2.0Transaction Definition

2.1 Context Overview

The Integrating the Healthcare Enterprise (IHE) Patient Demographics Query (PDQ) Integration Profile transaction is intended for use wherever Health Level Seven (HL7) messages are suitable to identify patients from a list of potentials. The IHE PDQ Integration Profile Transaction involves a request by a Patient Demographics Consumer for demographic information about patients whose demographic data matches data contained in the query message. The request is sent as a Patient Demographics query and received by a Patient Demographics Supplier. The Patient Demographics Supplier immediately processes the query and sends a Patient Demographics response to the Patient Demographics Consumer that originated the query. This response contains a list of patient demographics for matching patients if any were found. [1] The process flows in the IHE PDQ Integration Profile transaction are shown in the IHE IT Infrastructure Technical Framework, Volume 2 (IHE-ITI TF-2), Section 3.21.4.

In addition, the Pediatric Demographics option makes use of six additional demographic fields to aid record matching in databases with many pediatric records. If Pediatric Demographics are to be utilized, the additional demographic fields needed are shown in IHE IT Infrastructure (ITI) Technical Framework Supplement 2008-2009, Pediatric Demographics, Draft for Trial Implementation (August 22, 2008).

2.1.1 Transaction Constraints

Table 2-1 Transaction Constraints

Constraint
Data must be constrained as described in the data flows Section 2.1.6
The Patient Demographics Consumer interface must store and be able to communicate the data elements necessary for the Patient Demographics Supplier to be able to process the received query and return demographic information for matching patients
The Patient Demographics Supplier must be able to create a possibly empty list of matching patient demographic information solely based on the data elements received in the query message from the Patient Demographics Consumer

2.1.2 Interfaces

Table 2-2 Interfaces

Interface	Description	Used in Component/ Standard	Transaction/Content	T/C Optionality [2]
Patient Demographics Consumer	Queries the Patient Demographics Supplier for a list of patient demographic information, if any, and receives a list of corresponding patient demographic information from the Patient Demographics Supplier	IHE-ITI TF-2 Section 3.21.2	Patient Demographics Query [ITI-21]	R
Patient Demographics Consumer		IHE-ITI TF-2 Section 3.21.2	Patient Demographics and Visit Query [ITI-22]	O
Patient Demographics Supplier	Receives the query for a list of corresponding patient demographics from the Patient Demographics Consumer, sends a list of corresponding patient demographic information to the Patient Demographics Consumer, maintains one or more Patient Information Sources of patient demographics data	IHE-ITI TF-2 Section 3.21.2	Patient Demographics Query [ITI-21]	R
Patient Demographics Supplier		IHE-ITI TF-2 Section 3.21.2	Patient Demographics and Visit Query [ITI-22]	O

Implementation Constraints

Table 2-3 Interface and Transaction/Content Constraints

Constraint Code	Constraint Description
No applicable implementation constraints	NA

2.1.3 Interface Interactions

Interface interactions in the IHE PDQ Integration Profile transaction are shown in IHE-ITI TF-2, Section3.21.2.

2.1.4 Pre-conditions

Table 2-4 Pre-conditions

Pre-condition
It is expected that the security framework under which this Transaction operates is in accordance with the Interoperability Specification that references this construct. Therefore, all applicable HITSP Security and Privacy constructs are implemented as required
Patient Demographics Consumer contains patient demographic data suitable for matching
Patient Demographics Supplier maintains a list of patient demographic data suitable for matching and providing matching plus additional patient demographic data to the Patient Demographics Consumer. Security and Privacy policies will set limits on the release of patient demographics information to Patient Demographics Consumers

2.1.4.1 Process Triggers

Table 2-5 Process Triggers

Process Trigger
Triggers for Patient Demographics Consumer as described in IHE-ITI TF-2, Section 3.21.4.1.1
Triggers for Patient Demographics Supplier as described in IHE-ITI TF-2, Section 3.21.4.2.1

2.1.5 Post-conditions

Table 2-6 Post-conditions

Post-condition
Patient Demographics Consumer expanded patient demographic data for one or more patients where found by the Patient Demographics Supplier
Patient Demographics Supplier none beyond providing outputs related to this Transaction

