July 8, 2009

Version 1.0

HITSP Harmonization Framework and Exchange Architecture Technical Note

Submitted to:

Healthcare Information Technology Standards Panel

Submitted by:

Harmonization Framework and Exchange Architecture Tiger Team

Document Change History

Version Number	Description of Change	Name of Author	Date Published
0.0.1	Review Copy	Harmonization Framework and Exchange Architecture Tiger Team	June 30, 2009
1.0	Released for Implementation	Harmonization Framework and Exchange Architecture Tiger Team	July 8, 2009

Table of Contents

1.0 Introduction. 5

2.0 Key Definitions. 6

3.0 Conceptual View of HITSP Harmonization Framework. 8

3.1 Interoperability Specification (IS) 9

3.1.1 HITSP Interoperability Specification Requirements. 10

3.1.2 HITSP IS Design Specifications. 11

3.2 Service Collaboration. 11

3.3 Security, Privacy and Infrastructure. 12

3.4 Exchange Architecture. 13

4.0 Technical View of HITSP Harmonization Framework. 16

4.1 Model Conventions. 16

4.2 Reuse. 16

4.3 Harmonization Request 17

4.4 HITSP Interoperability Specification. 18

4.4.1 Harmonization Request Interoperability Specification. 21

4.4.2 Capability Specification. 26

4.4.3 System IS. 28

4.5 HITSP Harmonization Framework Model 29

4.5.1 Walk Through of the HITSP Harmonization Framework. 30

4.5.2 Traceability of Model to HITSP IS Sections and Tables. 32

5.0 HITSP Exchange Architecture Examples. 36

5.1 Scope. 36

5.2 Exchange Architecture Examples. 36

5.2.1 HITSP/IS09 Consultations and Transfers of Care Example. 38

5.2.2 HITSP/IS04 Emergency Responder Electronic Health Record Example. 41

6.0 Standards Types and Categorization. 43

6.1 Composite and Base StandardS. 43

6.1.1 Base Standard. 43

6.1.2 Composite Standard. 43

6.2 Selected Standards. 43

6.3 Regulatory Guidance. 43

6.4 Informative References. 43

7.0 Use Declarations within a Selected Standard. 44

7.1 Use Designations and Definitions. 44

8.0 Index. 45

9.0 Document Updates. 46

9.1 June 30, 2009. 46

9.2 July 8, 2009. 46

Figures and Tables

Figure 3-1 Interoperability Specification Framework. 8

Figure 3-2 Fundamental Relationships. 9

Figure 3-3 HITSP Harmonization Framework. 10

Figure 3-4 HITSP IS Requirements. 11

Figure 3-5 Security, Privacy and Infrastructure Service Collaborations. 12

Figure 3-6 Notional Exchange Architecture Topologies. 14

Figure 3-7 Exchange Architecture Instance of HITSP/IS04 Emergency Responder 15

Figure4-1 UML Class Diagram Legend. 16

Figure 4-2 Reusable Components. 17

Figure 4-3 Harmonization Request 18

Figure 4-4 HITSP IS Types. 19

Figure 4-5 Harmonization Request IS. 21

Figure 4-6 IER-Capability Methodology Followed by HITSP. 22

Figure 4-7 HITSP Information Exchange Requirements (IERs) 23

Figure 4-8 Data Requirements. 25

Figure 4-9 Capability Associations. 26

Figure 4-10 Capability Specification. 27

Figure 4-11 SC Orchestration of Ts, TPs, Cs and other SCs. 28

Figure 4-12 System IS. 28

Figure 4-13 Model of HITSP Harmonization Framework. 29

Figure 4-14 Traceability to HITSP Interoperability Specifications. 33

Figure 5-1 UML Component Diagram Legend . 37

Figure 5-2 Simple UML Exchange Clinical Summary Capability Exchange Architecture. 38

Figure 5-3 Simple PPT "Exchange Clinical Summary" Capability Exchange Architecture. 38

Figure 5-4 HITSP/IS09 Consultations and Transfers of Care Notional Exchange Architecture. 40

Figure 5-5 Notional HITSP/IS04 ER-EHR Exchange Architecture (showing different labeling styles) 42

Table 4-1 Requirements vs. Specifications Views. 20

Table 4-2 Sample IER Table. 24

Table 4-3 Sample IS Data Requirement Table. 25

Table 4-4 Traceability to HITSP Interoperability Specifications. 34

Table 5-1 HITSP/IS09 Capabilities Applicable to Consultations and Transfers of Care Systems. 39

Table 5-2 HITSP/IS04 Capabilities Applicable to ER-EHR Systems. 41