Integrating the Healthcare Enterprise

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IHE IT Infrastructure
Technical Framework
Volume 2b(ITI TF-2b)
Transactions Part B –Sections 3.29 – 3.64

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September 18, 201525

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IHE IT Infrastructure Technical Framework, Volume 2b (ITI TF-2b): Transactions Part B______________________________________________________________________________CONTENTS

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1 Introduction ................................................................................................................................ 6
1.1 Overview of the Technical Framework .............................................................................. 6
1.2 Overview of IT Infrastructure Technical Framework Volumes 2a, 2b, 2x, and 3 .............. 7
1.3 Audience ............................................................................................................................. 8
1.4 Relationship to Standards ................................................................................................... 8
1.5 Relationship to Real-world Architectures ........................................................................... 8
1.6 Comments ........................................................................................................................... 9
1.7 Copyright Permission.......................................................................................................... 9
2 Conventions ............................................................................................................................. 10
2.1 The Generic IHE Transaction Model ................................................................................ 10
2.2 HL7 Profiling Conventions ............................................................................................... 11
2.3 Use of Coded Entities and Coding Schemes..................................................................... 11
3 IHE Transactions ...................................................................................................................... 123.29 Intentionally Left Blank ................................................................................................... 123.30 Patient Identity Management ............................................................................................ 123.30.1
Scope .................................................................................................................. 123.30.2
Use Case Roles ................................................................................................... 12
Referenced Standards ......................................................................................... 13
3.30.33.30.4
Message sets and options.................................................................................... 13
3.30.5
Common HL7 Message Segments ..................................................................... 14
3.30.6
Interactions ......................................................................................................... 32
3.31 Patient Encounter Management ........................................................................................ 42
3.31.1
Scope .................................................................................................................. 42
3.31.2
Use Case Roles ................................................................................................... 42
3.31.3
Referenced Standards ......................................................................................... 42
3.31.4
Definition of the concept “Movement” .............................................................. 42
3.31.5
Message sets and options.................................................................................... 44
3.31.6
Common HL7 Message Segments ..................................................................... 51
3.31.7
Interactions ......................................................................................................... 53
3.32 Distribute Document Set on Media................................................................................... 92
3.32.1 Scope ........................................................................................................................ 92
3.32.2 Use Case Roles ......................................................................................................... 92
3.32.3 Referenced Standard ................................................................................................ 92
3.32.4 Interaction Diagram.................................................................................................. 93
3.33 Intentionally Left Blank .................................................................................................. 100
3.34 Retrieve Form................................................................................................................. 101
3.34.1 Scope ...................................................................................................................... 101
3.34.2 Use Case Roles ....................................................................................................... 101
3.34.3 Referenced Standards ............................................................................................. 101
3.34.4 Interaction Diagram................................................................................................ 102
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3.34.5 Protocol Requirements ........................................................................................... 107
3.35 Submit Form .................................................................................................................. 110
3.35.1 Scope ...................................................................................................................... 110
3.35.2 Use Case Roles ....................................................................................................... 110
3.35.3 Referenced Standards ............................................................................................. 110
3.35.4 Interaction Diagram............................................................................................... 111
3.35.5 Protocol Requirements ........................................................................................... 112
3.35.6 Security Considerations.......................................................................................... 115
3.36 Archive Form ................................................................................................................. 116
3.36.1 Scope ...................................................................................................................... 116
3.36.2 Use Case Roles ....................................................................................................... 116
3.36.3 Referenced Standards ............................................................................................. 116
3.36.4 Interaction Diagram................................................................................................ 117
3.36.5 Protocol Requirements ........................................................................................... 118
3.36.6 Security Considerations.......................................................................................... 120
3.37 Retrieve Clarifications ................................................................................................... 121
3.37.1 Scope ...................................................................................................................... 121
3.37.2 Use Case Roles ....................................................................................................... 121
3.37.3 Referenced Standards ............................................................................................. 122
3.37.4 Interaction Diagram................................................................................................ 122
3.37.5 Protocol Requirements ........................................................................................... 125
3.38 Cross Gateway Query .................................................................................................... 128
3.38.1 Scope ...................................................................................................................... 128
3.38.2 Use Case Roles ....................................................................................................... 128
3.38.3 Referenced Standard .............................................................................................. 129
3.38.4 Interaction Diagram................................................................................................ 129
3.38.5 Protocol Requirements ........................................................................................... 134
3.39 Cross Gateway Retrieve ................................................................................................. 137
3.39.1 Scope ...................................................................................................................... 137
3.39.2 Use Case Roles ....................................................................................................... 137
3.39.3 Referenced Standard .............................................................................................. 138
3.39.4 Interaction Diagram................................................................................................ 138
3.39.5 Protocol Requirements ........................................................................................... 140
3.40 Provide X-User Assertion .............................................................................................. 145
3.40.1
Scope ................................................................................................................ 145
3.40.2
Use Case Roles ................................................................................................. 145
3.40.3 Referenced Standards ............................................................................................. 145
3.40.4 Interaction Diagram................................................................................................ 147
3.41 Provide and Register Document Set-b ............................................................................ 155
3.41.1
Scope ................................................................................................................ 156
3.41.2
Use Case Roles ................................................................................................. 156
3.41.3 Referenced Standards ............................................................................................. 157
3.41.4 Interaction Diagrams .............................................................................................. 157
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3.41.5 Protocol Requirements ........................................................................................... 162
3.41.6 Actor Requirements................................................................................................ 166
3.41.7 Security Considerations.......................................................................................... 167
3.42 Register Document Set-b ................................................................................................ 172
3.42.1 Scope ...................................................................................................................... 172
3.42.2 Use Case Roles ....................................................................................................... 173
3.42.3 Referenced Standards ............................................................................................. 173
3.42.4 Interaction Diagram................................................................................................ 173
3.42.5 Protocol Requirements ........................................................................................... 176
3.42.6 Actor Requirements................................................................................................ 179
3.42.7 Security Considerations.......................................................................................... 179
3.43 Retrieve Document Set ................................................................................................... 183
3.43.1 Scope ...................................................................................................................... 183
3.43.2 Use Case Roles ...................................................................................................... 183
3.43.3 Referenced Standard .............................................................................................. 184
3.43.4 Interaction Diagram................................................................................................ 184
3.43.5 Protocol Requirements ........................................................................................... 188
3.43.6 Security Considerations.......................................................................................... 196
3.44 Patient Identity Feed HL7 V3 ........................................................................................ 200
3.44.1 Scope ...................................................................................................................... 200
3.44.2 Use Case Roles ....................................................................................................... 200
3.44.3 Referenced Standards ............................................................................................. 201
3.44.4 Interaction Diagrams .............................................................................................. 201
3.44.5 Security Requirements ........................................................................................... 222
3.45 PIXV3 Query ................................................................................................................. 227
3.45.1 Scope ...................................................................................................................... 227
3.45.2 Use Case Roles ....................................................................................................... 227
3.45.3 Referenced Standards ............................................................................................. 227
3.45.4 Interaction Diagrams .............................................................................................. 228
3.45.5 Security Requirements ........................................................................................... 241
3.46 PIXV3 Update Notification............................................................................................ 245
3.46.1 Scope ...................................................................................................................... 245
3.46.2 Use Case Roles ....................................................................................................... 245
3.46.3 Referenced Standards ............................................................................................. 245
3.46.4 Interaction Diagrams .............................................................................................. 246
3.46.5 Security Requirements ........................................................................................... 253
3.47 Patient Demographics Query HL7 V3 ........................................................................... 255
3.47.1 Scope ...................................................................................................................... 255
3.47.2 Use Case Roles ....................................................................................................... 256
3.47.3 Referenced Standards ............................................................................................. 256
3.47.4 Interaction Diagrams .............................................................................................. 257
3.47.5 Security Requirements ........................................................................................... 280
3.48 Retrieve Value Set.......................................................................................................... 284
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3.48.1 Scope ...................................................................................................................... 284
3.48.2 Use case roles ......................................................................................................... 284
3.48.3 Referenced Standards ............................................................................................. 284
3.48.4 Interaction Diagram................................................................................................ 285
3.48.5 Protocol Requirements ........................................................................................... 287
3.48.6 Security Requirements ........................................................................................... 292
3.49 Convey Printed Referral Request.................................................................................... 295
3.50 Request Referral.............................................................................................................. 295
3.51 Multi-Patient Stored Query ............................................................................................ 295
3.51.1 Scope ...................................................................................................................... 295
3.51.2 Use Case Roles ....................................................................................................... 295
3.51.3 Referenced Standard .............................................................................................. 296
3.51.4 Interaction Diagram................................................................................................ 296
3.51.5 Security Considerations.......................................................................................... 302
3.55 Cross Gateway Patient Discovery .................................................................................. 305
3.55.1 Scope ...................................................................................................................... 305
3.55.2 Use Case Roles ....................................................................................................... 307
3.55.3 Referenced Standard .............................................................................................. 307
3.55.4 Interaction Diagram................................................................................................ 308
3.55.5 Security Considerations.......................................................................................... 333
3.55.6 Protocol Requirements ........................................................................................... 336
3.60 Retrieve Multiple Value Sets ......................................................................................... 342
3.60.1 Scope ...................................................................................................................... 342
3.60.2 Use case roles ......................................................................................................... 342
3.60.3 Referenced Standards ............................................................................................. 342
3.60.4 Interaction Diagram................................................................................................ 343
3.60.5 Protocol Requirements ........................................................................................... 348
3.60.6 Security Requirements ........................................................................................... 350
3.61 Register On-Demand Document Entry .......................................................................... 351
3.61.1 Scope ...................................................................................................................... 351
3.61.2 Use Case Roles ....................................................................................................... 351
3.61.3 Referenced Standard .............................................................................................. 351
3.61.4 Interaction Diagram................................................................................................ 352
3.61.5 Protocol Requirements ........................................................................................... 355
3.61.7 Security Considerations.......................................................................................... 356
3.62 Reserved for Delete Document Set ................................................................................ 359
3.63 Reserved for Cross Gateway Fetch ................................................................................ 359
3.64 Reserved for Notify XAP-PID Link Change ................................................................. 359

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1 Introduction

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Integrating the Healthcare Enterprise (IHE) is an initiative designed to stimulate the integrationof the information systems that support modern healthcare institutions. Its fundamental objective
is to ensure that in the care of patients all required information for medical decisions is bothcorrect and available to healthcare professionals. The IHE initiative is both a process and a forum
for encouraging integration efforts. It defines a technical framework for the implementation of
established messaging standards to achieve specific clinical goals. It includes a rigorous testingprocess for the implementation of this framework. And it organizes educational sessions andexhibits at major meetings of medical professionals to demonstrate the benefits of thisframework and encourage its adoption by industry and users.

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The approach employed in the IHE initiative is to support the use of existing standards, e.g.,
HL7, ASTM, DICOM, ISO, IETF, OASIS and others as appropriate, rather than to define newstandards. IHE profiles further constrain configuration choices where necessary in thesestandards to ensure that they can be used in their respective domains in an integrated manner
between different actors. When clarifications or extensions to existing standards are necessary,
IHE refers recommendations to the relevant standards bodies.
This initiative has numerous sponsors and supporting organizations in different medical specialty
domains and geographical regions. In North America the primary sponsors are the Healthcare
Information and Management Systems Society (HIMSS) and the Radiological Society of North
America (RSNA). IHE Canada has also been formed. IHE Europe (IHE-EUR) is supported by alarge coalition of organizations including the European Association of Radiology (EAR) andEuropean Congress of Radiologists (ECR), the Coordination Committee of the Radiological andElectromedical Industries (COCIR), Deutsche Röntgengesellschaft (DRG), the EuroPACS
Association, Groupement pour la Modernisation du Système d'Information Hospitalier(GMSIH), Société Francaise de Radiologie (SFR), Società Italiana di Radiologia Medica(SIRM), and the European Institute for health Records (EuroRec). In Japan IHE-J is sponsoredby the Ministry of Economy, Trade, and Industry (METI); the Ministry of Health, Labor, andWelfare; and MEDIS-DC; cooperating organizations include the Japan Industries Association ofRadiological Systems (JIRA), the Japan Association of Healthcare Information Systems Industry(JAHIS), Japan Radiological Society (JRS), Japan Society of Radiological Technology (JSRT),
and the Japan Association of Medical Informatics (JAMI). Other organizations representing
healthcare professionals are invited to join in the expansion of the IHE process acrossdisciplinary and geographic boundaries.

1.1 Overview of the Technical Framework
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This document, the IHE IT Infrastructure Technical Framework (ITI TF), defines specificimplementations of established standards to achieve integration goals that promote appropriate
sharing of medical information to support optimal patient care. It is expanded annually, after aperiod of public review, and maintained regularly through the identification and correction oferrata. The current version, Rev. 12.0 for Final Text, specifies the IHE transactions defined andHL7, HEALTH LEVEL SEVEN and CDA are the registered trademarks of Health Level Seven International.

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implemented as of September 2015. The latest version of the document is always available via
the Internet at http://ihe.net/Technical_Frameworks.
The IHE IT Infrastructure Technical Framework identifies a subset of the functional componentsof the healthcare enterprise, called IHE actors, and specifies their interactions in terms of a set ofcoordinated, standards-based transactions. It describes this body of transactions in progressively
greater depth. Volume 1 (ITI TF-1) provides a high-level view of IHE functionality, showing thetransactions organized into functional units called integration profiles that highlight theircapacity to address specific IT Infrastructure requirements.
Volumes 2a, 2b, and 2x of the IT Infrastructure Technical Framework provides detailed technicaldescriptions of each IHE transaction used in the IT Infrastructure Integration Profiles. Volume 3
contains content specification and specifications used by multiple transactions. These volumes
are consistent and can be used in conjunction with the Integration Profiles of other IHE domains.
The other domains within the IHE initiative also produce Technical Frameworks within theirrespective areas that together form the IHE Technical Framework. For example, the following
IHE Technical Framework(s) are some of those which are available:

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IHE IT Infrastructure Technical Framework•

IHE Cardiology Technical Framework•

IHE Laboratory Technical Framework•

IHE Patient Care Coordination Technical Framework•

IHE Radiology Technical Framework

Where applicable, references are made to other technical frameworks. For the conventions onreferencing other frameworks, see ITI TF-1: 1.6.3.

1.2 Overview of IT Infrastructure Technical Framework Volumes 2a,2b, 2x, and 3

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The remainder of Section 1 further describes the general nature, purpose and function of theTechnical Framework. Section 2 presents the conventions used in this volume to define IHE
transactions.
Section 3 defines transactions in detail, specifying the roles for each Actor, the standards
employed, the information exchanged, and in some cases, implementation options for thetransaction. Section 3 is divided into two parts:

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Volume 2a: Sections 3.1 - 3.28 corresponding to transactions [ITI-1] through [ITI-28].

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Volume 2b: Sections 3.29 - 3.64 corresponding to transactions [ITI-29] through [ITI-64].

Volume 2x contains all appendices providing technical details associated with the transactions.
Volume 3, Section 4 contains specifications that are used by multiple transactions.

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Volume 3, Section 5 contains Content Specifications.

1.3 Audience
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The intended audience of this document is:•

IT departments of healthcare institutions•

Technical staff of vendors planning to participate in the IHE initiative•

Experts involved in standards development•

Those interested in integrating healthcare information systems and workflows

1.4 Relationship to Standards
The IHE Technical Framework identifies functional components of a distributed healthcare
environment (referred to as IHE actors), solely from the point of view of their interactions in thehealthcare enterprise. At its current level of development, it defines a coordinated set oftransactions based on ASTM, DICOM, HL7, IETF, ISO, OASIS and W3C standards. As thescope of the IHE initiative expands, transactions based on other standards may be included as
required.
In some cases, IHE recommends selection of specific options supported by these standards;
however, IHE does not introduce technical choices that contradict conformance to thesestandards. If errors in or extensions to existing standards are identified, IHE’s policy is to reportthem to the appropriate standards bodies for resolution within their conformance and standards
evolution strategy.
IHE is therefore an implementation framework, not a standard. Conformance claims for products
must still be made in direct reference to specific standards. In addition, vendors who have
implemented IHE integration capabilities in their products may publish IHE Integration
Statements to communicate their products’ capabilities. Vendors publishing IHE Integration
Statements accept full responsibility for their content. By comparing the IHE Integration
Statements from different products, a user familiar with the IHE concepts of actors andintegration profiles can determine the level of integration between them. See ITI TF-2x:
Appendix C for the format of IHE Integration Statements.

1.5 Relationship to Real-world Architectures
The IHE actors and transactions described in the IHE Technical Framework are abstractions of
the real-world healthcare information system environment. While some of the transactions are
traditionally performed by specific product categories (e.g., HIS, Clinical Data Repository,
Radiology Information Systems, Clinical Information Systems or Cardiology Information
Systems), the IHE Technical Framework intentionally avoids associating functions or actors withsuch product categories. For each Actor, the IHE Technical Framework defines only thosefunctions associated with integrating information systems. The IHE definition of an Actor should
therefore not be taken as the complete definition of any product that might implement it, nor
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should the framework itself be taken to comprehensively describe the architecture of a healthcare
information system.
The reason for defining actors and transactions is to provide a basis for defining the interactions
among functional components of the healthcare information system environment. In situations
where a single physical product implements multiple functions, only the interfaces between the
product and external functions in the environment are considered to be significant by the IHE
initiative. Therefore, the IHE initiative takes no position as to the relative merits of an integrated
environment based on a single, all-encompassing information system versus one based on
multiple systems that together achieve the same end. IHE demonstrations emphasize theintegration of multiple vendors’ systems based on the IHE Technical Framework.

1.6 Comments
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IHE International welcomes comments on this document and the IHE initiative. They can besubmitted using the Web-based comment form at http://www.ihe.net/ITI_Public_Comments orby sending an email to the co-chairs and secretary of the IT Infrastructure domain committees at
iti@ihe.net.

1.7 Copyright Permission
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Health Level Seven, Inc., has granted permission to the IHE to reproduce tables from the HL7
standard. The HL7 tables in this document are copyrighted by Health Level Seven, Inc. All rights
reserved. Material drawn from these documents is credited where used.

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Conventions

This document has adopted the following conventions for representing the framework concepts
and specifying how the standards upon which the IHE IT Infrastructure Technical Framework isbased should be applied.

2.1 The Generic IHE Transaction Model
Transaction descriptions are provided in Section 3. In each transaction description, the actors, theroles they play, and the transactions between them are presented as use cases.
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The generic IHE transaction description includes the following components:
Scope: a brief description of the transaction.
Use case roles: textual definitions of the actors and their roles, with a simple diagram relating
them, e.g.,:

Actor

Actor

Transaction

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Referenced Standards: the standards (stating the specific parts, chapters or sections thereof)
to be used for the transaction.
Interaction Diagram: a graphical depiction of the actors and messages that support thetransaction, with related processing within an Actor shown as a rectangle and time
progressing downward, similar to:

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Actor

Actor

Actor

MSG1
MSG2
MSG3

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The interaction diagrams used in the IHE IT Infrastructure Technical Framework aremodeled after those described in Grady Booch, James Rumbaugh, and Ivar Jacobson, The
Unified Modeling Language User Guide, ISBN 0-201-57168-4. Simple acknowledgment
messages are often omitted from the diagrams for brevity. One or more messages may berequired to satisfy a transaction. Each message is represented as an arrow starting fromthe Actor initiating the message.
Message definitions: descriptions of each message involved in the transaction, the events thattrigger the message, its semantics, and the actions that the message triggers in thereceiver.

2.2 HL7 Profiling Conventions
See ITI TF-2x: Appendix C for the HL7 profiling conventions as well as the networking
implementation guidelines.

2.3 Use of Coded Entities and Coding Schemes355

IHE does not produce, maintain or otherwise specify a coding scheme or other resource forcontrolled terminology (coded entities). Where applicable, coding schemes required by the HL7
and DICOM standards take precedence. In the cases where such resources are not explicitly
identified by standards, implementations may utilize any resource (including proprietary or local)
provided any licensing/copyright requirements are satisfied.

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3 IHE Transactions
This section defines each IHE transaction in detail, specifying the standards used, theinformation transferred, and the conditions under which the transaction is required or optional.

3.29 Intentionally Left Blank
3.30 Patient Identity Management
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This section corresponds to transaction ITI-30, “Patient Identity Management” of the IHE IT
Infrastructure Technical Framework. Transaction ITI-30 is used by the actors Patient
Demographics Supplier and Patient Demographics Consumer.
3.30.1 Scope

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This transaction transmits patient demographics in a patient identification domain (i.e., patient
identifiers assigned by the same assigning authority).
The term “patient demographics” is intended to convey the patient identification and full identityand also information on persons related to this patient, such as primary caregiver, family doctor,
guarantor, next of kin.
The transaction contains events for creating, updating, merging, linking and unlinking patients.

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It enables the sending system to qualify the reliability of a patient identity, and the type ofidentity used (official name, alias for VIP, unknown patient).
The transaction can be used in acute care settings for both inpatients (i.e., those who are assigned
a bed at the facility) and outpatients (i.e., those who are not assigned a bed at the facility).
The transaction can also be used in a pure ambulatory environment.

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3.30.2 Use Case Roles

Patient
Demographics
Supplier
Patient
Identity
SourcePatient
Demographics
Consumer

Patient Identifier
Cross-ReferenceManager

Patient Identity
Management

Actor: Patient Demographics SupplierRole: Adds and modifies patient demographics.
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Actor: Patient Demographics Consumer
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Role: Receives patient demographics.
Actor: Patient Identity Source
Role: Adds and modifies patient demographics.
Actor: Patient Identifier Cross-Reference Manager
Role: Receives patient demographics.

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3.30.3 Referenced Standards
HL7 2.5 Chapters 2, 3, 6, 15
3.30.4 Message sets and options
Transaction ITI-30 supports two options, “Merge” and “Link/Unlink”, in order to accommodate
the various methods used by healthcare organizations to reconcile duplicated identities.

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Any Patient Demographics Supplier or Patient Demographics Consumer Actor SHALL support
at least one of the two options “Merge” and “Link/Unlink” or both, according to the IHE national
extensions of this transaction. Any implementation framework will mandate both actors to
support the same option (see Sections 3.30.4.1 and 3.30.4.2).
Patient Identity Source and Patient Identity Cross-Reference Manager Actors may support thePediatric Demographics Option (see Section 3.30.4.3).
3.30.4.1 Required message subset with option “Merge”
Event

Trigger

Message Static definition

Create new patient

A28

ADT^A28^ADT_A05

Update patient information

A31

ADT^A31^ADT_A05

Change Patient Identifier List

A47

ADT^A47^ADT_A30

Merge two patients

A40

ADT^A40^ADT_A39

3.30.4.2 Required message subset with option “Link/Unlink”
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Event

Trigger

Message Static definition

Create new patient

A28

ADT^A28^ADT_A05

Update patient information

A31

ADT^A31^ADT_A05

Change Patient Identifier List

A47

ADT^A47^ADT_A30

Link Patient Information

A24

ADT^A24^ADT_A24

Unlink Patient Information

A37

ADT^A37^ADT_A37

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3.30.4.3 Optionality of Pediatric Demographics Fields

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The Pediatric Demographics Option does not require Patient Identity Source Actors to include
any attributes not already required by the corresponding HL7 message (as is described in thefollowing sections). This minimal set of requirements enables inclusion of the largest range ofPatient Identity Source Actor systems.
The Pediatric Demographics Option does place additional requirements on the Patient Identifier
Cross-reference Manager Actor, requiring them to accept and consider in matching* a set of HL7
attributes beyond what is required by standard PIX. See Table 3.30.4.3-1 for a description ofthese additional requirements. For example, we would expect that two patients with all furnisheddata elements identical except the First Name (e.g., “Maria” vs. “Marina”), and consecutive Birth
Order values would not be automatically linked or merged by the Patient Identifier CrossReference Manager.
3.30.4.4 Acknowledgement Support420

An actor that claims support for the Acknowledgement Support Option shall be capable of using
the enhanced acknowledgement mode as defined in the HL7 v2.x standard. See HL7 Volume 2C,
Section C.2.3 for further details.
3.30.4.5 Ambulatory Patient Data425

If the Patient Demographics Supplier supports the Ambulatory Patient Data Option, it SHALL
supply the patient address in field PID-11 for ambulatory patients whenever this address isknown.
3.30.5 Common HL7 Message Segments
This section describes the common HL7 message segments used in transaction ITI-30.

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Each table represents a segment. Fields for which a precise usage description is needed,
particularly those having usage C (conditional), are commented on below the table. The optional
fields are usually not commented on.
3.30.5.1 MSH - Message Header Segment
Standard Reference: HL7 Version 2.5, Chapter 2 (Section 2.15, “Message control”)
This segment defines the intent, supplier, destination, and some specifics of the syntax of themessage. It also uniquely identifies the message itself and dates its production.

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Table 3.30-1: MSH - Message Header
SEQ

LEN

DT

Usage

Card.

TBL
#

ITEM#

Element name

1

1

ST

R

[1..1]

00001

Field Separator

2

4

ST

R

[1..1]

00002

Encoding Characters

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SEQ

LEN

DT

Usage

Card.

TBL
#

ITEM#

Element name

3

227

HD

R

[1..1]

00003

Sending Application

4

227

HD

R

[1..1]

00004

Sending Facility

5

227

HD

R

[1..1]

00005

Receiving Application

6

227

HD

R

[1..1]

00006

Receiving Facility

7

26

TS

R

[1..1]

00007

Date/Time of Message

8

40

ST

X

[0..0]

00008

Security

9

15

MSG

R

[1..1]

00009

Message Type

10

20

ST

R

[1..1]

00010

Message Control Id

11

3

PT

R

[1..1]

00011

Processing Id

12

60

VID

R

[1..1]

00012

Version ID

13

15

NM

O

[0..1]

00013

Sequence Number

14

180

ST

X

[0..0]

00014

Continuation Pointer

15

2

ID

O

[0..1]

0155

00015

Accept Acknowledgement Type

16

2

ID

O

[0..1]

0155

00016

Application Acknowledgement Type

17

3

ID

RE

[1..1]

0399

00017

Country Code

18

16

ID

C

[0..1]

0211

00692

Character Set

19

250

CE

RE

[0..1]

00693

Principal Language of Message

20

20

ID

X

[0..0]

0356

01317

Alternate Character Set Handling
Scheme

21

427

EI

RE

[0..*]

01598

Message Profile Identifier440

MSH-1 Field Separator, required: This Technical Framework requires that applications support
as the recommended value specified in the HL7 standard, which is | (ASCII 124). See volume
2x: Appendix C.

445

MSH-2 Encoding Characters, required: This field contains the four characters in the following
order: the component separator, repetition separator, escape character, and subcomponent
separator. This Technical Framework requires that applications support the recommended values
for encoding characters as specified in the HL7 standard. The values are ^~\& (ASCII 94, 126,
92, and 38, respectively). See ITI TF-2x: Appendix C.
MSH-3 Sending Application (HD) and MSH-5 Receiving Application (HD), required. See
the constrainable profile definition of data type HD.
MSH-4 Sending Facility (HD) and MSH-6 Receiving Facility (HD), required. See theconstrainable profile definition of data type HD.

450

MSH-9 Message Type (MSG), required:
Components: <Message Code (ID)> ^ <Trigger Event (ID)> ^ <Message Structure (ID)>

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Definition: This field contains the message type, trigger event, and the message structure ID forthe message. All three components are required.
MSH-10 Message Control Id (ST), required:
455

Definition: This field contains a number or other identifier that uniquely identifies the message inthe context of exchange between trading partners. Each message should be given a unique
identifier by the sending system. The receiving system will echo this ID back to the sending
system in the Message Acknowledgment segment (MSA). The combination of this identifier andthe name of the sending application (MSH-3) should be unique across the healthcare enterprise.

460

MSH-12 Version ID (VID), required:
Components: <Version ID (ID)> ^ <Internationalization Code (CE)> ^ <International Version ID(CE)>
Definition: This field is matched by the receiving system to its own version to be sure themessage will be interpreted correctly.

465

The first component SHALL be populated with the value "2.5" representing HL7 Version 2.5.
MSH-15 Accept Acknowledgment Type (ID), optional.
As a minimal requirement for all actors, the Original Acknowledgement Mode shall besupported, in which case this field of the message will remain empty.

470

If an actor declares the “Acknowledgement Support” Option, it shall be able to use Enhanced
Acknowledgement Mode.
MSH-16 Application Acknowledgment Type (ID), optional.
As a minimal requirement for all actors, the Original Acknowledgement Mode shall besupported, in which case this field of the message will remain empty.

475

If an actor declares the “Acknowledgement Support” Option, it shall be able to use Enhanced
Acknowledgement Mode.
MSH-17 Country Code (ID), required if available.
Definition: This field contains the country of origin for the message. The values to be used arethose of ISO 3166, using the 3-character alphabetic form. Refer to HL7 Table 0399 - Country
code.

480

Examples of valid values:
JPN = Japan, USA = United States, GBR = United Kingdom, ITA = Italy, FRA = France, NLD =Netherlands.
MSH-18 Character Set (ID), conditional.

485

Definition: This field contains the character set for the entire message. Refer to HL7 Table 0211
- Alternate character sets for valid values.
Examples of valid values:
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490

8859/1: The printable characters from the ISO 8859/1 Character set used by Western Europe.
This character set can still be used, but 8859/15 should be used by preference. This character set
is the forward-compatible version of 8859/1 and includes new characters such as the Euro
currency symbol.
ISO IR87: Code for the Japanese Graphic Character set for information interchange (JIS X 02081990).
UNICODE UTF-8: UCS Transformation Format, 8-bit form.

495

Condition predicate: This field shall only be valued if the message uses a character set otherthan the 7-bit ASCII character set. Though the field is repeatable in HL7, IHE authorizes only
one occurrence (i.e., one character set). The character set specified in this field is used for theencoding of all of the characters within the message.
MSH-19 Principal Language of Message (CE), required if available. Coded from ISO 639.

500

Examples: DE = German, EN = English, ES=Spanish, JA = Japanese, FR = French, NL = Dutch,
IT = ItalianMSH-20 Alternate Character Set Handling Scheme (ID), not supported: Character set
switching is not allowed here.
MSH-21 Message Profile Identifier (EI), required if available.

505This field shall be valued in the messages for which a Message Profile has been officiallyregistered with HL7, and is recommended to be valued for all messages in accordance with IHE
Technical Framework transactions. See volume 2x: Appendix C.
3.30.5.2 EVN – Event Type Segment
Standard Reference: HL7 Version 2.5, Chapter 3, Section 3.4.1

510This segment is used to provide generic properties of the trigger event.
Table 3.30-2: EVN – Event Type segment
SEQ

LEN

DT

Usage

1

3

ID

X

[0..0]

Card.

TBL#

ITEM#

0003

00099

Event Type Code

2

26

TS

R

3

26

TS

4

3

5

250

6
7

Element name[1..1]

00100

Recorded Date TimeC

[0..1]

00101

Date/Time Planned Event

IS

O[0..1]

0062

00102

Event Reason Code

XCN

O

[0..*]

0188

00103

Operator ID

26

TS

C

[0..1]

01278

Event Occurred

241

HD

RE

[0..1]

01534

Event Facility

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515

EVN-1 Event Type Code (ID): Not supported (deprecated in HL7 2.5). The Event Type Code isgiven in MSH-9 of segment MSH.
EVN-2 Recorded Date Time (TS): Required. Date/time when the event was recorded.
EVN-3 Date/Time Planned Event (TS): Conditional. Date/time when the event was planned.
Condition predicate:•This field shall be populated in events “Pending Transfer” (A15) and “Cancel Pending
Transfer” (A26), which are supported by transaction ITI-31.

•

The update of a pending transfer uses message A08 and leaves this field empty. The
update of the planned date/time of the transfer is only possible through the ZBE segment
in message Z99, when using the option “Historic Movement Management” of transaction
ITI-31.

•Other planned events of transaction ITI-31, such as “Pending Admit”, “Pending
Discharge” and the cancels thereof, use a specific field of segment PV2 to give thedate/time of the planned event. For consistency of use, IHE recommends that the content
of the specific field of PV2 be also copied to EVN-3.

520

525

National extensions of this transaction may extend the condition above.
530

EVN-6 Event Occurred (TS): Conditional. This field contains the date/time that the event reallyoccurred.
Condition predicate:

535

540

•

This field shall not be populated in messages communicating pending events and theircancellations.

•

In messages communicating effective events (inserts and updates), this field shall be
populated with the real date/time of the notified event.

•

In messages communicating cancellations, this field shall be populated with the date/timethat was sent in the message that originally communicated the event being cancelled.

EVN-7 Event Facility (HD): Required if known to the sender. This field identifies the actual
facility where the event occurred as distinct from the sending facility (MSH-4).
3.30.5.3 PID - Patient Identification segment
Standard Reference: HL7 Version 2.5, Chapter 3 (Section 3.4.2)

545

The PID segment is used by all applications as the primary means of communicating patient
identification information. This segment contains permanent patient identifying and demographic
information that, for the most part, is not likely to change frequently.

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Table 3.30-3: PID - Patient Identification segment
SEQ

LEN

DT

Usage

1

4

SI

O

[0..1]

Card.

TBL#

00104

Set ID - PID

2

20

CX

X

[0..0]

00105

Patient ID

3

250

CX

R

[1..*]

00106

Patient Identifier List

4

20

CX

X

[0..0]

00107

Alternate Patient ID - PID

5

250

XPN

R

[1..*]

00108

Patient Name

6

250

XPN

O
(Note 1)[0..1]

00109

Mother’s Maiden Name

7

26

TS

CE
(Note 1)[0..1]

00110

Date/Time of Birth

8

1

IS

CE
(Note 1)

[1..1]

00111

Administrative Sex

9

250

XPN

X

[0..1]

00112

Patient Alias

10

250

CE

O

[0..1]

00113

Race

11

250

XAD

CE
(Note 1)[0..*]

00114

Patient Address

0001

0005

0289

ITEM#

Element name

12

4

IS

X

[0..1]

00115

County Code

13

250

XTN

O
(Note 1)[0..*]

00116

Phone Number - Home

14

250

XTN

O

[0..*]

00117

Phone Number - Business

15

250

CE

O

[0..1]

0296

00118

Primary Language

16

250

CE

O

[0..1]

0002

00119

Marital Status

17

250

CE

O

[0..1]

0006

00120

Religion

18

250

CX

C

[0..1]

00121

Patient Account Number

19

16

ST

X

[0..1]

00122

SSN Number - Patient

20

25

DLN

X

[0..1]

00123

Driver's License Number - Patient

21

250

CX

O

[0..*]

00124

Mother's Identifier

22

250

CE

O

[0..1]

00125

Ethnic Group

23

250

ST

O

[0..1]

00126

Birth Place

24

1

ID

O
(Note 1)[0..1]

00127

Multiple Birth Indicator

25

2

NM

O
(Note 1)[0..1]

00128

Birth Order

26

250

CE

O

[0..1]

0171

00129

Citizenship

27

250

CE

O

[0..1]

0172

00130

Veterans Military Status

28

250

CE

X

[0..0]

0212

00739

Nationality

29

26

TS

CE

[0..1]

00740

Patient Death Date and Time

30

1

ID

C

[0..1]

0136

00741

Patient Death Indicator

31

1

ID

CE

[0..1]

0136

01535

Identity Unknown Indicator

32

20

IS

CE

[0..*]

0445

01536

Identity Reliability Code

0189
0136

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SEQ

LEN

DT

Usage

33

26

TS

CE
(Note 1)[0..1]

01537

Last Update Date/Time

34

241

HD

O
(Note 1)[0..1]

01538

Last Update Facility

35

250

CE

CE

[0..1]

0446

01539

Species Code

36

250

CE

C

[0..1]

0447

01540

Breed Code

37

80

ST

O

[0..1]

01541

Strain

38

250

CE

O

[0..2]

01542

Production Class Code

39

250

CWE

O

[0..*]

01840

Tribal Citizenship

Note 1:

Card.

TBL#

ITEM#

Element name

If the Pediatric Demographics Option is supported, this element in the table above shall be R2 for the Patient
Identifier Cross-Reference Manager.

550
In accord with the HL7 Version 2.5 usage of this segment, fields PID-2 (Patient ID), PID-4(Alternate Patient ID), PID-19 (SSN patient number) and PID-20 (Driver’s license number) aresuperseded by field PID-3, as shown below; field PID-28 (Nationality) is superseded by field
PID-26 (Citizenship).
555

PID-3 – Patient Identifier List (CX), required. This field contains a list of identifiers (one ormore) used by the healthcare facility to uniquely identify a patient.
As shown in the constrained profile definition of data type CX in ITI TF-2x: Appendix N.1,
subfields CX-1 “ID number”, CX-4 “Assigning authority” are required, and CX-5 “Identifier
Type Code” is required if known for each identifier.

560

This field may be populated with various identifiers assigned to the patient by various assigningauthorities.
The authorized values for subfield CX-5 “Identifier Type Code” are given in HL7 Table 0203
(HL7 Version 2.5, Chapter 2A, Section 2A.17.5).
Values commonly used for Identifier Type Code in the context of PID-3 are as follows:

565

570

BC

Bank card number. Assigning authority is the bank.

BR

Birth Certificate number. Assigning authority is the birth state or national
government that issues the Birth Certificate.

DL

Driver’s license number. Assigning authority is the state

NH

National Health Plan Identifier. Assigning authority at the national level.

PE

Living Subject Enterprise Number. Assigning authority is the enterprise.

PI

Patient Internal Identifier assigned by the healthcare organization.

PPN

Passport number.

PRC

Permanent Resident Card Number

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Social Security Number.

575
PID-5 – Patient Name (XPN), required. This field contains one or more names for the patient.
At least one name must be provided, with at least the first subfield “Family Name” valued. See
the constrained profile definition of data type XPN.
PID-6 – Mother’s Maiden Name (XPN), conditional:
580

Condition predicate:This field is required if known for the Pediatrics Demographic Option. It serves to help link
records when other demographic data and search criteria are not exactly the same.
PID-7 – Date/Time of Birth (TS), conditional.
Condition predicate:

585

590

•

This field is required if available (i.e., known to the sender) in the following messages:
Creation of a new patient (A28 in ITI-30), inpatient admitted (A01 in ITI-31), registrationof an outpatient (A04 in ITI-31), update patient demographics (A31 in ITI-30), update
patient demographics in the context of an encounter (A08 in ITI-31).

•

In all other messages, it is optional.

•

If the exact date of birth is not known, it can be truncated to the year of birth (e.g., 1954)or to the year and month of birth (e.g., 195411).

PID-8 – Administrative Sex (IS), conditional.
Condition predicate:•This field is required if available in the following messages: Creation of a new patient(A28 in ITI-30), inpatient admitted (A01 in ITI-31), registration of an outpatient (A04 in
ITI-31), update patient demographics (A31 in ITI-30).

•

In all other messages, it is optional.

•

The authorized values are these, taken from HL7 User-defined Table 0001:

595

600

User-defined Table 0001: Administrative Sex
Value

Description

F

Female

M

Male

O

Other

U

Unknown

A

AmbiguousN

Not applicable

Comment

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PID-10 – Race (CE), optional: The patient race is information of critical medical importance inpractices such as imaging. Therefore this information shall be present if known, except whereprohibited. For example, France prohibits inclusion of Patient Race.
605

PID-11 – Patient Address (XAD), conditional:
Condition predicate:

610•

This field is required if available (if known to the sender) in the following messages:
Creation of a new patient (A28 in ITI-30), inpatient admitted (A01 in ITI-31), registrationof an outpatient (A04 in ITI-31), update patient demographics (A31 in ITI-30).

•

In all other messages, it is optional.

PID-13 – Home Phone Number (XTN), conditional.
Condition predicate:This field is required if known for the Pediatrics Demographic Option. It serves to help locate
records when other demographic data and search criteria are not exactly the same.
615

PID-18 – Patient Account Number (CX): Conditional.
HL7 Definition: This field contains the patient account number assigned by accounting to which
all charges, payments, etc., are recorded. It is used to identify the patient’s account.
Relationship to encounter: A patient account can span more than one enterprise encounter.

620

Condition predicate: At least one of the fields PID-18 “Patient Account Number” or PV1-19“Visit Number” shall be valued in the messages of transaction ITI-31 that use the PV1 segment.
Additional requirements for the presence of value in these fields may be documented in national
extensions of this transaction.
PID-24 – Multiple Birth Indicator (ID), conditional.
Condition predicate:625This field is required if known for the Pediatrics Demographic Option. It serves to help avoid
linking records for twins, which are often nearly identical.
PID-25 – Birth Order (NM), conditional.
Condition predicate:630This field is required if known for the Pediatrics Demographic Option. It serves to help avoid
linking records for twins, which are often nearly identical.
PID-29 – Patient Death Date and Time (TS), conditional:
Condition predicate:

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This field is required in the Patient Discharge message of transaction ITI-31 if theencounter is terminated by the patient’s death and the death date is known. It provides thedate/time of the patient’s death.

•

In all other Patient Discharge messages, it shall not be populated.

635

PID-30 – Patient Death Indicator (ID), conditional:
Condition predicate:•This field is required to be populated with value “Y” in the Patient Discharge message oftransaction ITI-31 when the encounter is terminated by the patient’s death.

•

Otherwise it is optional.

640

PID-31 – Identity Unknown Indicator (ID), conditional:
Condition predicate:•This field is required if available (i.e., known to the sender) in the following messages:
Creation of a new patient (A28 in ITI-30), inpatient admitted (A01 in ITI-31), registrationof an outpatient (A04 in ITI-31), update patient demographics (A31 in ITI-30), update
patient demographics in the context of an encounter (A08 in ITI-31).

•

In all other messages, it is optional.

645

The possible values are “Y”, and “N” which is the default.
650

The value “Y” means that the patient identity is unknown. In this case the field PID-3 shallcontain one single patient identifier, which is a temporary identifier, and the field PID-32 willcontain the value “AL” indicating that the patient name is an alias.
PID-32 – Identity Reliability Code (IS), conditional:
Condition predicate:

655

660

•

This field is required if available (i.e., known to the sender) in the following messages:
Creation of a new patient (A28 in ITI-30), inpatient admitted (A01 in ITI-31), registrationof an outpatient (A04 in ITI-31), update patient demographics (A31 in ITI-30) , update
patient demographics in the context of an encounter (A08 in ITI-31).

•

In all other messages, it is optional.

