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The IHE IT-Infrastructure committee continues to produce new and improved specifications for HIE interoperability. It is intended to be read by HIE and Healthcare IT Executives and Architects, Standards Development Architects, and health data exchange stakeholders in academia.
HIE-Whitepaper -- the whitepaper needed to be updated to include the FHIR based models that we have published in the MHD family. This also includes the use of QEDm and mXDE to make FHIR Resource level data available from the shared documents, making consumption more easy. StructureDefinition) and inclusion of examples.
Two independent projects this week sent to the FHIR mailing list their diagrams of how they are using FHIR as an API to classic XDS environments. The power of using FHIR as a simplifying API to classic environments. Our project will use FHIR as an abstraction layer for the application. These are great examples.
This is an update of what is going on in Security and Privacy in, and around, the FHIR specification. This is an update of what is going on in Security and Privacy in, and around, the FHIR specification. GDPR driven activities: The Security WG has done an assessment of FHIR in the context of GDPR.
That is that the HIE is designed for ONE purpose. For example a Health Information Exchange (HIE) that is designed for supporting Treatment. It is being considered to be added to SMART-on-FHIR , but is not fundamental there. Today a custodian trusting SMART-on-FHIR must presume Purpose from the indirect means.
Some examples where BPPC are used: Connecticut HIE: For release of Privileged Care information, a consent document SHALL be registered with HITE-CT in the form of a BPPC conformant document using the Opt-in for Legally Protected Data (ALL) policy. This article is all about IHE Document Sharing, and not about FHIR. Table 10.2.3-1
The IHE-MHDS does not define a Document Repository Actor but does include architecture support for distributed FHIR Servers and thus the concept of a Document Repository is included in MHDS. For example: XCA also does not make a distinction between a Document Registry or Document Repository, having a Responding Gateway Actor.
I have been made aware of Utah HIE that has a checkbox on their Consent to forbid break-glass. This is a consent only for HIE, not for within a hospital environment; but it is relevant to our FHIR consent (and CDA consent) work. It is a general form that the Patient has some check boxes they can choose.
But despite the availability of FHIR and of APIs from many vendors, interoperability is often described as “difficult and “not frictionless” according to Loyd Bittle, CEO and Founder at Innovar Healthcare. Patients, regulators, and payers are insisting on data exchange in health care.
Is this just another HIE? Of note, the XCPD, XCA, and XDR profiles do not currently support FHIR natively. These are just examples and may vary based on the organization’s existing technical infrastructure and requirements. The table below is an overview of Access-provided features and services.
For example, we all have a favorite gas station based on where we live and what our price and snack preferences are, this is an area where having different choices is great. FHIR-based API usage by Payers (Government and Commercial) in the next few years will usher in enriched datasets to TEFCA networks.
The recommendation I give here is restricted to the gross level: for Document Sharing at the XDS/XCA/DocumentReference metadata level; for FHIR REST at the returned Bundle.meta.security level, but not on each Resource in the Bundle; and for CDA at the CDA header, but not on each element. Available from the FHIR specification for easy reading.
Another example is only documents covering the last 6 months by specifying a StartTimeFrom and leaving open the stop time. IHE FormatCodes are mandatory In Wisconsin we have Interoperability What is MHD beyond XDS-on-FHIR? IHE FormatCodes are mandatory In Wisconsin we have Interoperability What is MHD beyond XDS-on-FHIR?
Add an ITI-65 FHIR Documents Publish option with support in ITI-65 to include a FHIR Document Bundle as an alternative to Binary. Converted from PDF to a FHIR IG. Added in conformance resources and Basic AuditAudit events with examples. There may be some of APPC brought in given the functionality of FHIR Consent.
Where the combined list is available in FHIR as a ValueSet of FormatCodes (updated in current build ) Important background :: Eating an Elephant -- How to approach IHE documentation on Health Information Exchange (HIE) and Healthcare Metadata The FormatCode is there to differentiate 'technical format'. So it is related to mime-type.
Micky is also active in the industry at a local and national level, including being on the Board of Directors of the New England Health Exchange Network (NEHEN), the Sequoia Project, the CARIN Alliance, and the FHIR Foundation and the Project Manager of the Argonaut Project, an industry collaboration to accelerate the adoption of FHIR.
Micky is also active in the industry at a local and national level, including being on the Board of Directors of the New England Health Exchange Network (NEHEN), the Sequoia Project, the CARIN Alliance, and the FHIR Foundation and the Project Manager of the Argonaut Project, an industry collaboration to accelerate the adoption of FHIR.
Micky is also active in the industry at a local and national level, including being on the Board of Directors of the New England Health Exchange Network (NEHEN), the Sequoia Project, the CARIN Alliance, and the FHIR Foundation and the Project Manager of the Argonaut Project, an industry collaboration to accelerate the adoption of FHIR.