2.1.5.1 Required Output

Table 2-7 Required Output

Required Output	Format/Usage
Patient Demographics Consumer has no specific outputs related to this Transaction	N/A
Patient Demographics Supplier outputs a Patient Demographics Response message containing, where applicable, demographic data for of one or more patients; where no list of applicable patient demographics data are found, indicators in the message as to the reason no data were provided	See Section 2.1.6 for message requirements

2.1.6 Data Flows

Consistent with the process flows discussed in Section 2.1, there are two data flows for the IHE PDQ Integration Profile Transaction:

Query to obtain Patient Demographics data from Patient Demographics Consumer to Patient Demographics Supplier

Response to a query to return Patient Demographics data from Patient Demographics Supplier to Patient Demographics Consumer

Details of these two data flows are contained in the two subsections below.

To better understand the data flows described in the two subsections below, the following definitions are applicable:

Patient Demographics Supplier: See explanation in Section 2.1.2, Interfaces

Patient Information Source: A collection of patient demographic data from one or more Patient ID Domains

Patient ID Domain: A collection of patient demographic data from a single Assigning Authority

2.1.6.1 Query Consumer to Supplier

The query portion of the IHE Patient Demographics Query Transaction (QBP^Q22), is described in IHE-ITI TF-2, Section 3.21.4.1.2. It consists of three segments: MSH, QPD and RCP.

Use of the QPD segment is described in IHE-ITI TF-2, Section 3.21.4.1.2.2. HITSP constraints on this usage are:

Data element QPD-2 must contain a unique value from the Patient Demographics Consumer that identifies each specific query message; an incrementing number may be used if desired

Data element QPD-3.4.2 must be an ISO Object Identifier (OID) and QPD-3.4.3 must contain ISO

Data element QPD-3.4.2 must be an ISO Object Identifier (OID) and QPD-8.4.3 must contain ISO and

See IHE-ITI TF-2 Table 3.21-3, for required values of QPD-3.1

See IHE TF Supplement 2008-2009 Pediatric Demographics (Draft for Trial Implementation) for optional values of QPD-3.1 for Pediatrics appropriate for HL7 Version 2.5 [3] .

2.1.6.2 Response Supplier to Consumer

The Patient Demographics response portion of the IHE Patient Demographics Query Transaction is described in IHE-ITI TF-2, Section 3.21.4.2.2. For HITSP, it consists of up to six segments: MSH, MSA, ERR, QAK, QPD, and PID.

Use of the QPD segment is described in IHE-ITI TF-2, Section 3.21.4.2.2.4.

A HITSP Constraint on this usage is that data element QPD-3.4.2 must be an ISO Object Identifier (OID) and QPD-3.4.3 must contain ISO.

Use of the PID segment is described in IHE-ITI TF-2, Section 3.21.4.2.2.5.

Table 2-8 shows additional HITSP Constraints on this usage.

