1.0 Introduction

HITSP/C19 - Entity Identity Assertion

The Entity Identity Assertion Component provides the mechanisms to ensure that an entity is the person or application that claims the identity provided. An example of this Component is the validation and assertion of a consumer logging on to a Personal Health Record (PHR) system

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

The 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 promote interoperability between participating systems such as Personal Health Record Systems (PHRs), Electronic Health Record Systems (EHRs), Practice Management Applications and others.

HITSP/C35 - Lab Result Terminology

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

HITSP/C36 - Lab Result Message

The 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/C37 - Lab Report Document

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

The 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/C62 - Unstructured Document

The 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/C75 - Healthcare Associated Infection (HAI) Report

The 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/C76 - Case Report Pre-Populate

The Case Report Pre-Populate Component supports the Data Mapping needed for Public Health Case Reports. Initially the Component supports only those data attributes that are universal or pertain to Drug Safety reporting. For those attributes that are universal in case reporting, this component may be used in support of pre-populating the remaining report types. However, other public health specific attributes will be addressed in subsequent releases

HITSP/C80 - Clinical Document and Message Terminology

The 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/C82 - Emergency Common Alerting Protocol

The Emergency Common Alerting Protocol Component selects the OASIS Common Alerting Protocol (CAP) v1.1 standard, and is used as a multicast notification message sent to an identified channel. The intended recipients are populations such as all emergency departments in XXX county, within a geographic area, etc

HITSP/C83 - CDA Content Modules

The 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/C87 - Anonymize Public Health Case Reporting Data

The 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/T14 - Send Laboratory Result Message

The 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/T15 - Collect and Communicate Security Audit Trail

The Collect and Communicate Security Audit Trail Transaction is a means to provide assurance that security policies are being followed or enforced and that risks are being mitigated. This document describes the mechanisms to define and identify security relevant events and the data to be collected and communicated as determined by policy, regulation or risk analysis. It also provides the mechanism to determine the record format to support analytical reports that are needed

HITSP/T16 - Consistent Time

The Consistent Time Transaction provides a mechanism to ensure that all of the entities that are communicating within the network have synchronized system clocks

HITSP/T17 - Secured Communication Channel

The 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/T23 - Patient Demographics Query

The Patient Demographics Query Transaction is intended to provide a list patients and their demographics query/patient(s) and their demographics identified response message pair (QBP^Q22, RSP^K22) for use wherever such needs exist. This Transaction document extracts the Health Level Seven (HL7) version 2.5 Query and Response data mapping. The underlying basis for this extraction can be found in the Integrating the Healthcare Enterprise IT Infrastructure Technical Framework, Patient Demographics Query integration profile

HITSP/T24 - Pseudonymize

The 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

HITSP/T29 - Notification of Document Availability

The Notification of Document Availability Transaction is based on the Integrating the Healthcare Enterprise (IHE) IT Infrastructure Technical Framework (TF) Supplement - Notification of Document Availability (NAV). The Notification of Document Availability Transaction defines a mechanism for a healthcare stakeholder (e.g. provider, public health, etc) to notify providers or the patient about information that is available for retrieval pertaining to an identified patient. This Transaction defines the format, content, encoding and transmission of notification messages and acknowledgements between IHE NAV Actors and a known recipient (either a person or system) that participate in the same XDS Affinity Domain

HITSP/T31 - Document Reliable Interchange

The Document Reliable Interchange Transaction provides a standards-based mechanism for conveying a set of medical documents in a point-to-point network-based communication. This Transaction uses the IHE Cross-Enterprise Document Reliable Interchange (XDR) Integration Profile, a companion to the IHE Cross-Enterprise Document Sharing (XDS) Integration Profile. Cross-Enterprise Document Reliable Interchange (XDR) uses the XDS defined metadata formats in a simpler environment in which the communicating parties have agreed to a point-to-point interchange rather than communicating via document sharing

HITSP/T33 - Transfer of Documents on Media

The Transfer of Documents on Media Transaction describes both the type of media (CD-ROM, USB Memory, and e-Mail) that may be used to write the documents and provides a directory structure that must be followed in order for the contents to be successfully accessed and processed by systems. An example might be to transport data from one healthcare provider to another healthcare provider, or a healthcare consumer may wish to move the contents of a Personal Health Record (PHR) using physical media or e-Mail. This Transaction uses the IHE Cross-Enterprise Document Media Interchange Integration Profile developed by Integrating the Healthcare Enterprise (IHE), a companion to the IHE Cross-Enterprise Document Sharing (XDS) Integration Profile

HITSP/T63 - Emergency Message Distribution Element

The Emergency Message Distribution Element Transaction selects the Emergency Data Exchange Language (EDXL) Distribution Element (DE) v1.0 standard, and is a multicast notification message sent to an identified population (assume this is not to the general public, but to specifically identified populations, such as emergency departments)

HITSP/T64 - Identify Communication Recipients

The Identify Communication Recipients Transaction is intended to serve the purpose of identification of communication recipients and the subsequent purpose of delivery of alerts and bi-directional communications (e.g., public health agencies notifying a specific group of service providers about an event.) The method and criteria by which individuals are added to a directory is a policy decision, which is out of scope for this construct. It uses the Integrating the Healthcare Enterprise (IHE) Personnel White Pages profile which provides access to basic directory information for identifying one or more recipients

