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Implementing Purpose Specific Records using IHE XDS

Implementing Purpose Specific Records using IHE XDS. Brief White Paper Proposal for 2008/09 presented to the IT Infrastructure Planning Committee J. Caumanns (eCR, Fraunhofer ISST, IHE-D) 16 October 2008. Motivation.

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Implementing Purpose Specific Records using IHE XDS

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  1. Implementing Purpose Specific Records using IHE XDS Brief White Paper Proposal for 2008/09 presented to the IT Infrastructure Planning Committee J. Caumanns (eCR, Fraunhofer ISST, IHE-D) 16 October 2008

  2. Motivation The EC Directive on the protection of personal data contains a number of key principles which must be complied with. Anyone processing personal data must comply with the eight enforceable principles of good practice: • Fairly and lawfully processed. • Processed for limited purposes. • Adequate, relevant and not excessive. • Accurate. • Not kept longer than necessary. • Processed in accordance with the data subject's rights. • Secure. • Not transferred to countries without adequate protection. no purpose = data retention ! source:http://en.wikipedia.org/wiki/Data_privacy#Europe

  3. Motivation EHR (LR) Patient Purpose for Data Collecting(e. g. acute care case) Purpose for Data Collecting(e. g. chronical disease) policy, access rights policy, access rights MDO MDO MDO MDO MDO MDO EHR-CR EHR-CR affinity domain affinity domain

  4. Purposes as Slices and Dices • Each purpose can be expressedas a slice or a dice of thefull n-dimensional “cube” of apatient’s data • Each purpose is associatedwith a policy: • access restrictions • content restrictions • obligations • ...

  5. Health Records: Types • Care-delivery Record (EHR-CR): A Care-delivery Record abstracts the information system or systems of a care delivery organization, which may support a broad variety of healthcare facilities. [IHE ITI 4.0]. • Longitudinal Record (EHR-LR): A longitudinal record is a collection of patient data that is contributed from multiple EHR-CRs. Such a record is often called a »patient record« or a »healthcare record« depending on the status of the provider. • Disease-oriented Record (EHR-DR): A disease-oriented record is a special kind of longitudinal record that is focussed on a single disease (or a set of closely related diseases). It only contains data from care acts that are related with this disease’s treatment. • Health-summary Record (EHR-SR): A health-summary record contains condensed medical data of a patient (e. g. medication lists and emergency data sets). • ... and probably many more

  6. Co-Existence of Multiple Record Types Strategy 1: One central, complete EHR-LR for each patient. Other record types can be “simulated” by filtering the EHR-LR. Strategy 2: Distributed, autonomous EHR-CRs as the data base. Other record types set up as an additional layer on top of EHR-CRs. Strategy 3: Records as aggregations of distributed folders (encounters).

  7. Topics to be covered by the White Paper • types of records for specific purposes (dimensions of the »cube« and the respective slices and dices) • evaluation of different approaches for implementing purpose specific records (e. g. using folders, nesting registries, multiple identifiers per patient) • dealing with overlapping records • aspects of a policy to express the purpose of a record (e. g. access restrictions) • means to bind a policy to a case specific record and to enforce that policy (i.e. how can other profiles such as BPPC and XPP be integrated) • implications on XDR and XDM • spanning purpose specific records among multiple affinity domains by using XUA, XCA, and XCPI • workflow aspects (e. g. discovering a specific record) and optimisations • life cycle aspects (e. g. the purpose is no longer given or is moving) • real-life example

  8. Editors • Jörg Caumanns (eCR, Fraunhofer ISST, IHE-D) • Jens-Uwe Thieme/Bas von Poppel (iSoft) • ...

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