Description
One of the key problems in healthcare informatics
is the inability to share patient records across enterprises.
To address this problem, an important industry initiative called
"Integrating the Healthcare Enterprise (IHE)" specified
the "Cross Enterprise Document Sharing (XDS)" Profile.
In the IHE XDS, healthcare enterprises that agree to work together form a
"Clinical Affinity Domain" and store healthcare documents
in an ebXML registry/repository architecture to facilitate their
sharing. The affinity domains also agree on a common set of policies
such as coding lists to be used to annotate
clinical documents in the registry/repository and the common schemes for
patient identification. However, since patients expect their records to follow them as they move from one clinical affinity domain to another, there is a need for affinity domains to be federated to enable information exchange.
In this paper we describe how IHE XDS can be enhanced to support
federated clinical affinity domains. We demonstrate that
federation of affinity domains are facilitated when ontologies,
rather than coding term lists, are used to annotate
clinical documents.
Furthermore we describe a patient identification protocol
that eliminates the need to keep a master patient index file
for the federation.