HITSP/T66 - Retrieve Value Set

The Retrieve Value Set Transaction is used to transform human or computer vocabularies. For example, it can be used to convert the initial capture of a human-readable concept into a computer vocabulary captured in a document or message that will be communicated. It may also be used in the reverse, to take computer vocabulary and convert to human-readable form

HITSP/T81 - Retrieval of Medical Knowledge

The Retrieval of Medical Knowledge Transaction enables the request and receipt of additional knowledge about a medical concept based on specific context parameters. This transaction does not prescribe the knowledge content of the message returned but provides the specifications for the query for and receipt of additional knowledge. It uses the Health Level 7 (HL7) Context-Aware Information Retrieval (Infobutton) Specification: URL Implementation Guide as the base standard for implementation

HITSP/TP13 - Manage Sharing of Documents

The Manage Sharing of Documents Transaction Package supports the sharing of patient records in the form of source attested objects called documents. A healthcare document is a composite of structured and coded health information, both narrative and tabular, that describes acts, observations and services for the purpose of exchange. No assumption is made by this construct in terms of the format and structure of the content of documents shared

HITSP/TP20 - Access Control

The Access Control Transaction Package 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. An example of this is a functional role that has the permission to perform an act (e.g., consumer updating a Personal Health Record (PHR). In an emergency, this construct must support the capability to alter access privileges to the appropriate level (failsafe/emergency access), which may include override of non-emergency consents

HITSP/TP21 - Query for Existing Data

The Query for Existing Data Transaction Package is based on the IHE Query for Existing Data Integration Profile (QED) which supports dynamic queries for clinical data, including vital signs, problems, medications, immunizations, diagnostic results, procedures and visit history. A wide variety of systems often needs access to dynamic clinical information stored and maintained in an EMR system or other clinical data repository. The construct makes the information widely available to other systems within and across enterprises to support provision of better clinical care

HITSP/TP22 - Patient ID Cross-Referencing

The Patient ID Cross-Referencing Transaction Package is used for identifying and cross-referencing different attributes for the same patient. It contains a query for cross-reference and patient identity feed transactions. These transactions are used to identify patients from a list of potentials, and/or to communicate patient demographic data

HITSP/TP30 - Manage Consent Directives

The Manage Consent Directives Transaction Package describes the messages needed to capture, manage, and communicate rights granted or withheld by a consumer to one or more identified entities in a defined role to access, collect, use or disclose individually identifiable health information (IIHI), and also supports the delegation of the patients right to consent. The transactions described in this construct are intended to be carried out by HITSP/TP13 - Manage Sharing of Documents

HITSP/TP50 - Retrieve Form for Data Capture

The Retrieve Form for Data Capture Transaction Package enables capture of supplemental data variables not typically maintained in an electronic health record or laboratory information system through a more seamless integration with the local information system. This allows for the local system to retrieve a form specific to the identified potential public health threat. In the context of quality, it allows for the local system to capture supplemental data elements required for quality reporting that may not be available to the electronic health record

Reference Document

Document Description

HITSP Interoperability Specification Overview

Provides background information about the HITSP and its role in the overall U.S. efforts to realize large scale interoperability of health information. The document also provides a description of the HITSP process for healthcare standards harmonization and explains how to use the Interoperability Specifications and other related documents to inform your health IT system development or refinement

HITSP Conventions List

Describes the conventions that are used to convey the full descriptions and usage of standards in the HITSP specifications

HITSP Acronyms List

Lists and defines the acronyms used in this document

HITSP Glossary

Provides definitions for relevant terms used by HITSP documents

HITSP Harmonization Framework

Describes the current framework within which the Interoperability Specifications are built

Public Health Case Reporting Detailed Use Case, March 21, 2008

AHIC Use Case that is the basis of this Interoperability Specification

TN900 - Security and Privacy Technical Note

Developed as a reference document to provide the overall context for use of the HITSP Security and Privacy constructs. It includes the following:

The scope, reference policy background, and Security and Privacy principles used in the development of the constructs

A detailed description and schematics of the conceptual relationship between the Security and Privacy constructs

A mapping of existing standards and constructs to be used in meeting the stated requirements of the AHIC Use Cases

A list of identified gaps and the recommended approaches to resolving those gaps

A roadmap for how the Security and Privacy constructs will evolve and eventually align with other HITSP Interoperability Specifications

A conceptual framework for Security and Privacy management, including reference information on privacy policies, risk assessment, and risk management

A description of the application of the Security and Privacy constructs to the HITSP Interoperability Specifications for the three initial AHIC Use Cases Biosurveillance, Electronic Health Records - Laboratory Results Reporting, and Consumer Empowerment

HITSP will periodically update this Technical Note as required by the introduction of new contexts for use.

TN901 - Technical Note for Clinical Documents

Developed as a reference document to provide the overall context for use of the HITSP Care Management and Health Records constructs. It includes the following:

The scope, background, and principles for use in the development of the CMHR constructs

A detailed description and schematics of the relationship between CMHR constructs

A conceptual framework for the construction of clinical documents

An overview of Clinical Document concepts

An overview of Vocabulary concepts