The field is repeatable. The possible values are taken from HL7 user-defined Table 0445:
User-defined Table 0445: Identity Reliability Code
Value
AL

Description

Comment (added by IHE for this profile)

Patient/Person Name is an Alias

Used in case of an unidentified patient (e.g., trauma
case)

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PID-33 – Last Update Date/Time (TS), conditional:
665

670

Condition predicate:•This field is required if available (i.e., known to the sender) in the following messages:
Creation of a new patient (A28 in ITI-30), inpatient admitted (A01 in ITI-31), registrationof an outpatient (A04 in ITI-31), update patient demographics (A31 in ITI-30), update
patient demographics in the context of an encounter (A08 in ITI-31).

•

In the cases of messages A08 and A31, the content of this field is equal to the value in
EVN-6-event occurred.

Note:

675

This field is required if known for the Pediatrics Demographic Option. The condition predicate above satisfies
this requirement. It serves to help avoid linking records for twins, which are often nearly identical. It is used inconjunction with PID-34.

PID-34 – Last Update Facility (HD), conditional.
Condition predicate:This field is required if known for the Pediatrics Demographic Option. It serves to help avoid
linking records for twins, whose records are often nearly identical, when used in conjunction
with PID-33.

680

PID-35 – Species Code (CE) and PID-36 – Breed Code (CE), conditional:
Condition predicate:•685

Required if known to the sender, when the patient is a non-human living subject, in thefollowing messages: Creation of a new patient (A28 in ITI-30), inpatient admitted (A01
in ITI-31), registration of an outpatient (A04 in ITI-31), update patient demographics(A31 in ITI-30), update patient demographics in the context of an encounter (A08 in ITI31).

3.30.5.4 PV1 - Patient Visit segment
Standard Reference: HL7 Version 2.5, Chapter 3 (Section 3.4.3)
690

The PV1 segment is used by Registration/Patient Administration applications to communicate
information on an account or visit-specific basis.

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Table 3.30-4: PV1 - Patient Visit segment
SEQ

LEN

DT

Usage

Card.

1

4

SI

O

[0..1]

2

1

IS

R

[1..1]

3

80

PL

C

[0..1]

4

2

IS

O

[0..1]

5

250

CX

O

[0..1]

6

80

PL

C

[0..1]

7

250

XC
N

O

[0..*]

8

250

XC
N

O

9

250

XC
N

10

3

11

80

12

TBL#

ITEM#

ELEMENT NAME

00131

Set ID - PV1

00132

Patient Class

00133

Assigned Patient Location

00134

Admission Type

00135

Preadmit Number

00136

Prior Patient Location

0010

00137

Attending Doctor[0..*]

0010

00138

Referring Doctor

X[0..0]

0010

00139

Consulting Doctor

ISO[0..1]

0069

00140

Hospital Service

PLC[0..1]

00141

Temporary Location

2

IS

O

[0..1]

0087

00142

Preadmit Test Indicator

13

2

IS

O

[0..1]

0092

00143

Re-admission Indicator

14

6

IS

O

[0..1]

0023

00144

Admit Supplier

15

2

IS

O

[0..*]

0009

00145

Ambulatory Status

16

2

IS

O

[0..1]

0099

00146

VIP Indicator

17

250

XC
N

O

[0..*]

0010

00147

Admitting Doctor

18

2

IS

O

[0..1]

0018

00148

Patient Type

19

250

CX

C

[0..1]

00149

Visit Number

20

50

FC

O

[0..*]

0064

00150

Financial Class

21

2

IS

O

[0..1]

0032

00151

Charge Price Indicator

22

2

IS

O

[0..1]

0045

00152

Courtesy Code

23

2

IS

O

[0..1]

0046

00153

Credit Rating

24

2

IS

O

[0..*]

0044

00154

Contract Code

25

8

DT

O

[0..*]

00155

Contract Effective Date

26

12

NM

O

[0..*]

00156

Contract Amount

27

3

NM

O

[0..*]

00157

Contract Period

28

2

IS

O

[0..1]

0073

00158

Interest Code

29

4

IS

O

[0..1]

0110

30

8

DT

O

[0..1]

31

10

IS

O

[0..1]

32

12

NM

O

[0..1]

33

12

NM

O

[0..1]

34

1

IS

O

[0..1]

35

8

DT

O

[0..1]

0004
0007

0021

0111

00159

Transfer to Bad Debt Code00160

Transfer to Bad Debt Date00161

Bad Debt Agency Code00162

Bad Debt Transfer Amount00163

Bad Debt Recovery Amount

00164

Delete Account Indicator

00165

Delete Account Date

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SEQ

LEN

DT

Usage

Card.

TBL#

ITEM#

36

3

IS

O

[0..1]

0112

00166

Discharge Disposition

ELEMENT NAME

37

47

DL
D

O

[0..1]

0113

00167

Discharged to Location

38

250

CE

O

[0..1]

0114

00168

Diet Type

39

2

IS

O

[0..1]

0115

00169

Servicing Facility

40

1

IS

X

[0..1]

0116

00170

Bed Status

41

2

IS

O

[0..1]

0117

00171

Account Status

42

80

PL

C

[0..1]

00172

Pending Location

43

80

PL

O

[0..1]

00173

Prior Temporary Location

44

26

TS

RE

[0..1]

00174

Admit Date/Time

45

26

TS

RE

[0..1]

00175

Discharge Date/Time

46

12

NM

O

[0..1]

00176

Current Patient Balance

47

12

NM

O

[0..1]

00177

Total Charges

48

12

NM

O

[0..1]

00178

Total Adjustments

49

12

NM

O

[0..1]

00179

Total Payments

50

250

CX

O

[0..1]

0203

00180

Alternate Visit ID

51

1

IS

C

[0..1]

0326

01226

Visit Indicator

52

250

XC
N

X

[0..*]

0010

01274

Other Healthcare Provider

General conditions of use:
695

700

•

All messages of transaction ITI-30 that use this segment, actually use a pseudo-PV1,
which is empty. The only field populated is PV1-2 “Patient Class” values “N” (NotApplicable).

•

The condition predicates described below only apply to the use of this segment in thecontext of transaction ITI-31.

PV1-2 – Patient Class (IS), required:
Definition: This field is used by systems to categorize patients by site. It does not have aconsistent industry-wide definition. It is subject to site-specific variations. Refer to User-defined
Table 0004 - Patient Class for suggested values.

705

User-defined Table 0004: Patient Class
Value

Description

E

Emergency

I

InpatientO

OutpatientP

Preadmit

Comment

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Value

Description

R

Recurring patient

B

Obstetrics

C

Commercial AccountN

Not ApplicableU

Unknown

Comment

National extensions of the PAM Profile may add further values to this table.
Messages of transaction ITI-31 may use any of the above values. The four first values (“E”
Emergency, “I” Inpatient, “O” Outpatient, “P” Preadmit) are in common use in most countries.
710

Conditions of use:•

Transaction ITI-30 uses only the value “N” (Not Applicable) in all messages that containthe PV1 segment.

•

In transaction ITI-31

715•

Change to inpatient (A06) uses value I or another value representing an inpatient.

•

Change to outpatient (A07) uses value O or another value representing an outpatient(i.e., not assigned to an inpatient bed).

PV1-3 – Assigned Patient Location (PL), conditional:
Condition predicate:

720•

This field is required in the Transfer (A02) and Cancel Transfer (A12) messages.

•

In all other messages of transaction ITI-31, it is required if known to the sender.

PV1-6 – Prior Patient Location (PL), conditional:
Condition predicate:

725

730

•

This field is required in the Transfer (A02)•

In all other messages of transaction ITI-31, it is optional.

PV1-7 – Attending Doctor (XCN), optional. It is recommended that when this field ispopulated, the segment PV1/PV2 be followed by a ROL segment containing the details on therole assumed by the attending doctor.
PV1-8 – Referring Doctor (XCN), optional. It is recommended that when this field ispopulated, the segment PV1/PV2 be followed by a ROL segment containing the details on therole assumed by the referring doctor.
PV1-9 – Consulting Doctor (XCN), not supported (deprecated by HL7). The consulting
doctor(s) are entirely described in the appropriate ROL segments following the PV1/PV2.

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PV1-11 – Temporary Location (PL), conditional:
735

Condition predicate: This field is used by the option “Temporary Patient Transfers Tracking” oftransaction ITI-31 (messages A09, A10, A32, A33).
PV1-19 – Visit Number (CX), Conditional. This fields contains the unique identifier assigned tothe encounter.

740

Condition predicate: At least one of the fields PID-18 “Patient Account Number” or PV1-19“Visit Number” shall be valued in the messages of transaction ITI-31 that use the PV1 segment.
Additional requirements for the presence of values in these fields may be documented in national
extensions of this transaction.
PV1-42 – Pending Location (PL), conditional.
Condition predicate:•This field is required in the Pending Transfer (A15) and Cancel Pending Transfer (A26)
messages.

•

In all other messages of transaction ITI-31, it is optional.

745

PV1-44 – Admit Date / Time (TS), required if available. This field contains the date/time of the
beginning of the encounter.
750

PV1-45 – Discharge Date / Time (TS), required if available. This field contains the date/time ofthe discharge (end of the encounter).
PV1-51 – Visit Indicator (IS), Conditional.

755This field specifies the level on which data are being sent. It is the indicator used to send data at
two levels, visit and account. HL7 recommends sending an ‘A’ or no value when the data in themessage are at the account level, or ‘V’ to indicate that the data sent in the message are at thevisit level.
Condition predicate: This field SHALL be valued with value “V” if the field PV1-19 “Visit
Number” is present. The field MAY be omitted otherwise.
3.30.5.5 MRG – Merge segment
Standard Reference: HL7 Version 2.5, Chapter 3 (Section 3.4.9)

760This segment contains the supplier patient identifiers list to be merged.
Table 3.30-5: MRG - Merge segment
SEQ

LEN

DT

Usage

Card.

1

250

CX

R

2

250

CX

3

250

CX

TBL#

ITEM#

Element name[1..*]

00211

Prior Patient Identifier List

X

[0..0]

00212

Prior Alternate Patient ID

O[0..1]

00213

Prior Patient AccountNumber

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765

SEQ

LEN

DT

Usage

Card.

4

250

CX

X

[0..0]

TBL#

ITEM#
00214

Prior Patient ID

Element name

5

250

CX

X

[0..0]

01279

Prior Visit Number

6

250

CX

X

[0..0]

01280

Prior Alternate Visit ID

7

250

XPN

O

[0..*]

01281

Prior Patient Name

Each of the patient identifiers appearing in the MRG-1 is to be merged with a target patient
identifier of the same type in the PID-3.
The type of identifier is a code given by the 5th component of the CX data type. See thecommonly used identifier types in the description of the PID segment above. See also thedefinition of data type CX in the “Common Data Types” section.
3.30.5.6 ROL – Role segment

770

Standard Reference: HL7 Version 2.5, Chapter 15 (Section 15.4.7)
The ROL segment communicates information on persons related to the patient.
Table 3.30-6: ROL Segment

775

SEQ

LEN

DT

Usage

Card.

TBL
#

1

60

2

2

EI

C

[0..1]

01206

Role Instance ID

ID

R[1..1]

0287

00816

Action Code

3

250

CE

R

[1..1]

0443

01197

Role-ROL

4

250

XCN

R

[1..*]

01198

Role Person

5

26

TS

O

[0..1]

01199

Role Begin Date/Time

6

26

TS

O

[0..1]

01200

Role End Date/Time

7

250

CE

O

[0..1]

01201

Role Duration

8

250

CE

O

[0..1]

01205

Role Action Reason

9

250

CE

O

[0..*]

01510

Provider Type

10

250

CE

O

[0..1]

01461

Organization Unit Type

11

250

XAD

O

[0..*]

00679

Office/Home
Address/Birthplace

12

250

XTN

O

[0..*]

00678

Phone

0406

ITEM #ELEMENT NAME

ROL-1 – Role Instance ID (EI), optional. This field is in fact optional in the context of ADT
messages.
ROL-2 – Action Code (ID), required

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ROL-3 – Role-ROL (CE) , required. This field defines the functional involvement of theperson. Values are given in User-defined Table 0443:
780
User-defined Table 0443: Provider role
Value

Description

Used withAD

AdmittingPV1-17 Admitting doctor

AT

AttendingPV1-7 Attending doctor

CP

Consulting Provider

FHCP

Family Health Care
Professional

PP

Primary Care Provider

RP

Referring Provider

RT

Referred to Provider

PV1-8 Referring doctor

ROL-4 – Role Person (XCN), required. Identification of the person playing the role.
3.30.5.7 OBX – Observation/Result segment
785

Standard Reference: HL7 Version 2.5, Chapter 7 (Section 7.4.2)
In transactions ITI-30 and ITI-31, the OBX segment is primarily used to convey patient heightand patient weight. For this reason, this segment is described in this section, although it always
appears as optional in transactions ITI-30 and ITI-31.

790

Table 3.30-7: OBX Segment
SEQ

LEN

DT

Usage

Card.

1

4

SI

O

[0..1]

2

2

ID

C

[1..1]

3

250

CE

R

4

20

ST

5

99999

Varies

6

250

7
8
9

TBL#

ITEM#

Element name00569

Set ID – OBX

00570

Value Type

[1..1]

00571

Observation IdentifierC[0..1]

00572

Observation Sub-ID

C[1..1]

00573

Observation Value

CEO[0..1]

00574

Units

60

ST

O

[0..1]

00575

References Range

5

IS

O

[0..1]

00576

Abnormal Flags

5

NM

O

[0..1]

00577

Probability

10

2

ID

O

[0..1]

0080

00578

Nature of Abnormal Test

11

1

ID

R

[0..1]

0085

00579

Observation Result Status

12

26

TS

O

[0..1]

00580

Effective Date of Reference Range

13

20

ST

O

[0..1]

00581

User Defined Access Checks

14

26

TS

O

[0..1]

00582

Date/Time of the Observation

0125

0078

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SEQ

LEN

DT

Usage

Card.

15

250

CE

O

[0..1]

TBL#

00583

ITEM#

Producer's ID

Element name

16

250

XCN

O

[0..1]

00584

Responsible Observer

17

250

CE

O

[0..1]

00936

Observation Method

18

22

EI

O

[0..1]

01479

Equipment Instance Identifier

19

26

TS

O

[0..1]

01480

Date/Time of the Analysis

OBX-2 Value Type (ID), conditional.
This field contains the type of observation.
Example: “NM” for a numeric observation such as patient weight or patient height.
795

Condition predicate: This field SHALL be valued if OBX-5 “Observation Value” is present. It
MAY be valued otherwise.
OBX-3 Observation Identifier (CE), required

800

The usage of LOINC® vocabulary is strongly recommended. Details of this free vocabulary canbe found at http://www.loinc.org. The first and third sub-fields, “Identifier” and “Name of
Coding System” are required in all transactions. The value of the “Name of Coding System” inthe case of LOINC is “LN”.
Example of the code used with the patient weight: 3142-7^BODY WEIGHT (STATED)^LN
OBX-4 Observation Sub-ID (CE), conditional
This field is used to distinguish between multiple OBX segments with the same observation ID.

805

Condition predicate: When field OBX-3 “Observation Identifier” has an identical value in two or
more OBX segments of the message, field OBX-4 “Observation Sub-ID” SHALL be populatedwith a distinct value in each of these OBX segments.
OBX-5 Observation Value (Varies), conditional.
This field contains the value of the observation itself.

810

Condition predicate: This field SHALL be valued if OBX-11 “Observation Result Status” hasanother value than “X”, “D”, “N” or “I” and if OBX-8 “Abnormal Flags” is empty. In all othercases this field MAY be valued.
OBX-11 Observation Result Status (ID), required.

815

This field contains the status of the results. In messages of transactions ITI-30 and ITI-31, thisstatus is most commonly “F” (Final).
Example of use of the OBX segment to carry the patient weight and height:
OBX|1|NM|3142-7^BODY WEIGHT (STATED)^LN||62|kg|||||F

OBX|2|NM|8303-0^BODY HEIGHT^LN||1.70|m|||||F

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3.30.5.8 AL1 – Patient Allergy Information segment
820

Standard Reference: HL7 Version 2.5, Chapter 3, Section 3.4.6
In transactions ITI-30 and ITI-31, the AL1 segment is used to inform the receiver of patientallergies. For this reason, this segment is described in this section, although it always appears as
optional in transactions ITI-30 and ITI-31.

825

Table 3.30-8: AL1 Segment
SEQ

LEN

DT

Usage

Card.

1

4

SI

R

[1..1]

2

250

CE

O

[0..1]

3

250

CE

R

[1..1]

4

250

CE

O

[0..1]

5

15

ST

O

6

8

DT

X

TBL#

ITEM#

Element name00203

Set ID – AL1

00204

Allergen Type Code00205

Allergen Code/Mnemonic/Description

00206

Allergen Severity Code[0..*]

00207

Allergen Reaction Code[0..0]

00208

Identification Date

0127
0128

One or more AL1 segments may appear in the messages of transactions ITI-30 and ITI-31 if any
allergies have been identified for the patient at time of registration.
3.30.6830

Interactions

All messages of this transaction shall be acknowledged by the ACK message as stated in ITI TF2x: Appendix C. For better readability, the acknowledgement messages are not shown on theinteraction diagrams of this transaction.

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3.30.6.1 Interaction diagram
Patient
Demographics
SourcePatient
Demographics
Consumer

Create a newpatient

ADT^A28^ADT_A05

Update patient
information

ADT^A31^ADT_A05

Merge twopatients

ADT^A40^ADT_A39

Change patient
identifier list

ADT^A47^ADT_A30

Link patient
information

ADT^A24^ADT_A24

Unlink patient
information

ADT^A37^ADT_A37

835

Figure 3.30-1: Interactions of Transaction ITI-30

3.30.6.2 Create New Patient - ADT^A28^ADT_A05
3.30.6.2.1
840

Trigger Event

This message is sent by a Patient Demographics Supplier to a Patient Demographics Consumer
to communicate the demographics of a new patient, as well as related information.
MSH-9 is valued ADT^A28^ADT_A05.
3.30.6.2.2

Message Static Definition
Table 3.30-9: Static definition of ADT^A28^ADT_A05

Segment

Usage

Card.

HL7 chapter

Message Header

R[1..1]

2

SFT

Software Segment

O[0..*]

2

EVN

Event TypeR

[1..1]

2

MSH

Meaning

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Segment

845

Usage

Card.

HL7 chapter

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

O[0..1]

3

ROL

Role

O

[0..*]

15

NK1

Next of Kin / Associated Parties

O[0..*]

3

PV1

Patient VisitR[1..1]

3

PV2

Patient Visit – Additional Info

X

[0..0]

3

ROL

Role

X

[0..0]

15

DB1

Disability Information

O[0..*]

3

OBX

Observation/Result

O[0..*]

7

AL1

Allergy Information

O[0..*]

3

DG1

Diagnosis Information

O[0..*]

6

DRG

Diagnosis Related GroupO[0..1]

6------ PROCEDURE begin

O[0..*]

PR1

ProceduresR[1..1]

6

ROL

Role

O

[0..*]

15------ PROCEDURE end

GT1

Guarantor

O[0..*]

6------ INSURANCE begin

O[0..*]

IN1

InsuranceR[1..1]

6

IN2

Insurance Additional Info.

O[0..1]

6

IN3

Insurance Additional Info - Cert.

O[0..1]

6

ROL

Role

O

[0..*]

15------ INSURANCE end

ACC

Accident InformationO[0..1]

6

UB1

Universal Bill InformationO[0..1]

6

UB2

Universal Bill 92 InformationO[0..1]

6

3.30.6.2.3

Meaning

Comments on segment usage

The ROL segment following the PID/PD1 segments is used to communicate “person level”
providers having an ongoing relationship with the patient, such as “family health care provider”
and “primary care provider”.
850

The PV1 segment in this message is required in the HL7 message structure, but it is a pseudo
PV1 carrying the only required field PV1-2 “Patient Class” with the value “N” meaning “Notapplicable”. This message does not convey any visit information.
The PV2 segment is not supported here, for the same reason.
The ROL segment following the PV1/PV2 segments is not supported here, for the same reason.

855

One or more OBX segments may be present to carry “permanent observations” such as thepatient weight or height.
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IHE IT Infrastructure Technical Framework, Volume 2b (ITI TF-2b): Transactions Part B______________________________________________________________________________The ROL segment following the IN1/IN2/IN3 segments serves to communicate providers related
to a specific insurance carrier.
3.30.6.2.4
860

Expected actions

The receiver shall add this new patient to its database, and shall report the result of this operation(success / error) in an acknowledgment message returned to the sender.
3.30.6.3 Update patient information - ADT^A31^ADT_A05
3.30.6.3.1

Trigger Event

This message is sent by a Patient Demographics Supplier to a Patient Demographics Consumer
to update the demographics of an existing patient.
865

MSH-9 is valued ADT^A31^ADT_A05.
3.30.6.3.2

Message Static Definition
Table 3.30-10: Static definition of ADT^A31^ADT_A05

Segment

Meaning

Usage

Card.

HL7 chapter

MSH

Message Header

R[1..1]

2

SFT

Software Segment

O[0..*]

2

EVN

Event TypeR

[1..1]

2

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

O[0..1]

3

ROL

Role

O

[0..*]

15

NK1

Next of Kin / Associated Parties

O[0..*]

3

PV1

Patient VisitR[1..1]

3

PV2

Patient Visit – Additional Info

X

[0..0]

3

ROL

Role

O

[0..*]

15

DB1

Disability Information

O[0..*]

3

OBX

Observation/Result

O[0..*]

7

AL1

Allergy Information

O[0..*]

3

DG1

Diagnosis Information

O[0..*]

6

DRG

Diagnosis Related GroupO[0..1]

6------ PROCEDURE begin

O[0..*]

PR1

ProceduresR[1..1]

6

O[0..*]

15
6

ROL

Role

---

--- PROCEDURE end

GT1

Guarantor

O[0..*]------ INSURANCE begin

O[0..*]

IN1

InsuranceR[1..1]

6

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Usage

Card.

HL7 chapter

IN2

Segment

Insurance Additional Info.

O[0..1]

6

IN3

Insurance Additional Info - Cert.

O[0..1]

6

ROL

Role

O

[0..*]

15------ INSURANCE end

ACC

Accident InformationO[0..1]

6

UB1

Universal Bill InformationO[0..1]

6

UB2

Universal Bill 92 InformationO[0..1]

6

3.30.6.3.3
870

Meaning

Comments on segment usage

To accommodate the situation in which the receiver does not know the patient, this message ispopulated with complete up-to-date demographics for the patient.
The ROL segment following the PID/PD1 segments is used to communicate “person level”
providers having an ongoing relationship with the patient, such as “family health care provider”
and “primary care provider”.

875

The PV1 segment in this message is required in the HL7 message structure, but it is a pseudo
PV1 carrying the only required field PV1-2 “Patient Class” with the value “N” meaning “Notapplicable”. This message does not convey any visit information.
The PV2 segment is not supported here, for the same reason.
The ROL segment following the PV1/PV2 segments is not supported here, for the same reason.

880

One or more OBX segments may be present to carry “permanent observations” such as thepatient weight or height.
The ROL segment following the IN1/IN2/IN3 segments serves to communicate providers related
to a specific insurance carrier.
3.30.6.3.4

885

Expected actions

The receiver shall update the patient record in its database, and shall report the result of thisoperation (success / error) in an acknowledgment message returned to the sender. If the receiver
did not previously have a record for this patient, it shall insert this patient into its database.
3.30.6.4

Merge two patients - ADT^A40^ADT_A39

This message is to be supported with the “Merge” Option of transaction ITI-30.
890

3.30.6.4.1

Trigger Event

895

The Patient Demographics Supplier notifies to a Patient Demographics Consumer, the merge ofrecords for a patient that was incorrectly filed under two different identifiers. This message isonly used to merge two patient identifiers of the same type, or two lists of patient identifiers. It is
not used to update other patient demographics information. The A31 trigger event should be used
for this purpose.
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MSH-9 is valued ADT^A40^ADT_A39.
3.30.6.4.2

Message Static Definition
Table 3.30-11: Static definition of ADT^A40^ADT_A39

Segment

Meaning

Usage

Card.

HL7 chapter

MSH

Message Header

R[1..1]

2

SFT

Software Segment

O[0..*]

2

EVN

Event TypeR

[1..1]

2------ PATIENT beginR[1..1]

PID

Patient IdentificationR[1..1]

PD1

Additional Demographics

O[0..1]

3

MRG

Merge InformationR[1..1]

3

PV1

Patient Visit

X[0..0]

3

3

---

900

3.30.6.4.3

Comments on segment usage

This transaction makes unrepeatable the PATIENT segment group: The message cancommunicate only one merge operation for one patient.

905

The “incorrect supplier identifier” identified in the MRG segment (MRG-1 - Prior Patient
Identifier List) is to be merged with the required “correct target identifier” of the same ”identifier
type code” component identified in the PID segment (PID-3 - Patient Identifier List). The“incorrect supplier identifier” would then logically never be referenced in future transactions.
The PV1 segment is not supported by IHE in this message.
3.30.6.4.4

910

Expected actions

The receiver shall merge the two patients in its database, and shall report the result of thisoperation (success / error) in an acknowledgment message returned to the sender.
If the receiver does not recognize the target patient identifiers, it shall perform a Change Patient
Identifier List instead of a Merge. This situation is not an error.
If the receiver does not recognize the supplier patient identifiers to be merged, it shall take noaction. This situation is not an error.

915

If the receiver does not support the Merge Option of this transaction, it shall application-reject
the message (see ITI TF-2x: C.2.3).

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3.30.6.5 Change Patient Identifier List - ADT^A47^ADT_A30
3.30.6.5.1
920

Trigger Event

The Patient Demographics Supplier notifies the change of a patient identifier list for a patient.
That is, a single PID-3-patient identifier list value has been found to be incorrect and has beenchanged.
This message is not used to update other patient demographics information. The A31 trigger
event should be used for this purpose.
MSH-9 is valued ADT^A47^ADT_A30.

925

3.30.6.5.2

Message Static Definition
Table 3.30-12: Static definition of ADT^A47^ADT_A30

Segment

Meaning

Usage

Card.

HL7 chapter

MSH

Message Header

R[1..1]

2

SFT

Software Segment

O[0..*]

2

EVN

Event TypeR

[1..1]

2------ PATIENT beginR[1..1]

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

O[0..1]

3

MRG

Merge InformationR[1..1]

3---

3.30.6.5.3
930

Comments on segment usage

The “incorrect supplier identifier” value is stored in the MRG segment (MRG-1-Prior Patient
Identifier List) and is to be changed to the “correct target patient ID” value stored in the PID
segment (PID-3–Patient Identifier List).
3.30.6.5.4

Expected actions

The receiver shall correct the identifier in its database, and shall report the result of this operation(success / error) in an acknowledgment message returned to the sender.
935

If the receiver already associates the target patient identifiers with another patient in its database,this is an error condition: A merge (A40) should have been sent instead of a change.
If the receiver does not recognize the supplier patient identifiers to be merged, no further action
is required and no error condition exists.
3.30.6.6 Link Patient Information List - ADT^A24^ADT_A24

940

This message is to be supported with the “Link/Unlink” Option of transaction ITI-30.

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3.30.6.6.1

945

Trigger Event

The Patient Demographics Supplier notifies the link of one patient identifier list (the first PID
segment) to another one (the second PID segment). Linking two or more patients does not
require the actual merging of patient information; following a link event, the affected patient data
records should remain distinct.
This message is not used to update other patient demographics information. The A31 trigger
event should be used for that purpose.
MSH-9 is valued to ADT^A24^ADT_A24.
3.30.6.6.2

Message Static Definition

950
Table 3.30-13: Static definition of ADT^A24^ADT_A24
Segment

955

Meaning

Usage

Card.

HL7 chapter

MSH

Message Header

R[1..1]

2

SFT

Software Segment

O[0..*]

2

EVN

Event TypeR

[1..1]

2

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

X[0..1]

3

PV1

Patient Visit

X[0..1]

3

DB1

Disability Information

X[0..1]

3

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

X[0..1]

3

PV1

Patient Visit

X[0..1]

3

DB1

Disability Information

X[0..1]

3

3.30.6.6.3

Comments on segment usage

The patient identifier list stored in the first PID segment (PID-3–Patient Identifier List) is to belinked with the patient identifier list stored in the second PID segment (PID-3–Patient Identifier
List).
Transaction ITI-30 restricts the use of this message to only the purpose of linking two patient
identifier lists. This is why segments PD1, PV1 and DB1 are not supported in this message.
3.30.6.6.4

960

Expected actions

The receiver links the identifier lists in its database, and reports the result of this operation(success / error) in an acknowledgment message returned to the sender. In case of success, eachpatient record persists with all its associated information (encounter, clinical, care, insurance,next of kin, etc.).

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965

In case the receiver did not recognize one or both of the patient identifier lists, the linking is still
performed (the receiver will record the link without creating any missing patient record) and noerror condition exists.
If the receiver does not support the Link/Unlink Option of this transaction, it shall applicationreject the message (see ITI TF-2x: C.2.3).
3.30.6.7 Unlink Patient Information List - ADT^A37^ADT_A37
3.30.6.7.1

970

Trigger Event

The Patient Demographics Supplier notifies the receiving system of the unlinking of one patient
identifier list (the first PID segment) from another one (the second PID segment).
MSH-9 is valued ADT^A37^ADT_A37.
3.30.6.7.2

Message Static Definition

975

Table 3.30-14: Static definition of ADT^A37^ADT_A37
Segment

Meaning

Usage

Card.

HL7 chapter

MSH

Message Header

R[1..1]

2

SFT

Software Segment

O[0..*]

2

EVN

Event TypeR

[1..1]

2

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

X[0..1]

3

PV1

Patient Visit

X[0..1]

3

DB1

Disability Information

X[0..1]

3

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

X[0..1]

3

PV1

Patient Visit

X[0..1]

3

DB1

Disability Information

X[0..1]

3

3.30.6.7.3

Comments on segment usage

The patient identifier lists stored in the two PID segments (PID-3–Patient Identifier List) are to
be unlinked.
980

Transaction ITI-30 restricts the use of this message to only the purpose of unlinking two patient
identifier lists. This is why segments PD1, PV1 and DB1 are not supported in this message.
3.30.6.7.4

Expected actions

The receiver unlinks the identifier lists in its database, and reports the result of this operation(success / error) in an acknowledgment message returned to the sender.

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985

In case of success the two patient records are unlinked, each of them keeping its own related
information (encounter, clinical, next of kin, insurance…).
In case the receiver did not recognize the link between these two patient identifier lists, no action
is performed and no error condition exists.
If the receiver does not support the Link/Unlink Option of this transaction, it shall applicationreject the message (see ITI TF-2x: C.2.3).

990

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3.31 Patient Encounter Management
This section corresponds to transaction ITI-31 “Patient Encounter Management” of the IHE IT
Infrastructure Technical Framework. Transaction ITI-31 is used by the actors Patient Encounter
Supplier and Patient Encounter Consumer.
995

3.31.1 Scope
This transaction enables systems to share encounter information within acute care settings forboth inpatients (i.e., those who are assigned an inpatient bed at the facility) and outpatients (i.e.,
those who are not assigned an inpatient bed at the facility).

1000

The transaction carries events for creating, updating, and canceling patient encounters as well as
the movements that take place within these encounters.
The capabilities of this transaction are organized into several optional subsets to address a wide
range of needs from the simplest one that only shares the basic encounter information to the mostsophisticated one that tracks all patient temporary moves in the healthcare facility.
3.31.2 Use Case Roles

Patient
Encounter Source

Patient
Encounter
Consumer

Patient Encounter
Management
1005
Actor: Patient Encounter SupplierRole: Sends inserts, cancels and updates of patient encounters and movements.
Actor: Patient Encounter Consumer
Role: Receives patient encounters and movement messages, and takes the appropriate actions.
1010

3.31.3 Referenced Standards
HL7 2.5 Chapters 2, 3, 6, 15
3.31.4 Definition of the concept “Movement”
As stated in Volume 1, a “Movement” is any change of the situation of the patient (location,
patient class, attending doctor, etc.) in the context of the encounter.
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1015

1020

1025

1030

The concept of “Movement” is a superset of the concept of “Transfer”. Like a transfer, amovement is an event that can be planned (pending) and executed (effective). Errors detected in
the recording of these pending and effective events can later be corrected through cancellations
or updates, which are distinct events. Three actions are associated with Movements:•

Insert: This action is the first recording of the Movement.

•

Update: This action corrects some attributes of a Movement formerly inserted. Thisaction is possible only with the option “Historic Movement Management” of transaction
ITI-30.

•Cancel: This action cancels a Movement that was erroneously recorded, and requests thereceiver to delete this Movement from its database. Only the current Movement can becancelled.

In some acute care settings, both the billing process and care provision process require precise
knowledge of the movements of the inpatient during his or her stay in the hospital. Applications
acting as Patient Encounter Supplier or Patient Encounter Consumer, divide the period of theencounter into “sub-encounters” delimited by the Movements. Each of these “sub-encounters”
provides a specific context to record and invoice the acts produced within this period. However,
if applications on both ends manage sub-encounters, which are periods of time, the messages oftransaction ITI-31 communicate Movements as events. Hence, applications manage periods oftime, but the messages carry the discrete events that delimit these periods of time.
Illustration:1035

1. Patient received at Emergency room by attending doctor U. (A04 / patient class E).
2. Doctor U admits the patient (A06 / patient class = I), into location BB, referring him toattending Doctor X.
3. The patient is moved to location GG (A02Transfer), keeping X for attending doctor.
4. The patient is healed and leaves the hospital (A03: Discharge).

1040

These 4 real world events are expressed with 5 trigger events / messages, two of which occur atthe same time (step 2). Here the encounter will be divided into 3 sub-encounters:

A04
Emergency &attending
doctor U

A06

A02
Location BB& attending
doctor X

A03
Location GG& attending
doctor X

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3.31.5 Message sets and options
1045

All messages of this transaction shall be acknowledged by the ACK message as described in ITI
TF-2x: Appendix C. For better readability, the acknowledgement messages are not shown on theinteraction diagrams of this transaction.
3.31.5.1 Basic Subset

1050

Table 3.31-1: Message Basic Subset for Transaction ITI-31
Trigger / Action

Category of event

insertAdmit inpatientA01

ADT^A01^ADT_A01

Register outpatient

A04

ADT^A04^ADT_A01

Discharge patient

A03

ADT^A03^ADT_A03

cancelA11

ADT^A11^ADT_A09

A13

ADT^A13^ADT_A01

The Basic Subset of transaction ITI-31 is composed of the above events and related messages. A
system implementing either Patient Encounter Supplier or Patient Encounter Consumer, shallsupport these 5 trigger events and messages.
1055
Patient Encounter
Supplier

Patient Encounter
Consumer

Admit inpatient

ADT^A01^ADT_A01

Discharge
patient

ADT^A03^ADT_A03

Registeroutpatient

ADT^A04^ADT_A04

Canceladmit/visit

ADT^A11^ADT_A09

Canceldischarge

ADT^A13^ADT_A01

Figure 3.31-1: Interaction Diagram for the Basic Subset

3.31.5.2 Inpatient/Outpatient Encounter Management Option
1060

This option adds support for management of patient class (Outpatient, Emergency, Inpatient,Pre-admitted, etc.) and of patient location (point of care, room, bed, etc.).

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The following is the required message set to support the “Inpatient/Outpatient Encounter
Management” Option:
Table 3.31-2: Message Subset for Inpatient/outpatient Encounter Management Option
Trigger / Action

Category of event

insertAdmit inpatientA01

ADT^A01^ADT_A01

Register outpatient

A04

ADT^A04^ADT_A01

Discharge patient

A03

Pre-admit patient

cancelA11

ADT^A11^ADT_A09

ADT^A03^ADT_A03

A13

ADT^A13^ADT_A01

A05

ADT^A05^ADT_A05

A38

ADT^A38^ADT_A38

Change patient class to
inpatient

A06

ADT^A06^ADT_A06

Change patient class to
outpatient

A07

ADT^A07^ADT_A06

Transfer patient

A02

ADT^A02^ADT_A02

A12

ADT^A12^ADT_A12

1065
A system implementing this option shall support these 11 trigger events and messages.
Figure 3.31-2 depicts the messages added by this option to the basic subset.
Patient Encounter
Supplier

1070

Patient Encounter
ConsumerPre-admit
inpatient

ADT^A05^ADT_A05

Cancelpre-admit

ADT^A38^ADT_A38

Change toinpatient

ADT^A06^ADT_A06

Change tooutpatient

ADT^A07^ADT_A07

Transferpatient

ADT^A02^ADT_A02

Cancel patienttransfer

ADT^A12^ADT_A12

Figure 3.31-2: Additional Interactions for “Inpatient/Outpatient Encounter Management”
Option
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3.31.5.3 Pending Event Management Option
This option adds support for management of pending events. This option also requires the“Inpatient/Outpatient Encounter Management” Option.
The following is the required message set to support the “Pending Event Management” Option:
1075
Table 3.31-3: Message Subset for Pending Event Management Option
Trigger / Action

Category of event

insertcancelAdmit inpatientA01

ADT^A01^ADT_A01

Register outpatient

A04

ADT^A04^ADT_A01

Discharge patient

A03

Pre-admit patient

A05

A11

ADT^A11^ADT_A09

ADT^A03^ADT_A03

A13

ADT^A13^ADT_A01

ADT^A05^ADT_A05

A38

ADT^A38^ADT_A38

Change patient class to inpatient

A06

ADT^A06^ADT_A06

Change patient class to outpatient

A07

ADT^A07^ADT_A06

Transfer patient

A02

ADT^A02^ADT_A02

A12

ADT^A12^ADT_A12

Pending admit

A14

ADT^A14^ADT_A05

A27

ADT^A27^ADT_A21

Pending transfer

A15

ADT^A15^ADT_A15

A26

ADT^A26^ADT_A21

Pending discharge

A16

ADT^A16^ADT_A16

A25

ADT^A25^ADT_A21

A system implementing this option shall support these 17 trigger events and messages.
1080

Figure 3.31-3 below depicts the messages added by this option to the basic subset and theInpatient/Outpatient Encounter Management Option.

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Patient Encounter
SourcePatient Encounter
Consumer

Pending admitof a inpatient

ADT^A14^ADT_A05

Cancelpending admit

ADT^A27^ADT_A21

Pendingtransfer

ADT^A15^ADT_A15

Cancel pendingtransfer

ADT^A26^ADT_A21

Pendingdischarge

ADT^A16^ADT_A16

Cancel pending
discharge

ADT^A25^ADT_A21

Figure 3.31-3: Additional Interactions for “Pending Event Management” Option

3.31.5.4 Advanced Encounter Management Option
1085This option provides support to manage changes of attending doctor, leaves of absence, andaccounts.
The following is the required message set to support the “Advanced Encounter Management”
Option:1090

Table 3.31-4: Message Subset for Advanced Encounter Management Option
Trigger / Action

Category of event

insertAdmit inpatientA01

ADT^A01^ADT_A01

Register outpatient

A04

ADT^A04^ADT_A01

Discharge patient

A03

Change attending doctor
Leave of absence

cancelA11

ADT^A11^ADT_A09

ADT^A03^ADT_A03

A13

ADT^A13^ADT_A01

A54

ADT^A54^ADT_A54

A55

ADT^A55^ADT_A52

A21

ADT^A21^ADT_A21

A52

ADT^A52^ADT_A52

Return from leave of absence

A22

ADT^A22^ADT_A21

A53

ADT^A53^ADT_A52

Move account information

A44

ADT^A44^ADT_A43

A system implementing this option shall support these 12 trigger events and messages.
Figure 3.31-4 below depicts the messages added by this option to the basic subset.
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Patient Encounter
SourcePatient Encounter
Consumer

Change attending
doctor

ADT^A54^ADT_A54

Cancel change
attending doctor

ADT^A55^ADT_A52

Leave of absence

ADT^A21^ADT_A21

Cancel leave ofabsence

ADT^A52^ADT_A52

Return from leave ofabsence

ADT^A22^ADT_A21

Cancel return fromleave of absence

ADT^A53^ADT_A52

Move accountinformation

ADT^A44^ADT_A43

Figure 3.31-4: Additional Interactions for “Advanced Encounter Management” Option

1095

3.31.5.5 Temporary Patient Transfers Tracking Option
This option tracks patient moves to and from temporary locations such as radiotherapy, scanner,
EKG, and dialysis.
The following is the required message set to support the “Temporary Patient Transfers Tracking”
Option:1100
Table 3.31-5: Message Subset for Temporary Patient Transfers Tracking Option
Trigger / Action

Category of event

insertcancelAdmit inpatientA01

ADT^A01^ADT_A01

Register outpatient

A04

ADT^A04^ADT_A01

Discharge patient

A03

ADT^A03^ADT_A03

Patient departing - Tracking

A09

ADT^A09^ADT_A09

A33

ADT^A33^ADT_A21

Patient arriving - Tracking

A10

ADT^A10^ADT_A09

A32

ADT^A32^ADT_A21

A11

ADT^A11^ADT_A09

A13

ADT^A13^ADT_A01

A system implementing this option shall support these 9 trigger events and messages.

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Figure 3.31-5 below depicts the messages added by this option to the basic subset.
1105
Patient Encounter
SourcePatient Encounter
Consumer

Patient departing,tracking

ADT^A09^ADT_A09

Patient arriving,
tracking

ADT^A10^ADT_A09

Cancel patient
departing, tracking

ADT^A33^ADT_A21

Cancel patient
arriving, tracking

ADT^A32^ADT_A21

Figure 3.31-5: Additional Interactions for “Temporary Patient Transfers Tracking” Option

3.31.5.6 Historic Movement Management
This option adds the capability to cancel or update safely any Movement.
1110

The Movement updated can be the current Movement (currently active or pending) or a
Movement in the past (i.e., historic Movement).
The Movement canceled can only be the current Movement (currently active or pending).

1115

1120

This capability is supported by the addition of segment ZBE below PV1/PV2. With this option,
this ZBE segment is required at this position in the messages associated with the following
trigger events: A01, A02, A03, A04, A05, A06, A07, A11, A12, A13, A14, A15, A16, A21,
A22, A25, A26, A27, A38, A52, A53, A54, A55, Z99. In the following sections the ZBE
segment is only shown in the message associated with trigger Z99 which is dedicated to theHistoric Movement Management Option. In the other messages, this segment will appear
whenever this option is active.
This segment ZBE brings the following features:•

It enables unique identification of the Movement (including admission and discharge).

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It carries an action code that describes the action to be performed on this Movement: The
three possible actions are:•

INSERT: The receiver must interpret the content of this message as a new
Movement.