Table 2-8 HITSP Additional PID Segment Constraints

SEQ	LEN	DT	OPT [4]	RPT	TBL	Data Element Name	Description / Comments
3.4.2	NA	ST	R	NA	NA	Assigning Authoritys Universal ID	Shall only contain an ISO Object Identifier (OID)
3.4.3	NA	ID	R	NA	NA	Assigning Authoritys Universal ID Type	Shall only contain ISO Note: ISO is the code that means OID
5.3	NA	ST	R2	NA	NA	Middle Names	If more than one middle name is available, all available middle names shall be concatenated with separating spaces in this component
10.3	NA	ID	O	NA	NA	Name of Coding System #1	HL70005
NA	NA	NA	NA	NA	NA	NA	Values for components 10.4 and 10.5 shall be coded as specified in HITSP/C80 Section 2.2.1.2.7 Race
11.1.1	NA	ST	O	NA	NA	Street or Mailing Address	Though not required by HL7 standard, use of national postal service standardized values is strongly recommended
11.1.2	NA	ST	O	NA	NA	Street Name
11.1.3	NA	ST	O	NA	NA	Dwelling Number
11.2	NA	ST	O	NA	NA	Other Designation	May be used for second line of Street Address
11.3	NA	ST	O	NA	NA	City	Though not required by HL7 standard, use of national postal service standardized values is strongly recommended
11.4	NA	ST	O	NA	NA	State/Province
11.5	NA	ST	O	NA	NA	ZIP/Postal Code
11.6	NA	ST	O	NA	NA	Country	NA Though not required by HL7 standard, use of the International Standards Organization Codes for Representation of Names and Countries, ISO-3166, is strongly recommended Available from American National Standards Institute, 25 West 43^rd Street, Fourth Floor, New York, NY 10036
13	250	XTN	O	Y	NA	Phone Number - Home	If repetition occurs, then first occurrence shall be the primary telephone number used for patient contact [5]
13.5		NM	O	NA	NA	Country Code	Though not required by HL7 standard, use of international and national standardized values is strongly recommended For Country Code, if no value is present, 1 assumed for United States and Canada
13.6		NM	O	NA	NA	Area/City Code
13.7		NM	O	NA	NA	Local Number
22.3	NA	ID	O	NA	NA	Name of Coding System #1	HL70189
22.6	NA	ID	O	NA	NA	NA	NA
NA	NA	NA	NA	NA	NA	NA	Values for components 22.4 and 22.5 shall be coded as specified in HITSP/C80 Section 2.2.1.2.2 Ethnicity

There are no additional HITSP constraints on the additional elements as specified in the Pediatrics Demographics option supplement.

2.2 List of HITSP Constructs

Table 2-9 List of HITSP Constructs

Construct Name	Description	Transaction/Content
No applicable constructs

2.2.1 Construct Dependencies

Table 2-10 Construct Dependencies

Construct	Depends On (Name of Component that it depends on)	Dependency Type (Pre-condition, post-condition, general)	Purpose (Reason for this dependency)
No applicable dependencies

2.2.2 Additional Constraints on Required Constructs

Table 2-11 Additional Constraints on Required Constructs

Data Element	Construct	Constraint	Constraint Type (Pre-condition, post-condition, general)	Purpose (Reason for this constraint)
No applicable constraints

2.3 Standards

2.3.1 Regulatory Guidance

Table 2-12 Regulatory Guidance

Regulation	Description
No applicable regulatory guidance

2.3.2 Selected Standards

Table 2-13 Selected Standards

Standard	Description
Health Level Seven (HL7) Version 2.5, Chapter 2 Control, Chapter 3 Patient Administration, Chapter 5 - Query	The HL7 Version 2.5 Messaging Standard is an application protocol for electronic data exchange in healthcare. It and prior versions have widespread use in the U.S. and internationally. Both message formats and value sets / code tables (e.g., diagnosis type, gender, patient class, result status, specimen collection method, abnormal flags, observation result status codes interpretation, timestamp format) are contained in the standard. For more information visit www.hl7.org
Integrating the Healthcare Enterprise (IHE) IT Infrastructure Technical Framework (ITI-TF) Revision 5.0 or later, Patient Demographics Query (PDQ) Integration Profile	Provides ways for multiple distributed applications to query a central patient information server for a list of patients, based on user-defined search criteria, and retrieve a patients demographic (and, optionally, visit or visit-related) information directly into the application. For more information visit www.ihe.net
Integrating the Healthcare Enterprise (IHE) IT Infrastructure Technical Framework (ITI-TF) Supplement 2008 - 2009, Pediatric Demographics, Draft for Trial Implementation (August 22, 2008)	The experience of immunization registries and other public health population databases has shown that matching and linking patient records from different sources for the same individual person in environments with large proportions of pediatric records requires additional demographic data. Pediatric Demographics makes use of the following six additional demographic fields to aid record matching in databases with many pediatric records. The latest version of the IHE Technical Framework is available at www.ihe.net

2.3.3 Informative Reference Standards

Table 2-14 Informative Reference Standards

Standard	Description
No applicable informative reference standards

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