129-[204]

Shall support Document Metadata Subscription

CAP129-[205]

Shall be applied where non-repudiation is required by the jurisdiction or information sharing agreements

Electronic Health Record (EHR) System

Health Information Exchange (HIE)

Quality Measure and Reporting Enterprise

Quality Measure Processing Entity

Performance Measurement Information Resource

Hospitals and clinicians will only receive measures applicable to their population

Pre-condition

New measure or updated measure is ready to be communicated to publish, record, send, or review

Trigger

Quality measures are provided with sufficient specification to enable the electronic upload and processing of queries without the need for local interpretation. Limitation on potentially ambiguous criteria should be part of the measurement endorsement process. Measures are unambiguous, well-defined

Assumptions

HITSP/C26 - Nonrepudiation of Origin

The Nonrepudiation of Origin Component provides the mechanisms to support Nonrepudiation of Origin, which refers to both the proof of the integrity and origin of documents in a high-assurance manner, which can be verified by any party. This Component does not provide Nonrepudiation of Receipt

HITSP/C106 Measurement Criteria Document

This Component supports communication of a quality measure (aka an "eMeasure"). Clinical concepts (e.g. "atrial fibrillation", "coronary artery disease") and parameters (e.g. "numerator", "denominator") in an eMeasure are formally defined to support consistent and unambiguous interpretation. The eMeasure is standardized as a structured document, where one can capture the complete narrative of the measureand a formalized computable representation of statements

HITSP/SC108 Access Control

The HITSP Access Control Service Collaboration provides the mechanism for security authorizations which control the enforcement of security policies including: role-based access control, entity based access control, context based access control, and the execution of consent directives

HITSP/SC109 Security Audit