•

CANCEL: This action code is always associated with a “cancel” trigger event. The
receiver shall delete the corresponding Movement (matched with its unique
identifier). Only the current Movement can be cancelled.

•

UPDATE: This action code is associated with the dedicated trigger event Z99
described in Section 3.31.7.30. The receiver shall update the corresponding
Movement (matched with its unique identifier), which can be the current Movement
or a historic Movement.

1125

1130

1135

1140

•

In the case of UPDATE or CANCEL, the ZBE segment carries the code of the original
trigger event that was associated with the action INSERT of the related Movement.

•

It carries an indicator “Historic Movement” informing whether the action to perform isabout the current Movement or a Historic one.

•

It provides the starting date/time of the “sub-encounter” that this Movement initiates.

•

It carries the ward to which this patient is assigned during this sub-encounter.

This option may apply to any combination of the previous subsets, except Temporary Patient
Transfers Tracking (Temporary Patient Transfers do not need to be uniquely identified).
Implementation note: The Patient Encounter Consumer must support transaction log update tomaintain integrity of the Movement records.
3.31.5.7 Acknowledgement Support

1145

An actor that claims support for the Acknowledgement Support Option shall be capable of using
the enhanced acknowledgement mode as defined in the HL7 v2.x standard. See HL7 Volume 2C,
Section C.2.3 for further details.
3.31.5.8 Ambulatory Patient Data
If the Patient Encounter Supplier supports the Ambulatory Patient Data Option, it SHALL
supply:1150

the patient address in field PID-11 for ambulatory patients whenever this address is known
the referring doctor in field PV1-8, if known, when registering an outpatient (MSH-9 Message
Type is ADT^A04) or when pre-registering a patient (MSH-9 Message Type is ADT^A05)
the ambulatory status of the patient into field PV1-15 if this information is known.

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3.31.5.9 Maintain Demographics Option
1155

This option adds support to manage “Update patient information” and “Merge patient identifierlist” in the context of an encounter.
The following is the required message set to support the “Maintain Demographics Option”:
Trigger / Action

Category of event1160

insertAdmit inpatientA01

ADT^A01^ADT_A01

Register outpatient

A04

ADT^A04^ADT_A01

Discharge patient

A03

ADT^A03^ADT_A03

Update patient
information

A08

ADT^A08^ADT_A01

Merge patient identifier
list

A40

ADT^A40^ADT_A39

cancelA11

ADT^A11^ADT_A09

A13

ADT^A13^ADT_A01

A Patient Encounter Supplier or Patient Encounter Consumer supporting the Maintain
Demographics Option shall support these 7 trigger events and messages.
Figure 3.31-6 depicts the messages added by this option to the basic subset.

1165

Figure 3.31-6: Additional Interactions for “Maintain Demographics” Option

3.31.6 Common HL7 Message Segments

1170

Messages in transaction ITI-31 use the same common HL7 message segments as those intransaction ITI-30; refer to Section 3.30.5. In addition, messages in transaction ITI-31 use the
ZBE segment, described below.

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3.31.6.1 ZBE – Movement Action segment
The ZBE segment was introduced in the German extension of the IHE Radiology Technical
Framework. It is extended here with three additional fields: ZBE-5, ZBE-6 and ZBE-7. ThisZBE segment is required with the “Historic Movement” Option of transaction ITI-31.
1175

1180

The purpose of this segment is to uniquely identify any movement at creation time (action
INSERT), so that any further correction brought to this movement (action UPDATE) or
cancellation of it (action CANCEL) can be achieved safely and consistently between the two
actors Patient Encounter Supplier and Patient Encounter Consumer.
Another security feature offered by this segment is to clearly distinguish current events fromevents that address a historic (past) movement to avoid any misinterpretation on the part of thereceiving application.
Table 3.31-6: ZBE segment description
SEQ

1185

1190

LEN

DT

Usage

Card.

ELEMENT NAME

1

EI

R

[1..*]

Movement ID

2

TS

R

[1..1]Start Movement Date/Time

3

TS

O

[0..1]End Movement Date/Time

4

ID

R

[1..1]

Movement Action (INSERT / UPDATE / CANCEL)

5

ID

R

[1..1]

Historical Movement Indicator (values: Y / N)

6

ID

C

[0..1]

Original trigger event code [in the case of an UPDATE of the
movement (trigger A08), this field conveys the original trigger
event that was sent with the INSERT]

7

XO
N

O

[0..1]

Responsible Ward (Medical or Nursing Ward, depending of thetrigger event of the message)

ZBE-1 – Movement ID (EI): required and repeatable to support cooperative Movement
Management. The Movement Identifier list is created with the action INSERT, and then recalledwith further actions such as UPDATE or CANCEL.
ZBE-2 – Start Movement Date/Time (TS): Required. It is the date/time of the creation of theMovement, i.e., the effective date time of the event that used action INSERT with thisMovement.
ZBE-3 – End Movement Date/Time (TS): Optional.
ZBE-4 – Action (ID): Required. Three possible values:

1195

•

INSERT: With any trigger event that inserts a movement.

•

UPDATE: With trigger event Z99•

CANCEL: With any “cancel” trigger event.

ZBE-5 –Historic Indicator (ID): Required. Values:
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•‘N’ when the message is related to the current (last or next) movement.

ZBE-6 – Original Trigger (ID): Conditional.
1200

1205

Condition predicate: This field shall be populated when ZBE-4 contains action UPDATE or
CANCEL. In this case, this field is populated with the trigger event that inserted (action
INSERT) the movement being currently updated or canceled.
ZBE-7 – Responsible Ward (XON): Optional. This field may be further constrained in national
extensions of this transaction. It will, for example, be associated with usage ‘RE’ in the Frenchextension.
3.31.7 Interactions
The following sections contain the static definitions of the messages belonging to the various
optional sets described above.

1210

The Historic Movement Management Option is not shown in these message tables. The reader isreminded that this option adds the ZBE segment below PV1/PV2.
3.31.7.1 Admit/Visit Notification (ADT^A01^ADT_A01)
3.31.7.1.1

1215

Trigger Event

This message is sent by a Patient Encounter Supplier to notify a Patient Encounter Consumer
that a patient has arrived at a healthcare facility for an episode of care in which the patient is
assigned to an inpatient bed. Such an episode is commonly referred to as “inpatient” care.
MSH-9 is valued ADT^A01^ADT_A01.
3.31.7.1.2

Message Static Definition
Table 3.31-7: Static definition of message ADT^A01^ADT_A01

Segment

Meaning

Usage

Card.

HL7 chapter

MSH

Message Header

R[1..1]

2

SFT

Software Segment

O[0..*]

2

EVN

Event TypeR

[1..1]

2

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

O[0..1]

3

ROL

Role

O

[0..*]

15

NK1

Next of Kin / Associated Parties

O[0..*]

3

PV1

Patient VisitR[1..1]

3

PV2

Patient Visit – Additional InfoO

[0..1]

3

ROL

Role

O

[0..*]

15

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Usage

Card.

HL7 chapter

DB1

Segment

Disability Information

MeaningO[0..*]

3

OBX

Observation/Result

O[0..*]

7

AL1

Allergy Information

O[0..*]

3

DG1

Diagnosis Information

O[0..*]

6

DRG

Diagnosis Related GroupO[0..1]

6------ PROCEDURE begin

O[0..*]

PR1

ProceduresR[1..1]

6

ROL

Role

O

[0..*]

15------ PROCEDURE end

GT1

Guarantor

O[0..*]

6------ INSURANCE begin

O[0..*]

IN1

InsuranceR[1..1]

6

IN2

Insurance Additional Info.

O[0..1]

6

IN3

Insurance Additional Info - Cert.

O[0..1]

6

ROL

Role

O

[0..*]

15------ INSURANCE end

ACC

Accident InformationO[0..1]

6

UB1

Universal Bill InformationO[0..1]

6

UB2

Universal Bill 92 InformationO[0..1]

6

PDA

Patient Death and AutopsyO[0..1]

31220

3.31.7.1.3

Comments on segment usage

1225

Providers with an ongoing relationship with the patient may be communicated in ROL segments
immediately following the PID/PD1 segments. Providers specific to an episode of care may be
communicated in ROL segments immediately following the PV1/PV2 segments. Providers
specific to a particular insurance carrier may be communicated in ROL segments immediately
following the IN1/IN2/IN3 segments.
One or more OBX segments may be present to carry “permanent observations” such as thepatient weight or height.
3.31.7.1.4

Expected actions

The receiver shall update the patient’s status to indicate that the patient has been admitted.
1230

The receiver shall report the result of this operation (success / error) in an acknowledgment
message returned to the sender.
In case this Movement (new admission) conflicts with an existing current movement for thepatient (an admission is already opened for this patient) the message is discarded and an error
condition is raised.

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1235

3.31.7.2 Cancel Admit/Visit Notification – ADT^A11^ADT_A09
3.31.7.2.1

1240

Trigger Event

This message is sent by a Patient Encounter Supplier to cancel a previous notification to a Patient
Encounter Consumer as a notification that a patient has been admitted for an inpatient stay (via
trigger event A01) or registered for an outpatient visit (via trigger event A04). See Section
3.31.5.8 for the message to be used to cancel a pre-admit notification, and Section 3.31.5.14 forthe message to be used to cancel a pending admit notification.
MSH-9 is valued ADT^A11^ADT_A09.
3.31.7.2.2

1245

Message Static Definition
Table 3.31-8: Static definition of message ADT^A11^ADT_A09

Segment

Meaning

Usage

Card.

HL7 chapter

MSH

Message Header

R[1..1]

2

SFT

Software Segment

O[0..*]

2

EVN

Event TypeR

[1..1]

2

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

O[0..1]

3

PV1

Patient VisitR[1..1]

3

PV2

Patient Visit – Additional InfoO

[0..1]

3

DB1

Disability Information

O[0..*]

3

OBX

Observation/Result

O[0..*]

7

DG1

Diagnosis Information

X[0..0]

6

3.31.7.2.3

Comments on segment usageNone.
3.31.7.2.4
1250

Expected actions

The receiver shall reset the patient’s status in its system to the value existing immediately before
the admit or visit notification was received.
The receiver shall report the result of this operation (success / error) in an acknowledgment
message returned to the sender.

1255

In case this Movement conflicts with the current situation of the patient (i.e., no inpatient nor
outpatient visit has been opened for this patient) the message is discarded but no error conditionis raised.

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3.31.7.3 Register a Patient (ADT^A04^ADT_A01)
3.31.7.3.1

1260

Trigger Event

This message is sent by a Patient Encounter Supplier to notify a Patient Encounter Consumer
that a patient has arrived at a healthcare facility for an episode of care in which the patient is not
assigned to a bed. Examples of such episodes include outpatient visits, ambulatory careencounters, and emergency room visits.
MSH-9 is valued ADT^A04^ADT_A01.
3.31.7.3.2

1265

Message Static Definition
Table 3.31-9: Static definition of message ADT^A04^ADT_A01

Segment

Meaning

Usage

Card.

HL7 chapter

MSH

Message Header

R[1..1]

2

SFT

Software Segment

O[0..*]

2

EVN

Event TypeR

[1..1]

2

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

O[0..1]

3

ROL

Role

O

[0..*]

15

NK1

Next of Kin / Associated Parties

O[0..*]

3

PV1

Patient VisitR[1..1]

3

PV2

Patient Visit – Additional InfoO

[0..1]

3

ROL

Role

O

[0..*]

15

DB1

Disability Information

O[0..*]

3

OBX

Observation/Result

O[0..*]

7

AL1

Allergy Information

O[0..*]

3

DG1

Diagnosis Information

O[0..*]

6

DRG

Diagnosis Related GroupO[0..1]

6------ PROCEDURE begin

O[0..*]

PR1

ProceduresR[1..1]

6

ROL

Role

O

[0..*]

15------ PROCEDURE end

GT1

Guarantor

O[0..*]

6------ INSURANCE begin

O[0..*]

IN1

InsuranceR[1..1]

6

IN2

Insurance Additional Info.

O[0..1]

6

IN3

Insurance Additional Info - Cert.

O[0..1]

6

ROL

Role

O

[0..*]

15------ INSURANCE end

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Usage

Card.

ACC

Segment

Accident Information

MeaningO[0..1]

6

HL7 chapter

UB1

Universal Bill InformationO[0..1]

6

UB2

Universal Bill 92 InformationO[0..1]

6

PDA

Patient Death and AutopsyO[0..1]

3

3.31.7.3.3

Comments on segment usage

Field PV1-44-admit date/time is used to carry the date and time that the encounter started.

1270

Providers with an ongoing relationship with the patient may be communicated in ROL segments
immediately following the PID/PD1 segments. Providers specific to an episode of care may be
communicated in ROL segments immediately following the PV1/PV2 segments. Providers
specific to a particular insurance carrier may be communicated in ROL segments immediately
following the IN1/IN2/IN3 segments.
One or more OBX segments may be present to carry “permanent observations” such as thepatient weight or height.

1275

3.31.7.3.4

Expected actions

The receiver shall update the patient’s status to indicate that the visit has started.
The receiver shall report the result of this operation (success / error) in an acknowledgment
message returned to the sender.
1280

In case an inpatient encounter is already opened, the outpatient encounter is still recorded by thereceiver. This is not a situation of conflict and no error condition is raised.
3.31.7.4 Discharge/End Visit (ADT^A03^ADT_A03)
3.31.7.4.1

1285

Trigger Event

This message is sent by a Patient Encounter Supplier to notify a Patient Encounter Consumer
that a patient’s stay at a healthcare facility has ended. Inpatient encounters are generally closed
by an A03. Outpatient encounters may or may not be closed by an A03, depending on thehealthcare organization policies.
MSH-9 is valued ADT^A03^ADT_A03.
3.31.7.4.2

1290

Message Static Definition
Table 3.31-10: Static definition of message ADT^A03^ADT_A03
Usage

Card.

MSH

Segment

Message Header

MeaningR[1..1]

2

HL7 chapter

SFT

Software Segment

O[0..*]

2

EVN

Event TypeR

[1..1]

2

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Usage

Card.

PID

Segment

Patient Identification

MeaningR[1..1]

3

HL7 chapter

PD1

Additional Demographics

O[0..1]

3

ROL

Role

O

[0..*]

15

NK1

Next of Kin / Associated Parties

O[0..*]

3

PV1

Patient VisitR[1..1]

3

PV2

Patient Visit – Additional Info

X

[0..0]

3

ROL

Role

O

[0..*]

15

DB1

Disability Information

O[0..*]

3

AL1

Allergy Information

O[0..*]

3

DG1

Diagnosis Information

O[0..*]

6

DRG

Diagnosis Related GroupO[0..1]

6------ PROCEDURE begin

O[0..*]

PR1

ProceduresR[1..1]

6

O[0..*]

15

ROL

Role

---

--- PROCEDURE end

OBX

Observation/Result

O[0..*]

7

GT1

Guarantor

O[0..*]

6------ INSURANCE begin

O[0..*]

IN1

InsuranceR[1..1]

6

IN2

Insurance Additional Info.

O[0..1]

6

IN3

Insurance Additional Info - Cert.

O[0..1]

6

ROL

Role

O

[0..*]

15------ INSURANCE end

ACC

Accident InformationO[0..1]

6

PDA

Patient Death and AutopsyO[0..1]

3

3.31.7.4.3

Comments on segment usage

Field PV1-3-assigned patient location is used to indicate the patient’s last location prior todischarge (or end of visit).
1295

Field PV1-45-discharge date/time is used to carry either the date and time of discharge (for an
inpatient) or the date and time that the visit ended (for an outpatient).

1300

Providers with an ongoing relationship with the patient may be communicated in ROL segments
immediately following the PID/PD1 segments. Providers specific to an episode of care may be
communicated in ROL segments immediately following the PV1/PV2 segments. Providers
specific to a particular insurance carrier may be communicated in ROL segments immediately
following the IN1/IN2/IN3 segments.

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Within a Patient Discharge message, if the encounter has been terminated by the patient's death,then the field PID-30 Patient Death Indicator shall be populated. In this case PID-29 Patient
Death Date and Time shall be populated as well, provided that the value is known..
3.31.7.4.4
1305

Expected actions

The receiver shall update the patient’s status to “discharged” (or “visit ended”).
The receiver shall report the result of this operation (success / error) in an acknowledgment
message returned to the sender.
In case this Movement conflicts with the current situation of the patient (no inpatient nor
outpatient visit opened for this patient) the message is discarded but no error condition is raised.

1310

3.31.7.5 Cancel Discharge/End Visit – ADT^A13^ADT_A01
3.31.7.5.1

Trigger Event

This message is sent by a Patient Encounter Supplier to a Patient Encounter Consumer to cancel
a previous notification (via trigger event A03) that a patient’s stay at a healthcare facility had
ended.
1315

MSH-9 is valued ADT^A13^ADT_A01.
3.31.7.5.2

Message Static Definition
Table 3.31-11: Static definition of message ADT^A13^ADT_A01

Segment

Meaning

Usage

Card.

HL7 chapter

MSH

Message Header

R[1..1]

2

SFT

Software Segment

O[0..*]

2

EVN

Event TypeR

[1..1]

2

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

O[0..1]

3

ROL

Role

O

[0..*]

15

NK1

Next of Kin / Associated Parties

O[0..*]

3

PV1

Patient VisitR[1..1]

3

PV2

Patient Visit – Additional InfoO

[0..1]

3

ROL

Role

O

[0..*]

15

DB1

Disability Information

O[0..*]

3

OBX

Observation/Result

O[0..*]

7

AL1

Allergy Information

O[0..*]

3

DG1

Diagnosis Information

O[0..*]

6

DRG

Diagnosis Related GroupO[0..1]

6------ PROCEDURE begin

O[0..*]

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Segment

1320

Usage

Card.

PR1

ProceduresR[1..1]

6

ROL

Role

O

[0..*]

15------ PROCEDURE end

HL7 chapter

6

GT1

Guarantor

O[0..*]------ INSURANCE begin

O[0..*]

IN1

InsuranceR[1..1]

6

IN2

Insurance Additional Info.

O[0..1]

6

IN3

Insurance Additional Info - Cert.

O[0..1]

6

ROL

Role

O

[0..*]

15------ INSURANCE end

ACC

Accident InformationO[0..1]

6

UB1

Universal Bill InformationO[0..1]

6

UB2

Universal Bill 92 InformationO[0..1]

6

PDA

Patient Death and AutopsyO[0..1]

3

3.31.7.5.3

Comments on segment usage

Field PV1-3-patient location shall contain the patient’s location after the cancellation has beenprocessed. This may be different from the patient’s location prior to the discharge/end visit
notification.
3.31.7.5.4

1325

Meaning

Expected actions

The receiver shall reset the patient’s status to its value prior to the receipt of the discharge/end
visit message, and shall update the patient’s location to the value in field PV1-3-patient location.
The receiver shall report the result of this operation (success / error) in an acknowledgment
message returned to the sender.
In case this Movement conflicts with the current situation of the patient (no prior discharge
received) the message is discarded but no error condition is raised.

1330

3.31.7.6 Update Patient Information (ADT^A08^ADT_A01)
3.31.7.6.1

1335

Trigger Event

This message is sent by a Patient Encounter Supplier to notify a Patient Encounter Consumer
that some non-movement-related information (such as address, date of birth, etc.) has changed
for a patient. It is used when information about the patient has changed not related to any othertrigger event.
MSH-9 is valued ADT^A08^ADT_A01.

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3.31.7.6.2

Message Static Definition
Table 3.31-12: Static definition of message ADT^A08^ADT_A01

Segment

1340

Meaning

Usage

Card.

HL7 chapter

MSH

Message Header

R[1..1]

2

SFT

Software Segment

O[0..*]

2

EVN

Event TypeR

[1..1]

2

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

O[0..1]

3

ROL

Role

O

[0..*]

15

NK1

Next of Kin / Associated Parties

O[0..*]

3

PV1

Patient VisitR[1..1]

3

PV2

Patient Visit – Additional InfoO

[0..1]

3

ROL

Role

O

[0..*]

15

DB1

Disability Information

O[0..*]

3

OBX

Observation/Result

O[0..*]

7

AL1

Allergy Information

O[0..*]

3

DG1

Diagnosis Information

O[0..*]

6

DRG

Diagnosis Related GroupO[0..1]

6------ PROCEDURE begin

O[0..*]

PR1

ProceduresR[1..1]

6

O[0..*]

15
6

ROL

Role

---

--- PROCEDURE end

GT1

Guarantor

O[0..*]------ INSURANCE begin

O[0..*]

IN1

InsuranceR[1..1]

6

IN2

Insurance Additional Info.

O[0..1]

6

IN3

Insurance Additional Info - Cert.

O[0..1]

6

O[0..*]

15

ROL

Role

---

--- INSURANCE end

ACC

Accident InformationO[0..1]

6

UB1

Universal Bill InformationO[0..1]

6

UB2

Universal Bill 92 InformationO[0..1]

6

PDA

Patient Death and AutopsyO[0..1]

3

3.31.7.6.3

Comments on segment usage

Providers with an ongoing relationship with the patient may be communicated in ROL segments
immediately following the PID/PD1 segments. Providers specific to an episode of care may be
communicated in ROL segments immediately following the PV1/PV2 segments. Providers
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1345

specific to a particular insurance carrier may be communicated in ROL segments immediately
following the IN1/IN2/IN3 segments.
One or more OBX segments may be present to carry “permanent observations” such as thepatient weight or height.
3.31.7.6.4

1350

Expected actions

The receiver shall update the patient record in its database to contain the information in themessage.
The receiver shall report the result of this operation (success / error) in an acknowledgment
message returned to the sender.
In case this Movement conflicts with the current situation of the patient (no active encounter forthis patient, or the patient is unknown) the message is discarded but no error condition is raised.

1355

3.31.7.7 Pre-Admit (ADT^A05^ADT_A05)
3.31.7.7.1

Trigger Event

This message is sent by a Patient Encounter Supplier to a Patient Encounter Consumer tocommunicate information that has been collected about a patient to be admitted as an inpatient(or to be registered as an outpatient).
1360

MSH-9 is valued ADT^A05^ADT_A05.
3.31.7.7.2

Message Static Definition
Table 3.31-13: Static definition of message ADT^A05^ADT_A05

Segment

Meaning

Usage

Card.

HL7 chapter

MSH

Message Header

R[1..1]

2

SFT

Software Segment

O[0..*]

2

EVN

Event TypeR

[1..1]

2

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

O[0..1]

3

ROL

Role

O

[0..*]

15

NK1

Next of Kin / Associated Parties

O[0..*]

3

PV1

Patient VisitR[1..1]

3

PV2

Patient Visit – Additional Info

X

[0..0]

3

ROL

Role

O

[0..*]

15

DB1

Disability Information

O[0..*]

3

OBX

Observation/Result

O[0..*]

7

AL1

Allergy Information

O[0..*]

3

DG1

Diagnosis Information

O[0..*]

6

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Segment

1365

1370

Usage

Card.

DRG

Diagnosis Related Group

MeaningO[0..1]

HL7 chapter------ PROCEDURE begin

O[0..*]

PR1

ProceduresR[1..1]

6

O[0..*]

15
6

6

ROL

Role

---

--- PROCEDURE end

GT1

Guarantor

O[0..*]------ INSURANCE begin

O[0..*]

IN1

InsuranceR[1..1]

6

IN2

Insurance Additional Info.

O[0..1]

6

IN3

Insurance Additional Info - Cert.

O[0..1]

6

O[0..*]

15

ROL

Role

---

--- INSURANCE end

ACC

Accident InformationO[0..1]

6

UB1

Universal Bill InformationO[0..1]

6

UB2

Universal Bill 92 InformationO[0..1]

6

PDA

Patient Death and AutopsyO[0..1]

3

3.31.7.7.3

Comments on segment usage

Field PV2-8-expected admit date/time is used to carry the expected date and time when thepatient is to be admitted (or registered).
Providers with an ongoing relationship with the patient may be communicated in ROL segments
immediately following the PID/PD1 segments. Providers specific to an episode of care may be
communicated in ROL segments immediately following the PV1/PV2 segments. Providers
specific to a particular insurance carrier may be communicated in ROL segments immediately
following the IN1/IN2/IN3 segments.
One or more OBX segments may be present to carry “permanent observations” such as thepatient weight or height.
3.31.7.7.4

1375

Expected actions

The receiver shall update the patient’s status to pre-admitted.
The receiver shall report the result of this operation (success / error) in an acknowledgment
message returned to the sender.
There is no particular potential conflict between this Movement and any previously received
message related to the same patient.

1380

If the receiver does not support the Inpatient/Outpatient Encounter Management Option of thistransaction, it shall application-reject the message (see ITI TF-2x: C.2.3).

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3.31.7.8 Cancel Pre-Admit – ADT^A38^ADT_A38
3.31.7.8.1
1385

Trigger Event

This message is sent by a Patient Encounter Supplier to a Patient Encounter Consumer to cancel
a previous notification (via trigger event A08) that a patient was to be updated to pre-admitted(or pre-registered) status.
MSH-9 is valued ADT^A38^ADT_A38.
3.31.7.8.2

1390

Message Static Definition
Table 3.31-14: Static definition of message ADT^A38^ADT_A38
Usage

Card.

MSH

Segment

Message Header

MeaningR[1..1]

2

HL7 chapter

SFT

Software Segment

O[0..*]

2

EVN

Event TypeR

[1..1]

2

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

O[0..1]

3

PV1

Patient VisitR[1..1]

3

PV2

Patient Visit – Additional InfoO

[0..1]

3

DB1

Disability Information

O[0..*]

3

OBX

Observation/Result

O[0..*]

7

DG1

Diagnosis Information

O[0..*]

6

DRG

Diagnosis Related GroupO[0..*]

6

3.31.7.8.3

Comments on segment usageNone.
3.31.7.8.4
1395

Expected actions

The receiver shall reset the patient’s status to its value prior to the receipt of the pre-admit
message.
The receiver shall report the result of this operation (success / error) in an acknowledgment
message returned to the sender.

1400

In case this Movement conflicts with the current situation of the patient (no pre-admit registered
for this patient, or the patient is unknown) the message is discarded but no error condition israised.
If the receiver does not support the Inpatient/Outpatient Encounter Management Option of thistransaction, it shall application-reject the message (see ITI TF-2x: C.2.3).

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3.31.7.9 Change Outpatient to Inpatient (ADT^A06^ADT_A06)
3.31.7.9.1
1405

Trigger Event

This message is sent by a Patient Encounter Supplier to notify a Patient Encounter Consumer
that it has been decided to admit a patient that was formerly in a non-admitted status, such as
Emergency.
MSH-9 is valued ADT^A06^ADT_A06.
3.31.7.9.2

Message Static Definition

1410
Table 3.31-15: Static definition of message ADT^A06^ADT_A06
Usage

Card.

MSH

Segment

Message Header

MeaningR[1..1]

2

HL7 chapter

SFT

Software Segment

O[0..*]

2

EVN

Event TypeR

[1..1]

2

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

O[0..1]

3

ROL

Role

O

[0..*]

15

MRG

Merge Information

C[0..1]

3

NK1

Next of Kin / Associated Parties

O[0..*]

3

PV1

Patient VisitR[1..1]

3

PV2

Patient Visit – Additional Info

X

[0..0]

3

ROL

Role

O

[0..*]

15

DB1

Disability Information

O[0..*]

3

OBX

Observation/Result

O[0..*]

7

AL1

Allergy Information

O[0..*]

3

DG1

Diagnosis Information

O[0..*]

6

DRG

Diagnosis Related GroupO[0..1]

6------ PROCEDURE begin

O[0..*]

PR1

ProceduresR[1..1]

6

ROL

Role

O

[0..*]

15------ PROCEDURE end

GT1

Guarantor

O[0..*]

6------ INSURANCE begin

O[0..*]

IN1

InsuranceR[1..1]

6

IN2

Insurance Additional Info.

O[0..1]

6

IN3

Insurance Additional Info - Cert.

O[0..1]

6

ROL

Role

O

[0..*]

15------ INSURANCE end

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Usage

Card.

ACC

Segment

Accident InformationO[0..1]

6

UB1

Universal Bill InformationO[0..1]

6

UB2

Universal Bill 92 InformationO[0..1]

6

3.31.7.9.3

Meaning

HL7 chapter

Comments on segment usage

The new patient location should appear in PV1-3 - Assigned Patient Location while the oldpatient location (if different) should appear in PV1-6 - Prior Patient Location.
1415

1420

1425

Condition predicate on use of the segment MRG:
A change from outpatient to inpatient status may be accompanied by the closing of theoutpatient account and the opening of an inpatient account. This may be expressed bypopulating the outpatient account number into MRG-3-prior account number and theinpatient account number into PID-18-patient account number. The use of the MRG
segment in this case is strictly conventional and is not intended to communicate an actual
merge.
Providers with an ongoing relationship with the patient may be communicated in ROL segments
immediately following the PID/PD1 segments. Providers specific to an episode of care may be
communicated in ROL segments immediately following the PV1/PV2 segments. Providers
specific to a particular insurance carrier may be communicated in ROL segments immediately
following the IN1/IN2/IN3 segments.
One or more OBX segments may be present to carry “permanent observations” such as thepatient weight or height.
3.31.7.9.4

1430

Expected actions

The receiver shall update the patient’s class to “inpatient,” and if necessary shall update thepatient’s location to the value in field PV1-3-patient location.
If the MRG segment is included, the receiver shall update the patient’s account number from thevalue in MRG-3-prior account number to the value in PID-18-patient account number.

1435

The receiver shall report the result of this operation (success / error) in an acknowledgment
message returned to the sender.
In case this Movement conflicts with the current situation of the patient (no active outpatientencounter is known for this patient, or the patient is unknown) the message is still processed andinitiates a new inpatient encounter for a possibly new patient, and no error condition is raised.

1440

If the receiver does not support the Inpatient/Outpatient Encounter Management Option of thistransaction, it shall application-reject the message (see ITI TF-2x: C.2.3).

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3.31.7.10

Change Inpatient to Outpatient (ADT^A07^ADT_A06)

3.31.7.10.1 Trigger Event
This message is sent by a Patient Encounter Supplier to notify a Patient Encounter Consumer
that a patient is no longer in an “admitted” status, but is still being seen for an episode of care.
1445

MSH-9 is valued ADT^A07^ADT_A06.
3.31.7.10.2 Message Static Definition
Table 3.31-16: Static definition of message ADT^A07^ADT_A06
Segment

Meaning

Usage

Card.

HL7 chapter

MSH

Message Header

R[1..1]

2

SFT

Software Segment

O[0..*]

2

EVN

Event TypeR

[1..1]

2

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

O[0..1]

3

ROL

Role

O

[0..*]

15

MRG

Merge Information

C[0..1]

3

NK1

Next of Kin / Associated Parties

O[0..*]

3

PV1

Patient VisitR[1..1]

3

PV2

Patient Visit – Additional Info

X

[0..0]

3

ROL

Role

O

[0..*]

15

DB1

Disability Information

O[0..*]

3

OBX

Observation/Result

O[0..*]

7

AL1

Allergy Information

O[0..*]

3

DG1

Diagnosis Information

O[0..*]

6

DRG

Diagnosis Related GroupO[0..1]

6------ PROCEDURE begin

O[0..*]

PR1

ProceduresR[1..1]

6

O[0..*]

15
6

ROL

Role

---

--- PROCEDURE end

GT1

Guarantor

O[0..*]------ INSURANCE begin

O[0..*]

IN1

InsuranceR[1..1]

6

IN2

Insurance Additional Info.

O[0..1]

6

IN3

Insurance Additional Info - Cert.

O[0..1]

6

O[0..*]

15

O[0..1]

6

ROL

Role

---

--- INSURANCE end

ACC

Accident Information

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Usage

Card.

UB1

Segment

Universal Bill Information

MeaningO[0..1]

6

HL7 chapter

UB2

Universal Bill 92 InformationO[0..1]

6

3.31.7.10.3 Comments on segment usage
1450

The new patient location should appear in PV1-3 - Assigned Patient Location while the oldpatient location (if different) should appear in PV1-6 - Prior Patient Location.
Condition predicate on use of the segment MRG:

1455

1460

1465

A change from inpatient to outpatient status may be accompanied by the closing of theinpatient account and the opening of an outpatient account. This may be expressed bypopulating the inpatient account number into MRG-3-prior account number and theoutpatient account number into PID-18-patient account number. The use of the MRG
segment in this case is strictly conventional and is not intended to communicate an actual
merge.
Providers with an ongoing relationship with the patient may be communicated in ROL segments
immediately following the PID/PD1 segments. Providers specific to an episode of care may be
communicated in ROL segments immediately following the PV1/PV2 segments. Providers
specific to a particular insurance carrier may be communicated in ROL segments immediately
following the IN1/IN2/IN3 segments.
One or more OBX segments may be present to carry “permanent observations” such as thepatient weight or height.
3.31.7.10.4 Expected actions
The receiver shall update the patient’s class to “outpatient,” and if necessary shall update thepatient’s location to the value in field PV1-3-patient location.

1470

If the MRG segment is included, the receiver shall update the patient’s account number from thevalue in MRG-3-prior account number to the value in PID-18-patient account number.
The receiver shall report the result of this operation (success / error) in an acknowledgment
message returned to the sender.

1475

In case this Movement conflicts with the current situation of the patient (no active inpatientencounter is known for this patient, or the patient is unknown) the message is still processed andinitiates a new outpatient encounter for a possibly new patient, and no error condition is raised.
If the receiver does not support the Inpatient/Outpatient Encounter Management Option of thistransaction, it shall application-reject the message (see ITI TF-2x: C.2.3).

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3.31.7.11

Transfer a Patient (ADT^A02^ADT_A02)

3.31.7.11.1 Trigger Event
1480

This message is sent by a Patient Encounter Supplier to notify a Patient Encounter Consumer
that a patient is being transferred from one location to another. The new location will be reflectedin the institution’s bed census.
MSH-9 is valued ADT^A02^ADT_A02.
3.31.7.11.2 Message Static Definition

1485
Table 3.31-17: Static definition of message ADT^A02^ADT_A02
Usage

Card.

HL7 chapter

MSH

Segment

Message Header

MeaningR[1..1]

2

SFT

Software Segment

O[0..*]

2

EVN

Event TypeR

[1..1]

2

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

O[0..1]

3

ROL

Role

O

[0..*]

15

PV1

Patient VisitR[1..1]

3

PV2

Patient Visit – Additional InfoO

[0..1]

3

ROL

Role

O

[0..*]

15

DB1

Disability Information

O[0..*]

3

OBX

Observation/Result

O[0..*]

7

PDA

Patient Death and AutopsyO[0..1]

3

3.31.7.11.3 Comments on segment usage
The new patient location should appear in PV1-3 - Assigned Patient Location while the oldpatient location should appear in PV1-6 - Prior Patient Location.
1490

Providers with an ongoing relationship with the patient may be communicated in ROL segments
immediately following the PID/PD1 segments. Providers specific to an episode of care may be
communicated in ROL segments immediately following the PV1/PV2 segments.
One or more OBX segments may be present to carry “permanent observations” such as thepatient weight or height.

1495

Segment DG1 should be used to communicate diagnosis information only if it is necessary tocommunicate with a receiver that is using a version of HL7 prior to V2.5.
3.31.7.11.4 Expected actions
The receiver shall update the patient’s location to the value in field PV1-3-patient location.

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1500

The receiver shall report the result of this operation (success / error) in an acknowledgment
message returned to the sender.
In case this Movement conflicts with the current situation of the patient (no active inpatientencounter is known for this patient, or the patient is unknown or the known patient location was
not the one declared in PV1-6) the message is still processed, the new situation is registered (theencounter and the patient are created if needed) and no error condition is raised.

1505

If the receiver does not support the Inpatient/Outpatient Encounter Management Option of thistransaction, it shall application-reject the message (see ITI TF-2x: C.2.3).
3.31.7.12

Cancel Transfer – ADT^A12^ADT_A12

3.31.7.12.1 Trigger Event
1510

This message is sent by a Patient Encounter Supplier to a Patient Encounter Consumer to cancel
a previous notification (via trigger event A02) that a patient was being moved from one location
to another.
MSH-9 is valued ADT^A12^ADT_A12.
3.31.7.12.2 Message Static Definition

1515

Table 3.31-18: Static definition of message ADT^A12^ADT_A12
Segment

Meaning

Usage

Card.

HL7 chapter

MSH

Message Header

R[1..1]

2

SFT

Software Segment

O[0..*]

2

EVN

Event TypeR

[1..1]

2

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

O[0..1]

3

PV1

Patient VisitR[1..1]

3

PV2

Patient Visit – Additional InfoO

[0..1]

3

DB1

Disability Information

O[0..*]

3

OBX

Observation/Result

O[0..*]

7

DG1

Diagnosis Information

X[0..0]

6

3.31.7.12.3 Comments on segment usage
Field PV1-3-patient location shall contain the patient’s location prior to the transfer.
3.31.7.12.4 Expected actions
1520

The receiver shall reset the patient’s location to the value in field PV1-11-temporary location or
to the value in field PV1-3-patient location, as appropriate.

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message returned to the sender.

1525

In case this Movement conflicts with the current situation of the patient (no transfer previously
notified, or encounter unknown, or patient unknown) the message is discarded, and no error
condition is raised.
If the receiver does not support the Inpatient/Outpatient Encounter Management Option of thistransaction, it shall application-reject the message (see ITI TF-2x: C.2.3).
3.31.7.13

Pending Admit (ADT^A14^ADT_A05)

3.31.7.13.1 Trigger Event
1530

This message is sent by a Patient Encounter Supplier to notify a Patient Encounter Consumer
that it is planned to admit a patient.
MSH-9 is valued ADT^A14^ADT_A05.
3.31.7.13.2 Message Static Definition

1535

Table 3.31-19: Static definition of message ADT^A14^ADT_A05
Segment

Meaning

Usage

Card.

HL7 chapter

MSH

Message Header

R[1..1]

2

SFT

Software Segment

O[0..*]

2

EVN

Event TypeR

[1..1]

2

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

O[0..1]

3

ROL

Role

O

[0..*]

15

NK1

Next of Kin / Associated Parties

O[0..*]

3

PV1

Patient VisitR[1..1]

3

PV2

Patient Visit – Additional Info

X

[0..0]

3

ROL

Role

O

[0..*]

15

DB1

Disability Information

O[0..*]

3

OBX

Observation/Result

O[0..*]

7

AL1

Allergy Information

O[0..*]

3

DG1

Diagnosis Information

O[0..*]

6

DRG

Diagnosis Related GroupO[0..1]

6------ PROCEDURE begin

O[0..*]

PR1

ProceduresR[1..1]

6

ROL

Role

O

[0..*]

15------ PROCEDURE end

GT1

Guarantor

O[0..*]

6

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Usage

Card.

---

Segment--- INSURANCE begin

MeaningO[0..*]

HL7 chapter

IN1

InsuranceR[1..1]

6

IN2

Insurance Additional Info.

O[0..1]

6

IN3

Insurance Additional Info - Cert.

O[0..1]

6

ROL

Role

O

[0..*]

15------ INSURANCE end

ACC

Accident InformationO[0..1]

6

UB1

Universal Bill InformationO[0..1]

6

UB2

Universal Bill 92 InformationO[0..1]

6

PDA

Patient Death and AutopsyO[0..1]

3

3.31.7.13.3 Comments on segment usage
Field PV2-8-expected admit date/time is used to carry the expected date and time when thepatient is to be admitted.
1540

One or more OBX segments may be present to carry “permanent observations” such as thepatient weight or height.
3.31.7.13.4 Expected actions
The receiver shall update the patient’s status to “pending admit”.
The receiver shall report the result of this operation (success / error) in an acknowledgment
message returned to the sender.

1545

There is no particular potential conflict between this Movement and any previously received
message related to the same patient.
If the receiver does not support the Pending Event Management Option of this transaction, it
shall application-reject the message (see ITI TF-2x: C.2.3).
3.31.7.14

1550

Cancel Pending Admit – ADT^A27^ADT_A21

3.31.7.14.1 Trigger Event
This message is sent by a Patient Encounter Supplier to a Patient Encounter Consumer to cancel
a previous notification (via trigger event A14) that a patient was expected to be admitted.
MSH-9 is valued ADT^A27^ADT_A21.
3.31.7.14.2 Message Static Definition

1555

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Table 3.31-20: Static definition of message ADT^A27^ADT_A21
Usage

Card.

HL7 chapter

MSH

Segment

Message Header

MeaningR[1..1]

2

SFT

Software Segment

O[0..*]

2

EVN

Event TypeR

[1..1]

2

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

O[0..1]

3

PV1

Patient VisitR[1..1]

3

PV2

Patient Visit – Additional InfoO

[0..1]

3

DB1

Disability Information

O[0..*]

3

OBX

Observation/Result

O[0..*]

7

3.31.7.14.3 Comments on segment usage
1560

One or more OBX segments may be present to carry “permanent observations” such as thepatient weight or height.
3.31.7.14.4 Expected actions
The receiver shall reset the patient’s status to its value prior to the receipt of the “pending admit”
message.

1565

The receiver shall report the result of this operation (success / error) in an acknowledgment
message returned to the sender.
In case this Movement conflicts with the current situation of the patient (no pending admit
previously notified, or patient unknown) the message is discarded, and no error condition israised.

1570

If the receiver does not support the Pending Event Management Option of this transaction, it
shall application-reject the message (see ITI TF-2x: C.2.3).
3.31.7.15

Pending Transfer (ADT^A15^ADT_A15)

3.31.7.15.1 Trigger Event
This message is sent by a Patient Encounter Supplier to notify a Patient Encounter Consumer
that it is planned to transfer a patient.
1575

MSH-9 is valued ADT^A15^ADT_A15.
3.31.7.15.2 Message Static Definition
Table 3.31-21: Static definition of message ADT^A15^ADT_A15
Segment
MSH

Meaning
Message Header

Usage

Card.

R

[1..1]

HL7 chapter
2

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Usage

Card.

SFT

Segment

Software Segment

MeaningO[0..*]

2

HL7 chapter

EVN

Event TypeR

[1..1]

2

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

O[0..1]

3

ROL

Role

O

[0..*]

15

PV1

Patient VisitR[1..1]

3

PV2

Patient Visit – Additional InfoO

[0..1]

3

ROL

Role

O

[0..*]

15

DB1

Disability Information

O[0..*]

3

OBX

Observation/Result

O[0..*]

7

DG1

Diagnosis Information

O[0..*]

6

3.31.7.15.3 Comments on segment usage
1580

Providers with an ongoing relationship may be communicated in ROL segments immediately
following the PID/PD1 segments. Providers specific to an episode of care may be communicatedin ROL segments immediately following the PV1/PV2 segments.
One or more OBX segments may be present to carry “permanent observations” such as thepatient weight or height.