Micky is also active in the industry at a local and national level, including being on the Board of Directors of the New England Health Exchange Network (NEHEN), the Sequoia Project, the CARIN Alliance, and the FHIR Foundation and the Project Manager of the Argonaut Project, an industry collaboration to accelerate the adoption of FHIR.
HIE-Whitepaper IHE publications in html * kanban has not been started as too much is in flux * publications github where we are doing our work [link] publications * meeting minutes [link] IHE/publications/wiki * html rendering of current work for committee review (not proper external publication) [link] github.io/publications/
This is described in the Enabling Document Sharing through IHE Profiles white paper (HIE using IHE). A Community deploying an HIE this way needs to define some metadata constraints and practices, so that the documents are found when they are needed. Each document shared is described by metadata.
Micky is also active in the industry at a local and national level, including being on the Board of Directors of the New England Health Exchange Network (NEHEN), the Sequoia Project, the CARIN Alliance, and the FHIR Foundation and the Project Manager of the Argonaut Project, an industry collaboration to accelerate the adoption of FHIR.
Micky is also active in the industry at a local and national level, including being on the Board of Directors of the New England Health Exchange Network (NEHEN), the Sequoia Project, the CARIN Alliance, and the FHIR Foundation and the Project Manager of the Argonaut Project, an industry collaboration to accelerate the adoption of FHIR.
Best example is that Sickle Cell diagnosis has historically been used to exclude people from serving in the military. An example might be a document specifically assembled as an "Emergency Data set", a critical set of data with minimal facts useful in an emergency. Some data are only sensitive in specific context.
We can't change Healthcare by writing very complex standards like the current FHIR ConsentDirective , which is fundamentally a " Contract " resource. First I recommend that FHIR make ConsentDirective a resource rather than just profiles of Contract. Essentially the common HIE policies from BPPC.
Etienne Boshoff, Managing Director at EHR Enhancify Healthcare interoperability is advancing through the adoption of Electronic Health Records (EHRs), standardized APIs like FHIR, and emerging technologies such as blockchain. Policies like the 21st Century Cures Act and ONC/CMS rules enhance data access and prevent information blocking.
A great example of this is de-identified patient data sets, where we’re able to take a large volume of data and determine trends. TEFCA proposes that the adoption of FHIR access with OAuth2.0 will help in providing secure access through third-party entities/applications.
There is some strong discussion going on at HL7 around privacy concerns, especially now that HL7 FHIR has enabled easy application writing. Apple is a good example of building Privacy in by design, and they have few (not zero) issues. Hack it on later and it is surely going to be problematic.
Available from the FHIR specification for easy reading. See FHIR Demonstration of DS4P. One specific example is 42CFR Part 2 – SAMSA covered treatment- that must be explicitly marked with a 'do not disclose without explicit authorization by the patient'. "M", because the content is less sensitive than normal, but still medical.
PMIR model is about one master Patient instance ; PIXm model is about cross-references to identifiers ; This is further explained in the " HIE Whitepaper - Patient Identity Management " PMIR PMIR model is one where a community wants to cooperate on a master Patient identity for each patient, a "golden" patient. The elephant in the room is.
It can also leverage the open, API-compatible Fast Healthcare Interoperability Resources (FHIR) interface, a set of standards that will be available in every major EHR to consolidate lifetime clinical records from different EHR providers. It's the lattice work or the skeleton for it," Shegewi said.
For example, how can you ensure the data wasn’t changed or corrupted during the transfer? The professionals that manage the information data analysts and health informaticists, for example serve as architects of interoperability, using technology standards like FHIR to build bridges between islands of patient data.
Update HIE Whitepaper and MHDS with newest Profiles. Previously PDQm supported only the FHIR query, which does not give the server the power to utilize algorithms. Support for the normal FHIR dynamic discovery using the metadata endpoint returning a CapabilityStatement is used in operational environments to detect server support.
Using Long Term signatures as Documents in an HIE (aka Document Sharing) would tend to be available for a long time, and over a broad distance. As part of this we will be providing examples and pointing at some code that people could use. This specification is based on FHIR Version 4.0.1
If you’re not sure whether you’re participating in TEFCA, contact your health information exchange (HIE), QHIN, or electronic health record (EHR) provider. For example, eHealth Exchange participants are taking advantage of its single API to join Carequality and TEFCA with no additional subscription fees or paperwork to sign.
But, what if a fhir-based app they use has server/architecture outside of ca? For example, if a portion of the resource is sensitive. Some may not segment application registrations in such a way Access by a patient seems like it would be straightforward, but perhaps not. The patient has the unfettered right to see the data.
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