1585

Segment DG1 should be used to communicate diagnosis information only if it is necessary tocommunicate with a receiver that is using a version of HL7 prior to V2.5.
The planned date for this pending transfer is given in field EVN-3 of segment EVN. See Section
3.30.5.2.
3.31.7.15.4 Expected actions

1590

The receiver shall record that a transfer is pending for this patient.
The receiver shall report the result of this operation (success / error) in an acknowledgment
message returned to the sender.
In case this Movement conflicts with the current situation of the patient (no active inpatientencounter, or patient unknown) the message is discarded, and no error condition is raised.

1595

If the receiver does not support the Pending Event Management Option of this transaction, it
shall application-reject the message (see ITI TF-2x: C.2.3).
3.31.7.16

Cancel Pending Transfer – ADT^A26^ADT_A21

3.31.7.16.1 Trigger Event
1600

This message is sent by a Patient Encounter Supplier to a Patient Encounter Consumer to cancel
a previous notification (via trigger event A25) that it was planned to transfer a patient.

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MSH-9 is valued ADT^A26^ADT_A21.
3.31.7.16.2 Message Static Definition
Table 3.31-22: Static definition of message ADT^A26^ADT_A21
Segment

1605

Meaning

Usage

Card.

HL7 chapter

MSH

Message Header

R[1..1]

2

SFT

Software Segment

O[0..*]

2

EVN

Event TypeR

[1..1]

2

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

O[0..1]

3

PV1

Patient VisitR[1..1]

3

PV2

Patient Visit – Additional InfoO

[0..1]

3

DB1

Disability Information

O[0..*]

3

OBX

Observation/Result

O[0..*]

7

3.31.7.16.3 Comments on segment usage
One or more OBX segments may be present to carry “permanent observations” such as thepatient weight or height.
The planned date for the pending transfer that is cancelled, is given in field EVN-3 of segment
EVN. See Section 3.30.5.2.

1610

3.31.7.16.4 Expected actions
The receiver shall reset the patient’s status to the value immediately before the Pending Transfer
message was received.
The receiver shall report the result of this operation (success / error) in an acknowledgment
message returned to the sender.

1615

In case this Movement conflicts with the current situation of the patient (no pending transfer
known, or no active inpatient encounter, or patient unknown) the message is discarded, and noerror condition is raised.
If the receiver does not support the Pending Event Management Option of this transaction, it
shall application-reject the message (see ITI TF-2x: C.2.3).

1620

3.31.7.17

Pending Discharge (ADT^A16^ADT_A16)

3.31.7.17.1 Trigger Event
This message is sent by a Patient Encounter Supplier to notify a Patient Encounter Consumer
that it is planned to discharge a patient.
MSH-9 is valued ADT^A16^ADT_A16.
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1625

3.31.7.17.2 Message Static Definition
Table 3.31-23: Static definition of message ADT^A16^ADT_A16
Segment

Meaning

Usage

Card.

HL7 chapter

MSH

Message Header

R[1..1]

2

SFT

Software Segment

O[0..*]

2

EVN

Event TypeR

[1..1]

2

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

O[0..1]

3

ROL

Role

O

[0..*]

15

NK1

Next of Kin / Associated Parties

O[0..*]

3

PV1

Patient VisitR[1..1]

3

PV2

Patient Visit – Additional InfoRE

[0..1]

3

ROL

Role

O

[0..*]

15

DB1

Disability Information

O[0..*]

3

OBX

Observation/Result

O[0..*]

7

AL1

Allergy Information

O[0..*]

3

DG1

Diagnosis Information

O[0..*]

6

DRG

Diagnosis Related GroupO[0..1]

6------ PROCEDURE begin

O[0..*]

PR1

ProceduresR[1..1]

6

O[0..*]

15
6

ROL

Role

---

--- PROCEDURE end

GT1

Guarantor

O[0..*]------ INSURANCE begin

O[0..*]

IN1

InsuranceR[1..1]

6

IN2

Insurance Additional Info.

O[0..1]

6

IN3

Insurance Additional Info - Cert.

O[0..1]

6

O[0..*]

15

O[0..1]

6

ROL

Role

---

--- INSURANCE end

ACC

Accident Information

3.31.7.17.3 Comments on segment usage
1630

Field PV2-9-expected discharge date/time is used to carry the expected date and time when thepatient is to be discharged.
One or more OBX segments may be present to carry “permanent observations” such as thepatient weight or height.

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3.31.7.17.4 Expected actions
The receiver shall update the patient’s status to “pending discharge”.
1635

The receiver shall report the result of this operation (success / error) in an acknowledgment
message returned to the sender.
In case this Movement conflicts with the current situation of the patient (no active inpatientencounter, or patient unknown) the message is discarded, and no error condition is raised.

1640

If the receiver does not support the Pending Event Management Option of this transaction, it
shall application-reject the message (see ITI TF-2x: C.2.3).
3.31.7.18

Cancel Pending Discharge – ADT^A25^ADT_A21

3.31.7.18.1 Trigger Event
This message is sent by a Patient Encounter Supplier to a Patient Encounter Consumer to cancel
a previous notification (via trigger event A16) that a patient was expected to be discharged.
1645

MSH-9 is valued ADT^A25^ADT_A21.
3.31.7.18.2 Message Static Definition
Table 3.31-24: Static definition of message ADT^A25^ADT_A21
Usage

Card.

MSH

Segment

Message Header

MeaningR[1..1]

2

HL7 chapter

SFT

Software Segment

O[0..*]

2

EVN

Event TypeR

[1..1]

2

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

O[0..1]

3

PV1

Patient VisitR[1..1]

3

PV2

Patient Visit – Additional InfoO

[0..1]

3

DB1

Disability Information

O[0..*]

3

OBX

Observation/Result

O[0..*]

7

3.31.7.18.3 Comments on segment usage
1650

One or more OBX segments may be present to carry “permanent observations” such as thepatient weight or height.
3.31.7.18.4 Expected actions
The receiver shall reset the patient’s status to its value prior to the receipt of the “pending
discharge” message.

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1655

The receiver shall report the result of this operation (success / error) in an acknowledgment
message returned to the sender.
In case this Movement conflicts with the current situation of the patient (no pending discharge
known, or no active inpatient encounter, or patient unknown) the message is discarded, and noerror condition is raised.

1660

If the receiver does not support the Pending Event Management Option of this transaction, it
shall application-reject the message (see ITI TF-2x: C.2.3).
3.31.7.19

Change Attending Doctor – ADT^A54^ADT_A54

3.31.7.19.1 Trigger Event
1665

This message is sent by a Patient Encounter Supplier to notify a Patient Encounter Consumer
that there has been a change in the doctor responsible for the patient’s treatment.
MSH-9 is valued ADT^A54^ADT_A54.
3.31.7.19.2 Message Static Definition
Table 3.31-25: Static definition of message ADT^A54^ADT_A54
Segment

1670

Meaning

Usage

Card.

HL7 chapter

MSH

Message Header

R[1..1]

2

SFT

Software Segment

O[0..*]

2

EVN

Event TypeR

[1..1]

2

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

O[0..1]

3

ROL

Role

O

[0..*]

15

PV1

Patient VisitR[1..1]

3

PV2

Patient Visit – Additional InfoO

[0..1]

3

ROL

Role

O

[0..*]

15

3.31.7.19.3 Comments on segment usage
Field PV1-7-attending doctor shall contain the new attending doctor.
Providers with an ongoing relationship may be communicated in ROL segments immediately
following the PID/PD1 segments. Providers specific to an episode of care may be communicatedin ROL segments immediately following the PV1/PV2 segments.

1675

Field ROL-4-role begin date/time and ROL-5-role end date/time are used to communicate thebegin and end date and time of the attending doctor (or of the admitting, consulting, and/orreferring doctor, as appropriate and as designated in ROL-7-role code). When segment ROL isused to communicate this information, field ROL-2-action code should be valued UP.

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3.31.7.19.4 Expected actions
1680

The receiver shall record the patient’s new attending doctor.
The receiver shall report the result of this operation (success / error) in an acknowledgment
message returned to the sender.

1685

In case this Movement conflicts with the current situation of the patient (no active inpatient or
outpatient encounter, or patient unknown) the message is discarded, but no error condition israised. If the receiver does not support the Advanced Encounter Management Option of thistransaction, it shall application-reject the message (see ITI TF-2x: C.2.3).
3.31.7.20

Cancel Change Attending Doctor – ADT^A55^ADT_A52

3.31.7.20.1 Trigger Event
1690

This message is sent by a Patient Encounter Supplier to cancel a previous notification to a Patient
Encounter Consumer of a change to the patient’s attending doctor.
MSH-9 is valued ADT^A55^ADT_A52.
3.31.7.20.2 Message Static Definition
Table 3.31-26: Static definition of message ADT^A55^ADT_A52
Segment
MSH

1695

Meaning
Message Header

Usage

Card.

HL7 chapter

R[1..1]

2

SFT

Software Segment

O[0..*]

2

EVN

Event TypeR

[1..1]

2

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

O[0..1]

3

PV1

Patient VisitR[1..1]

3

PV2

Patient Visit – Additional InfoO

[0..1]

3

3.31.7.20.3 Comments on segment usage
Field PV1-7-attending doctor shall contain the patient’s attending doctor prior to the notificationof change.
3.31.7.20.4 Expected actions

1700

The receiver shall reset the patient’s attending doctor to the value in field PV1-7-attending
doctor.
The receiver shall report the result of this operation (success / error) in an acknowledgment
message returned to the sender.

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1705

In case this Movement conflicts with the current situation of the patient (no active inpatient or
outpatient encounter, or patient unknown) the message is discarded, but no error condition israised.
If the receiver does not support the Advanced Encounter Management Option of this transaction,
it shall application-reject the message (see ITI TF-2x: C.2.3).
3.31.7.21

Patient Goes on a Leave of Absence – ADT^A21^ADT_A21

3.31.7.21.1 Trigger Event
1710

This message is sent by a Patient Encounter Supplier to notify a Patient Encounter Consumer
that a patient has left the healthcare institution temporarily.
MSH-9 is valued ADT^A21^ADT_A21.
3.31.7.21.2 Message Static Definition

1715

Table 3.31-27: Static definition of message ADT^A21^ADT_A21
Segment

Meaning

Usage

Card.

HL7 chapter

MSH

Message Header

R[1..1]

2

SFT

Software Segment

O[0..*]

2

EVN

Event TypeR

[1..1]

2

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

O[0..1]

3

PV1

Patient VisitR[1..1]

3

PV2

Patient Visit – Additional InfoO

[0..1]

3

DB1

Disability Information

O[0..*]

3

OBX

Observation/Result

O[0..*]

7

3.31.7.21.3 Comments on segment usage
Field EVN-6-event occurred shall contain the date and time that the patient actually left theinstitution. PV2-47-expected LOA return shall contain the date and time that the patient is
expected to return from the leave of absence.
1720

One or more OBX segments may be present to carry “permanent observations” such as thepatient weight or height.
3.31.7.21.4 Expected actions
The receiver shall record that the patient has left the institution on a leave of absence.

1725

The receiver shall report the result of this operation (success / error) in an acknowledgment
message returned to the sender.

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In case this Movement conflicts with the current situation of the patient (no active encounter, or
patient unknown) the message is discarded, but no error condition is raised.
If the receiver does not support the Advanced Encounter Management Option of this transaction,
it shall application-reject the message (see ITI TF-2x: C.2.3).
1730

3.31.7.22

Cancel Leave of Absence for a Patient – ADT^A52^ADT_A52

3.31.7.22.1 Trigger Event
This message is sent by a Patient Encounter Supplier to cancel a previous notification to a Patient
Encounter Consumer that a patient had left the healthcare institution temporarily.
MSH-9 is valued ADT^A52^ADT_A52.
1735

3.31.7.22.2 Message Static Definition
Table 3.31-28: Static definition of message ADT^A52^ADT_A52
Segment

Meaning

Usage

Card.

HL7 chapter

MSH

Message Header

R[1..1]

2

SFT

Software Segment

O[0..*]

2

EVN

Event TypeR

[1..1]

2

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

O[0..1]

3

PV1

Patient VisitR[1..1]

3

PV2

Patient Visit – Additional InfoO

[0..1]

3

3.31.7.22.3 Comments on segment usage
1740

Field EVN-6-event occurred shall contain the date and time that the leave of absence wascancelled.
3.31.7.22.4 Expected actions
The receiver shall cancel the patient’s leave of absence.
The receiver shall report the result of this operation (success / error) in an acknowledgment
message returned to the sender.

1745

In case this Movement conflicts with the current situation of the patient (no leave of absence
previously notified, or no active encounter, or patient unknown) the message is discarded, but noerror condition is raised.
If the receiver does not support the Advanced Encounter Management Option of this transaction,
it shall application-reject the message (see ITI TF-2x: C.2.3).

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1750

3.31.7.23

Patient Returns from a Leave of Absence – ADT^A22^ADT_A21

3.31.7.23.1 Trigger Event
This message is sent by a Patient Encounter Supplier to notify a Patient Encounter Consumer
that a patient has returned from a leave of absence.
MSH-9 is valued ADT^A22^ADT_A21.
1755

3.31.7.23.2 Message Static Definition
Table 3.31-29: Static definition of message ADT^A22^ADT_A21
Segment

Meaning

Usage

Card.

HL7 chapter[1..1]

2

MSH

Message Header

R

SFT

Software Segment

O[0..*]

2

EVN

Event TypeR

[1..1]

2

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

O[0..1]

3

PV1

Patient VisitR[1..1]

3

PV2

Patient Visit – Additional InfoO

[0..1]

3

DB1

Disability Information

O[0..*]

3

OBX

Observation/Result

O[0..*]

7

3.31.7.23.3 Comments on segment usage
1760

Field EVN-6-event occurred shall contain the date and time that the patient actually returned
from the leave of absence. PV2-47-expected LOA return shall contain the date and time that thepatient was expected to return from the leave of absence.
One or more OBX segments may be present to carry “permanent observations” such as thepatient weight or height.
3.31.7.23.4 Expected actions

1765

The receiver shall record that the patient has returned from the leave of absence.
The receiver shall report the result of this operation (success / error) in an acknowledgment
message returned to the sender.

1770

In case this Movement conflicts with the current situation of the patient (no leave of absence
previously notified, or no active encounter, or patient unknown) the message is discarded, but noerror condition is raised.
If the receiver does not support the Advanced Encounter Management Option of this transaction,
it shall application-reject the message (see ITI TF-2x: C.2.3).

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3.31.7.24
Cancel Patient Return from a Leave of Absence –ADT^A53^ADT_A52
1775

3.31.7.24.1 Trigger Event
This message is sent by a Patient Encounter Supplier to cancel a previous notification to a Patient
Encounter Consumer that a patient had returned from a leave of absence.
MSH-9 is valued ADT^A53^ADT_A52.
3.31.7.24.2 Message Static Definition

1780
Table 3.31-30: Static definition of message ADT^A53^ADT_A52
Usage

Card.

HL7 chapter

MSH

Segment

Message Header

MeaningR[1..1]

2

SFT

Software Segment

O[0..*]

2

EVN

Event TypeR

[1..1]

2

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

O[0..1]

3

PV1

Patient VisitR[1..1]

3

PV2

Patient Visit – Additional InfoO

[0..1]

3

3.31.7.24.3 Comments on segment usage

1785

Field EVN-6-event occurred shall contain the date and time that the return from leave of absence
was cancelled. PV2-47-expected LOA return shall contain the date and time that the patient is
expected to return from the leave of absence.
3.31.7.24.4 Expected actions
The receiver shall cancel the patient’s return from leave of absence.
The receiver shall report the result of this operation (success / error) in an acknowledgment
message returned to the sender.

1790

In case this Movement conflicts with the current situation of the patient (no return from leave ofabsence previously notified, or no active encounter, or patient unknown) the message isdiscarded, but no error condition is raised.
If the receiver does not support the Advanced Encounter Management Option of this transaction,
it shall application-reject the message (see ITI TF-2x: C.2.3).

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1795

3.31.7.25

Move account information – ADT^A44^ADT_A43

3.31.7.25.1 Trigger Event
This message is sent by a Patient Encounter Supplier to notify a Patient Encounter Consumer
that an account previously associated with one patient is now associated with another patient.
MSH-9 is valued ADT^A44^ADT_A43.
1800

3.31.7.25.2 Message Static Definition
Table 3.31-31: Static definition of message ADT^A44^ADT_A43
Segment

Meaning

Usage

Card.

HL7 chapter[1..1]

2

MSH

Message Header

R

SFT

Software Segment

O[0..*]

2

EVN

Event TypeR

[1..1]

2------ PATIENT beginR[1..*]

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

O[0..1]

3

MRG

Merge InformationR[1..1]

3------ PATIENT end

3.31.7.25.3 Comments on segment usage
None.
1805

3.31.7.25.4 Expected actions
The receiver shall associate the account in MRG-3-prior patient account number with the patient
in PID-3-patient identifier list, and shall remove associations of that account with the patient in
MRG-1-prior patient identifier list.

1810

The receiver shall report the result of this operation (success / error) in an acknowledgment
message returned to the sender.
In case this message conflicts with the current situation (account unknown or supplier patient
unknown) the message is discarded, but no error condition is raised.
If the receiver does not support the Advanced Encounter Management Option of this transaction,
it shall application-reject the message (see ITI TF-2x: C.2.3).

1815

3.31.7.26

Patient Departing – Tracking (ADT^A09^ADT_A09)

3.31.7.26.1 Trigger Event
This message is only used within the context of the “Temporary Patient Transfers Tracking”
Option.
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1820

1825

This message is sent by a Patient Encounter Supplier to notify a Patient Encounter Consumer
that a patient has departed a location without the patient’s official bed census location having
changed. The HL7 standard describes three situations that qualify as non-census location
changes: (a) patient tracking (i.e., pre-notification before an official transfer), (b) the patient is intransit between locations for some time, (c) a notification of temporary location change. This
IHE transaction only uses the latter: notification of temporary location change.
MSH-9 is valued ADT^A09^ADT_A09.
3.31.7.26.2 Message Static Definition
Table 3.31-32: Static definition of message ADT^A09^ADT_A09
Segment

Meaning

Usage

Card.

HL7 chapter

MSH

Message Header

R[1..1]

2

SFT

Software Segment

O[0..*]

2

EVN

Event TypeR

[1..1]

2

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

O[0..1]

3

PV1

Patient VisitR[1..1]

3

PV2

Patient Visit – Additional InfoO

[0..1]

3

DB1

Disability Information

O[0..*]

3

OBX

Observation/Result

O[0..*]

7

DG1

Diagnosis Information

O[0..*]

6

3.31.7.26.3 Comments on segment usage
1830

If the patient has left for a non-temporary location (tracking), then field PV1-3-patient location
shall contain the patient’s new location and field PV1-6-prior patient location shall contain thepatient’s old location.
If the patient will be in transit for some time, then field PV1-42-pending location shall containthe new location and field PV1-6-prior patient location shall contain the patient’s old location.

1835

If the patient is moving to a temporary location, then field PV1-11-temporary location shallcontain the new temporary location. If the patient is moving from a temporary location, thenfield PV1-43-prior temporary location shall contain the old temporary location. If the patient ismoving from a permanent location, then field PV1-6-prior patient location shall contain the oldpermanent location.

1840

One or more OBX segments may be present to carry “permanent observations” such as thepatient weight or height.
Segment DG1 should be used to communicate diagnosis information only if it is necessary tocommunicate with a receiver that is using a version of HL7 prior to V2.5.

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3.31.7.26.4 Expected actions
1845

The receiver shall reset the patient’s location to the value in field PV1-11-temporary location,
field PV1-42-pending location, or field PV1-3-patient location, as appropriate.
The receiver shall report the result of this operation (success / error) in an acknowledgment
message returned to the sender.

1850

In case this message conflicts with the current situation, the message is discarded but no error
condition is raised.
If the receiver does not support the Temporary Patient Location Tracking Option of thistransaction, it shall application-reject the message (see ITI TF-2x: C.2.3).
3.31.7.27

Cancel Patient Departing – Tracking – ADT^A33^ADT_A21

3.31.7.27.1 Trigger Event
1855

This message is only used within the context of the “Temporary Patient Transfers Tracking”
Option. This message is sent by a Patient Encounter Supplier to a Patient Encounter Consumer tocancel a previous notification (via trigger event A09) that a patient has departed a location
without the patient’s official bed census location having changed.
MSH-9 is valued ADT^A33^ADT_A21.

1860

3.31.7.27.2 Message Static Definition
Table 3.31-33: Static definition of message ADT^A33^ADT_A21
Segment

Meaning

Usage

Card.

HL7 chapter

MSH

Message Header

R[1..1]

2

SFT

Software Segment

O[0..*]

2

EVN

Event TypeR

[1..1]

2

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

O[0..1]

3

PV1

Patient VisitR[1..1]

3

PV2

Patient Visit – Additional InfoO

[0..1]

3

DB1

Disability Information

O[0..*]

3

OBX

Observation/Result

O[0..*]

7

3.31.7.27.3 Comments on segment usage
1865

If the patient was in a non-temporary location, then field PV1-3-patient location shall contain thepatient’s location prior to the erroneous A09 event. If the patient was in a temporary location,then field PV1-11-temporary location shall contain the patient’s location prior to the erroneous
A09 event.

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One or more OBX segments may be present to carry “permanent observations” such as thepatient weight or height.
1870

3.31.7.27.4 Expected actions
The receiver shall reset the patient’s location to the value in field PV1-11-temporary location or
to the value in field PV1-3-patient location, as appropriate.
The receiver shall report the result of this operation (success / error) in an acknowledgment
message returned to the sender.

1875

In case this message conflicts with the current situation, the message is discarded but no error
condition is raised.
If the receiver does not support the Temporary Patient Location Tracking Option of thistransaction, it shall application-reject the message (see ITI TF-2x: C.2.3).
3.31.7.28

1880

Patient Arriving – Tracking – ADT^A10^ADT_A09

3.31.7.28.1 Trigger Event
This message is only used within the context of the “Temporary Patient Transfers Tracking”
Option.

1885

1890

This message is sent by a Patient Encounter Supplier to a Patient Encounter Consumer as a
notification that a patient has arrived at a new location without the patient’s official bed census
location having changed. The HL7 standard describes three varieties of these non-census
location changes involving three different kinds of notification: (a) an unofficial notification oflocation change prior to the official notification of patient tracking, (b) the patient is in transit
between locations for some time, (c) a notification of a temporary location change. This IHE
transaction only uses the latter: notification of temporary location change.
MSH-9 is valued ADT^A10^ADT_A09.
3.31.7.28.2 Message Static Definition
Table 3.31-34: Static definition of message ADT^A10^ADT_A09
Usage

Card.

HL7 chapter

MSH

Segment

Message Header

MeaningR[1..1]

2

SFT

Software Segment

O[0..*]

2

EVN

Event TypeR

[1..1]

2

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

O[0..1]

3

PV1

Patient VisitR[1..1]

3

PV2

Patient Visit – Additional InfoO

[0..1]

3

DB1

Disability Information

O[0..*]

3

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Usage

Card.

HL7 chapter

OBX

Segment

Observation/Result

MeaningO[0..*]

7

DG1

Diagnosis Information

X[0..0]

6

3.31.7.28.3 Comments on segment usage
1895

1900

If the patient is arriving at a temporary location, field PV1-11-temporary location shall indicate
this temporary location. If the patient is moving from one temporary location to another, thenfield PV1-43-prior temporary location may also be used.
If the patient is arriving at a permanent location from a temporary location, field PV1-3-patient
location shall be used for the new location and field PV1-43-prior temporary location shall be
used for the old location.
One or more OBX segments may be present to carry “permanent observations” such as thepatient weight or height.
3.31.7.28.4 Expected actions

1905

The receiver shall update the patient’s location to the value in field PV1-11-temporary locationor to the value in field PV1-3-patient location, as appropriate.
The receiver shall report the result of this operation (success / error) in an acknowledgment
message returned to the sender.
In case this message conflicts with the current situation, the message is discarded but no error
condition is raised.

1910

If the receiver does not support the Temporary Patient Location Tracking Option of thistransaction, it shall application-reject the message (see ITI TF-2x: C.2.3).
3.31.7.29

Cancel Patient Arriving – Tracking – ADT^A32^ADT_A21

3.31.7.29.1 Trigger Event
1915

This message is sent by a Patient Encounter Supplier to a Patient Encounter Consumer to cancel
a previous notification (via trigger event A10) that a patient arrived at a location without thepatient’s official bed census location having changed, as for example when the patient arrives at
a diagnostic or treatment service.
MSH-9 is valued ADT^A32^ADT_A21.
3.31.7.29.2 Message Static Definition

1920
Table 3.31-35: Static definition of message ADT^A32^ADT_A21
Segment
MSH

Meaning
Message Header

Usage

Card.

HL7 chapter

R[1..1]

2

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Usage

Card.

HL7 chapter

SFT

Segment

Software Segment

MeaningO[0..*]

2

EVN

Event TypeR

[1..1]

2

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

O[0..1]

3

PV1

Patient VisitR[1..1]

3

PV2

Patient Visit – Additional InfoO

[0..1]

3

DB1

Disability Information

O[0..*]

3

OBX

Observation/Result

O[0..*]

7

3.31.7.29.3 Comments on segment usage

1925

If the patient was in a non-temporary location, then field PV1-3 - Assigned Patient Location may
contain (if known) the original patient location prior to the erroneous A10 (patient arrivingtracking) event. If the patient was in a temporary location, then field PV1-11 - Temporary
Location may contain (if known) the original patient location prior to the erroneous A10 (patient
arriving-tracking) event.
One or more OBX segments may be present to carry “permanent observations” such as thepatient weight or height.

1930

3.31.7.29.4 Expected actions
If field PV1-3 - Assigned Patient Location is populated, the receiver shall reset the patient’s
permanent location to the value contained in that field. If field PV1-11 - Temporary Location is
populated, the receiver shall reset the patient’s permanent location to the value contained in thatfield.

1935

The receiver shall report the result of this operation (success / error) in an acknowledgment
message returned to the sender.
In case this message conflicts with the current situation, the message is discarded but no error
condition is raised.

1940

If the receiver does not support the Temporary Patient Location Tracking Option of thistransaction, it shall application-reject the message (see ITI TF-2x: C.2.3).
3.31.7.30

Update Patient Movement Information – ADT^Z99^ADT_A01

3.31.7.30.1 Trigger Event
This message is only used within the context of the “Historic Movement Management” Option.
1945

It is sent by a Patient Encounter Supplier to a Patient Encounter Consumer to communicate an
update of a Movement, which can be the current Movement or a historic one.
MSH-9 is valued ADT^Z99^ADT_A01.

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3.31.7.30.2 Message Static Definition
Table 3.31-36: Static definition of message ADT^Z99^ADT_A01
Segment

1950

Meaning

Usage

Card.

HL7 chapter

MSH

Message Header

R[1..1]

2

SFT

Software Segment

O[0..*]

2

EVN

Event TypeR

[1..1]

2

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

O[0..1]

3

ROL

Role

O

[0..*]

15

NK1

Next of Kin / Associated Parties

O[0..*]

3

PV1

Patient VisitR[1..1]

3

PV2

Patient Visit – Additional InfoO

[0..1]

3

ZBE

Movement segment

R[1..1]

ROL

Role

O

[0..*]

15

DB1

Disability Information

O[0..*]

3

OBX

Observation/Result

O[0..*]

7

AL1

Allergy Information

O[0..*]

3

DG1

Diagnosis Information

O[0..*]

6

DRG

Diagnosis Related GroupO[0..1]

6------ PROCEDURE begin

O[0..*]

PR1

ProceduresR[1..1]

6

ROL

Role

O

[0..*]

15------ PROCEDURE end

GT1

Guarantor

O[0..*]

6------ INSURANCE begin

O[0..*]

IN1

InsuranceR[1..1]

6

IN2

Insurance Additional Info.

O[0..1]

6

IN3

Insurance Additional Info - Cert.

O[0..1]

6

ROL

Role

O

[0..*]

15------ INSURANCE end

ACC

Accident InformationO[0..1]

6

UB1

Universal Bill InformationO[0..1]

6

UB2

Universal Bill 92 InformationO[0..1]

6

PDA

Patient Death and AutopsyO[0..1]

3

3.31.7.30.3 Comments on segment usage
The ZBE segment is mandatory in this message. See the description of this segment in Section
3.31.6.1.
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3.31.7.30.4 Expected actions
1955

Otherwise, the receiver shall update the Movement in its database, and shall report the result of
this operation (success / error) in an acknowledgment message returned to the sender.
If the receiver does not know the Movement to be updated (identified by ZBE-3 in the ZBE
segment), it discards the message and raises an error condition.
A receiver not supporting the Historic Movement Management Option shall application-reject
the message (see ITI TF-2x: C.2.3).

1960

3.31.7.31

Merge two patients - ADT^A40^ADT_A39

3.31.7.31.1 Trigger Event

1965

The Patient Encounter Supplier notifies the merge of records for a patient that was incorrectly
filed under two different identifiers. This message is only used to merge two patient identifiers of
the same type, or two lists of patient identifiers, it is not supposed to update other patient
demographics information. The A08 trigger event should be used for this purpose.
MSH-9 is valued ADT^A40^ADT_A39.
3.31.7.31.2 Message Static Definition
Table 3.31-37: Static definition of message ADT^Z40^ADT_A39
Usage

Card.

HL7 chapter

MSH

Segment

Message Header

MeaningR[1..1]

2

SFT

Software Segment

O[0..*]

2

EVN

Event TypeR

[1..1]

2------ PATIENT beginR[1..1]

PID

Patient IdentificationR[1..1]

3

PD1

Additional Demographics

O[0..1]

3

MRG

Merge InformationR[1..1]

3

PV1

Patient Visit

X[0..0]

3

---

1970

3.31.7.31.3 Comments on segment usage
This transaction makes unrepeatable the PATIENT segment group: The message cancommunicate only one merge operation for one patient.

1975

The “incorrect supplier identifier” identified in the MRG segment (MRG-1-Prior Patient
Identifier List) is to be merged with the required “correct target identifier” of the same “identifier
type code” component identified in the PID segment (PID-3-Patient Identifier List). The“incorrect supplier identifier” would then logically never be referenced in future transactions.

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3.31.7.31.4 Expected actions
1980

The receiver shall merge the two patients in its data base, and shall report the result of thisoperation (success / error) in an acknowledgment message returned to the sender.
If the receiver does not recognize the target patient identifiers, it shall perform a Change Patient
Identifier List instead of a Merge.
If the receiver does not recognize the supplier patient identifiers to be merged, it shall take noaction. This situation is not an error.

1985

3.32 Distribute Document Set on MediaThis section corresponds to transaction ITI-32 of the IHE IT Infrastructure Technical
Framework. Transaction ITI-32 is used by the Portable Media Creator to create the media
content and by Portable Media Importer to read the media content.
3.32.1 Scope

1990

In the Distribute Document Set on Media transaction the Portable Media Creator sends
information to media reading actors by means of Interchange Media where it stores theinformation.
3.32.2 Use Case Roles
Portable MediaCreatorPortable Media
Importer

DistributeDocument Set on
Media

1995

Actor: Portable Media Creator
Role: Assemble the media content and store it on the media to be distributed.
Actor: Portable Media Importer
Role: Read the Document Submission Set content of distributed media in order to access the
document(s) and the relevant metadata and perform import of the documents on the media.

2000

3.32.3 Referenced Standard
ITI TF-3: 4 Metadata used in Document Sharing profiles
DICOM PS 3.10 Media Storage and File Format for Data Interchange (DICOM file format).
http://dicom.nema.org/
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2005

DICOM PS 3.12 Media Formats and Physical Media for Data Interchange, Annex F - 120mm
CD-R media, Annex R - USB Connected Removable Devices, Annex V - ZIP File Over Media,
and Annex W - Email Media. http://dicom.nema.org/
XHTML™ 1.0 The Extensible HyperText Markup Language (Second Edition). A Reformulationof HTML 4 in XML 1.0. W3C Recommendation 26 January 2000, revised 1 August 2002.
http://www.w3.org/TR/xhtml1.

2010

XHTML™ Basic. W3C Recommendation 19 December 2000. http://www.w3.org/TR/xhtmbasic.
MDN: RFC 3798 Message Disposition Notification. http://www.rfc-editor.org/rfc/rfc3798.txt
3.32.4 Interaction Diagram
PortableMedia
CreatorPortable
Media
Importer

Distribute Document
Set on Media

2015

3.32.4.1 Distribute Document Set on MediaThis transaction defines the interchange of XDS document submission sets on media. It specifies
the requirements for a directory structure, and the physical media where stored.

2020

The file directory structure restrictions and file organization are specified below. These are basedon industry standard file systems with restrictions chosen based on experience with demonstrated
interoperability in the field of reliable exchange. These are defined in Part 10 of the DICOM
standard and summarized below.
The media that are supported are:
•

2025

2030

CD-R media. The physical media specification used for the storage on CD-R is a
restricted subset of the widely used CD-R media. The restrictions were chosen to ensureinteroperability and media reliability. The standard directory and file structure can berecorded to the CD-R media by widely available software, but this software must be set
to comply with the interoperability restrictions on recording format. This media
specification relies on the healthcare experience gained by CD-R media widely used inradiology and cardiology. It is defined by Annex F in Part 12 of the DICOM standard andis also used in the IHE Radiology PDI Profile for the interchange of images,

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IHE IT Infrastructure Technical Framework, Volume 2b (ITI TF-2b): Transactions Part B______________________________________________________________________________•USB Removable Devices. This media specification encompasses a wide range of USB
connected flash media, removable storage devices, etc. The standard directory and filestructure can be recorded onto any of these media by any system that supports the USB
Removable Device type defined by the USB Implementers Forum. This specification isdefined in Annex R in Part 12 of the DICOM standard.

•

Email transport of ZIP files. This media specification defines the encoding of thedirectory and file structure as an ordinary ZIP file (maintaining the directory structure)
and attaches that ZIP file to an email message. Some additional constraints are added tothe email message header to facilitate recognizing the message. This specification isdefined in the annexes to part 12 of the DICOM standard called: ZIP File Media andEmail media. The ZIP over Email Response Option enables the Portable Media Importerto send an acknowledgment message to the Portable Media Importer.

2035

2040

3.32.4.1.1 Trigger Events
2045

The user at the Portable Media Creator wishes to transport information by the creation andtransport of interchange media. The Portable Media Creator assembles the Interchange Media
content and stores it on the media.
If the ZIP over Email Response Option is supported, the Portable Media Importer shall detect
whether the Import was successful or not.
3.32.4.1.2 Message Semantics

2050

2055

The message semantics of this transaction are described in terms of content specifications for the
media.
The Portable Media Creator shall be able to include one or multiple Submission Set(s), including
document(s) and associated metadata. Additionally it shall include a README.TXT file and an
INDEX.HTM and associated files for use to display the media content using a simple browser.
It may include other files and directories that the Portable Media Importer will ignore.
3.32.4.1.2.1 Media File system and File Naming Restrictions
The following restrictions are needed to ensure broad interoperability:

2060

2065

•

Strict ISO 9660 Level 1 compliance for filenames and directories, even on non-CDR
media.

•

Strict ISO 9660 Level 1 compliance for recording methods on CDR media. This meansno packet writing.

•

Filenames should not be in lower case, nor have lower case equivalent file names
encoded as Joliet or Rock Ridge extensions to the ISO 9660 file system.

•

Only file and folder names referenced by the DICOMDIR file are restricted to 8
characters with no extension. Specifically, it is not permitted to name DICOM files based

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on their SOP Instance UID, since that would exceed the 8 character limit and use theillegal period character, and it is not permitted to add a “.dcm” extension or similar.
Note:

2070

Refer to RAD TF-3: Appendix E of the IHE Radiology Technical Framework for a reference to common
implementation misinterpretations and/or errors that are detrimental to interoperability.

3.32.4.1.2.2 Content Organization Overview

Figure 3.32.4.1-1: General structure of the media

2075

2080

The media shall contain at the “root” directory level, as shown in the figure above:•

An IHE_XDM directory.

•

Two files for helping to access the content of the media: README.TXT and INDEX.HTM•

An Autorun file or equivalent shall not be present in the root directory. Executable files
may be present, but shall not be configured to start automatically.

As shown in the figure above, the IHE_XDM directory shall contain one sub-directory per
submission set included on the media.
There may be other files present on the media for other purposes, (e.g., use in compliance with
the IHE Radiology PDI Profile). The presence or absence of these files shall not affectperformance of this transaction.

2085

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Figure 3.32.4.1-2: Structure of a submission set directory on the media

As shown on the figure above, each submission set directory shall contain:
2090•

A METADATA.XML file containing the XDS Registry metadata, as described in ITI TF3: 4.3.1.2.2. This shall include the metadata as specified in ITI TF-3: Table 4.3.1.1-3
Metadata Attribute Optionality. This may include XDSFolder objects, associations, andother metadata contents. There is no relationship between an XDSFolder and a media
directory, although some people do call media directories “folders”. The metadata for thesubmission set shall include unique and different submissionTime.

•One file for each “simple part” document referenced in the metadata as an
XDSDocumentEntry•

One sub-directory for each “multipart” document referenced in the metadata as an
XDSDocumentEntry (see ITI TF-3: Table 4.2.3.2-1, attribute mimeType set to“multipart/related”)•

Potentially other files and directories that are ignored by the Portable Media Importer

2095

2100

The “multipart” document shall be structured as one sub-directory containing all the parts as file,including the “start” part corresponding to the main file to be open by the “multipart” document
viewer. An example of “multipart” document is shown in Figure 3.32.4.1-3.
2105

Figure 3.32.4.1-3: Structure on the media of a directory which is functionally equivalent toa “XDS multipart document”

2110

2115

The URI element of the metadata describing a file that is present on this media shall point to thefile containing the document, through a relative URL which corresponds to the file name forsimple part document and to the concatenation of the sub-directory and the main file name for“multipart” document (e.g., DOC00002/DOC00002.XML). Note that in cases where the files are
not located within this media directory for the Submission Set, it is possible that the relative
URL may begin with “../” so that a single copy the document can be present for multiple
purposes.
In Figure 3.32.4.1-2, the METADATA.XML file of the Submission Set stored in the SUBSET01
directory will contain many XDSDocumentEntry objects having their elements set as follows(see ITI TF-3: Table 4.1-5, URI attribute for details):

2120<ExtrinsicObject id="Document1" mimeType="text/xml"... (with URI set to “DOC00001.XML”)<ExtrinsicObject id="Document2" mimeType="text/xml"... (with URI set to “DOC00002/DOC00002.XML”)

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The file named INDEX.HTM in the root directory shall be encoded in compliance with the
XHTML Basic recommendation from W3C. It may contain a description of the submission sets,
including especially:
2125•

Patient ID and demographics•

Source Facility information

Note:

2130

XDM Distribute Document Set on Media transaction does not require that all the submission sets included in the
media are relative to the same patient.

It may also describe other content which is on the media, including the means to launch any
executable that may be present on the media.
There shall also be a README.TXT file located in the root directory that shall contain:•

Contact information regarding the Institution that created the media.

•

Information regarding the Application that created the media.

2135

•

Name of the product application and software version•

Contact information of the vendor of the application that created the media•

General information about the overall organization of the interchange media. This is notintended to be specific to the content stored on this instance of interchange media, which
if necessary should be placed in the INDEX.HTM file.

•

Information regarding the Media Viewer application (if a Media Viewer is contained)

2140

2145

•

Operating system(s) supported•

Name of the product application and software version•

Contact information of vendor that provided the Media Viewer application•

Disclaimer statement about the intended usage of the application•

List of minimum requirements•

Additional information regarding the usage of the application

Note that generally the README.TXT file is independent of the clinical content of the media,
i.e., the same README.TXT may be included on all media created by that application at that
institution. Experience has shown that this kind of README.TXT file is very valuable forresolving problems.
2150

In addition, if the Portable Media Creator implements support for the Web Content Option of the
PDI Profile then the INDEX.HTM file must meet the requirements of the PDI Profile Web
Content Option.
The INDEX.HTM file located in the root directory shall contain:•

An informative header containing:

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2155

2160

•

Identification of the institution that created the interchange media•

Optionally, a disclaimer statement about privacy/security from the institution that createdthe interchange media•

a link to an entry point for accessing the web content of the IHE_PDI directory•a link to the README.TXT file•a link to additional non-constrained data (if it exists)•a manifest which lists the data that can be imported by a Portable Media Importer Actor.
(i.e., all DICOM content on the media)•

a manifest which lists any patient-related data contained on the CD that cannot be
imported (i.e., additional non-constrained content that doesn’t have an importable
DICOM equivalent on the media).

•a link to a launch point for a DICOM viewer, if present on the interchange media

2165

3.32.4.1.2.3 Response message2170

If the ZIP over Email Response Option is supported and a response was requested, thePortable Media Importer shall send a response, based on the [MDN] mechanism, dependingof the success of the Import operation:•

Success: the MDN “disposition-type” field is set to “displayed”•

Error: the MDN “disposition-type” field is set to “deleted” and the MDN “dispositionmodifier” is set to “Error: xxxx” where “xxxx” is the text detailing the error.

Note 1:

Older implementations of MDN might use “processed” instead of “display”. The current RFC has removed thisoption but Portable Media Creator should be prepared to receive it. If they receive it, they have to look in theerror field to see whether there is an error.

Note 2:

The general mechanism for use of Email is described in ITI TF-2x: Appendix T (Informative)2175

3.32.4.1.3 Media Identification
2180

The Portable Media Creator Actor may add a human-readable identification on the outside of thephysical medium, reflecting the originating institution, the time of the creation and content of themedia. The method of media marking is outside the scope of this transaction.
If the ZIP over Email Response Option is supported, Portable Media Creator shall be
configurable to include in its message header the request for a response:•

2185“Disposition-Notification-To:”, followed by the email address to which Portable Media
Importer shall send the response

Then, the Portable Media Importer shall acknowledge this operation by sending a MDN responseto the email address included in the message.
And finally, the Portable Media Creator shall consider that the import is successful unless:
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2190

the disposition-modifier contains the word “error” or “failure”, case insensitive.

Note: This transaction does not specify how errors should be processed because the variety of
appropriate responses is too great.
If the ZIP over Email Option is supported, the subject line of the email shall contain the phrase:•

XDM/1.0/DDM
Note:

2195

In case the same Email complies also with the DICOM Email, it is recommended that the subject contains thephrase: XDM/1.0/DDM+DICOM-ZIP

3.32.4.1.4 Expected Actions

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The Portable Media Importer shall verify the integrity of the media by comparing their size andhash with the value of the corresponding entries in the METADATA.XML file of the relevant
submission set directory. Mismatching documents shall be indicated to the user. Media faults
shall be indicated to the user.
If the XDM Portable Media Importer is grouped with a Content Consumer of one or more IHE
Content Profiles, that actor is able to perform its processing on the documents it is designed tosupport.
Note:

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This awkward phrasing means that ability to process data on portable media is described by saying that theprocessing actor is grouped with a Portable Media Importer Actor.

3.32.4.1.4.1 Basic Patient Privacy Enforcement Option
If the Basic Patient Privacy Enforcement Option is implemented:

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1. The Portable Media Creator Actor shall populate the confidentialityCode in the document
metadata with the list of values that identify the sensitivity classifications that apply tothe associated document. All documents submitted shall have confidentiality codes. The
confidentiality codes for different documents in the same submission may be different.
2. The Portable Media Creator Actor shall be able to be configured with the Patient Privacy
Policies, Patient Privacy Policy Identifiers (OIDs) and associated information necessary
to understand and enforce the policies. The details of this are product specific and not
specified by IHE.
3. The Portable Media Creator Actor may have user interface or business rule capabilities todetermine the appropriate confidentiality codes for each document. The details of this areproduct specific and not specified by IHE.

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4. The Portable Media Importer Actor shall be able to be configured with the Patient
Privacy Policies, Patient Privacy Policy Identifiers (OIDs) and associated informationnecessary to understand and enforce the policies. The meanings of the codes on the media
must be provided out of band, e.g., by telephone, fax, or email. The detail of how this isdone is product specific and not specified by IHE. If the documents are transferredinternally within the organization or to other members of the recipient's affinity domain,
appropriate internal confidentiality codes shall be applied.
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5. The Portable Media Creator Actor shall be able to publish the consent documents and any
applicable digital signatures that apply to the collection of content that it has created on
portable media.
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6. The Portable Media Importer Actor shall have the ability to coerce the confidentiality
code in the metadata associated with the document from the codes used by the Exporterto the codes used by the Importer.
The Portable Media Importer Actor shall abide by the XDS Affinity Domain Policies represented
by the confidentialityCode in the metadata associated with the document. The Portable MediaCreator Actor likely will have user access controls or business rule capabilities to determine thedetails of how confidentiality codes apply to query results. The details of this are product specificand not specified by IHE. These rules shall reduce the query results to only those that areappropriate to the current situation for that actor and user.
3.32.4.1.5 Security considerations
In the case of physical media, encryption of the CD-R or USB shall not be used.

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If the ZIP over Email Option is supported, the transaction shall be secured by S/MIME (seeIHE ATNA) and comply with the security process as defined in the DICOM Part 15 Appendix(Secure Use of ZIP File Media over Email). The security process requires the use of S/MIME
to both encrypt and sign the message. The encryption is used to maintain confidentiality during
the transport. The signature is used to maintain integrity during transport and indicates that thesender is authorized to send the message.
Portable Media Creators that create media shall generate one or more ATNA “Export” events
into the audit trail to describe the media creation event. These events shall describe eachsubmission set and/or study that is exported.

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Portable Media Importers that import media shall generate one or more ATNA “Import” events
into the audit trail to describe the media import event. These events shall describe eachsubmission set and/or study that is imported.
Note:

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It is easy to build a partial implementation of actors in the XDM Profile that lack the auditing capability. For
example, a person can manually create media that comply with the requirements of the XDM media. It is possiblethat the manual process omits the generation of audit records for their activity. This would not be a compliant orcomplete implementation of the actors, but it is easy to make this kind of mistake.

The Portable Media Importer shall check the hash value and size as found in the XDS metadata
to detect corruption within the metadata or media. The Portable Media Importer shall notify theuser if any errors are detected.

3.33 Intentionally Left Blank
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3.34 Retrieve Form
This section corresponds to transaction ITI-34 of the IHE IT Infrastructure Technical
Framework. Transaction ITI-34 is used by the Form Filler and Form Manager or Form Processor
Actors.
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3.34.1 Scope
This transaction involves a Form Filler requesting a form from a Form Manager or Form
Processor. The Form Filler has a formID, and possibly additional workflow information,
obtained by a means that is outside the scope of this transaction. The Form Filler may also
provide a form instance id to reference a previously submitted form. The Form Manager or Form
Processor will return a form or URL corresponding to the given formID, and optionally a form
instance id, or else it returns an error response. Forms are defined and constrained below by theformat options.
3.34.2 Use Case Roles
Form Filler

Form Manager

Form Processor

Retrieve Form

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Actor: Form Filler
Role: A forms display and editing system capable of allowing form fields to be completed.
Actor: Form Manager
Role: A system that provides forms based upon requests that provide specific formIDs, andoptionally additional work flow data. . Form data is submitted to a Form Receiver.

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Actor: Form Processor
Role: A system that provides forms based upon requests that provide specific formIDs, andoptionally additional work flow data. Form data from this actor shall be submitted back to itself.
3.34.3 Referenced Standards

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Implementors of this transaction shall comply with all requirements described in ITI TF-2x:
Appendix V: Web Services for IHE Transactions.
IETF RFC 1738, Uniform Resource Locators (URL), December 1994,
http://www.faqs.org/rfcs/rfc1738.html
IETF RFC 2616 HyperText Transfer Protocol HTTP/1.1

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Extensible Markup Language (XML) 1.0 (Second Edition). W3C Recommendation 6 October
2000. http://www.w3.org/TR/REC-xml.
ITI TF-2x: Appendix V Web Services for IHE Transactions
XForms 1.1, W3C Working Draft. http://www.w3.org/TR/2004/WD-xforms11-20041115/

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XHTML™ 1.0 The Extensible HyperText Markup Language (Second Edition).A Reformulationof HTML 4 in XML 1.0. W3C Recommendation 26 January 2000, revised 1 August 2002.
http://www.w3.org/TR/xhtml1.
XHTML™ Basic. W3C Recommendation 19 December 2000. http://www.w3.org/TR/xhtmbasic.
http://www.w3.org/TR/xhtml-basic

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3.34.4 Interaction Diagram
Form Manager orForm Processor

Form Filler

Retrieve Form
RequestRetrieve Form
Response

3.34.4.1 Retrieve Form Request

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Retrieve Form involves a Form Filler requesting a form from a Form Manager or Form
Processor. The Form Filler shall supply workflow data and prepopulation data. The Form Filler
may also supply a form instance id.
The Retrieve Form Request shall provide an archiveURL value, as a nil value or as a URL
pointing to a Form Archiver Actor. See Section 3.34.4.1.2 for details.

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The Form Filler requests that Form Filler or Form Processor use context information in theselection and/or creation of the returned form by supplying the prepopData argument with wellformed xml representing the Form Filler context. Specification of the prepopData schema is left
to content profiles. This value may be nil.

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IHE IT Infrastructure Technical Framework, Volume 2b (ITI TF-2b): Transactions Part B______________________________________________________________________________The Form Filler supplies any additional workflow information to be used in the selection and/or
creation of the form using the context element of the workflowData parameter. Specification ofthis context element is left to content profiles.
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The response to a Retrieve Form Request returns the form, or reference to a form, and may
return a form instance id.
3.34.4.1.1 Trigger Events
The Form Filler, based upon human decision or application of a rule for automatic operation,
requests a form hosted by a Form Manager or Form Processor.

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3.34.4.1.2 Message Semantics
Implementors of this transaction shall comply with all requirements described in ITI TF-2x:
Appendix V: Web Services for IHE Transactions. The following parameters are specified for thistransaction.
Parameter Name

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Description

Value

prepopData

R

REQ

The xml context information supplied
by a Form Filler for use in prepopulating form fields

This value shall be nil or a wellformed xml document.

workflowDataR

The xml representation of workflow
specific values.

This value is a well-formed xml
document.as defined below.

formIDR

The identifier of a form.

A string identifying the form

encodedResponseR

Tells the Form Manager whether or
not to return an encoded response{true,false}archiveURL

R

Tells the Form Manager whether or
not the Form Filler is exercising theArchive Option

the URL of any Form Filler
identified Form Archiver or thenull string

context

R

The xml specifics of workflow
context

Defined by content profiles; maybe nilinstanceIDR

An id value of a previously submitted
instance of data.

A string identifying an instanceof previously submitted data;
may be nil.

The contents of the prepopData parameter is defined in a prepopData schema specified by IHE
content profiles. When there is no prepopData the attribute xsi:nil shall be set to “true” (see thesupport materials).
The content of workflowData parameter shall minimally be:

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<workflowData><formID>a String identifying the form</formID><encodedResponse>false</encodedResponse><archiveURL /><context/><instanceID/></workflowData>
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See the schema provided with the support materials(ftp://ftp.ihe.net/TF_Implementation_Material/ITI/). The workflowData may be extended by IHE
content profiles with further definition of the <context> element.
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3.34.4.1.3 Expected Actions

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Upon receipt of the Retrieve Form request, the Form Manager or Form Processor shall parse therequest and shall return the requested response in the RetrieveFormResponse element, or errors
with SOAP Faults. The Form Manager shall return the form or URL based on the values of: a)
the encodedResponse; b) the formID; c) any additional workflowData; d) the optionally supplied
instanceID.
If encodedResponse is ‘true’, then the response from the Form Manager or Form Processor shallbe either a Structured (XML) or Unstructured (non-XML) element. When the encodedResponse
parameter is 'true', all anchor addresses that are not fragment identifiers shall be composed ofabsolute URIs.

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If encodedResponse is ‘false’, then the response from the Form Manager or Form Processor shallbe a URL element that can be used directly by a web browser for retrieval and operation of theform.
The Form Manager or Form Processor may assign and return a value for a form instanceID.

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When the Form Filler provides a valid URL in the archiveURL parameter of the request, theForm Manager or Form Processor shall return a form that shall perform an Archive Formtransaction upon form submission, in addition to any predefined actions associated with the form
submission. As shown in Section 3.36 Archive Form, this additional archival transaction is
between Form Filler and Form Archiver Actors.
When the Form Filler supplies data in the prepopData parameter, the Form Manager or Form
Processor may use this information to determine the form to be returned and to pre-populate thefields of the form. The exact use of the prepopData, and the structure, is deferred to the
publication of an IHE content profile.
The Form Manager or Form Processor shall use the values within the workflowData parameter,
as well as the optionally supplied instanceID, to determine the form to be returned and to prepopulate the fields of the form.
The value of the formID has been previously assigned by the Form Manager or Form Processor
to identify a form to be returned to the Form Filler using one of the named format options. A
Form Manager or Form Processor may support multiple named options, but for each formID
there is only one named option that is supported.

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The Form Manager or Form Processor shall use the SOAP Faults defined in Table 3.34.4.1.3-1
when appropriate. Form Fillers shall be capable of accepting other values beyond the ones
specified here.

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Table 3.34.4.1.3-1: SOAP Faults
Description of error

CodeReason Text

There is missing information, such as no formID

SenderRequired Information Missing

No form is available

SenderUnknown formID

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An example of a SOAP Fault is:

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<env:Envelope xmlns:env="http://www.w3.org/2003/05/soap-envelope"
xmlns:xml="http://www.w3.org/XML/1998/namespace"><env:Body><env:Fault><env:Code><env:Value>env:Sender</env:Value></env:Code><env:Reason><env:Text xml:lang="en">Required Information Missing</env:Text></env:Reason></env:Fault></env:Body></env:Envelope>3.34.4.1.4 Security Considerations
As noted in the mitigations section of ITI TF-1: 17.5 Security Considerations, endpoints are free
to implement TLS as needed for additional privacy and protection. Content profiles, based upon
the nature of the data, may need to require use of ATNA.
3.34.4.2 Retrieve Form Response

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3.34.4.2.1 Trigger Events
This message is triggered by a Form Manager or Form Processor Actor responding to a Retrieve
Form request.
3.34.4.2.2 Message Semantics
The form or URL is returned.

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The following parameters are specified for the response of this transaction
Element Name
form

REQ
R

Description

Constraints

The xml element container for theform. The form element Shallcontain one of: {Structured,
Unstructured, URL} and may also
contain an instanceID.

An element of typeurn:ihe:iti:rfd:2007:formDataType, thus it has only child elements
and no value.

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Element Name
form/Structured

form/Unstructured

REQ

Description

O [Note 1]

The xml element container for the
return of encoded, structured form
content.

xs:anyThe xml element container for the
return of encoded, unstructured,base64 encoded form content.

xs:base64Binary

O [Note 1]

Constraints

This element may be further
constrained by content profiles.
May only be present when theForm Request has
encodedResponse value of true.

This element may be further
constrained by content profiles.
May only be present when theForm Request has
encodedResponse value of true.

form/URL

O [Note 2]

The xml element container for the
return of a pointer to the form.

xs:anyURI
Required when the Form Request
has encodedResponse value offalse.

form/instanceIDO

The xml element containing thevalue of a form instance

xs:string

contentTypeR

Has no meaning when the Form
Request encodedResponse value isfalse.

xs:string
Required; may be nil.
The value may be constrained bycontent profiles.

responseCodeR

Not defined.

xs:string
Required; may be nil
The value may be constrained bycontent profiles.

Note 1: When the Form Request has encodedResponse value of true, then one of the two fields isrequired, and the URL field is forbidden.
Note 2: When the Form Request has encodedResponse value of false, then the URL field is
required, and Structured and Unstructured are forbidden.
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3.34.4.2.3 Expected Actions
The Form Filler shall retrieve from the URLvalue returned if the Retrieve Form
encodedResponse value was false.
Regardless of the Retrieve Form encodedResponse value, the Form Filler may fill any form
fields needed for form submission, and may display the form for user interaction.

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3.34.4.2.3.1 XHTML Handling
A Form Manager or Form Processor shall return a form. If the form is returned as a URL,
because encodedResponse is false on the request, the form shall be formatted as XHTML using
XHTML Basic and W3C HTML Compatibility Guidelines provided in the Appendix C of the
W3C XHTML 1.0 Recommendation. If the form is returned as Structured content, it shall be
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capable of being transformed into XHTML. In all cases, the returned form shall support theSubmit and all required Archive transactions.
3.34.4.2.3.2 XForm Option

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A Form Manager or Form Processor that supports the XForms Option shall additionally becapable of returning a form, whether returned as the response or referenced by a returned URL,
that conforms to XForms 1.1. The host language for the XForm shall be XHTML Basicaccording to the W3C HTML Compatibility Guidelines provided in the Appendix C of the W3C
XHTML 1.0 Recommendation. The returned form shall support the Submit and all required
Archive transactions.
3.34.5 Protocol Requirements

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The Retrieve Form request and response shall be transmitted using Synchronous Web Services
Exchange, according to the requirements specified in ITI TF-2x: Appendix V.
The Retrieve Form transaction shall use SOAP 1.2.
WSDL Namespace Definitions

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ihe

urn:ihe:iti:rfd:2007

soap12

http://schemas.xmlsoap.org/wsdl/soap12/

wsaw

http://www.w3.org/2005/08/addressing

xsd

http://www.w3.org/2001/XMLSchema

These are the requirements for the Retrieve Form transaction presented in the order in which
they would appear in the WSDL definition:•

The following types shall be imported (xds:import) in the /definitions/types section:••

The /definitions/message/part/@element attribute of the Retrieve Form Request message
shall be defined as: “ihe:RetrieveFormRequest”•

The /definitions/message/part/@element attribute of the Retrieve Form Response
message shall be defined as: “ihe:RetrieveFormResponse”•

The /definitions/portType/operation/input/@wsaw:Action attribute for the Retrieve Form
Request message shall be defined as “urn:ihe:iti:2007:RetrieveForm”•

The /definitions/portType/operation/output/@wsaw:Action attribute for the Retrieve
Form Response message shall be defined as: “urn:ihe:iti:2007:RetrieveFormResponse”•

The /definitions/binding/operation/soap12:operation/@soapAction attribute shall bedefined as “urn:ihe:iti:2007:RetrieveForm”

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Namespace=”urn:ihe:iti:rfd:2007”, schema=”RFD.xsd”

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These are the requirements that affect the wire format of the SOAP message. The other WSDL
properties are only used within the WSDL definition and do not affect interoperability. Fullsample request and response messages are in Section 3.34.5.1 Sample SOAP Messages.
For informative WSDL for the Form Manager see ITI TF-2x: Appendix W. A full XML Schema
Document for the RFD types is available online on the IHE FTP site
(ftp://ftp.ihe.net/TF_Implementation_Material/ITI/).

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3.34.5.1 Sample SOAP Messages
The samples in the following two sections show a typical SOAP request and its relative SOAP
response. The sample messages also show the WS-Addressing headers <Action/>,2455<MessageID/>, .; these WS-Addressing headers are populated according to ITI TF-2x: Appendix
V: Web Services for IHE Transactions. Some of the body of the SOAP message is omitted forbrevity.
3.34.5.1.1 Sample Retrieve Form SOAP Request

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<soap:Envelope xmlns:soap="http://www.w3.org/2003/05/soap-envelope"
xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
xmlns:xsd="http://www.w3.org/2001/XMLSchema"><soap:Header><wsa:To>http://localhost:4040/axis2/services/someservice</wsa:To><wsa:MessageID>urn:uuid:76A2C3D9BCD3AECFF31217932910053</wsa:MessageID><wsa:Action soap:mustUnderstand="1">urn:ihe:iti:
2007:RetrieveForm</wsa:Action></soap:Header><soap:Body><RetrieveFormRequest xmlns="urn:ihe:iti:rfd:2007"><prepopData>...some xml content...</prepopdata><workflowData><formID>1</formID><encodedResponse>false</encodedResponse><archiveURL /><context /><instanceID /></workflowData></RetrieveFormRequest></soap:Body></soap:Envelope>3.34.5.1.2 Sample Retrieve Form SOAP Response
2480<soap:Envelope xmlns:soap="http://www.w3.org/2003/05/soap-envelope"2485

xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
xmlns:xsd="http://www.w3.org/2001/XMLSchema"><soap:Header><wsa:To>http://localhost:4040/axis2/services/someservice</wsa:To><wsa:MessageID>urn:uuid:76A2C3D9BCD3AECFF31217932910053</wsa:MessageID>
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<wsa:Action soap:mustUnderstand="1">urn:ihe:iti:
2007:RetrieveFormResponse</wsa:Action></soap:Header><soap:Body><RetrieveFormResponse xmlns="urn:ihe:iti:rfd:2007"><form><URL>http://somehost/xxx/services/someForm</URL><instanceID>1.2.3.4.5</instanceID></form><contentType /><responseCode /></RetrieveFormResponse></soap:Body></soap:Envelope>

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3.35 Submit Form
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This section corresponds to transaction ITI-35 of the IHE IT Infrastructure Technical
Framework. Transaction ITI-35 is used by the Form Filler and Form Receiver or Form Processor
Actors.
3.35.1 Scope
This transaction involves a Form Filler submitting a form to a Form Receiver or Form Processor.

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3.35.2 Use Case Roles
Form Filler

Form ReceiverForm Processor

Submit Form

Actor: Form Filler
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Role: A forms display and editing system capable of allowing form fields to be completed.
Actor: Form Receiver
Role: A system that receives submitted form data from forms constructed by Form Managers.
Actor: Form Processor

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Role: A system that receives submitted form data from forms constructed by this same instanceof the Form Processor.
3.35.3 Referenced Standards
Implementors of this transaction shall comply with all requirements described in ITI TF-2x:
Appendix V: Web Services for IHE Transactions.

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IETF RFC 1738, Uniform Resource Locators (URL), December 1994,
http://www.faqs.org/rfcs/rfc1738.html
IETF RFC 2616 HyperText Transfer Protocol HTTP/1.1
Extensible Markup Language (XML) 1.0 (Second Edition). W3C Recommendation 6 October
2000. http://www.w3.org/TR/REC-xml.

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3.35.4 Interaction Diagram
Form Receiver orForm Processor

Form Filler

Submit Form [ITI-35]

Ack/Nak response

3.35.4.1 Submit Form
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This transaction is initiated by a Form Filler submitting form instance data, using XML as aformat, to a Form Receiver or Form Processor.
3.35.4.1.1 Trigger Events
The Submit Form transaction is triggered by the submission action from within the form.
3.35.4.1.2 Message Semantics

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The Submit Form transaction shall carry a SubmitFormRequest element, with submitted form
data as XML child elements of the SubmitFormRequest element. Content profiles may further
constrain the content of the SubmitFormRequest element.
See the schema provided with the support materials (see ITI TF-2x: Appendix W).
3.35.4.1.3 Expected Actions

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Upon receipt of the Submit Form request, the Form Receiver or Form Processor shall return a
SubmitFormResponse element, or errors with SOAP Faults, for example if the posted datacannot be recognized.
The Form Filler may display the results of the response from the Form Receiver or Form
Processor.

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The Form Receiver or Form Processor shall use the SOAP Faults defined in Table 3.35.4.1.3-1
when appropriate. Form Fillers shall be capable of accepting other values beyond the ones
specified here.
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Table 3.35.4.1.3-1: SOAP Faults
Description of error

CodeCannot recognize the posted data

SenderReason Text
Required Information Missing

An example of a SOAP Fault is:
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<env:Envelope xmlns:env="http://www.w3.org/2003/05/soap-envelope"
xmlns:xml="http://www.w3.org/XML/1998/namespace"><env:Body><env:Fault><env:Code><env:Value>env:Sender</env:Value></env:Code><env:Reason><env:Text xml:lang="en">Required Information Missing</env:Text></env:Reason></env:Fault></env:Body></env:Envelope>

3.35.4.2 Submit Form Response
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3.35.4.2.1 Trigger Events
This message is triggered by a Form Filler submitting form instance data.
3.34.4.2.2 Message Semantics
The Submit Form Response shall return a SubmitFormResponseType element containing:

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•

A responseCode string that may be constrained by Content Profiles•

An optional content element containing formData, as is returned byRetrieveFormResponse•

An optional contentType string that may be constrained by Content Profiles.

See the schema provided with the support materials (see ITI TF-2x: Appendix W).
3.35.4.2.3 Expected Actions
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The Form Filler may display the results of the response from the Form Receiver or Form
Processor. The form behavior may be further profiled by content domain profiles.
3.35.5 Protocol Requirements
Implementors of this transaction shall comply with all requirements described in ITI TF-2x:
Appendix V: Web Services for IHE Transactions.

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The Submit Form transaction shall use SOAP 1.2.
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IHE IT Infrastructure Technical Framework, Volume 2b (ITI TF-2b): Transactions Part B______________________________________________________________________________WSDL Namespace Definitions

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ihe

urn:ihe:iti:rfd:2007

soap12

http://schemas.xmlsoap.org/wsdl/soap12/

wsaw

http://www.w3.org/2005/08/addressing

xsd

http://www.w3.org/2001/XMLSchema

These are the requirements for the Submit Form transaction presented in the order in which theywould appear in the RFD Submit Form WSDL definition:•

The following types shall be imported (xds:import) in the /definitions/types section:•

2595

Namespace=”urn:ihe:iti:rfd:2007”, schema=”RFD.xsd”•

The /definitions/message/part/@element attribute of the Submit Form Request message
shall be defined as: “ihe:SubmitFormRequest”•

The /definitions/message/part/@element attribute of the Submit Form Response message
shall be defined as: “ihe:SubmitFormResponse”•

Refer to Table 3.35.5-1 for additional attribute requirements.
Table 3.35.5-1: Additional Attribute Requirements
Attribute

Value/definitions/portType/operation@nameSubmitForm/definitions/portType/operation/input/@wsaw:Actionurn:ihe:iti:2007:SubmitForm/definitions/portType/operation/output/@wsa
w:Action

urn:ihe:iti:2007:SubmitFormResponse/definitions/binding/operation/soap12:operati
on/@soapAction

urn:ihe:iti:2007:SubmitForm

2600
These are the requirements that affect the wire format of the SOAP message. The other WSDL
properties are only used within the WSDL definition and do not affect interoperability. Fullsample request and response messages are in Section 3.35.5.1 Sample SOAP Messages.
For informative WSDL see ITI TF-2x: Appendix W.
2605

The <ihe:SubmitFormRequest> element is defined as:•

One or more <xs:any> elements

This allows the Form Manager to construct forms that submit form data using any XML
representation.

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IHE IT Infrastructure Technical Framework, Volume 2b (ITI TF-2b): Transactions Part B______________________________________________________________________________The <ihe:SubmitFormResponseType> element is defined as:
2610•

An optional <ihe:content> element which is of type <ihe:formDataType> as also used in
the Retrieve Form Response. If present it shall contain:•

One of the following:

2615

•

<ihe:Structured> containing XML encoding of a form•

<ihe:Unstructured> containing base64Binary encoding of a form•

<ihe:URL> containing the URL of a form•

An optional <ihe:instanceID> of type xs:string.

•

An optional <ihe:contentType> element, of type xs:string.

•A required <ihe:responseCode> element of type xs:string.

3.35.5.1 Sample SOAP Messages
2620

The samples in the following two sections show a typical SOAP request and its relative SOAP
response. The sample messages also show the WS-Addressing headers <Action/>,<MessageID/>, .; these WS-Addressing headers are populated according to ITI TF-2x: Appendix
V: Web Services for IHE Transactions. Some of the body of the SOAP message is omitted forbrevity.

2625

2630

2635

2640

3.35.5.1.1 Sample Submit Form SOAP Request<?xml version='1.0' encoding='UTF-8'?><soap:Envelope xmlns:soap="http://www.w3.org/2003/05/soap-envelope"
xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
xmlns:xsd="http://www.w3.org/2001/XMLSchema"><soap:Header><wsa:To>http://localhost:4040/axis2/services/someservice</wsa:To><wsa:MessageID>urn:uuid:76A2C3D9BCD3AECFF31217932910053</wsa:MessageID><wsa:Action soap:mustUnderstand="1">urn:ihe:iti:
2007:SubmitForm</wsa:Action></soap:Header><soap:Body><SubmitFormRequest xmlns="urn:ihe:iti:rfd:2007">…
</SubmitFormRequest></soap:Body></soap:Envelope>2645

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3.35.5.1.2 Sample Submit Form SOAP Response
2650

2655

2660

2665

<?xml version='1.0' encoding='UTF-8'?><soap:Envelope xmlns:soap="http://www.w3.org/2003/05/soap-envelope"
xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
xmlns:xsd="http://www.w3.org/2001/XMLSchema"><soap:Header><wsa:To>http://localhost:4040/axis2/services/someservice</wsa:To><wsa:MessageID>urn:uuid:76A2C3D9BCD3AECFF31217932910053</wsa:MessageID><wsa:Action soap:mustUnderstand="1">urn:ihe:iti:
2007:SubmitFormResponse</wsa:Action></soap:Header><soap:Body><SubmitFormResponseType xmlns="urn:ihe:iti:rfd:2007"><content><URL>http://somehost/xxx/services/someForm</URL><instanceID>1.2.3.4.5</instanceID></content><contentType /><responseCode /></SubmitFormResponseType></soap:Body></soap:Envelope>

3.35.6 Security Considerations
2670

As noted in the mitigations section of ITI TF-1: 17.5 Security Considerations, endpoints are free
to implement TLS as needed for additional privacy and protection. Content profiles, based upon
the nature of the data, may need to require use of ATNA.

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3.36 Archive Form
2675

This section corresponds to transaction ITI-36 of the IHE IT Infrastructure Technical
Framework. Transaction ITI-36 is used by the Form Filler and Form Archiver Actors.
3.36.1 Scope
This transaction involves a Form Filler submitting form instance data to a Form Archiver.

2680

3.36.2 Use Case Roles
Form Filler

Form ArchiverArchive Form

Actor: Form Filler
2685

Role: A forms display and editing system capable of allowing form fields to be completed.
Actor: Form ArchiverRole: A system that receives submitted forms for archival purposes.
3.36.3 Referenced Standards

2690

Implementors of this transaction shall comply with all requirements described in ITI TF-2x:
Appendix V: Web Services for IHE Transactions.
IETF RFC 1738, Uniform Resource Locators (URL), December 1994,
http://www.faqs.org/rfcs/rfc1738.html
IETF RFC 2616 HyperText Transfer Protocol HTTP/1.1

2695

Extensible Markup Language (XML) 1.0 (Second Edition). W3C Recommendation 6 October
2000. http://www.w3.org/TR/REC-xml.

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3.36.4 Interaction Diagram
Form
ArchiverForm Filler

Archive Form [ITI-36]

Ack/Nak response

3.36.4.1 Archive Form
2700

This transaction is initiated by a Form Filler submitting a data to a Form Archiver for archival
purposes.
3.36.4.1.1 Trigger Events

2705

The Form Filler shall use this transaction to submit data to a Form Archiver for archival
purposes. The Archive Form transaction may be initiated by a Form Filler, or it may be triggered
as a secondary submission action from within a form.
3.36.4.1.2 Message Semantics
The Archive Form transaction shall carry a ArchiveFormRequest element, with submitted form
data as XML child elements of the ArchiveFormRequest element. Content profiles may further
constrain the content of the ArchiveFormRequest element.

2710

See the schema provided with the support materials (see ITI TF-2x: Appendix W).
3.36.4.1.3 Expected Actions
Upon receipt of the Archive Form request, the Form Archiver shall return aArchiveFormResponse element, or errors with SOAP Faults, for example if the posted datacannot be recognized.

2715

The Form Filler may display the results of the response from the Form Archiver.
The Form Archiver shall use the SOAP Faults defined in Table 3.36.4.1.3-1 when appropriate.
Form Fillers shall be capable of accepting other values beyond the ones specified here.

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Table 3.36.4.1.3-1: SOAP Faults
Description of error

CodeCannot recognize the posted data

Reason Text

SenderRequired Information Missing

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An example of a SOAP Fault is:

2725

2730

<env:Envelope xmlns:env="http://www.w3.org/2003/05/soap-envelope"
xmlns:xml="http://www.w3.org/XML/1998/namespace"><env:Body><env:Fault><env:Code><env:Value>env:Sender</env:Value></env:Code><env:Reason><env:Text xml:lang="en">Required Information Missing</env:Text></env:Reason></env:Fault></env:Body></env:Envelope>2735
3.36.4.2 Archive Form Response
3.36.4.2.1 Trigger Events
This message is triggered by a Form Filler archiving form instance data.
3.36.4.2.2 Message Semantics
2740

An ArchiveFormResponse element it returned, which contains:•

A responseCode string that may be constrained by Content Profiles

See the schema provided with the support materials (see ITI TF-2x: Appendix W).
3.36.4.2.3 Expected Actions
2745

The Form Filler may display the results of the response from the Form Archiver. The form
behavior may be further profiled by content domain profiles.
3.36.5 Protocol Requirements
The Archive Form request and response shall be transmitted using Synchronous Web Services
Exchange, according to the requirements specified in ITI TF-2x: Appendix V.

2750

The Archive Form transaction shall use SOAP 1.2.
WSDL Namespace Definitions
ihe

urn:ihe:iti:rfd:2007

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soap12

http://schemas.xmlsoap.org/wsdl/soap12/

wsaw

http://www.w3.org/2005/08/addressing

xsd

http://www.w3.org/2001/XMLSchema

These are the requirements for the Archive Form transaction presented in the order in which theywould appear in the Archive Form WSDL definition:
2755•

The following types shall be imported (xds:import) in the /definitions/types section:•

Namespace=”urn:ihe:iti:rfd:2007”, schema=”RFD.xsd”•

The /definitions/message/part/@element attribute of the Archive Form Request message
shall be defined as: “ihe:ArchiveFormRequest”•

The /definitions/message/part/@element attribute of the Archive Form Response message
shall be defined as: “ihe:ArchiveFormResponse”•

Refer to Table 3.36.5 for additional attribute requirements.

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Table 3.36.5: Additional Attribute Requirements
Attribute

2765

Value

/definitions/portType/operation@nameArchiveForm/definitions/portType/operation/input/@wsaw:Actionurn:ihe:iti:2007:ArchiveForm/definitions/portType/operation/output/@wsa
w:Action

urn:ihe:iti:2007:ArchiveFormR
esponse/definitions/binding/operation/soap12:operati
on/@soapAction

urn:ihe:iti:2007:ArchiveForm

These are the requirements that affect the wire format of the SOAP message. The other WSDL
properties are only used within the WSDL definition and do not affect interoperability. Fullsample request and response messages are in Section 3.36.5.1 Sample SOAP Messages.
For informative WSDL see ITI TF-2x: Appendix W.
The <ihe:ArchiveFormRequest> element is defined as:

2770

•

One or more <xs:any> elements

This allows the Form Manager to construct forms that archive form data using any XML
representation.
•

The <ihe:ArchiveFormResponse> element is defined as:

A required <ihe:responseCode> element of type xs:string.

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3.36.5.1 Sample SOAP Messages
The samples in the following two sections show a typical SOAP request and its relative SOAP
response. The sample messages also show the WS-Addressing headers <Action/>,2780<MessageID/>, .; these WS-Addressing headers are populated according to ITI TF-2x: Appendix
V: Web Services for IHE Transactions. Some of the body of the SOAP message is omitted forbrevity.
3.36.5.1.1 Sample Archive Form SOAP Request

2785

2790

2795

<?xml version='1.0' encoding='UTF-8'?><soap:Envelope xmlns:soap="http://www.w3.org/2003/05/soap-envelope"
xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
xmlns:xsd="http://www.w3.org/2001/XMLSchema"><soap:Header><wsa:To>http://localhost:4040/axis2/services/someservice</wsa:To><wsa:MessageID>urn:uuid:76A2C3D9BCD3AECFF31217932910053</wsa:MessageID><wsa:Action soap:mustUnderstand="1">urn:ihe:iti:
2007:ArchiveForm</wsa:Action></soap:Header><soap:Body><ArchiveFormRequest xmlns="urn:ihe:iti:rfd:2007">…
</ArchiveFormRequest></soap:Body></soap:Envelope>

3.36.5.1.2 Sample Archive Form SOAP Response
2800

2805

2810

<?xml version='1.0' encoding='UTF-8'?><soap:Envelope xmlns:soap="http://www.w3.org/2003/05/soap-envelope"
xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
xmlns:xsd="http://www.w3.org/2001/XMLSchema"><soap:Header><wsa:To>http://localhost:4040/axis2/services/someservice</wsa:To><wsa:MessageID>urn:uuid:76A2C3D9BCD3AECFF31217932910053</wsa:MessageID><wsa:Action soap:mustUnderstand="1">urn:ihe:iti:
2007:ArchiveFormResponse</wsa:Action></soap:Header><soap:Body><ArchiveResponse xmlns="urn:ihe:iti:rfd:2007"><responseCode /></ArchiveFormResponse></soap:Body></soap:Envelope>2815
3.36.6 Security Considerations
As noted in the mitigations section of ITI TF-1: 17.5 Security Considerations, endpoints are free
to implement TLS as needed for additional privacy and protection. Content profiles, based upon
the nature of the data, may need to require use of ATNA.
2820

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3.37 Retrieve Clarifications
This section corresponds to transaction ITI-37 of the IHE IT Infrastructure Technical
Framework. Transaction ITI-37 is used by the Form Filler and Form Manager or Form Processor
Actors.
2825

3.37.1 Scope
This transaction involves a Form Filler requesting a set of clarifications from a Form Manager orForm Processor. A Form Filler supporting the Retrieve Clarifications Option shall perform thisrequest periodically, based upon a duration defined by or agreed upon with the Form Manager /Form Receiver or Form Processor. Note that not all use cases will need to support this option.

2830

The Form Filler has an orgID, obtained by a means that is outside the scope of this transaction,and the Form Manager or Form Processor will either return a form that contains either the data to
be clarified or a set of links to other forms that can be retrieved using the Retrieve Formtransaction. All updates / clarifications / new data are submitted to the Form Receiver using theSubmit Form transaction.

2835
3.37.2 Use Case Roles
Form Filler

Form Manager

Form Processor

Retrieve
Clarifications

Actor: Form Filler
2840

Role: A forms display and editing system capable of allowing form fields to be completed.
Actor: Form Manager
Role: A system that provides clarification information based upon requests that provide specificorgIDs.
Actor: Form Processor

2845

Role: A system that provides clarification information based upon requests that provide specificorgIDs.

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3.37.3 Referenced Standards
IETF RFC 1738, Uniform Resource Locators (URL), December 1994,
http://www.faqs.org/rfcs/rfc1738.html
2850

IETF RFC 2616 HyperText Transfer Protocol HTTP/1.1
Extensible Markup Language (XML) 1.0 (Second Edition). W3C Recommendation 6 October
2000. http://www.w3.org/TR/REC-xml.
ITI TF-2x: Appendix V Web Services for IHE Transactions
XForms 1.1, W3C Working Draft. http://www.w3.org/TR/2004/WD-xforms11-20041115/

2855
3.37.4 Interaction Diagram
Form Filler

Form Manager orForm Processor

Retrieve Clarifications Request

Retrieve Clarifications
Response

3.37.4.1 Retrieve Clarifications Request
2860

This transaction is initiated whenever a Form Filler which supports the Retrieve Clarifications
Option needs to obtain clarification information relevant to the organization or site.
3.37.4.1.1 Trigger Events

2865

The Retrieve Clarification event is triggered by the need for information on current clarifications
to be made available within an EHR system. The transaction does not specify when the Retrieve
Clarification happens, only that this transaction is available when information regarding
clarifications is needed from a Form Manager or Form Processor. It is the responsibility of theForm Filler that supports this option to periodically execute this transaction.

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3.37.4.1.2 Message Semantics
2870

Implementors of this transaction shall comply with all requirements described in ITI TF-2x:
Appendix V: Web Services for IHE Transactions.
The following parameters are specified for this transaction.
Parameter Name

2875

2880

REQ

Description

ValueclarificationDataR

The xml representation ofclarification specific values.

This value is a well-formed
xml document.as defined
below.

orgID

R

encodedResponseR

Tells the Form Manager whether
or not to return an encoded
response{true,false}archiveURL

R

Tells the Form Manager whether
or not the Form Filler is
exercising the Archive Option

the URL of any Form Filler
identified Form Archiver; maybe nilcontext

R

The xml specifics of workflow
context

Defined by content profiles;
may be nil

A string identifying theorganization

The clarificationData may be extended by IHE content profiles with further definition of the<context> element. The content of clarificationData shall minimally be:<clarificationData><orgID>a String identifying the form</orgID><encodedResponse>false</encodedResponse><archiveURL /><context/></clarificationData>
3.37.4.1.3 Expected Actions

2885

Upon receipt of the Retrieve Clarifications request, the Form Manager or Form Processor shallparse the request and shall return the requested response in the RetrieveClarificationsResponse
element, or errors with SOAP Faults.
The Form Manager or Form Processor shall return the form or URL based on the values of: a)
the encodedResponse; b) the orgID; c) any additional clarificationData.
If no clarification information is available, this is shall be indicated by a form indicating that noclarification information is available.

2890

If encodedResponse is ‘true’, then the response from the Form Manager or Form Processor shallbe either a Structured (XML) or Unstructured (non-XML) element. When the encodedResponse
parameter is 'true' all anchor addresses that are not fragment identifiers shall be composed ofabsolute URIs.
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If encodedResponse is ‘false’, then the response from the Form Manager or Form Processor shallbe a URL element that can be used directly by a web browser for retrieval and operation of theform.
The value of the orgID has been previously assigned by the Form Manager or Form Processor
and identifies use one of the named format options. A Form Manager may support multiple
named options, but for each orgID there is only one named option that is supported.

2900

The Form Manager shall use the SOAP Faults defined in Table 3.37.4.1.3-1 when appropriate.
Form Fillers shall be capable of accepting other values beyond the ones specified here.
Table 3.37.4.1.3-1: SOAP Faults
Description of error

Code

There is missing information, such as no orgID
No form is available

2905

2910

2915

2920

SenderSenderReason Text
Required Information Missing
Unknown orgID

An example of a SOAP Fault is:<env:Envelope xmlns:env="http://www.w3.org/2003/05/soap-envelope"
xmlns:xml="http://www.w3.org/XML/1998/namespace"><env:Body><env:Fault><env:Code><env:Value>env:Sender</env:Value></env:Code><env:Reason><env:Text xml:lang="en">Unknown orgID</env:Text></env:Reason></env:Fault></env:Body></env:Envelope>

The orgID has been assigned by the Form Manager or Form Processor use one of the named
format options. A Form Manager or Form Processor may support multiple named options, but
for each orgID there is only one named option that is supported.
3.37.4.1.4 Security Considerations

2925

The security considerations for the Retrieve Clarifications request message are no different thanthose of the Retrieve Form request message (see Section 3.34.4.1.4).

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3.37.4.2 Retrieve Clarifications Response
3.37.4.2.1 Trigger Events
The Delivery of a Form is triggered by a Form Manager or Form Processor Actor providing aform based upon the orgID supplied with the Retrieve Clarifications transaction.
2930

3.37.4.2.2 Message Semantics
The form or URL is returned in response to the Retrieve Clarifications.
3.37.4.2.3 Expected Actions
The Form Filler may display the form or navigate to the returned URL to retrieve the form.
3.37.4.2.3.1 XHTML Handling

2935

A Form Manager or Form Processor shall return a form, whether returned as the response orreferenced by a returned URL, formatted as XHTML using XHTML Basic and W3C HTMLCompatibility Guidelines provided in the Appendix C of the W3C XHTML 1.0
Recommendation. The returned form shall support the Submit and all required Archive
transactions.

2940

3.37.4.2.3.2 XForm Option

2945

A Form Manager or Form Processor that supports the XForms Option shall additionally becapable of returning a form, whether returned as the response or referenced by a returned URL,
that conforms to XForms 1.1. The host language for the XForm shall be XHTML Basicaccording to the W3C HTML Compatibility Guidelines provided in the Appendix C of the W3C
XHTML 1.0 Recommendation. The returned form shall support the Submit and all required
Archive transactions.
3.37.5 Protocol Requirements
The Retrieve Clarifications request and response shall be transmitted using Synchronous Web
Services Exchange, according to the requirements specified in ITI TF-2x: Appendix V.

2950

The Retrieve Clarifications transaction shall use SOAP 1.2.
WSDL Namespace Definitions
ihe

urn:ihe:iti:rfd:2007

soap12

http://schemas.xmlsoap.org/wsdl/soap12/

wsaw

http://www.w3.org/2005/08/addressing

xsd

http://www.w3.org/2001/XMLSchema

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These are the requirements for the Retrieve Clarifications transaction presented in the order inwhich they would appear in the WSDL definition:•

The following types shall be imported (xds:import) in the /definitions/types section:
•

2960

2965

2970

2975

Namespace=” urn:ihe:iti:rfd:2007”, schema=”RFD.xsd”•

The /definitions/message/part/@element attribute of the Retrieve Clarifications Request
message shall be defined as: “ihe:RetrieveClarificationsRequest”•

The /definitions/message/part/@element attribute of the Retrieve Clarifications Response
message shall be defined as: “ihe:RetrieveClarificationsResponse”•

The /definitions/portType/operation/input/@wsaw:Action attribute for the Retrieve
Clarifications Request message shall be defined as“urn:ihe:iti:2007:RetrieveClarifications”•

The /definitions/portType/operation/output/@wsaw:Action attribute for the Retrieve
Clarifications Response message shall be defined as:“urn:ihe:iti:2007:RetrieveClarificationsResponse”•

The /definitions/binding/operation/soap12:operation/@soapAction attribute shall bedefined as “urn:ihe:iti:2007:RetrieveClarifications”

These are the requirements that affect the wire format of the SOAP message. The other WSDL
properties are only used within the WSDL definition and do not affect interoperability. Fullsample request and response messages are in Section 3.34.5.1 Sample SOAP Messages.
For informative WSDL for the Form Manager see ITI TF-2x: Appendix W. A full XML Schema
Document for the RFD types is available online on the IHE FTP site
(ftp://ftp.ihe.net/TF_Implementation_Material/ITI/).
3.37.5.1 Sample SOAP Messages
The samples in the following two sections show a typical SOAP request and its relative SOAP
response. The sample messages also show the WS-Addressing headers <Action/>,<MessageID/>, …; these WS-Addressing headers are populated according to2980

ITI TF-2x: Appendix V: Web Services for IHE Transactions.
3.37.5.1.1 Sample Retrieve Clarifications SOAP Request

2985

2990

<?xml version="1.0" encoding="utf-8"?><soap:Envelope xmlns:soap="http://www.w3.org/2003/05/soap-envelope"
xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
xmlns:xsd="http://www.w3.org/2001/XMLSchema"><soap:Header><wsa:To>http://localhost:4040/axis2/services/someservice</wsa:To><wsa:MessageID>urn:uuid:76A2C3D9BCD3AECFF31217932910053</wsa:MessageID>
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2995

3000

3005

3010

3015

3020

3025

<wsa:Action soap:mustUnderstand="1">urn:ihe:iti:
2007:RetrieveClarifications</wsa:Action></soap:Header><soap:Body><RetrieveClarificationsRequest xmlns="urn:ihe:iti:rfd:2007"><clarificationData><orgID>123</formID><encodedResponse>false</encodedResponse><archiveURL /><context /></clarificationData></RetrieveClarificationsRequest></soap:Body></soap:Envelope>

3.37.5.1.2 Sample Retrieve Clarifications SOAP Response<soap:Envelope xmlns:soap="http://www.w3.org/2003/05/soap-envelope"
xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
xmlns:xsd="http://www.w3.org/2001/XMLSchema"><soap:Header><wsa:To>http://localhost:4040/axis2/services/someservice</wsa:To><wsa:MessageID>urn:uuid:76A2C3D9BCD3AECFF31217932910053</wsa:MessageID><wsa:Action soap:mustUnderstand="1">urn:ihe:iti:
2007:RetrieveClarificationsResponse</wsa:Action></soap:Header><soap:Body><RetrieveClarificationsResponse xmlns="urn:ihe:iti:rfd:2007"><form><URL>http://somehost/xxx/services/someForm</URL></form><contentType /><responseCode /></RetrieveClarificationsResponse></soap:Body></soap:Envelope>

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3.38 Cross Gateway Query
3030

This section corresponds to transaction ITI-38 of the IHE ITI Technical Framework. Transaction
ITI-38 is used by cooperating Initiating Gateway and Responding Gateway Actors.
3.38.1 Scope

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3040

The scope of the Cross Gateway Query transaction is based on the Registry Stored Query
transaction [ITI-18]. The same set of stored queries is required to be supported and the options
controlling what kind of data is returned are the same. Differences from the Registry Stored
Query transactions are:•

The Cross Gateway Query is between an Initiating Gateway and Responding Gateway.

•

Initiating Gateway shall specify the homeCommunityId attribute in all Cross-Community
Queries which do not contain a patient identifier.

•The homeCommunityID attribute shall be returned within all appropriate elements.

•

Responding Gateways shall support the Asynchronous Web Services Exchange Option
on the Cross Gateway Query. Support for this function is required in order to enable useof Asynchronous Web Services Exchange in any cross-community interaction. Without
this support an Initiating Gateway would require unique configuration, per Responding
Gateway, to know if Asynchronous Web Services Exchange was supported. It is expectedthat Asynchronous Web Services Exchange will be desired by the majority ofcommunities.

•

Asynchronous Web Services Exchange is an option on the Initiating Gateway, see ITI
TF-1: 18.2.2.

•

For stored queries that rely on concepts that a community may not support, namely
associations, folders and submission sets, a Responding Gateway is allowed to respondwith zero entries.

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There shall be an agreed upon common coding/vocabulary scheme used for the Cross Gateway
Query. For example, a common set of privacy consent vocabularies shall be used.
3.38.2 Use Case Roles
3055
Initiating
Gateway

Responding
Gateway

Cross Gateway
Query

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Figure 3.38.2-1: Use Case Roles

Actor: Initiating Gateway
Role: To formulate a Cross Gateway Query on behalf of a user.
3060

Actor: Responding Gateway
Role: To respond to a Cross Gateway Query based on the internal configuration of thecommunity.
3.38.3 Referenced Standard

3065

Implementers of this transaction shall comply with all requirements described in ITI TF-2x:
Appendix V Web Services for IHE Transactions.
ebRIM

OASIS/ebXML Registry Information Model v3.0

ebRS

OASIS/ebXML Registry Services Specifications v3.0

ITI TF-3:4

Metadata used in Document Sharing profiles

3070
3.38.4 Interaction Diagram
Initiating
Gateway

Responding
Gateway

Cross Gateway Query
Request
Cross Gateway Query
Response

3.38.4.1 Cross Gateway Query
3075

This is a query request between an Initiating Gateway and a Responding Gateway. The query
request contains:•

A reference to a pre-defined query defined by the Registry Stored Query transaction [ITI18].

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Parameters to the query. The query parameters are defined by the Registry Stored Query
transaction. The homeCommunityId attribute is required for every Registry Stored Query
which does not specify a patient identity.

3.38.4.1.1 Trigger Events

3085

This message is initiated when the Initiating Gateway has determined that it must interact with
the Responding Gateway to satisfy a Registry Stored Query [ITI-18] request received from an
XDS.b Document Consumer or a query request from other internal non-IHE actor. Wheninitiating this message to satisfy a Registry Stored Query [ITI-18] request the Initiating Gateway
shall pass all parameters, either known or unknown, into the Cross Gateway Query.
3.38.4.1.2 Message Semantics
The message semantics are based on the Registry Stored Query. See ITI TF-2a: 3.18.4.1.2.

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Initiating Gateways which support the On-Demand Documents Option shall be capable ofquerying for an On-Demand Document Entry either through internal mechanisms or, when the
XDS Affinity Domain Option is also declared, through interaction with an XDS Document
Consumer which supports the On-Demand Documents Option.
Responding Gateways which support the On-Demand Documents Option shall be able torespond to a query of an On-Demand Document Entry, either through internal mechanisms or,when grouped with a Document Consumer, through interaction with appropriate XDS Actors
which support On-Demand Documents. Of special note are the use of homeCommunityId,
specifying the patient identifier and special handling of some stored queries. These are explained
below.
3.38.4.1.2.1 homeCommunityId

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The homeCommunityId attribute is required on the Cross Gateway Query. The
homeCommunityId is a globally unique identifier for a community and is used to obtain the Web
Services endpoint of services that provide access to data in that community. homeCommunityId
is structured as an OID limited to 64 characters and specified in URI syntax, for example thehomeCommunityId of 1.2.3 would be formatted as urn:oid:1.2.3.

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Its use is as follows:

3110

•

It is returned within the response to Cross Gateway Query and Registry Stored Query
transactions to indicate the association of a response element with a community. It is
specified as the ebRIM 'home' attribute within the relevant response elements. Document
Consumers process the value as an opaque unique identifier.

•

It is an optional parameter to Registry Stored Query requests, not requiring a patient id
parameter, and Retrieve Document Set requests to indicate which community to direct
the request.

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The Initiating Gateway shall specify the homeCommunityId parameter within all queries which
do not include a patient identifier parameter. These would be queries which specify anentryUUID or uniqueID. The homeCommunityId shall contain the value that identifies thecommunity associated with the Responding Gateway. The homeCommunityId value is specified
as the home attribute on the AdhocQuery element of the query request, as in:<AdhocQuery id=”…” home=”urn:oid:1.2.3” … >Each Cross Gateway Query request can have at most one homeCommunityId value. If multiple
entryUUID or uniqueID values are specified they must all be associated with the same
homeCommunityId value. Multiple individual query requests can be used to retrieve dataassociated with different homeCommunityIds. This restriction is expected to be temporary as
query syntax is extended to handle multiple homeCommunityIds in a single query request.
3.38.4.1.2.2 Specifying patient identifier

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The Initiating Gateway shall specify in relevant queries a patient identifier known to the
Responding Gateway. The mechanism used by the Initiating Gateway to determine the correct
patient identifier to use is outside the intended scope of this transaction. The Responding
Gateway can expect to be able to resolve the patient identifier. If the patient identifier is
unknown by the Responding Gateway’s community, the Responding Gateway shall return either
a successful response with no elements or an error with errorCode XDSUnknownPatientId,
depending on local policy.
3.38.4.1.2.3 Special handling of some stored queries

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Some stored queries rely on the support of concepts which may not be used within a community.
It is also possible that a Responding Gateway community may have policies which restrict thesharing of information related to those concepts. The concepts of concern are submission sets,folders and associations. In either case a Responding Gateway shall respond to the appropriate
stored queries by returning zero results. Table 3.38.4.1.2.3-1 lists all the stored queries which
rely on specialized concepts.

3140

Table 3.38.4.1.2.3-1: Stored Queries
Query Name

Concepts

Requirement

FindDocuments

None

Required by all

FindSubmissionSets

Submission Set

Zero elements when no submission set concept in community

FindFolders

FolderZero elements when no folder concept in community

GetAllSubmission Set,
Folder,
Association

Return all appropriate document entries and other entries dependingon which of the other concepts the community supports

GetDocuments

None

Required by all

GetFolders

FolderZero elements when no folder concept in community

GetAssociations

Association

Zero elements when no association concept in community

GetDocumentsAndAssociations

Association

Return only document entries if no association concept

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Query Name

Concepts

Requirement

GetSubmissionSets

Submission Set

Zero elements when no submission set concept in community

GetSubmissionSetAndContents

Submission Set

Zero elements when no submission set concept in community

GetFolderAndContents

FolderZero elements when no folder concept in community

GetFoldersForDocument

FolderZero elements when no folder concept in community

GetRelatedDocuments

Association

Zero elements when no association concept in community

3.38.4.1.3 Expected Actions
Actors supporting this transaction shall support the Expected Actions described in ITI TF-2a:3.18.4.1.3. In addition:
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3150

The Responding Gateway Actor shall:•

Return an XDSUnknownCommunity error code if the value of homeCommunityId isspecified and is not known by the Responding Gateway.

•

Verify the homeCommunityId is specified on relevant queries and return an
XDSMissingHomeCommunityId error code if missing.

•Route the query to the local XDS Document Registry or perform equivalent action toform a query response. When routing to a local XDS Document Registry, the Responding
Gateway shall pass all parameters into the Registry Stored Query [ITI-18] transaction.

•

When routing a response from a local XDS Document Registry, the Responding Gateway
shall pass all entities received in the Registry Stored Query response into the response to
the Cross Gateway Query.

•

Ensure that the response contains the value identifying the Responding Gateway’s
community for the homeCommunityId attribute in every appropriate element. The
elements that shall include the ebRIM home attribute are:

3155

•

If returntype=”LeafClass” the ExtrinsicObject and RegistryPackage elements shallcontain the home attribute.

•

If returnType=”ObjectRef” the ObjectRef element shall contain the home attribute.

•

Ensure that every RegistryError element returned in the response shall have thelocation attribute set to the homeCommunityId of the Responding Gateway.

3160

The Initiating Gateway Actor shall:
3165•

On receiving the response from the Responding Gateway, verify the homeCommunityId
is present where appropriate. If homeCommunityId is not present in any of theExtrinsicObject, RegistryPackage or ObjectRef elements the Initiating Gateway shallreflect an XDSMissingHomeCommunityId to the initiator of the transaction – either theDocument Consumer or the internal actor. All XDSMissingHomeCommunityId errors

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generated by the Initiating Gateway shall include, in the context of the message,
identification of the Responding Gateway that returned the invalid response and theelement or elements that were in error.
•

3175

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3185

If the XDS Affinity Domain Option is supported and if needed, consolidate results frommultiple Responding Gateways. This includes reflecting in the consolidated results
returned in response to the originating Registry Stored Query [ITI-18] all successes andfailures received from Responding Gateways. If both successes and failures are received
from Responding Gateways, the Initiating Gateway shall return both RegistryObjectList
and RegistryErrorList in one response and specify PartialSuccess status. If an
XDSUnknownPatientId error is returned from a Responding Gateway then the Initiating
Gateway shall not include this error in the consolidated results sent to the Document
Consumer. The removal of the XDSUnknownPatientId is done to maintain compatibility
with the XDS Profile’s use of Registry Stored Query since Document Consumers are notexpecting to receive this error. Other than removal of the XDSUnknownPatientId, theInitiating Gateway shall pass all entities received in the Cross Gateway Query response
into the response to the Registry Stored Query [ITI-18].

3.38.4.1.3.1 Compatibility of Options

3190

The presence or absence of the optional $XDSDocumentEntryType parameter triggers the
behaviors on the Responding Gateway. If this value is specified, and the Responding Gateway(or XDS community supported by the Responding Gateway) does not support it, it shall beignored. If it is specified, and the Responding Gateway (or underlying XDS community) does
support it, the proper information is returned. See ITI TF-2a: 3.18.4.1.2.5 for more details
regarding compatibility of the Registry Stored Query transaction.
3.38.4.1.4 Security Considerations

3195

Both the Initiating Gateway and Responding Gateway shall audit the Cross Gateway Query. The
audit entries shall be equivalent to the entries required for the Registry Stored Query.
The Initiating Gateway:•

If receiving a Registry Stored Query transaction from a Document Consumer, shall audit
as if it were a Document Registry. See ITI TF-2a: 3.18.5.1.2.

•

In addition, shall audit the Cross Gateway Query as if it were a Document Consumer
except that for EventTypeCode the Initiating Gateway shall specify EV(“ITI-38”, “IHE
Transactions”, and “Cross Gateway Query”) (see ITI TF-2a: 3.18.5.1.1).

•

In addition, if interacting with a local Document Registry, shall audit as if it were a
Document Consumer (see ITI TF-2a: 3.18.5.1.1).

•

The Responding Gateway:3200

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3210

•

Shall audit the Cross Gateway Query as if it were a Document Registry except that for
EventTypeCode the Responding Gateway shall specify EV(“ITI-38”, “IHE
Transactions”, “Cross Gateway Query”). See ITI TF-2a: 3.18.5.1.2.

•

In addition, if interacting with a local Document Registry, shall audit as if it were a
Document Consumer. See ITI TF-2a: 3.18.5.1.1.

3.38.5 Protocol Requirements
The Cross Gateway Query request and response will be transmitted using Synchronous or
Asynchronous Web Services Exchange, according to the requirements specified in ITI TF-2x:
Appendix V. The protocol requirements are identical to the Registry Stored Query except as
noted below.

3215
Table 3.38.5-1: WSDL Namespace Definitions
soap

http://schemas.xmlsoap.org/wsdl/soap/

soap12

http://schemas.xmlsoap.org/wsdl/soap12/

wsaw

http://www.w3.org/2006/05/addressing/wsdl/

xsd

http://www.w3.org/2001/XMLSchema

ihe

urn:ihe:iti:xds-b:2007rs

urn:oasis:names:tc:ebxml-regrep:xsd:rs:3.0

lcm

urn:oasis:names:tc:ebxml-regrep:xsd:lcm:3.0

query

urn:oasis:names:tc:ebxml-regrep:xsd:query:3.0

Responding Gateway: These are the requirements for the Cross Gateway Query transaction
presented in the order in which they would appear in the Responding Gateway WSDL definition:
3220•

The following types shall be imported (xsd:import) in the /definitions/types section:•

3225

namespace=" urn:oasis:names:tc:ebxml-regrep:xsd:query:3.0",
schemaLocation="query.xsd"•

The /definitions/message/part/@element attribute of the Cross Gateway Query Request
message shall be defined as “query:AdhocQueryRequest”•

The /definitions/message/part/@element attribute of the Cross Gateway Query Response
message shall be defined as “query:AdhocQueryResponse”•

Refer to Table 3.38.5-2 below for additional attribute requirements
Table 3.38.5-2: Additional Attribute Requirements
Attribute

Value/definitions/portType/operation@nameRespondingGateway_CrossGateway
Query

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Attribute

Value/definitions/portType/operation/input/@wsaw:Ac
tion

urn:ihe:iti:2007:CrossGatewayQuery/definitions/portType/operation/output/@wsaw:A
ction

urn:ihe:iti:2007:CrossGatewayQuery
Response/definitions/binding/operation/soap12:operation/@soapAction

urn:ihe:iti:2007:CrossGatewayQuery

3230
These are the requirements that affect the wire format of the SOAP message. The other WSDL
properties are only used within the WSDL definition and do not affect interoperability. Fullsample request and response messages are in Section 3.38.5.1 Sample SOAP Messages.
For informative WSDL for the Responding Gateway Actor see ITI TF-2x: Appendix W.
3235

3.38.5.1 Sample SOAP Messages

3240

The samples in the following two sections show a typical SOAP request and its relative SOAP
response. The sample messages also show the WS-Addressing headers <Action/>,<MessageID/>, <ReplyTo/>…; these WS-Addressing headers are populated according to the
W3C WS-Addressing standard. The body of the SOAP message is omitted for brevity; in a real
scenario the empty element will be populated with the appropriate metadata.
Samples presented in this section are also available online on the IHE FTP site, see ITI TF-2x:
Appendix W.
3.38.5.1.1 Sample Cross Gateway Query SOAP Request
3.38.5.1.1.1 Synchronous Web Services Exchange

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3255

<s:Envelope xmlns:s="http://www.w3.org/2003/05/soap-envelope"
xmlns:a="http://www.w3.org/2005/08/addressing"><s:Header><a:Action s:mustUnderstand="1">urn:ihe:iti:2007:CrossGatewayQuery</a:Action><a:MessageID>urn:uuid:def119ad-dc13-49c1-a3c7-e3742531f9b3</a:MessageID><a:ReplyTo><a:Address>http://www.w3.org/2005/08/addressing/anonymous</a:Address></a:ReplyTo><a:To s:mustUnderstand="1">http://localhost/service/IHEXCARespondingGateway.svc</a:To></s:Header><s:Body><query:AdhocQueryRequest xmlns:query="urn:oasis:names:tc:ebxml-regrep:xsd:query:3.0"/></s:Body></s:Envelope>3.38.5.1.1.2 Asynchronous Web Services Exchange
3260

3265

<s:Envelope xmlns:s="http://www.w3.org/2003/05/soap-envelope"
xmlns:a="http://www.w3.org/2005/08/addressing"><s:Header><a:Action s:mustUnderstand="1">urn:ihe:iti:2007:CrossGatewayQuery</a:Action><a:MessageID>urn:uuid:def119ad-dc13-49c1-a3c7-e3742531f9b3</a:MessageID><a:ReplyTo><a:Address>http://192.168.2.4:9080/XcaService/InitiatingGatewayReceiver.svc</a:Address></a:ReplyTo>

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3270<a:To s:mustUnderstand="1">http://localhost/XcaService/RespondingGatewayReceiver.svc</a:To></s:Header><s:Body><query:AdhocQueryRequest xmlns:query="urn:oasis:names:tc:ebxml-regrep:xsd:query:3.0"/></s:Body></s:Envelope>3.38.5.1.2 Sample Cross Gateway Query SOAP Response
3275

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3285

3.38.5.1.2.1 Synchronous Web Services Exchange<s:Envelope xmlns:s="http://www.w3.org/2003/05/soap-envelope"
xmlns:a="http://www.w3.org/2005/08/addressing"><s:Header><a:Action s:mustUnderstand="1">urn:ihe:iti:2007:CrossGatewayQueryResponse</a:Action><a:RelatesTo>urn:uuid:def119ad-dc13-49c1-a3c7-e3742531f9b3</a:RelatesTo></s:Header><s:Body><query:AdhocQueryResponse xmlns:query="urn:oasis:names:tc:ebxml-regrep:xsd:query:3.0"/></s:Body></s:Envelope>3.38.5.1.2.2 Asynchronous Web Services Exchange
3290

3295

<s:Envelope xmlns:s="http://www.w3.org/2003/05/soap-envelope"
xmlns:a="http://www.w3.org/2005/08/addressing"><s:Header><a:Action s:mustUnderstand="1">urn:ihe:iti:2007:CrossGatewayQueryResponse</a:Action><a:MessageID>urn:uuid:D6C21225-8E7B-454E-9750-821622C099DB</a:MessageID><a:RelatesTo>urn:uuid:def119ad-dc13-49c1-a3c7-e3742531f9b3</a:RelatesTo><a:To s:mustUnderstand="1">http://localhost:2647/XcaService/InitiatingGatewayReceiver.svc</a:To></s:Header><s:Body><query:AdhocQueryResponse xmlns:query="urn:oasis:names:tc:ebxml-regrep:xsd:query:3.0"/></s:Body></s:Envelope>3300

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3.39 Cross Gateway Retrieve
This section corresponds to transaction ITI-39 of the IHE Technical Framework. Transaction
ITI-39 is used by the Initiating Gateway and Responding Gateway Actors.
3.39.1 Scope
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3310

The scope of the Cross Gateway Retrieve transaction is semantically the same as the Retrieve
Document Set transaction [ITI-43]. Differences from the Retrieve Document Set transactionsare:•

The Cross Gateway Retrieve is between an Initiating Gateway and a Responding
Gateway.

•

The ‘homeCommunityId’ parameter is required. This means that the homeCommunityId
parameter which is optional on the Retrieve Document Set transaction is required by thistransaction.

•

Responding Gateways shall support the Asynchronous Web Services Exchange Option
on the Cross Gateway Retrieve. Support for this function is required in order to enable
use of Asynchronous Web Services Exchange in any cross-community interaction.
Without this support an Initiating Gateway would require unique configuration, per
Responding Gateway, to know if Asynchronous Web Services Exchange was supported.
It is expected that Asynchronous Web Services Exchange will be desired by the majority
of communities.

•

Asynchronous Web Services Exchange is an option on the Initiating Gateway, see ITI
TF-1: 18.2.2.

3315

3320

3.39.2 Use Case Roles
Initiating
Gateway

Responding
Gateway

Cross Gateway
Retrieve

Figure 3.39.2-1: Use Case Roles

3325
Actor: Initiating Gateway
Role: To formulate a Cross Gateway Retrieve in response to Retrieve Document Set transactions
or other internal interaction.
Actor: Responding Gateway
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Role: To return the documents requested.
3.39.3 Referenced Standard
Implementors of this transaction shall comply with all requirements described in ITI TF-2x:
Appendix V Web Services for IHE Transactions.
ebRIM OASIS/ebXML Registry Information Model v3.0

3335

ebRS OASIS/ebXML Registry Services Specifications v3.0
ITI TF-3:4

Metadata used in Document Sharing profiles

MTOM
SOAP Message Transmission Optimization Mechanism
http://www.w3.org/TR/soap12-mtom/
3340

3.39.4 Interaction Diagram
Initiating
Gateway

Responding
Gateway

Cross Gateway
Retrieve Request
Cross Gateway
Retrieve Response

3.39.4.1 Cross Gateway Retrieve
The Cross Gateway Retrieve uses the same syntax and standards as the Retrieve Document Set
transaction specified in XDS (see Section 3.43).
3345

3.39.4.1.1 Trigger Events
This message is initiated by the Initiating Gateway to retrieve a set of documents from anothercommunity represented by a Responding Gateway. The Initiating Gateway may be responding to
a Retrieve Document Set transaction or may use a proprietary mechanism for triggering the
Cross Gateway Retrieve.

3350

3.39.4.1.2 Message Semantics
The message semantics for Cross Gateway Retrieve are the same as Retrieve Document Set (sSection 3.43.4.1.2). The Initiating Gateway shall specify the homeCommunityId parameter
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within the Retrieve Document Set. The homeCommunityId shall contain the value that identifies
the community associated with the Responding Gateway.
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3365

Initiating Gateways which support the On-Demand Documents Option shall be capable ofretrieving an On-Demand Document Entry either through internal mechanisms or, when the
XDS Affinity Domain Option is also declared, through interaction with an XDS Document
Consumer which supports the On-Demand Documents Option.
Responding Gateways which support the On-Demand Documents Option shall be able torespond to retrieval of an On-Demand Document Entry either through internal mechanisms or,when grouped with a Document Consumer, through interaction with appropriate XDS Actors
which support On-Demand Documents. Responding Gateways which support the Persistence ofRetrieved Documents Option shall specify the NewRepositoryUniqueId element indicating the
document is available for later retrieval and be able to return exactly the same document in all
future retrieve requests for the document identified by NewDocumentUniqueId.
3.39.4.1.3 Expected Actions
Actors supporting this transaction shall support the Expected Actions described in the Section
3.43.4.1.3.

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3375

The Responding Gateway shall determine the local system or systems which hold the documents
requested and interact with those systems. The Responding Gateway may use a Retrieve
Document Set transaction or other internally defined interaction, to retrieve the document or
documents. If more than one system is contacted the Responding Gateway shall consolidate theresults from the multiple systems into one response to the Initiating Gateway. If both successes
and failures are received the Responding Gateway may choose to use PartialSuccess status toreflect both failure and success. The Responding Gateway may alternatively choose to suppress
the failures and report only successes.
Every RegistryError element returned in the response shall have the location attribute set to thehomeCommunityId of the Responding Gateway.

3380

3385

If the XDS Affinity Domain Option is supported, the Initiating Gateway Actor shall, if needed,
consolidate results from multiple Responding Gateways. This includes reflecting in the
consolidated results returned to the originating Retrieve Document Set [ITI-43] all successes andfailures received from Responding Gateways. If both successes and failures are received from
Responding Gateways, the Initiating Gateway shall return both DocumentResponse andRegistryErrorList elements in one response and specify PartialSuccess status.
3.39.4.1.3.1 Compatibility of Options
If the Initiating Gateway does not support the On-Demand Document Option, it will never send a
Cross Gateway Retrieve request for an On-Demand Document. In this case, none of theattributes specific to On-Demand Documents will be included in the response.

3390

If the Initiating Gateway does support the On-Demand Document Option, it will only direct
Cross Gateway Retrieve requests for On-Demand Documents to responders which have returned
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IHE IT Infrastructure Technical Framework, Volume 2b (ITI TF-2b): Transactions Part B______________________________________________________________________________an On-Demand Document Entry in a Cross Gateway Query response. Thus there are nocompatibility concerns with this transaction.
3.39.4.1.4 Security Considerations
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Both the Initiating Gateway and Responding Gateway shall audit the Cross Gateway Retrieve.
The audit entries shall be equivalent to the entries required for the Retrieve Document Set.
The Initiating Gateway:•

If receiving a Retrieve Document Set transaction from a Document Consumer, shall audit
as if it were a Document Repository (see Section 3.43.6).

•

In addition, shall audit the Cross Gateway Retrieve as if it were a Document Consumer
except that for EventTypeCode the Initiating Gateway shall specify EV(“ITI-39”, “IHE
Transactions”, and “Cross Gateway Retrieve”) (see Section 3.43.6).

•

In addition, if interacting with a local Document Repository, shall audit as if it were a
Document Consumer (see Section 3.43.6). One audit record shall be created for each
Document Repository contacted.

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The Responding Gateway:•

Shall audit the Cross Gateway Retrieve as if it were a Document Repository except thatfor EventTypeCode the Responding Gateway shall specify EV(“ITI-39”, “IHE
Transactions”, “Cross Gateway Retrieve”) (see Section 3.43.6).

•

In addition, if interacting with a local Document Repository, shall audit as if it were a
Document Consumer (see Section 3.43.6). One audit record shall be created for each
Document Repository contacted.

3.39.5 Protocol Requirements

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The Cross Gateway Retrieve request and response will be transmitted using Synchronous or
Asynchronous Web Services Exchange, according to the requirements specified in ITI TF-2x:
Appendix V. The protocol requirements are identical to the Retrieve Document Set except as
noted below.
Table 3.39.5-1: WSDL Namespace Definitions
soap

http://schemas.xmlsoap.org/wsdl/soap/

soap12

http://schemas.xmlsoap.org/wsdl/soap12/

wsaw

http://www.w3.org/2006/05/addressing/wsdl/

xsd

http://www.w3.org/2001/XMLSchema

ihe

urn:ihe:iti:xds-b:2007rs

urn:oasis:names:tc:ebxml-regrep:xsd:rs:3.0

lcm

urn:oasis:names:tc:ebxml-regrep:xsd:lcm:3.0

query

urn:oasis:names:tc:ebxml-regrep:xsd:query:3.0

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Responding Gateway: These are the requirements for the Cross Gateway Retrieve transaction
presented in the order in which they would appear in the Responding Gateway WSDL definition:•

The following types shall be imported (xsd:import) in the /definitions/types section:••

The /definitions/message/part/@element attribute of the Cross Gateway Retrieve
Request message shall be defined as “ihe:RetrieveDocumentSetRequest”•

The /definitions/message/part/@element attribute of the Cross Gateway Retrieve
Response message shall be defined as “ihe:RetrieveDocumentSetResponse”•

Refer to Table 3.39.5-2 below for additional attribute requirements

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namespace="urn:ihe:iti:xds-b:2007", schema="IHEXDS.xsd"

Table 3.39.5-2: Requirements for portType and Binding attributes
Attribute

Value/definitions/portType/operation@nameRespondingGateway_CrossGa
tewayRetrieve/definitions/portType/operation/input/@wsaw:Ac
tion

urn:ihe:iti:2007:CrossGateway
Retrieve/definitions/portType/operation/output/@wsaw:A
ction

urn:ihe:iti:2007:CrossGateway
RetrieveResponse/definitions/binding/operation/soap12:operation/@soapAction

urn:ihe:iti:2007:CrossGateway
Retrieve

These are the requirements that affect the wire format of the SOAP message. The other WSDL
properties are only used within the WSDL definition and do not affect interoperability. Fullsample request and response messages are in Section 3.43.5.1 Sample SOAP Messages.
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For informative WSDL for the Responding Gateway Actor see ITI TF-2x: Appendix W.
The <ihe:RetrieveDocumentSetRequest/> element is defined in Section 3.43.5. When usedwithin the Cross Gateway Retrieve the <ihe:HomeCommunityId/> element is required.
The <ihe:RetrieveDocumentSetResponse/> element is defined in Section 3.43.5.
3.39.5.1 Sample SOAP Messages

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The samples in the following two sections show a typical SOAP request and its relative SOAP
response. The sample messages also show the WS-Addressing headers <Action/>,<MessageID/>, <ReplyTo/>…; these WS-Addressing headers are populated according to the
W3C WS-Addressing standard. The body of the SOAP message is omitted for brevity; in a real
scenario the empty element will be populated with the appropriate metadata.

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Samples presented in this section are also available online on the IHE FTP site, see ITI TF-2x:
Appendix W.
3.39.5.1.1 Sample Cross Gateway Retrieve SOAP Request
3.39.5.1.1.1 Synchronous Web Services Exchange

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<s:Envelope
xmlns:s="http://www.w3.org/2003/05/soap-envelope"
xmlns:a="http://www.w3.org/2005/08/addressing"><s:Header><a:Action s:mustUnderstand="1">urn:ihe:iti:2007:CrossGatewayRetrieve</a:Action><a:MessageID>urn:uuid:0fbfdced-6c01-4d09-a110-2201afedaa02</a:MessageID><a:ReplyTo><a:Address>http://www.w3.org/2005/08/addressing/anonymous</a:Address></a:ReplyTo><a:To
s:mustUnderstand="1">http://localhost:2647/XcaService/IHEXCAGateway.svc</a:To></s:Header><s:Body><RetrieveDocumentSetRequest xmlns="urn:ihe:iti:xds-b:2007"><DocumentRequest><HomeCommunityId>urn:oid:1.2.3.4</HomeCommunityId><RepositoryUniqueId>1.3.6.1.4...1000</RepositoryUniqueId><DocumentUniqueId>1.3.6.1.4...2300</DocumentUniqueId></DocumentRequest><DocumentRequest><HomeCommunityId>urn:oid:1.2.3.5</HomeCommunityId><RepositoryUniqueId>1.3.6.1.4...2000</RepositoryUniqueId><DocumentUniqueId>1.3.6.1.4...2301</DocumentUniqueId></DocumentRequest></RetrieveDocumentSetRequest></s:Body></s:Envelope>

3.39.5.1.1.2 Asynchronous Web Services Exchange<s:Envelope

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xmlns:s="http://www.w3.org/2003/05/soap-envelope"
xmlns:a="http://www.w3.org/2005/08/addressing"><s:Header><a:Action s:mustUnderstand="1">urn:ihe:iti:2007:CrossGatewayRetrieve</a:Action><a:MessageID>urn:uuid:0fbfdced-6c01-4d09-a110-2201afedaa02</a:MessageID><a:ReplyTo><a:Address>http://192.168.2.4:9080/XcaService/InitiatingGatewayReceiver.svc</a:Address></a:ReplyTo><a:To
s:mustUnderstand="1">http://localhost:2647/XcaService/RespondingGatewayReceiver.svc</a:To></s:Header><s:Body><RetrieveDocumentSetRequest xmlns="urn:ihe:iti:xds-b:2007"><DocumentRequest><HomeCommunityId>urn:oid:1.2.3.4</HomeCommunityId><RepositoryUniqueId>1.3.6.1.4...1000</RepositoryUniqueId><DocumentUniqueId>1.3.6.1.4...2300</DocumentUniqueId></DocumentRequest><DocumentRequest><HomeCommunityId>urn:oid:1.2.3.5</HomeCommunityId><RepositoryUniqueId>1.3.6.1.4...2000</RepositoryUniqueId><DocumentUniqueId>1.3.6.1.4...2301</DocumentUniqueId></DocumentRequest>

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3505</RetrieveDocumentSetRequest></s:Body></s:Envelope>

3.39.5.1.2 Sample Cross Gateway Retrieve SOAP Response
3.39.5.1.2.1 Synchronous Web Services Exchange
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<s:Envelope xmlns:s="http://www.w3.org/2003/05/soap-envelope"
xmlns:a="http://www.w3.org/2005/08/addressing"><s:Header><a:Action
s:mustUnderstand="1">urn:ihe:iti:2007:CrossGatewayRetrieveResponse</a:Action><a:RelatesTo>urn:uuid:0fbfdced-6c01-4d09-a110-2201afedaa02</a:RelatesTo></s:Header><s:Body><RetrieveDocumentSetResponse
xmlns="urn:ihe:iti:xds-b:2007"
xmlns:lcm="urn:oasis:names:tc:ebxml-regrep:xsd:lcm:3.0"
xmlns:query="urn:oasis:names:tc:ebxml-regrep:xsd:query:3.0"
xmlns:rim="urn:oasis:names:tc:ebxml-regrep:xsd:rim:3.0"
xmlns:rs="urn:oasis:names:tc:ebxml-regrep:xsd:rs:3.0"><rs:RegistryResponse status="urn:oasis:names:tc:ebxmlregrep:ResponseStatusType:Success"/><DocumentResponse><HomeCommunityId>urn:oid:1.2.3.4</HomeCommunityId><RepositoryUniqueId>1.3.6.1.4...1000</RepositoryUniqueId><DocumentUniqueId>1.3.6.1.4...2300</DocumentUniqueId><mimeType>text/xml</mimeType><Document>UjBsR09EbGhjZ0dTQUxNQUFBUUNBRU1tQ1p0dU1GUXhEUzhi</Document></DocumentResponse><DocumentResponse><HomeCommunityId>urn:oid:1.2.3.5</HomeCommunityId><RepositoryUniqueId>1.3.6.1.4...2000</RepositoryUniqueId><DocumentUniqueId>1.3.6.1.4...2301</DocumentUniqueId><mimeType>text/xml</mimeType>

3540<Document>UjBsR09EbGhjZ0dTQUxNQUFBUUNBRU1tQ1p0dU1GUXhEUzhi</Document></DocumentResponse></RetrieveDocumentSetResponse></s:Body></s:Envelope>3545

3.39.5.1.2.2 Asynchronous Web Services Exchange

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<s:Envelope xmlns:s="http://www.w3.org/2003/05/soap-envelope"
xmlns:a="http://www.w3.org/2005/08/addressing"><s:Header><a:Action
s:mustUnderstand="1">urn:ihe:iti:2007:CrossGatewayRetrieveResponse</a:Action><a:MessageID>urn:uuid:D6C21225-8E7B-454E-9750-821622C099DB</a:MessageID><a:RelatesTo>urn:uuid:0fbfdced-6c01-4d09-a110-2201afedaa02</a:RelatesTo><a:To
s:mustUnderstand="1">http://localhost:2647/XcaService/InitiatingGatewayReceiver.svc</a:To></s:Header><s:Body><RetrieveDocumentSetResponse
xmlns="urn:ihe:iti:xds-b:2007"
xmlns:lcm="urn:oasis:names:tc:ebxml-regrep:xsd:lcm:3.0"
xmlns:query="urn:oasis:names:tc:ebxml-regrep:xsd:query:3.0"
xmlns:rim="urn:oasis:names:tc:ebxml-regrep:xsd:rim:3.0"
xmlns:rs="urn:oasis:names:tc:ebxml-regrep:xsd:rs:3.0">

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<rs:RegistryResponse status="urn:oasis:names:tc:ebxmlregrep:ResponseStatusType:Success"/><DocumentResponse><HomeCommunityId>urn:oid:1.2.3.4</HomeCommunityId><RepositoryUniqueId>1.3.6.1.4...1000</RepositoryUniqueId><DocumentUniqueId>1.3.6.1.4...2300</DocumentUniqueId><mimeType>text/xml</mimeType><Document>UjBsR09EbGhjZ0dTQUxNQUFBUUNBRU1tQ1p0dU1GUXhEUzhi</Document></DocumentResponse><DocumentResponse><HomeCommunityId>urn:oid:1.2.3.5</HomeCommunityId><RepositoryUniqueId>1.3.6.1.4...2000</RepositoryUniqueId><DocumentUniqueId>1.3.6.1.4...2301</DocumentUniqueId><mimeType>text/xml</mimeType><Document>UjBsR09EbGhjZ0dTQUxNQUFBUUNBRU1tQ1p0dU1GUXhEUzhi</Document></DocumentResponse></RetrieveDocumentSetResponse></s:Body></s:Envelope>3585

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IHE IT Infrastructure Technical Framework, Volume 2b (ITI TF-2b): Transactions Part B______________________________________________________________________________

3.40 Provide X-User Assertion
This section corresponds to transaction ITI-40 of the IHE IT Infrastructure Technical
Framework.
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3.40.1 Scope
Transaction ITI-40 is used by the X-Service User to pass a claimed identity assertion to the XService Provider. The X-Service User and X-Service Provider use the X-Assertion Provider
as the third party issuer of the claimed identity assertion.
3.40.2 Use Case Roles

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Actor: X-Service User
Role: User of a transaction that requires a Cross-Enterprise User Assertion
Actor: X-Service Provider
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Role: Service provider on a transaction that requires a Cross-Enterprise User Assertion
3.40.3 Referenced Standards
3.40.3.1 Normative -- required to use this transaction•

OASIS http://www.oasis-open.org/committees/security/.

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SAMLCore SAML V2.0 Core standard•

WSS10 OASIS Standard, "OASIS Web Services Security: SOAP Message Security 1.0(WS-Security 2004)", March 2004.

•

WSS11 OASIS Standard, "OASIS Web Services Security: SOAP Message Security 1.1(WS-Security 2004)", February 2006.

•

WSS:SAMLTokenProfile1.0 OASIS Standard, “Web Services Security: SAML Token
Profile”, December 2004•

WSS:SAMLTokenProfile1.1 OASIS Standard, “Web Services Security: SAML Token
Profile 1.1”, February 2006•

XSPA-SAMLv1.0 OASIS Standard, “Cross-Enterprise Security and Privacy
Authorization (XSPA) Profile of the Security Assertion Markup Language (SAML) for
Healthcare v1.0” , November 2009•

SAML 2.0 Profile For XACML 2.0 OASIS Standard, February 2005

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3.40.3.2 Informative -- assist with understanding or implementing this transaction
•

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•

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IHE Profiles•

Personnel White Pages Profile•

Enterprise User Authentication Profile•

Basic Patient Privacy Consents Profile

OASIS
•

SAML V2.0 Standards http://www.oasis-open.org/committees/security/.

•

SAML V2.0 Technical Overview•

SAML Executive Overview•

SAML Tutorial presentation by Eve Maler of Sun Microsystems•

SAML Specifications•

WS-Trust - OASIS Web Services Secure Exchange (WS-SX) TC•

XSPA-XACMLv1.0 OASIS Standard, “Cross-Enterprise Security and Privacy
Authorization (XSPA) Profile of XACML v2.0 for Healthcare v1.0” , November
2009

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3.40.4 Interaction Diagram

Figure 3.40.1-1: X-User Assertion Messages

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3.40.4.1 Provide X-User Assertion
The Provide X-User Assertion is profiled to assure interoperability between an X-Service Userand an X-Service Provider that need an Assertion about the entity requesting the service. There
are many ways to provide an Assertion that are all acceptable and may be used by parties thathave agreed to their use.

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The Provide X-User Assertion transaction sets some minimal interoperability profiling for thisuse-case. The Provide X-User Assertion transaction shall be used when there is no other agreed
upon policy that would assure User Assertion interoperability (e.g., WS-SecurityPolicy).
3.40.4.1.1 Trigger

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Configuration of the X-Service Provider and X-Service User indicates when the X-User
Assertion transaction is necessary.

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3.40.4.1.2 Message Semantics

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The X-User Assertion must be protected at all times against confidentiality exposure, malicious
modification, and trust relationship between those communicating it. The IHE Actors that aregrouped with XUA may already require IHE-ATNA and thus TLS Mutual-Authentication,
Integrity, and Confidentiality.
The X-Service User shall include the OASIS Web Services Security (WSS) Header, and shall
include a SAML 2.0 Assertion as the security token.

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Any ATNA Audit Messages that the X-Service User records in relationship to a transaction
protected by the XUA (e.g., XDS.b Registry Stored Query, and XDS.b Retrieve Document Set),
shall have the user identity recorded according to the XUA specific ATNA encoding rules (See3.40.4.2 ATNA Audit encoding). This assures that the X-Service User and X-Service Provider
ATNA Audit messages can be correlated at the ATNA Audit Repository.
Any ATNA Audit Messages recorded by Actor grouped with the X-Service User Actor, shallhave the user identity recorded according to the XUA specific ATNA encoding rules (See3.40.4.2 ATNA Audit encoding). For example: The XDS.b Document Consumer Actor records
the Query event, this event record will include the identity provided in the XUA Identity
Assertion. This assures that the X-Service User and X-Service Provider ATNA Audit messages
can be correlated at the ATNA Audit Repository.
The SAML 2.0 Assertion is profiled as follows (bold is used when SAML 2.0 terms are used):

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•

The Assertion shall contain a Subject. The Subject contains the logical identifier of theprincipal performing the original service request (person, application, etc.) and remains
unchanged through operations acting on the assertion (e.g., proxying the Assertion).
•

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•

The SAML Assertion Conditions are profiled as:•

NotBefore shall be populated with the issue instant of the Assertion•

NotOnOrAfter is not specified by XUA because reasonable time limits are not clear
at the IHE Profile level. The Expiration is provided by the X-Assertion Provider andwould be variable on an Affinity Domain and/or System level.

•

The assertion shall contain an AudienceRestriction containing an Audience whose
value is a URI identifying the X-Service Provider (e.g., XDS Registry, XDS
Repository). It may contain an Audience whose value is a URI identifying theAffinity Domain.

•

The Assertion may contain ProxyRestriction and OneTimeUser conditions but
XUA Actors may ignore these conditions.

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The Subject shall contain a SubjectConfirmation element. The bearer confirmation
method shall be supported; the holder-of-key method may be supported. Thesemethods are defined in the SAML 2.0 Profile specification, Section 3.

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IHE IT Infrastructure Technical Framework, Volume 2b (ITI TF-2b): Transactions Part B______________________________________________________________________________•The Assertion shall contain an AuthnStatement specify the AuthnContextClassRef orAuthnContextDeclRef•

The Assertion may contain other statements (e.g., Attributes) The <AttributeStatement>element describes a statement by the SAML authority asserting that the requesting user isassociated with the specified attributes. When Local Policy requires that the following
attributes are carried in the SAML assertion then they should be encoded as follows:

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•

Subject ID : The value on the Subject ID attribute shall be a plain text description of
the user's name (not user ID).
•

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This <Attribute> element shall have the Name attribute set to“urn:oasis:names:tc:xspa:1.0:subject:subject-id”. The name of the user shall beplaced in the value of the <AttributeValue> element. (Keep in mind that the term
“subject” in SAML and XACML refers to the individual making the request; inthis specification, the term “User” is generally used with the same meaning, butwhen referring to attributes defined in SAML or XACML, the naming conventionof the standard is retained.)<saml:Attribute Name="urn:oasis:names:tc:xspa:1.0:subject:subject-id"><saml:AttributeValue>Walter H.Brattain IV</saml:AttributeValue></saml:Attribute>

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•

Subject Organization : The value on Subject Organization attribute shall be a plain text
description of the organization.
•

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This <Attribute> element shall have the Name attribute set to“urn:oasis:names:tc:xspa:1.0:subject:organization”. In plain text, the organizationthat the user belongs to shall be placed in the value of the <AttributeValue>element.
<saml:Attribute Name="urn:oasis:names:tc:xspa:1.0:subject:organization"><saml:AttributeValue>Family Medical Clinic</saml:AttributeValue></saml:Attribute>•

Subject Organization ID Attribute
•

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This <Attribute> element shall have the Name attribute set to“urn:oasis:names:tc:xspa:1.0:subject:organization-id” A unique identifier for theorganization that the user is representing in performing this transaction shall beplaced in the value of the <AttributeValue> element. This organization ID shallbe consistent with the plain-text name of the organization provided in the User
Organization Attribute. The organization ID may be an Object Identifier (OID),
using the urn format (that is, “urn:oid:” appended with the OID); or it may be a
URL assigned to that organization.
<saml:Attribute Name="urn:oasis:names:tc:xspa:1.0:subject:organization-id"><saml:AttributeValue>http://familymedicalclinic.org</saml:AttributeValue></saml:Attribute>

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Home Community ID Attribute

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This <Attribute> element shall have the Name attribute set to“urn:ihe:iti:xca:2010:homeCommunityId”. The value shall be the Home
Community ID (an Object Identifier) assigned to the Community that is initiating
the request, using the urn format (that is, “urn:oid:” appended with the OID).
<saml:Attribute Name="urn:ihe:iti:xca:2010:homeCommunityId"><saml:AttributeValue>urn:oid:2.16.840.1.113883.3.190</saml:AttributeValue></saml:Attribute>•
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National Provider Identifier (NPI) Attribute•

A National Provider Identifier (NPI) is a unique identifier issued to health careproviders by their national authority. (e.g., in the United States this is a 10-digit
number assigned by the Centers for Medicare and Medicaid Services (CMS)).
This attribute provides the ability to specify an NPI value as part of the SAML
assertion that accompanies a message. When a simple string is used there needs tobe a mutually agreed upon assigning authority. The HL7 CE type can be used to
explicitly show the assigning authority (See use in the Subject-Role Option).

•

This <Attribute> element SHALL have the Name attribute set to“urn:oasis:names:tc:xspa:1.0:subject:npi”. An example of the syntax of thiselement follows:

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<saml:Attribute Name="urn:oasis:names:tc:xspa:1.0:subject:npi"><saml:AttributeValue>1234567890</saml:AttributeValue></saml:Attribute>•

The Assertion may contain other statements (e.g., Attributes)•

The Assertion shall be signed by the X-Assertion Provider as defined in SAML Core.

The interface between the X-Service User and the X-Assertion Provider is not specified by
XUA. This interface needs to be protected against risks (e.g., exposure of the SAML Token tointerception for malicious use). Assertions need to be carefully managed in the X-Service User toensure they are not exposed in the application code or any subsequent use of the Assertion.
3.40.4.1.2.1 Subject-Role Option

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When the Subject-Role Option is used the X-Service User shall encode the relevant user subject
roles from a locally defined Code-Set into a subject role <Attribute> element(s). The SubjectRole values communicated are assertions from the X-Service User perspective.
The subject role <Attribute> element shall have the Name attribute set to“urn:oasis:names:tc:xacml:2.0:subject:role”. The value of the <AttributeValue> element is achild element, “Role”, in the namespace “urn:hl7-org:v3”, whose content is defined by the “CE”
(coded element) data type from the HL7 version 3 specification. The codeSystem shall identify
the Value-Set. The codeSystemName shall identify the name of the Value-Set. The Code
Element shall contain the role value from the identified Value-Set that represents the role that the
XUA user is playing when making the request. No other parts of the CE data type shall be used.
The following is an example of the syntax of this element:

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3765<saml:Attribute Name="urn:oasis:names:tc:xacml:2.0:subject:role"><saml:AttributeValue><Role xmlns="urn:hl7-org:v3" xsi:type="CE" code="46255001"
codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED_CT"
displayName="Pharmacist"/></saml:AttributeValue></saml:Attribute>

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3.40.4.1.2.2 Authz-Consent Option
When the Authz-Consent Option is supported and a policy identifier needs to be sent, the XService User shall include the document unique ID of the Patient Privacy Policy
Acknowledgement Document or include the Patient Privacy Policy Identifier for a policy that has
been previously published encoded as SAML attributes.

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A Patient Privacy Policy Acknowledgement Document unique ID shall be encoded as a SAML
attribute in the IHE ITI namespace, “urn:ihe:iti:bppc:2007:docid”, with name format“urn:oasis:names:tc:SAML:2.0:attrname-format:uri”. Access to the content is not specified.
Access through an XDS/XCA/XDR/XDM mechanism is a potential approach. Similarly, thisoption does not specify how the policy documents should be used to make access control
decisions. A sample attribute fragment is given in Figure 3.40-2.
<saml2:Attribute FriendlyName="Patient Privacy Policy Acknowledgement Document"
Name="urn:ihe:iti:bppc:2007:docid"
NameFormat="urn:oasis:names:tc:SAML:2.0:attrname-format:uri"><saml2:AttributeValue xmlns:xs="http://www.w3.org/2001/XMLSchema"
xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
xsi:type="xs:anyURI">urn:oid:1.2.3.xxx</saml2:AttributeValue></saml2:Attribute>

Figure 3.40-2: Sample attribute holding a reference to patient acknowledgement

An Patient Privacy Policy Identifier shall be encoded as a SAML attribute in the IHE ITI
namespace, “urn:ihe:iti:xua:2012:acp”, with name format``urn:oasis:names:tc:SAML:2.0:attrname-format:uri’’. The policy identifier shall be expressedusing the xs:anyURI data type. The referenced policy identifier is the OID of a published policy.
Access to this policy is not specified further. A sample is given in Figure 3.40-3.
<saml2:Attribute FriendlyName="Patient Privacy Policy Identifier"Name="urn:ihe:iti:xua:2012:acp"
NameFormat="urn:oasis:names:tc:SAML:2.0:attrname-format:uri"><saml2:AttributeValue xmlns:xs="http://www.w3.org/2001/XMLSchema"
xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
xsi:type="xs:anyURI">urn:oid:1.2.3.yyyy</saml2:AttributeValue></saml2:Attribute>

Figure 3.40-3: Sample attribute holding a reference to a privacy policy
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3.40.4.1.2.2.1 Patient Identifier Attribute

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This attribute is optional, as it may not be needed for cases in which the data being exchanged
does not pertain to a specific patient (e.g., population health data). The value of the Patient
Identifier attribute is recommended when the InstanceAccessConsentPolicy attribute is specified
in an Authorization Decision Statement.
This <Attribute> element shall have the Name attribute set to:“urn:oasis:names:tc:xacml:2.0:resource:resource-id”.

3815

The patient identifier of the requesting organization shall be placed in the value of the<AttributeValue> element. The patient identifier shall consist of two parts; the OID for theassigning authority and the identifier of the patient within that assigning authority. The value
shall be formatted using the CX syntax. As an example, a patient identifier of 543797436 for an
assigning authority with an OID of 1.2.840.113619.6.197, has been encoded into the follow
SAML assertion snippet. Please note that the '&' character has been properly encoded in the
XML content in the following example.

3820<saml:Attribute Name="urn:oasis:names:tc:xacml:2.0:resource:resource-id"><saml:AttributeValue>543797436^^^&amp;1.2.840.113619.6.197&amp;ISO</saml:AttributeValue></saml:Attribute>3825

3.40.4.1.2.3 PurposeOfUse Option
The PurposeOfUse <Attribute> element shall have the Name attribute set to“urn:oasis:names:tc:xspa:1.0:subject:purposeofuse”. The value of the <AttributeValue> element
is a child element, “PurposeOfUse”, in the namespace “urn:hl7-org:v3”, whose content isdefined by the “CE” (coded element) data type from the HL7 version 3 specification.

3830

The PurposeOfUse element shall contain the coded representation of the Purpose for Use that isin effect for the request.
An example of the syntax of this element is as follows:

3835

3840

3845

<saml:Attribute Name="urn:oasis:names:tc:xspa:1.0:subject:purposeofuse"><saml:AttributeValue><PurposeOfUse xmlns="urn:hl7-org:v3" xsi:type="CE" code="12"
codeSystem="1.0.14265.1"
codeSystemName="ISO 14265 Classification of Purposes for processing personal health information"
displayName="Law Enforcement"/></saml:AttributeValue></saml:Attribute>

Codes are assigned by the local Security Domain and a Code-Set needs to be managed. A goodsource Vocabulary for PurposeOfUse is ISO 14265 – Health Informatics – Classification of
purposes for processing personal health information. The Value-Set used may include local
codes or codes drawn from formal vocabulary.
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The value of the Purpose of Use attribute shall be a urn:hl7-org:v3:CE element, specifying thecoded value representing the user's purpose in issuing the request, choosing from the value set
given by local Policy. The codeSystem attribute of this element must be present, and mustspecify the OID of the "Purpose of Use" code system.
3.40.4.1.2.3.1 ATNA encoding of PurposeOfUse
When the PurposeOfUse Option is used the X-Service User and X-Service Provider SHALL
place the PurposeOfUse value into the ATNA Audit Message associated with the transaction
according to the ATNA Audit Message transaction ITI-20 (see ITI-TF-2a: 3.20.7.3).

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3.40.4.1.3 Expected Actions
The X-Service Provider shall validate the Identity Assertion by processing the Web-Services
Security header in accordance with the Web-Services Security Standard, and SAML 2.0
Standard processing rules (e.g., check the digital signature is valid and chains to an X-Identity
Provider that is configured as trusted). If this validation fails, then the grouped Actor’s associatedtransaction shall return with an error code as described in WS-Security core specification Section
12 (Error Handling, using the SOAP Fault mechanism), and the ATNA Audit event for
Authentication Failure shall be recorded according to ATNA rules.
Any ATNA Audit Messages recorded by Actor grouped with the X-Service Provider Actor, shallhave the user identity recorded according to the XUA specific ATNA encoding rules (seeSection3.40.4.2 ATNA Audit encoding). For example: The XDS.b Document Consumer
performing a Registry Stored Query records the Query event; this event record will include theidentity provided in the XUA Identity Assertion. This assures that the X-Service User and XService Provider ATNA Audit messages can be correlated at the ATNA Audit Repository.
The X-Service Provider may use standards transactions to communicate with the X-Assertion
Provider (e.g., WS-Trust, SAML 2.0 Protocol) to obtain information not included in the assertion
provided (e.g., Attributes that might be related to structural roles).
The X-Service Provider may utilize the identity in access control decisions. Appropriate error
messages, not defined here, shall be returned. The X-Service Provider may ignore any otherstatements (e.g., Attributes).

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The X-Service Provider may use the authentication class references to determine the method thatwas used to authenticate the user. For example the X-Service Provider may have a configurable
list of authentication class references that it is willing to recognize as authentication methods thatare acceptable, thus treating other authentication class references as not authorized.
Assertions need to be carefully managed inside the X-Service Provider to ensure they are notexposed in the application code or any subsequent use of the Assertion.
3.40.4.1.3.1 Subject-Role Option
When the Subject-Role Option is used, the X-Service Provider may utilize the Subject-Rolevalues in local policy for access control decision making.
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IHE IT Infrastructure Technical Framework, Volume 2b (ITI TF-2b): Transactions Part B______________________________________________________________________________The X-Service Provider may need to bridge the Subject-Role values into local role vocabulary.
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The Subject-Role may be used to populate the ATNA Audit Message.
3.40.4.1.3.2 Authz-Consent Option

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When the Authz-Consent Option is used, the X-Service Provider may utilize the Authz-Consent
values in local policy for access control decision making. The Authz-Consent values are offeredby the X-Service User as an indicator of the specific consent or authorization that the X-Service
User has determined authorizes the transaction. The values are informative to the X-Service
Provider which may choose to ignore the values.
This may require the X-Service Provider to lookup the metadata by reference to the values given,and may require the X-Service Provider to retrieve the consent documents.
The Authz-Consent value may be used to populate the ATNA Audit Message.

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3.40.4.1.3.3 PurposeOfUse Option

3900

When the PurposeOfUse Option is used the X-Service Provider SHALL place the PurposeOfUse
into the ATNA Audit Message associated with the transaction (see Section 3.40.4.1.2.3.1). This
PurposeOfUse in the audit log can be used at the Audit Record Repository to inform reporting
such as Accounting of Disclosures or Breach Notifications. The X-Service Provider MAY use
the PurposeOfUse value in Access Control decisions.
3.40.4.2 ATNA Audit encoding
When an ATNA Audit message needs to be generated and the user is authenticated by way of an
X-User Assertion, the ATNA Audit message UserName element shall record the X-User
Assertion using the following encoding:3905

alias"<"user"@"issuer">"
where:

3910•

alias is the optional string within the SAML Assertion's Subject element SPProvidedID
attribute•

user is the required content of the SAML Assertion's Subject element•

issuer is the X-Assertion Provider entity ID contained with the content of SAML
Assertion's Issuer element

3.40.4.3 Informative Material on WS-Trust

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If the X-Service Provider uses WS-Trust in order to obtain a SAML assertion from an X-Identity
Provider, it is suggested to use the version 1.3 of the WS-Trust specification, as described in[WS-Trust].

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3.41 Provide and Register Document Set-b

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This section corresponds to transaction [ITI-41] of the IHE Technical Framework. Provide andRegister Document Set-b is used by the Document Source to provide a set of documents to theDocument Repository, and to request that the Document Repository store these documents andthen register them with the Document Registry. The Document Source or Metadata-Limited
Document Source may also provide a set of documents to a Document Recipient.
Integration Profiles using this Transaction
Cross-Enterprise Document Sharing-b (XDS.b)
Cross-Enterprise Document Reliable Interchange (XDR)

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The Provide and Register Document Set-b transaction describes the interaction between theDocument Source/Metadata-Limited Document Source and the Document Recipient Actors, andthe Document Source and Document Repository Actors. The interaction between the Document
Repository and the XDS Document Registry is described separately in the Register Document
Set-b transaction [ITI-42].

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This transaction aligns with the Registry Services standard (ebRS) for the format of the
document metadata as defined in ITI TF-3: 4. The ebRS standard covers the interaction with aservice that includes a registry with integrated repository. From the point of view of theDocument Source, the separate nature of the XDS Document Registry and Document Repository
Actors is not relevant.

3935

By specifying separate Document Registry and Document Repository Actors, XDS offers
additional flexibility of having a single Document Registry index content for multiple Document
Repositories. The ebRIM portion of the registry standard supports this possibility though theExternalLink object type.

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In XDS, the documents and metadata go to the Document Repository Actor and then themetadata is forwarded on to the Document Registry Actor. They move in this direction forseveral reasons:•Allows best reuse of ebXML Registry specified metadata and web services protocols•

Document Source only needs to know the identity of the Document Repository.
Document Repository knows the identity of the Document Registry. If Provide andRegister Document Set-b transaction were sent to the Document Registry then routing
decisions for documents would be more complex.

•

Resulting protocols are simpler•

Simplifies the common case where the Document Source and the Document Repository
are grouped.

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Actors that support the Asynchronous Web Services Exchange Option and implement theProvide and Register Document Set-b [ITI-41] transaction shall support Asynchronous Web
Services Exchange on all XDS.b or XDR transactions they implement. Refer to ITI TF-2x: V.5
Synchronous and Asynchronous Web Services Exchange for an explanation of Asynchronous
Web Services Exchange.

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3.41.1 Scope
The Provide and Register Document Set-b transaction passes a Repository Submission Request(see ITI TF-3: 4.3.1.2.1) from a Document Source to a Document Repository, Document
Recipient, or a Metadata-Limited Document Source to a Document Recipient.
A Provide and Register Document Set-b transaction shall carry:

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3965

•

Metadata describing zero or more documents•

Within metadata, one XDSDocumentEntry object per document•

XDS Submission Set definition along with the linkage to new documents and references
to existing documents•

Zero or more XDS Folder definitions along with linkage to new or existing documents•

Zero or more documents

3.41.2 Use Case Roles
Document Source

Document Recipient

Document Repository

Provide and Register
Document Set – b

Actor: Document Source
3970

Role: A system that submits documents and associated metadata to a Document Repository.
Detailed requirements for this actor are discussed in Section 3.41.6.1.
Actor: Metadata-Limited Document Source
Role: A system that submits documents and a limited set of associated metadata to a Document
Recipient. Detailed requirements for this actor are discussed in Section 3.41.6.1.
Actor: Document Recipient

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Role: A system that receives a set of documents. Typically this document set will be madeavailable to the intended recipient who will chose to either view it or integrate it into theElectronic Healthcare Record (EHR).
Detailed requirements for this actor are discussed in Section 3.41.6.2.
Actor: Document Repository

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Role: A document storage system that receives documents and associated metadata and:•Stores the documents•

Enhances submitted metadata with repository information to enable later retrieval of
documents•

Forwards the enhanced metadata to the Document Registry.

Detailed requirements for this actor are discussed in Section 3.41.6.2.
3.41.3 Referenced Standards
Implementors of this transaction shall comply with all requirements described in: ITI TF-2x:
Appendix V: Web Services for IHE Transactions.
ebRIM

OASIS/ebXML Registry Information Model v3.0

ebRS

OASIS/ebXML Registry Services Specifications v3.0

ITI TF-3:4

Metadata used in Document Sharing profiles

MTOM

SOAP Message Transmission Optimization Mechanism http://www.w3.org/TR/soap12-mtom/

XOP

XML-binary Optimized Packaging http://www.w3.org/TR/2005/REC-xop10-20050125/

3990
3.41.4 Interaction Diagrams
Document
SourceDocument
Repository

Provide and Register Document Set – b
RequestProvide and Register Document Set – b
Response

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Document
SourceDocument
Recipient

Provide and Register Document Set – b
RequestProvide and Register Document Set – b
Response3995

3.41.4.1 Provide and Register Document Set-b Request
A Document Source or Metadata-Limited Document Source sends documents and associatedmetadata to a Document Recipient, or a Document Repository that has an associated Document
Registry.

4000

The Document Repository shall, upon receipt of a Provide and Register Document Set-b [ITI-41]
transaction send a corresponding Register Document Set-b [ITI-42] transaction to the Document
Registry Actor.
•

4005

4010

The Document Repository Actor shall create and insert the
XDSDocumentEntry.repositoryUniqueId, XDSDocumentEntry.size, andXDSDocumentEntry.hash attributes for each document received from the Provide andRegister Document Set-b [ITI-41] transaction into the resulting Register Document Set-b[ITI-42] transaction metadata. The combination of XDSDocumentEntry.uniqueId and
XDSDocumentEntry.repositoryUniqueId attributes value shall later be accepted in a
Retrieve Document Set transaction [ITI-43] for that document and the document shall be
returned.

3.41.4.1.1 Trigger Events
The Document Source or Metadata-Limited Document Source, based on a human decision or theapplication of a certain rule of automatic operation, wants to submit•

4015

A set of zero or more documents to the Document Repository and the associatedmetadata to the Document Registry.
or•

A set of one or more documents to a Document Recipient.

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3.41.4.1.2 Message Semantics

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The sections in ITI TF-3: 4.1 specify the mapping of XDS concepts to ebRS and ebRIM
semantics and document metadata. A full example of document metadata submission can befound in ITI TF-2x: Appendix W.
The Provide and Register Document Set-b message shall include the metadata attributes as
defined in ITI TF-3: 4.3.1.2.1 and ITI TF-3: Table 4.3.1.1-3.
3.41.4.1.3 Expected Actions

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4035

4040

A Document Recipient receives the metadata and the associated document(s). It shall be able tointerpret the submission without any context (e.g., a prior submission). The Document Recipient
may validate the metadata as described in ITI TF-3: Table 4.3.1.1-3.
If the Document Recipient declares the Accepts Limited Metadata Option it shall not reflect anerror because the limitedMetadata attribute is present. Furthermore, if the Document Recipientchooses to validate the metadata and the limitedMetadata attribute is present, it shall validate inaccordance with the requirements in ITI TF-3: Table 4.3.1.1-3 column labeled “XDS MetadataLimited Document Source”.
The Document Source may include Folders in metadata. If the Document Recipient is not able toprocess the Folder specific content it shall return a PartialFolderContentNotProcessed warningwhich includes a textual description identifying that Folder Content was not processed. In thiscase the Document Recipient is expected to have processed the rest of the submission
successfully.
In the case where the Document Source submits a replacement of documents, if the Document
Recipient is not able to process the replacement semantics in the submission it shall return aPartialReplaceContentNotProcessed warning which includes a textual description identifyingthat the replacement semantics were not processed. In this case the Document Recipient is
expected to have processed the rest of the submission successfully.
A Document Repository shall forward the metadata to the Document Registry using the Register
Document Set-b transaction [ITI-42].

4045

The Document Repository receives this message. Each document within the message shall be
stored into the Document Repository as an octet stream with an associated MIME type.
The Document Repository shall modify the received document metadata before initiating theRegister Document Set-b transaction to the Document Registry by adding/replacing:•

The repositoryUniqueId for this Document Repository to allow for the Document
Consumer to correctly identify the proper Document Repository for each document(XDSDocumentEntry.repositoryUniqueId).

•

A hash value (XDSDocumentEntry.hash)•

A size (XDSDocumentEntry.size).

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IHE IT Infrastructure Technical Framework, Volume 2b (ITI TF-2b): Transactions Part B______________________________________________________________________________A Register Document Set-b transaction with this modified metadata shall be issued to theDocument Registry.
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The Document Repository shall ensure that when any Retrieve Document Set transaction isreceived requesting a specific document(s), it shall be provided to the Document Consumer
unchanged from the octet stream that was submitted (full fidelity repository) and shall match thesize and hash attributes of the XDSDocumentEntry object.
If the Document Repository or Document Recipient detects a failure it shall return an error
message to the Document Source or Metadata-Limited Document Source thus terminating thistransaction. The conditions of failure and possible error messages are given in the ebRS standard
and detailed in ITI TF-3: 4.2.4 Error Reporting.
3.41.4.1.3.1 Basic Patient Privacy Enforcement Option
If the Basic Patient Privacy Enforcement Option is implemented:

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4085

1. The Document Source Actor shall populate the confidentialityCode in the document
metadata with the list of values that identify the sensitivity classifications that apply tothe associated document. The confidentiality codes for different documents in the same
submission may be different.
2. The Document Source Actor shall be able to be configured with the Patient Privacy
Policies, Patient Privacy Policy Identifiers (OIDs) and associated information necessary
to understand and enforce the XDS Affinity Domain Policy. The details of this areproduct specific and not specified by IHE.
3. The Document Source Actor may have user interface or business rule capabilities todetermine the appropriate confidentiality codes for each document. The details of this areproduct specific and not specified by IHE. However, the information about how
confidentiality codes are assigned must be part of the published policy for the XDS
Affinity Domain. Note: For example, when publishing a document, the Document
Source, might show a list of checkboxes where a user can select which of the available
consents a document is to be published.
4. The Document Recipient Actor shall be able to be configured with the Patient Privacy
Policies, Patient Privacy Policy Identifiers (OIDs) and associated information necessary
to understand and enforce the policies. The meanings of the codes on the media must be
provided out of band, e.g., by telephone, fax, or email. The detail of how this is done isproduct specific and not specified by IHE. If the documents are transferred internallywithin the organization or to other members of the recipient's affinity domain, appropriate
internal confidentiality codes shall be applied.
5. The Document Recipient Actor shall have the ability to coerce the confidentiality code in
the metadata associated with the document from the codes used by the Document Source
to the codes used by the Document Recipient.

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6. The Document Recipient Actor shall abide by the XDS Affinity Domain Policies
represented by the confidentialityCode in the metadata associated with the document. The
Document Recipient Actor likely will have user access controls or business rulecapabilities to determine the details of how confidentiality codes apply to query results.
The details of this are product specific and not specified by IHE. These rules shall reduce
the query results to only those that are appropriate to the current situation for that actor
and user.
3.41.4.2 Provide and Register Document Set-b Response

4100

The Document Repository or Document Recipient shall send a Provide and Register Document
Set-b Response when the processing of a Provide and Register Document Set-b Request iscomplete.
The Provide and Register Document Set-b Response message shall carry the status of therequested operation and an error message if the requested operation failed. The conditions offailure and possible error messages are given in the ebRS standard and detailed in ITI TF-3: 4.2.4
Error Reporting.

4105

3.41.4.2.1 Trigger Events
The following events can trigger this message:•

Documents successfully received and processed by the Document Recipient•

Documents were not successfully received by the Document Recipients•

Documents stored to the Document Repository successfully and metadata stored to theDocument Registry successfully (The registry part is carried out as part of a Register
Document Set-b transaction)•

Documents stored to the Document Repository successfully but an error occurred instoring the metadata to the Document Registry•

Documents were not successfully stored to the Document Repository

4110

4115

3.41.4.2.2 Message Semantics
The Provide and Register Document Set-b Response message shall carry the status of therequested operation and an error message if the requested operation failed. The conditions offailure and possible error messages are given in the ebRS standard and detailed in ITI TF-3: 4.2.4
Error Reporting.

4120

3.41.4.2.3 Expected Actions
The Document Source now knows that the transaction succeeded/failed and can continue.
The document(s) received by the Document Recipient shall be available for further processing
according to the capabilities of the system. These capabilities are not specified by IHE, but may
include viewing the document or storing them to an Electronic Healthcare Record (EHR).
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The document(s) added to the Document Repository are now available for retrieval. The
metadata added to the registry shall be available for discovery via Registry Stored Query
transactions.
3.41.5 Protocol Requirements

4130

Implementors of this transaction shall comply with all requirements described in ITI TF-2x:Appendix V: Web Services for IHE Transactions.
The Provide and Register Document Set-b transaction shall use SOAP12 and MTOM with XOP
encoding (labeled MTOM/XOP in this specification). See ITI TF-2x: Appendix V for details.
WSDL Namespace Definitions
ihe

urn:ihe:iti:xds-b:2007rs

urn:oasis:names:tc:ebxml-regrep:xsd:rs:3.0

lcm

urn:oasis:names:tc:ebxml-regrep:xsd:lcm:3.0

query

urn:oasis:names:tc:ebxml-regrep:xsd:query:3.04135
Document Repository: These are the requirements for the Provide and Register Document Set-b
transaction presented in the order in which they would appear in the Document Repository
WSDL definition:
•
4140

4145

4150

The following types shall be imported (xsd:import) in the /definitions/types section:•namespace="urn:oasis:names:tc:ebxml-regrep:xsd:rs:3.0", schema="rs.xsd"•

namespace="urn:ihe:iti:xds-b:2007", schemaLocation="IHEXDS.xsd"•

The /definitions/message/part/@element attribute of the Provide and Register Document
Set-b Request message shall be defined as“ihe:ProvideAndRegisterDocumentSetRequest”•

The /definitions/message/part/@element attribute of the Provide and Register Document
Set-b Response message shall be defined as “rs:RegistryResponse”•

Refer to Table 3.41.5.b below for additional attribute requirements•

To support the Asynchronous Web Services Exchange Option on the Document Source,
the Document Repository and Document Recipient shall support the use of a nonanonymous response EPR in the WS-Addressing replyTo header.

These are the requirements that affect the wire format of the SOAP message. The other WSDL
properties are only used within the WSDL definition and do not affect interoperability. Fullsample request and response messages are in Section 3.41.5.1 Sample SOAP Messages.
For informative WSDL for the Document Repository Actor see ITI TF-2x: Appendix W.
4155

The <ihe:ProvideAndRegisterDocumentSetRequest/> element is defined as:
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One <lcm:SubmitObjectsRequest/> element that contains the submission set metadata•

Zero or more <ihe:Document/> elements that contain the base64encoded data for the
documents being submitted to the Document Repository or Document Recipient. The<ihe:Document/> element also includes the document id attribute (ihe:Document/@id) oftype xsd:anyURI to match the document ExtrinsicObject id in the metadata and providing
the necessary linkage

4160

The use of MTOM/XOP is governed by the following rules:•

The Document Repository or Document Recipient shall accept documents in a Provide
and Register Document Set-b transaction in MTOM/XOP format. The response message
shall use MTOM/XOP format.

•

The Document Source shall generate Provide and Registry Document Set-b transactions
in MTOM/XOP format. It shall accept the response message in MTOM/XOP format.

4165

Table 3.41.5.b: Additional Attribute Requirements
Attribute

Value/definitions/portType/operation@nameDocumentRepository_
ProvideAndRegisterDocumentSet-b/definitions/portType/operation/i
nput/@wsaw:Action

urn:ihe:iti:2007:
ProvideAndRegisterDocumentSet-b/definitions/portType/operation/o
utput/@wsaw:Action

urn:ihe:iti:2007:
ProvideAndRegisterDocumentSetbResponse/definitions/binding/operation/so
ap12:operation/@soapAction

urn:ihe:iti:2007:CrossGatewayQuery

4170
A full XML Schema Document for the XDS.b types is available online on the IHE FTP site, see
ITI TF-2x: Appendix W.
3.41.5.1 Sample SOAP Messages
4175

4180

The samples in the following two sections show a typical SOAP request and its relative SOAP
response. The sample messages also show the WS-Addressing headers <Action/>,<MessageID/>, <ReplyTo/>…; these WS-Addressing headers are populated according to the
ITI TF-2x: Appendix V: Web Services for IHE Transactions. The body of the SOAP message isomitted for brevity; in a real scenario the empty element will be populated with the appropriate
metadata.
Samples presented in this section are also available online on the IHE FTP site, see ITI TF-2x:
Appendix W.

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3.41.5.1.1 Sample Provide and Register Document Set-b SOAP Request
3.41.5.1.1.1 Synchronous Web Services Exchange
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POST /axis2/services/repository HTTP/1.1
Content-Type: multipart/related; boundary=MIMEBoundaryurn_uuid_76A2C3D9BCD3AECFF31217932910180;
type="application/xop+xml"; start="<0.urn:uuid76A2C3D9BCD3AECFF31217932910181@apache.org>";
start-info="application/soap+xml"; action="urn:ihe:iti:2007:ProvideAndRegisterDocumentSet-b"
User-Agent: Axis2
Host: localhost:4040
Content-Length: 4567--MIMEBoundaryurn_uuid_76A2C3D9BCD3AECFF31217932910180
Content-Type: application/xop+xml; charset=UTF-8; type="application/soap+xml"
Content-Transfer-Encoding: binary
Content-ID: <0.urn:uuid:76A2C3D9BCD3AECFF31217932910181@apache.org><?xml version='1.0' encoding='UTF-8'?><soapenv:Envelope xmlns:soapenv="http://www.w3.org/2003/05/soap-envelope"
xmlns:wsa="http://www.w3.org/2005/08/addressing"><soapenv:Header><wsa:To>http://localhost:4040/axis2/services/test11966a</wsa:To><wsa:MessageID>urn:uuid:76A2C3D9BCD3AECFF31217932910053</wsa:MessageID><wsa:Action soapenv:mustUnderstand="1">urn:ihe:iti:2007:ProvideAndRegisterDocumentSetb</wsa:Action></soapenv:Header><soapenv:Body><xdsb:ProvideAndRegisterDocumentSetRequest xmlns:xdsb="urn:ihe:iti:xds-b:2007"><lcm:SubmitObjectsRequest xmlns:lcm="urn:oasis:names:tc:ebxml-regrep:xsd:lcm:3.0"><rim:RegistryObjectList xmlns:rim="urn:oasis:names:tc:ebxml-regrep:xsd:rim:3.0"><!-- Registry Metadata goes here -->

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</rim:RegistryObjectList></lcm:SubmitObjectsRequest><xdsb:Document id="Document01"><xop:Include href="cid:1.urn:uuid:76A2C3D9BCD3AECFF3121793290229@apache.org"
xmlns:xop="http://www.w3.org/2004/08/xop/include"/></xdsb:Document></xdsb:ProvideAndRegisterDocumentSetRequest></soapenv:Body></soapenv:Envelope>--MIMEBoundaryurn_uuid_76A2C3D9BCD3AECFF31217932910180
Content-Type: text/plain
Content-Transfer-Encoding: binary
Content-ID: <1.urn:uuid:76A2C3D9BCD3AECFF31217932910229@apache.org>
This is my document.
It is great!

--MIMEBoundaryurn_uuid_76A2C3D9BCD3AECFF31217932910180--4235

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3.41.5.1.1.2 Asynchronous Web Services Exchange

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<s:Envelope xmlns:s="http://www.w3.org/2003/05/soap-envelope"
xmlns:a="http://www.w3.org/2005/08/addressing"><s:Header><a:Action s:mustUnderstand="1">urn:ihe:iti:2007:ProvideAndRegisterDocumentSetb</a:Action><a:MessageID>urn:uuid:6d296e90-e5dc-43d0-b455-7c1f3eb35d83</a:MessageID><a:ReplyTo><a:Address>http://192.168.2.4:9080/XdsService/DocumentSourceReceiver.svc</a:Address></a:ReplyTo><a:To
s:mustUnderstand="1">http://localhost:2647/XdsService/DocumentRepositoryReceiver.svc</a:To></s:Header><s:Body><ProvideAndRegisterDocumentSetRequest
xmlns="urn:ihe:iti:xds-b:2007"
xmlns:lcm="urn:oasis:names:tc:ebxml-regrep:xsd:lcm:3.0"
xmlns:rim="urn:oasis:names:tc:ebxml-regrep:xsd:rim:3.0"
xmlns:rs="urn:oasis:names:tc:ebxml-regrep:xsd:rs:3.0"><lcm:SubmitObjectsRequest>

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<!—Rest of SubmitObjectsRequest message goes here --></lcm:SubmitObjectsRequest><Document
id="Document01">UjBsR09EbGhjZ0dTQUxNQUFBUUNBRU1tQ1p0dU1GUXhEUzhi</Document></ProvideAndRegisterDocumentSetRequest></s:Body></s:Envelope>

3.41.5.1.2 Sample Provide and Register Document Set-b SOAP Response
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3.41.5.1.2.1 Synchronous Web Services Exchange<s:Envelope
xmlns:s="http://www.w3.org/2003/05/soap-envelope"
xmlns:a="http://www.w3.org/2005/08/addressing"><s:Header><a:Action s:mustUnderstand="1">
urn:ihe:iti:2007:ProvideAndRegisterDocumentSet-bResponse</a:Action><a:RelatesTo>urn:uuid:6d296e90-e5dc-43d0-b455-7c1f3eb35d83</a:RelatesTo></s:Header><s:Body><rs:RegistryResponse
status="urn:oasis:names:tc:ebxml-regrep:ResponseStatusType:Success"xmlns:rs="urn:oasis:names:tc:ebxml-regrep:xsd:rs:3.0" /></s:Body></s:Envelope>

3.41.5.1.2.2 Asynchronous Web Services Exchange<s:Envelope

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xmlns:s="http://www.w3.org/2003/05/soap-envelope"
xmlns:a="http://www.w3.org/2005/08/addressing"><s:Header><a:Action s:mustUnderstand="1">

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urn:ihe:iti:2007:ProvideAndRegisterDocumentSet-bResponse</a:Action><a:MessageID>urn:uuid:D6C21225-8E7B-454E-9750-821622C099DB</a:MessageID><a:RelatesTo>urn:uuid:6d296e90-e5dc-43d0-b455-7c1f3eb35d83</a:RelatesTo><a:To
s:mustUnderstand="1">http://localhost:2647/XdsService/DocumentSourceReceiver.svc</a:To></s:Header><s:Body><rs:RegistryResponse
status="urn:oasis:names:tc:ebxml-regrep:ResponseStatusType:Success"xmlns:rs="urn:oasis:names:tc:ebxml-regrep:xsd:rs:3.0" /></s:Body></s:Envelope>

3.41.6 Actor Requirements
This section summarizes the responsibilities of the actors relevant to this transaction.
3.41.6.1 Document Source
4310

An implementation of the Document Source or Metadata-Limited Document Source Actor shallbe capable of the following operations:
•

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4320

Submit one or more documents. Whether a submission contains a single or multiple
documents depends on workflows, policies, and other external factors which are outsideof the scope of this transaction.

An implementation of the XDS Document Source Actor may support one or more of thefollowing XDS.b options:•

Document Replace Option: In this option the Document Source offers the ability tosubmit a document as a replacement for another document already in theregistry/repository.

•

Document Addendum Option In this option the Document Source shall offer the ability
to submit a document as an addendum to another document already in theregistry/repository.

•

Document Transformation Option In this option the Document Source shall offer theability to submit a document as a transformation of another document already in theregistry/repository.

4325

Note: In order to support document replacement/addendum/transformation grouping with the Document Consumer may benecessary in order to Query the registry (e.g., for UUIDs of existing document entries)•
4330

Folder Management Option. In this option the Document Source offers the ability toperform the following operation:•

Create a folder•

Add one or more documents to a folder

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Note: In order to support document addition to an existing folder, grouping with the Document Consumer may benecessary in order to Query the registry (e.g., for UUIDs of existing folder).

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These operations are discussed in ITI TF-3: 4.3.1.2 XDS Specific Requirements.
3.41.6.2 Document Repository or Document Recipient
A Document Repository or Document Recipient shall be capable of accepting submissions
containing multiple documents.
Note: The Document Source may submit single documents or multiple documents depending on its needs.

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A Document Repository shall validate the following metadata element received as part of aProvide and Register transaction:
•

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4355

XDSDocumentEntry.uniqueId – a submission shall be rejected if not unique within therepository and the hashes of the two documents do not match. If the hashes of the
documents match, the Document Repository shall accept the duplicate document.

A Document Repository or Document Recipient shall validate the following metadata element
received as part of a Provide and Register transaction:•

XDSSubmissionSet.sourceId – a Document Repository or Document Recipient may
choose to accept submissions only from certain sources and use this field to perform thefiltering.

•

XDSDocumentEntry.hash – a submission shall be rejected if the hash is included in thesubmission and its value does not match the hash for the received document (ignoringcase), as calculated by the Document Repository or Document Recipient; an
XDSRepositoryMetadataError shall be returned on mismatch.

•

XDSDocumentEntry.size – a submission shall be rejected if the size is included in thesubmission and its value does not match the size of the received document, as computedby the Document Repository or Document Recipient; an XDSRepositoryMetadataError
shall be returned on mismatch.

3.41.7 Security Considerations
4360

Relevant XDS Affinity Domain security considerations are discussed in the XDS Security
Considerations Section (see ITI TF-1: 10.7).
3.41.7.1 Audit Record Considerations
The Provide and Register Document Set-b transaction is either a PHI-Import event or a PHIExport event, depending on actor, as defined in ITI TF-2a: Table 3.20.6-1, with the following
exceptions.

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3.41.7.1.1 Document Source audit message:
Field Name
Event
AuditMessage/
EventIdentification

Opt

Value Constraints

EventID

M

EV(110106, DCM, “Export”)

EventActionCodeM“R” (Read)

EventDateTimeM

not specialized

EventOutcomeIndicatorM

not specialized

EventTypeCode

M

EV(“ITI-41”, “IHE Transactions”, “Provide and Register Document
Set-b”)

UserIDM

If Asynchronous Web Services Exchange is being used, the content of
the <wsa:ReplyTo/> element. Otherwise, not specialized.

AlternativeUserIDM

the process ID as used within the local operating system in the local
system logs.

UserNameUnot specialized

UserIsRequestorU

not specialized

RoleIDCodeM

EV(110153, DCM, “Source”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointID

M

The machine name or IP address.

UserID

M

Identity of the human that initiated the transaction.

AlternativeUserIDU

not specialized

UserNameUnot specialized

UserIsRequestorU

not specialized

RoleIDCodeU

Access Control role(s) the user holds that allows this transaction.

NetworkAccessPointTypeCode

NA

NetworkAccessPointID

NA

Source (Document Source) (1)
Human Requestor (0..n)
Destination (Document Repository) (1)Audit Source (Document Source) (1)Patient (1)SubmissionSet (1)Where:

SourceAuditMessage/
ActiveParticipant

Human
Requestor(if known)
AuditMessage/
ActiveParticipant

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Destination

UserID

M

SOAP endpoint URI.

AuditMessage/
ActiveParticipant

AlternativeUserIDU

not specialized

UserNameUnot specialized

UserIsRequestorM“false”

RoleIDCodeM

EV(110152, DCM, “Destination”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointID

M

The machine name or IP address.

AuditSourceIDU

not specialized

AuditEnterpriseSiteIDU

not specialized

AuditSourceTypeCodeU

not specialized

ParticipantObjectTypeCodeM“1” (Person)

ParticipantObjectTypeCodeRole

M“1” (Patient)

ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCodeM

not specialized

ParticipantObjectSensitivityU

not specialized

ParticipantObjectID

M

The patient ID in HL7 CX format.

ParticipantObjectNameU

not specialized

ParticipantObjectQueryU

not specialized

ParticipantObjectDetailUnot specialized

Submission
Set

ParticipantObjectTypeCodeM“2” (System)

ParticipantObjectTypeCodeRole

M“20” (job)(AuditMessage/
ParticipantObjectIde
ntification)

ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCode

M

EV(“urn:uuid:a54d6aa5-d40d-43f9-88c5-b4633d873bdd”, “IHE XDS
Metadata”, “submission set classificationNode”)

ParticipantObjectSensitivityU

not specialized

ParticipantObjectID

M

The submissionSet unique ID

ParticipantObjectNameU

not specialized

Audit
SourceAuditMessage
AuditSourceIdentifi
cationPatient(AuditMessage/
ParticipantObjectIde
ntification)

ParticipantObjectQueryU

not specialized

ParticipantObjectDetailUnot specialized

3.41.7.1.2 Document Repository or Document Recipient audit message:
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Field Name
Event
AuditMessage/
EventIdentification

Opt

Value Constraints

EventID

M

EV(110107, DCM, “Import”)

EventActionCodeM“C” (Create)

EventDateTimeM

not specialized

EventOutcomeIndicatorM

not specialized

EventTypeCode

M

EV(“ITI-41”, “IHE Transactions”, “Provide and Register Document
Set-b”)

Source (Document Source) (1)Destination (Document Repository or Document Recipient) (1)Audit Source (Document Repository or Document Recipient) (1)Patient (1)SubmissionSet (1)4385

Where:
SourceAuditMessage/
ActiveParticipant

Destination
AuditMessage/
ActiveParticipant

If Asynchronous Web Services Exchange is being used, the content of
the <wsa:ReplyTo/> element. Otherwise, not specialized.

UserID

M

AlternativeUserIDU

not specialized

UserNameUnot specialized

UserIsRequestorU

not specialized

RoleIDCodeM

EV(110153, DCM, “Source”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointID

M

The machine name or IP address.

UserID

M

SOAP endpoint URI

AlternativeUserIDM

the process ID as used within the local operating system in the local
system logs.

UserNameUnot specialized

UserIsRequestorM“false”

RoleIDCodeM

EV(110152, DCM, “Destination”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointID

M

The machine name or IP address.

Audit Source

AuditSourceIDU

not specialized

AuditMessage/
AuditSourceIdentificati
on

AuditEnterpriseSiteIDU

not specialized

AuditSourceTypeCodeU

not specialized

ParticipantObjectTypeCodeM“1” (Person)

ParticipantObjectTypeCodeRole

M“1” (Patient)

ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCodeM

not specialized

ParticipantObjectSensitivityU

not specialized

ParticipantObjectID

M

The patient ID in HL7 CX format.

Patient(AuditMessag
e/ParticipantOb
jectIdentificat
ion)

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ParticipantObjectNameU

not specialized

ParticipantObjectQueryU

not specialized

ParticipantObjectDetailUnot specialized

Submission
Set

ParticipantObjectTypeCodeM“2” (System)

ParticipantObjectTypeCodeRole

M“20” (job)(AuditMessage/
ParticipantObjectIde
ntification)

ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCode

M

EV(“urn:uuid:a54d6aa5-d40d-43f9-88c5-b4633d873bdd”, “IHE XDS
Metadata”, “submission set classificationNode”)

ParticipantObjectSensitivityU

not specialized

ParticipantObjectID

M

The submissionSet unique ID

ParticipantObjectNameU

not specialized

ParticipantObjectQueryU

not specialized

ParticipantObjectDetailUnot specialized

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3.42 Register Document Set-b

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This section corresponds to transaction [ITI-42] of the IHE IT Infrastructure Technical
Framework. Transaction [ITI-42] is used by the Document Repository Actor to register a set of
documents with the Document Registry in XDS.b.
Integration Profiles using this Transaction
Cross-Enterprise Document Sharing-b (XDS.b)

Actors that support the Asynchronous Web Services Exchange Option and implement theRegister Document Set-b transaction shall support the following:•

Document Repository Actor shall support Asynchronous Web Services Exchange for theProvide & Register Document Set – b [ITI-41] and Register Document Set – b [ITI-42],
and Retrieve Document Set [ITI-43] transactions•

Document Registry Actor shall support Asynchronous Web Services Exchange for theRegistry Stored Query [ITI-18] and Register Document Set – b [ITI-42] transactions

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Refer to Section ITI TF-2x: V.5 Synchronous and Asynchronous Web Services Exchange for an
explanation of Asynchronous Web Services Exchange.
3.42.1 Scope
The Register Document Set-b transaction passes a Submission Request from a Document
Repository Actor to a Document Registry Actor.
A Register Document Set-b transaction shall carry:

4410

•

Metadata describing zero or more documents•

XDS Submission Set definition along with the linkage to new documents and references
to existing documents•

An optional XDS Folder definitions along with linkage to new or existing documents

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3.42.2 Use Case Roles
Document Repository
Or
Integrated Document
Source/Repository

Document
Registry

RegisterDocument Set – b

Actor: Document Repository or Integrated Document Source/Repository
Role: A document storage system that submits document metadata to a Document Registry.
Actor: Document Registry4420

Role: A document indexing system that receives and stores document metadata.
Note: Within this transaction, the Document Repository and Integrated Document Source/Repository Actors can be usedinterchangeably

3.42.3 Referenced Standards
4425

Implementors of this transaction shall comply with all requirements described in ITI TF-2x:
Appendix V: Web Services for IHE Transactions.
ebRIM

OASIS/ebXML Registry Information Model v3.0

ebRS

OASIS/ebXML Registry Services Specifications v3.0

HL7V2

HL7 Version 2.5

ITI TF-3: 4

Metadata used in Document Sharing profiles

3.42.4 Interaction Diagram

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Document
Repository

Document
Registry

Register Document Set – b Request

Register Document Set – b Response

4430
3.42.4.1 Register Document Set-b Request
The Document Repository sends metadata for a set of documents to the Document Registry.
3.42.4.1.1 Trigger Events
4435

The Register Document Set-b Request message is triggered when:•

4440

A Document Repository wants to register metadata for a set of documents it holds. These
documents may have been stored in the Document Repository by a Document Source(using the Provide and Register Document Set-b transaction [ITI-41]) or generated
internally by an Integrated Document Source/Repository.

3.42.4.1.2 Message Semantics
The sections in ITI TF-3: 4.1 specify the mapping of XDS concepts to ebRS and ebRIM
semantics and document metadata. A full example of document metadata submission can befound in ITI TF-2x: Appendix W.
3.42.4.1.4 Expected Actions

4445

Upon receipt of a Register Document Set-b Request message, the Document Registry with theaid of the Registry Adaptor shall do the following:•

Accept all valid SubmitObjectsRequests.

•

Perform metadata validations•

The Document Registry Actor shall store and later include in query responses all
IHE-defined metadata attributes received in the Register Document Set-b [ITI-42]
transaction.

•

If the Document Registry Actor does not send the XDSExtraMetadataNotSaved
warning in its response, it shall also store and later include in query responses all nonIHE-defined metadata attributes.

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4455•

Update the registry with the contained metadata•

Return a RegistryResponse message given the status of the operation.

If the registry rejects the metadata, then, the following shall occur:

4460

•

An error is returned•

The error status includes an error message•

The request is rolled back3.42.4.1.4.1 Basic Patient Privacy Enforcement Option
If the Basic Patient Privacy Enforcement Option is implemented:

4465

4470

4475

1. The Integrated Document Source / Repository Actor shall populate theconfidentialityCode in the document metadata with the list of values that identify thesensitivity classifications that apply to the associated document. The confidentiality codesfor different documents in the same submission may be different.
2. The Integrated Document Source / Repository Actor shall be able to be configured with
the Patient Privacy Policies, Patient Privacy Policy Identifiers (OIDs) and associatedinformation necessary to understand and enforce the XDS Affinity Domain Policy. The
details of this are product specific and not specified by IHE.
3. The Integrated Document Source / Repository Actor may have a user interface orbusiness rule capabilities to determine the appropriate confidentiality codes for eachdocument. The details of this are product specific and not specified by IHE. However, theinformation about how confidentiality codes are assigned must be part of the publishedpolicy for the XDS Affinity Domain. For example, when publishing a document, theIntegrated Document Source / Repository might show a list of checkboxes where a user
can select which of the available consents a document is to be published.
3.42.4.1.5 Protocol Requirements
The Register Document Set-b transaction shall use SOAP12. Furthermore:

4480

4485

•

The Document Registry Actor shall accept the Register Document Set-b Request
formatted as a SIMPLE SOAP message and respond with the Register Document Set-b
Response formatted as a SIMPLE SOAP message.

•

The Document Repository Actor shall generate the Register Document Set-b Request
formatted as a SIMPLE SOAP message and accept the Register Document Set-b
Response formatted as a SIMPLE SOAP message.

See ITI TF-2x: Appendix V for details.

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3.42.4.2 Register Document Set-b Response
3.42.4.2.1 Trigger Events
4490

The Document Registry finishes processing a Register Document Set-b Request Message andshall respond with:•

Register Document Set-b Response

3.42.4.2.2 Message Semantics

4495

The Register Document Set-b Response message shall carry the status of the requested operation
and an error message if the requested operation failed. The conditions of failure and possible
error messages are given in the ebRS standard and detailed in ITI TF-3: 4.2.4 Error Reporting.
3.42.4.2.3 Expected Actions
The Document Repository now knows that the transaction succeeded/failed and can continue.
The metadata added to the registry as a result of this transaction is now available for discovery.
3.42.5 Protocol Requirements

4500

Implementors of this transaction shall comply with all requirements described in ITI TF-2x:
Appendix V: Web Services for IHE Transactions.
WSDL Namespace Definitions

4505

ihe

urn:ihe:iti:xds-b:2007rs

urn:oasis:names:tc:ebxml-regrep:xsd:rs:3.0

lcm

urn:oasis:names:tc:ebxml-regrep:xsd:lcm:3.0

query

urn:oasis:names:tc:ebxml-regrep:xsd:query:3.0

Document Registry: These are the requirements for the Register Document Set-b transaction
presented in the order in which they would appear in the Document Registry WSDL definition:•

The following types shall be imported (xsd:import) in the /definitions/types section:•namespace="urn:oasis:names:tc:ebxml-regrep:xsd:rs:3.0", schema=" rs.xsd"•

namespace="urn:oasis:names:tc:ebxml-regrep:xsd:lcm:3.0", schema=" lcm.xsd"•

The /definitions/message/part/@element attribute of the Register Document Set-b
Request message shall be defined as “lcm:SubmitObjectsRequest”•

The /definitions/message/part/@element attribute of the Register Document Set-b
Response message shall be defined as “rs:RegistryResponse”•

Refer to Table 3.42.5.b below for additional attribute requirements

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To support the Asynchronous Web Services Exchange Option on the Document
Repository, the Document Registry shall support the use of a non-anonymous response
EPR in the WS-Addressing replyTo header.

These are the requirements that affect the wire format of the SOAP message. The other WSDL
properties are only used within the WSDL definition and do not affect interoperability. Fullsample request and response messages are in Section 3.42.5.1 Sample SOAP Messages.
4520

For informative WSDL for the Document Registry Actor see ITI TF-2x: Appendix W.
Table 3.42.5.b: Additional Attribute Requirements
Attribute

Value/definitions/portType/operation@name

DocumentRepository_RegisterDocumentSet-b/definitions/portType/operation/input/@wsaw:Action

urn:ihe:iti:2007:RegisterDocumentSet-b/definitions/portType/operation/output/@wsaw:Action

urn:ihe:iti:2007:
ProvideAndRegisterDocumentSetbResponse/definitions/binding/operation/soap12:operation/@soap
Actionurn:ihe:iti:2007: RegisterDocumentSet-b

3.42.5.1 Sample SOAP Messages
4525

4530

The samples in the following two sections show a typical SOAP request and its relative SOAP
response. The sample messages also show the WS-Addressing headers <Action/>,<MessageID/>, <ReplyTo/>…; these WS-Addressing headers are populated according to ITI
TF-2x: Appendix V: Web Services for IHE Transactions. The body of the SOAP message isomitted for brevity; in a real scenario the empty element will be populated with the appropriate
metadata.
Samples presented in this section are also available online on the IHE FTP site, see ITI TF-2x:
Appendix W.
3.42.5.1.1 Sample Register Document Set-b SOAP Request
3.42.5.1.1.1 Synchronous Web Services Exchange

4535

4540

4545

<s:Envelope xmlns:s="http://www.w3.org/2003/05/soap-envelope"
xmlns:a="http://www.w3.org/2005/08/addressing"><s:Header><a:Action s:mustUnderstand="1">urn:ihe:iti:2007:RegisterDocumentSet-b</a:Action><a:MessageID>urn:uuid:1ec52e14-4aad-4ba1-b7d3-fc9812a21340</a:MessageID><a:ReplyTo><a:Address>http://www.w3.org/2005/08/addressing/anonymous</a:Address></a:ReplyTo s:mustUnderstand="1"><a:To >http://localhost:2647/XdsService/IHEXDSRegistry.svc</a:To></s:Header><s:Body><lcm:SubmitObjectsRequest
xmlns:lcm="urn:oasis:names:tc:ebxml-regrep:xsd:lcm:3.0"

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xmlns:rim="urn:oasis:names:tc:ebxml-regrep:xsd:rim:3.0"
xmlns:rs="urn:oasis:names:tc:ebxml-regrep:xsd:rs:3.0"><!—Rest of SubmitObjectsRequest message goes here -->4555</lcm:SubmitObjectsRequest></s:Body></s:Envelope>

3.42.5.1.1.2 Asynchronous Web Services Exchange

4560

4565

4570

4575

<s:Envelope xmlns:s="http://www.w3.org/2003/05/soap-envelope"
xmlns:a="http://www.w3.org/2005/08/addressing"><s:Header><a:Action s:mustUnderstand="1">urn:ihe:iti:2007:RegisterDocumentSet-b</a:Action><a:MessageID>urn:uuid:1ec52e14-4aad-4ba1-b7d3-fc9812a21340</a:MessageID><a:ReplyTo><a:Address>
http://192.168.2.4:9080/XdsService/DocumentRepositoryReceiver.svc</a:Address></a:ReplyTo><a:To
s:mustUnderstand="1">http://localhost:2647/XdsService/DocumentRegistryReceiver.svc</a:To></s:Header><s:Body><lcm:SubmitObjectsRequest
xmlns:lcm="urn:oasis:names:tc:ebxml-regrep:xsd:lcm:3.0"
xmlns:rim="urn:oasis:names:tc:ebxml-regrep:xsd:rim:3.0"
xmlns:rs="urn:oasis:names:tc:ebxml-regrep:xsd:rs:3.0"><!—Rest of SubmitObjectsRequest message goes here -->4580</lcm:SubmitObjectsRequest></s:Body></s:Envelope>

3.42.5.1.2 Sample Register Document Set-b SOAP Response
3.42.5.1.2.1 Synchronous Web Services Exchange
4585

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4595

<s:Envelope
xmlns:s="http://www.w3.org/2003/05/soap-envelope"
xmlns:a="http://www.w3.org/2005/08/addressing"><s:Header><a:Action s:mustUnderstand="1">urn:ihe:iti:2007:RegisterDocumentSet-bResponse</a:Action><a:RelatesTo>urn:uuid:1ec52e14-4aad-4ba1-b7d3-fc9812a21340</a:RelatesTo></s:Header><s:Body><rs:RegistryResponse
status="urn:oasis:names:tc:ebxml-regrep:ResponseStatusType:Success"xmlns:rs="urn:oasis:names:tc:ebxml-regrep:xsd:rs:3.0"/></s:Body></s:Envelope>

3.42.5.1.2.2 Asynchronous Web Services Exchange
4600<s:Envelope
xmlns:s="http://www.w3.org/2003/05/soap-envelope"
xmlns:a="http://www.w3.org/2005/08/addressing"><s:Header><a:Action s:mustUnderstand="1">urn:ihe:iti:2007:RegisterDocumentSetbResponse</a:Action>

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<a:MessageID>urn:uuid:D6C21225-8E7B-454E-9750-821622C099DB</a:MessageID><a:RelatesTo>urn:uuid:1ec52e14-4aad-4ba1-b7d3-fc9812a21340</a:RelatesTo><a:To
s:mustUnderstand="1">http://localhost:2647/XdsService/DocumentRepositoryReceiver.svc</a:To></s:Header><s:Body><rs:RegistryResponse
status="urn:oasis:names:tc:ebxml-regrep:ResponseStatusType:Success"xmlns:rs="urn:oasis:names:tc:ebxml-regrep:xsd:rs:3.0"/></s:Body></s:Envelope>

3.42.6 Actor Requirements
The Document Repository Actor shall:•
4620

Make (all) the new document(s) included in the XDS Submission Set available for
retrieval via the Retrieve Document Set transaction before it initiates the Register
Document Set-b Request message with the Registry Actor.

This is necessary because:

4625

•

The Document Registry Actor may choose to validate the successful storage of the
document(s) before acknowledging the Register Document Set-b Request transaction.

•

The Document Consumer Actor may retrieve the document(s) before the Register
Document Set-b Response is received by the Document Repository Actor.

3.42.7 Security Considerations
Relevant XDS Affinity Domain Security background is discussed in the XDS Security
Considerations Section (see ITI TF-1: 10.7).
4630

3.42.7.1 Audit Record Considerations
The Register Document Set-b transaction is either a PHI-Import event or a PHI-Export event,depending on actor, as defined in ITI TF-2a: Table 3.20.6-1, with the following exceptions.
3.42.7.1.1 Document Repository or Integrated Document Source/Repository audit
message:
Field Name
Event
AuditMessage/
EventIdentification

Opt

Value Constraints

EventID

M

EV(110106, DCM, “Export”)

EventActionCodeM“R” (Read)

EventDateTimeM

not specialized

EventOutcomeIndicatorM

not specialized

EventTypeCode

M

EV(“ITI-42”, “IHE Transactions”, “Register Document Set-b”)

Source (Document Repository or Integrated Document Source/Repository) (1)
Human Requestor (0..n)
Destination (Document Registry) (1)Audit Source (Document Repository or Integrated Document Source/Repository) (1)
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Patient (0..1)
SubmissionSet (1)4635

Where:

SourceUserIDM

If Asynchronous Web Services Exchange is being used, the content of
the <wsa:ReplyTo/> element. Otherwise, not specialized.

AlternativeUserIDM

the process ID as used within the local operating system in the local
system logs.

UserNameUnot specialized

UserIsRequestorU

not specialized

AuditMessage/
ActiveParticipant

RoleIDCodeM

EV(110153, DCM, “Source”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointID

M

The machine name or IP address.

UserID

M

Identity of the human that initiated the transaction.

AlternativeUserIDU

not specialized

UserNameUnot specialized

UserIsRequestorU

not specialized

RoleIDCodeU

Access Control role(s) the user holds that allows this transaction.

NetworkAccessPointTypeCode

NA

NetworkAccessPointID

NA

Destination

UserID

M

SOAP endpoint URI.

AuditMessage/
ActiveParticipant

AlternativeUserIDU

not specialized

UserNameUnot specialized

UserIsRequestorM“false”

Human
Requestor(if known)
AuditMessage/
ActiveParticipant

RoleIDCodeM

EV(110152, DCM, “Destination”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointID

M

The machine name or IP address.

Audit Source

AuditSourceIDU

not specialized

AuditMessage/
AuditSourceIdentification

AuditEnterpriseSiteIDU

not specialized

AuditSourceTypeCodeU

not specialized

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ParticipantObjectTypeCode

M

ParticipantObjectTypeCodeRole

M“1” (patient)

ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCodeM

not specialized

ParticipantObjectSensitivityU

not specialized

ParticipantObjectIDM

the patient ID in HL7 CX format.

ParticipantObjectNameU

not specialized

ParticipantObjectQueryU

not specialized

ParticipantObjectDetailUnot specialized

Submission
Set

ParticipantObjectTypeCodeM“2” (System)

ParticipantObjectTypeCodeRole

M“20” (job)(AuditMessage/
ParticipantObjectIdentif
ication)ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCode

M

EV(“urn:uuid:a54d6aa5-d40d-43f9-88c5-b4633d873bdd”, “IHE XDS
Metadata”, “submission set classificationNode”)

ParticipantObjectSensitivityU

not specialized

ParticipantObjectID

M

The submissionSet unique ID

ParticipantObjectNameU

not specialized

ParticipantObjectQueryU

not specialized

ParticipantObjectDetailUnot specialized

Patient (ifknown)(AuditMessage/
ParticipantObjectIdentif
ication)“1” (person)

3.42.7.1.2 Document Registry audit message:
Event
AuditMessage/
EventIdentification

Field Name

Opt

Value Constraints

EventID

M

EV(110107, DCM, “Import”)

EventActionCodeM“C” (Create)

EventDateTimeM

not specialized

EventOutcomeIndicatorM

not specialized

EventTypeCode

M

EV(“ITI-42”, “IHE Transactions”, “Register Document Set-b”)

Source (Document Repository or Integrated Document Source/Repository) (1)Destination (Document Registry ) (1)Audit Source (Document Registry) (1)Patient (0..1)
SubmissionSet (1)Where:
SourceAuditMessage/
ActiveParticipant

If Asynchronous Web Services Exchange is being used, the content of
the <wsa:ReplyTo/> element. Otherwise, not specialized.

UserID

M

AlternativeUserIDU

not specialized

UserNameUnot specialized

UserIsRequestorU

not specialized

RoleIDCodeM

EV(110153, DCM, “Source”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointID

M

The machine name or IP address.

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Destination

UserID

M

SOAP endpoint URI

AuditMessage/
ActiveParticipant

AlternativeUserIDM

the process ID as used within the local operating system in the local
system logs.

UserNameUnot specialized

UserIsRequestorM“false”

RoleIDCodeM

EV(110152, DCM, “Destination”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointID

M

The machine name or IP address.

Audit Source

AuditSourceIDU

not specialized

AuditMessage/
AuditSourceIdentification

AuditEnterpriseSiteIDU

not specialized

AuditSourceTypeCodeU

not specialized

ParticipantObjectTypeCodeM“1” (person)

ParticipantObjectTypeCodeRole

M“1” (patient)

ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCodeM

not specialized

ParticipantObjectSensitivityU

not specialized

ParticipantObjectIDM

the patient ID in HL7 CX format.

ParticipantObjectNameU

not specialized

ParticipantObjectQueryU

not specialized

ParticipantObjectDetailUnot specialized

Submission
Set

ParticipantObjectTypeCodeM“2” (System)

ParticipantObjectTypeCodeRole

M“20” (job)(AuditMessage/
ParticipantObjectIdentif
ication)ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCode

M

EV(“urn:uuid:a54d6aa5-d40d-43f9-88c5-b4633d873bdd”, “IHE XDS
Metadata”, “submission set classificationNode”)

ParticipantObjectSensitivityU

not specialized

ParticipantObjectID

M

The submissionSet unique ID

ParticipantObjectNameU

not specialized

4650

Patient (ifknown)(AuditMessage/
ParticipantObjectIdentif
ication)ParticipantObjectQueryU

not specialized

ParticipantObjectDetailUnot specialized

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3.43 Retrieve Document Set
4655

This section corresponds to transaction ITI-43 of the IHE Technical Framework. The Document
Consumer, Document Repository, On-Demand Document Source, and Initiating Gateway Actors
use transaction ITI-43.
Integration Profiles using this Transaction
Cross-Enterprise Document Sharing-b (XDS.b)
Cross-Community Access (XCA)

4660

Actors that support the Asynchronous Web Services Exchange Option shall support
Asynchronous Web Services Exchange on all XDS.b transactions they implement. Refer to
Section ITI TF-2x: V.5 Synchronous and Asynchronous Web Services Exchange for an
explanation of Asynchronous Web Services Exchange.
3.43.1 Scope

4665

This transaction is used by the Document Consumer to retrieve a set of documents from theDocument Repository, On-Demand Document Source, or Initiating Gateway. The Document
Consumer has already obtained the XDSDocumentEntry uniqueId and the Document Repository
repositoryUniqueId from the Document Registry/Initiating Gateway by means of the Registry
Stored Query transaction.

4670
3.43.2 Use Case Roles

Document
ConsumerDocument Repository,Integrated Document
Source/Repository, or
On-Demand Document Source

Initiating Gateway

Retrieve
Document Set

4675

Actor: Document Consumer
Role: Obtains document.
Actor: Document Repository or Integrated Document Source/Repository
Role: Provides documents.
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Actor: Initiating Gateway
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Role: An Initiating Gateway which implements the XDS Affinity Domain Option
retrieves a set of documents by using the Cross Gateway Retrieve transaction and/or a
Retrieve Document Set transaction.
Actor: On-Demand Document Source
Role: Creates documents in response to a request for retrieval of an on-demand
document entry.

4685

Note: Within this transaction, the Document Repository and Integrated Document Source/Repository Actors can be usedinterchangeably.

3.43.3 Referenced Standard
4690

Implementors of this transaction shall comply with all requirements described in ITI TF-2x:
Appendix V: Web Services for IHE Transactions.
ebRIM

OASIS/ebXML Registry Information Model v3.0

ebRS

OASIS/ebXML Registry Services Specifications v3.0

ITI TF-3:4

Metadata in Document Sharing profiles

MTOM

SOAP Message Transmission Optimization Mechanism http://www.w3.org/TR/soap12-mtom/

XOP

XML-binary Optimized Packaging http://www.w3.org/TR/2005/REC-xop10-20050125/

3.43.4 Interaction Diagram

Document
ConsumerDocument Repository/
Initiating Gateway/OnDemand Document Source
Retrieve Document Set Request

Retrieve Document Set Response

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3.43.4.1 Retrieve Document Set Request
3.43.4.1.1Trigger Events
4700

4705

The Document Consumer obtains document(s) uniqueId via the Registry Stored Query
transaction. If the Registry Stored Query was sent to the Initiating Gateway the Document
Consumer shall address the Retrieve Document Set to the Initiating Gateway. In this case no
resolution of repositoryUniqueId is needed by the Document Consumer. The Document
Consumer shall specify the homeCommunityId element in the Retrieve Document Set
transaction if it was found in the entry containing the uniqueId of the document being retrieved.
For more information regarding the homeCommunityId see Section 3.38.4.1.2.
Once the document(s) uniqueId have been obtained, the Document Consumer will start the
Retrieve Document Set Request with the Document Repository.
3.43.4.1.2 Message Semantics

4710

4715

4720

The Retrieve Document Set Request shall carry the following information:•

A required repositoryUniqueId that identifies the repository from which the document is
to be retrieved. This value corresponds to XDSDocumentEntry.repositoryUniqueId.

•

A required documentUniqueId that identifies the document within the repository. Thisvalue corresponds to the XDSDocumentEntry.uniqueId.

•

If available, the homeCommunityId element that identifies the community holding the
document. The homeCommunityId element shall be specified if the XDSDocumentEntry
containing the uniqueId of the document contains the homeCommunityId attribute. See
ITI TF-2a: 3.18.4.1.2 for details.

The repositoryUniqueId associated to each document requested can be different therefore
allowing a single request to identify multiple repositories.
3.43.4.1.3 Expected Actions
When receiving a Retrieve Document Set Request, a Document Repository or an Initiating
Gateway shall generate a Retrieve Document Set Response containing the requested documents
or error codes if the documents could not be retrieved.

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4730

An XCA Initiating Gateway receiving the Retrieve Document Set Request shall use thehomeCommunityId to obtain the Web Services endpoint of the Responding Gateways or, in thecase where homeCommunityId identifies the local community, use the repositoryUniqueId toobtain the Web Services endpoint of the Document Repositories. The process of obtaining the
Web Services endpoint is not further specified in this transaction. The Initiating Gateway shallsend Cross Gateway Retrieves/Retrieve Document Set transactions to each appropriate
Responding Gateway/Document Repository, consolidate the results, and return them to theDocument Consumer.

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3.43.4.1.3.1 Basic Patient Privacy Enforcement Option
If the Basic Patient Privacy Enforcement Option is implemented:
4735

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4745

1. The Document Consumer Actor shall abide by the XDS Affinity Domain Policies
represented by the confidentialityCode in the metadata associated with the document. The
Document Consumer Actor likely will have user access controls or business rulecapabilities to determine the details of how confidentiality codes apply to query results.
The details of this are product specific and not specified by IHE. These rules shall reduce
the query results to only those that are appropriate to the current situation for that actor
and user.
2. The Document Consumer Actor shall be able to be configured with Patient Privacy
Policies, Patient Privacy Policy Identifiers (OIDs) and associated information necessary
to understand and enforce the XDS Affinity Domain Policy. The details of this areproduct specific and not specified by IHE.
3.43.4.2 Retrieve Document Set Response
3.43.4.2.1 Trigger Events
This message will be triggered by a Retrieve Document Set Request Message
3.43.4.2.2 Message Semantics

4750

4755

The Retrieve Document Set Response Message shall carry the following information, for each of
the returned documents:•

A homeCommunityId. This value shall be the same as the homeCommunityId value in
the Retrieve Document Set Request Message. If the homeCommunityId value is notpresent in the Retrieve Document Set Request Message, this shall not be present.

•

A required repositoryUniqueId that identifies the repository from which the document is
to be retrieved. This value shall be the same as the value of the repositoryUniqueId in theoriginal Retrieve Document Set Request Message. This value corresponds to
XDSDocumentEntry.repositoryUniqueId.

•

A required documentUniqueId that identifies the document within the repository. Thisvalue shall be the same as the documentUniqueId in the original Retrieve Document Set
Request Message. This value corresponds to the XDSDocumentEntry.uniqueId.

•

The retrieved document as a XOP Infoset•

The MIME type of the retrieved document•

Errors or warnings in case the document(s) could not be retrieved successfully

4760

4765

If the documentUniqueId is associated with an On-Demand Document Entry, the Retrieve
Document Set Response Message shall contain a NewDocumentUniqueId element that identifies
the document that is returned in the Retrieve Document Set Response. This identifier shall be
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different than the DocumentUniqueId element which identifies the On-Demand Document Entry.
The Retrieve Document Set Response Message may also include a NewRepositoryUniqueId
element that identifies the Document Repository which holds the document returned in the
Retrieve Document Set Response. If this element is not included, the document returned in the
response has not been persisted for later retrieval. If the On-Demand Document Source
implements the Persistence of Retrieved Documents Option, this element shall be specified. If a
future Retrieve Document Set Message for the same DocumentUniqueId returns the same
NewDocumentUniqueId, the content of the document shall be identical to the prior returned
content. On-Demand Document Source Actors are encouraged to re-use Document uniqueId’s
whenever content has not changed in order to facilitate identification of new content by
Document Consumers.
3.43.4.2.3 Expected Actions

4780

A Document Repository or On-Demand Document Source shall return the document(s) indicatedin the request.
The Document Repository shall return the document or an error code in case the document could
not be return. The conditions of failure and possible error messages are given in the ebRS
standard and detailed in ITI TF-3: 4.2.4 Error Reporting.

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4790

An On-Demand Document Source which supports the Persistence of Retrieved Documents
Option shall save the document content returned in the retrieve response and register a Stable
Document Entry which describes the saved document. The On-Demand Document Source shallcomplete the registration of the Stable Document Entry prior to responding to the Retrieve
Document Set request. If a prior document has been saved this new document may, dependingon the type of data generated by the Document Source, replace the prior document. The
registration of the new Stable Document Entry shall include
A Submission Set
A DocumentEntry representing the stable DocumentEntry.
A HasMember association linking DocumentEntry to SubmissionSet.

4795

4800

An IsSnapshotOf Association which identifies the sourceObject as the new Stable Document
Entry and the targetObject as the On-Demand Document Entry which contains the uniqueID
used in the Retrieve Document Set request. See ITI TF-3: 4.2.2.2 for information about the
IsSnapshotOf Association.
If this is not the first request for this on-demand document and a prior document was replaced, aReplace Association which identifies the prior document.
3.43.4.2.3.1 Compatibility of Options
If the Document Consumer does not support the On-Demand Documents Option it will neversend a Retrieve Document Set request for an On-Demand Document entry. In this case, none of
the new attributes will be included in the response.
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If the Document Consumer does support the On-Demand Documents Option, it will only direct
requests for On-Demand Document Entries to responders which have specified their uniquerepositoryUniqueId in the On-Demand Document Entry from the registry. Thus, unless there isan error in the metadata, there are no compatibility concerns with this transaction.
3.43.5 Protocol Requirements

4810

Implementors of this transaction shall comply with all requirements described in ITI TF-2x:
Appendix V: Web Services for IHE Transactions.
The Retrieve Document Set transaction shall use SOAP12 and MTOM with XOP encoding(labeled MTOM/XOP in this specification). See ITI TF-2x: Appendix V for details. The
Document Repository shall:

4815

•

Accept the Retrieve Document Set Request message in MTOM/XOP format.

•

Generate the Retrieve Document Set Response message in MTOM/XOP format

The Document Consumer shall:•

Generate the Retrieve Document Set Request message in MTOM/XOP format.

•

Accept the Retrieve Document Set Response message in MTOM/XOP format.

4820
WSDL Namespace Definitions

4825

ihe

urn:ihe:iti:xds-b:2007rs

urn:oasis:names:tc:ebxml-regrep:xsd:rs:3.0

lcm

urn:oasis:names:tc:ebxml-regrep:xsd:lcm:3.0

query

urn:oasis:names:tc:ebxml-regrep:xsd:query:3.0

Document Repository: These are the requirements for the Retrieve Document Set transaction
presented in the order in which they would appear in the Document Repository WSDL
definition:•

The following types shall be imported (xsd:import) in the /definitions/types section:•

4830

namespace="urn:ihe:iti:xds-b:2007", schema="IHEXDS.xsd"•

The /definitions/message/part/@element attribute of the Retrieve Document Set Request
message shall be defined as “ihe:RetrieveDocumentSetRequest”•

The /definitions/message/part/@element attribute of the Retrieve Document Set
Response message shall be defined as “ihe:RetrieveDocumentSetResponse”•

Refer to Table 3.43.5.b below for additional attribute requirements

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To support the Asynchronous Web Services Exchange Option on the Document Consumer, theDocument Repository shall support the use of a non-anonymous response EPR in the WSAddressing replyTo header.
Table 3.43.5.b: Additional Attribute Requirements
Attribute

4840

Value

/definitions/portType/operation@name

DocumentConsumer_
RetrieveDocumentSet/definitions/portType/operation/input/@wsaw:Actionurn:ihe:iti:2007:
RetrieveDocumentSet/definitions/portType/operation/output/@wsa
w:Action

urn:ihe:iti:2007:
RetrieveDocumentSetResp
onse/definitions/binding/operation/soap12:operati
on/@soapAction

urn:ihe:iti:2007:
RetrieveDocumentSet

These are the requirements that affect the wire format of the SOAP message. The other WSDL
properties are only used within the WSDL definition and do not affect interoperability. Fullsample request and response messages are in Section 3.43.5.1 Sample SOAP Messages.
For informative WSDL for the Document Repository Actor see in ITI TF-2x: Appendix W.
The <ihe:RetrieveDocumentSetRequest/> element is defined as:
•

4845

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One or more <ihe:DocumentRequest/> elements, each one representing an individual
document that the Document Consumer wants to retrieve from the Document Repository.
Each <ihe:DocumentRequest/> element contains:•

A required <ihe:RepositoryUniqueId/> element that identifies the repository fromwhich the document is to be retrieved. This value corresponds to
XDSDocumentEntry.repositoryUniqueId.

•

A required <ihe:DocumentUniqueId/> that identifies the document within therepository. This value corresponds to the XDSDocumentEntry.uniqueId.

•

An optional <ihe:HomeCommunityId/> element that corresponds to the homeattribute of the Identifiable class in ebRIM.

This allows the Document Consumer to specify one or more documents to retrieve from theDocument Repository.
The <ihe:RetrieveDocumentResponse/> element is defined as:•

A required /ihe:RetrieveDocumentSetResponse/rs:RegistryResponse element•

An optional sequence of <ihe:DocumentResponse/> elements containing

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A <ihe:HomeCommunityId/> element. The value of this element shall be the same as
the value of the/RetrieveDocumentSetRequest/DocumentRequest/HomeCommunityId element in the
Retrieve Document Set Request Message. If the <ihe:HomeCommunityId/> element
is not present in the Retrieve Document Set Request Message, this value shall not bepresent.

4865•

A required <ihe:RepositoryUniqueId/> that identifies the repository from which the
document is to be retrieved. The value of this element shall be the same as the valueof the /RetrieveDocumentSetRequest/DocumentRequest/RepositoryUniqueId elementin the original Retrieve Document Set Request Message. This value corresponds to
XDSDocumentEntry.repositoryUniqueId.

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•

A required <ihe:DocumentUniqueId/> that identifies the document within therepository. The value of this element shall be the same as the value of the/RetrieveDocumentSetRequest/DocumentRequest/DocumentUniqueId element in theoriginal Retrieve Document Set Request Message. This value corresponds to
XDSDocumentEntry.uniqueId.

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•

A required <ihe:Document/> element that contains the retrieved document inbase64binary encoded format•

A required <ihe:mimeType/> element that indicates the MIME type of the retrieved
document•

An optional <ihe:NewDocumentUniqueId/> element that identifies the document
returned in the request when retrieval is of an On-Demand Document. This is required
when retrieval is of an On-Demand Document.

•

An optional <ihe:NewRepositoryUniqueId/> element that identifies the Document
Repository that will support retrieval of the document created as a result of retrieval of
the On-Demand Document. This is required when the On-Demand Document Source
supports the Persistence of Retrieved Documents Option.

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4885

The /RetrieveDocumentSetResponse/rs:RegistryResponse/@status attributes provides the overall
status of the request: It shall contain one of the following values:
urn:oasis:names:tc:ebxml-regrep:ResponseStatusType:Success
urn:ihe:iti:2007:ResponseStatusType:PartialSuccess4890

urn:oasis:names:tc:ebxml-regrep:ResponseStatusType:Failure

See ITI TF-3: 4.2.4 Error Reporting for the interpretation of these values.
For each document requested in a /RetrieveDocumentSetRequest/DocumentRequest element:

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•
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•

@severity is urn:oasis:names:tc:ebxml-regrep:ErrorSeverityType:Warning•@errorCode is specified•@codeContext contains the warning message•@location contains the DocumentUniqueId of the document requested•

The document shall be returned in an instance of/RetrieveDocumentSetResponse/DocumentResponse/Document as a XOP Infoset. The
returned document and warning are correlated via the DocumentUniqueId.

•

If an error is reported when retrieving a document, then a/RetrieveDocumentSetResponse/rs:RegistryResponse/rs:RegistryErrorList/
rs:RegistryError element shall be returned with:

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4910

If a warning is reported when retrieving the document, then a/RetrieveDocumentSetResponse/rs:RegistryResponse/rs:RegistryErrorList/
rs:RegistryError element shall be returned with:•@severity is urn:oasis:names:tc:ebxml-regrep:ErrorSeverityType:Error•@errorCode is specified•@codeContext contains the error message•@location contains the DocumentUniqueId of the document requested•

No corresponding RetrieveDocumentSetResponse/DocumentResponse element shall be
returned•If the document is successfully retrieved (without warning) then no/RetrieveDocumentSetResponse/rs:RegistryResponse/rs:RegistryErrorList/
rs:RegistryError element shall be present and a/RetrieveDocumentSetResponse/DocumentResponse/Document element shall be returned
containing the document as a XOP Infoset.

The /RetrieveDocumentSetResponse/rs:RegistryResponse/rs:ResponseSlotList element is not
used in this transaction.
4920

The /RetrieveDocumentSetResponse/rs:RegistryResponse/@requestId attribute is not used in thistransaction.
A full XML Schema Document for the XDS.b types is available online on the IHE FTP site, see
ITI TF-2x: Appendix W.
3.43.5.1 Sample SOAP Messages

4925

The samples in the following two sections show a typical request and its relative response. The
sample messages also show the WS-Addressing headers <Action/>, <MessageID/>,

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IHE IT Infrastructure Technical Framework, Volume 2b (ITI TF-2b): Transactions Part B______________________________________________________________________________<ReplyTo/>…; these WS-Addressing headers are populated according to ITI TF-2x: Appendix
V: Web Services for IHE Transactions.
3.43.5.1.1 Sample Retrieve Document Set SOAP Request
3.43.5.1.1.1 Synchronous Web Services Exchange
4930

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POST /tf6/services/xdsrepositoryb HTTP/1.1
Content-Type: multipart/related;boundary=MIMEBoundaryurn_uuid_3448B7F8EA6E8B9DFC1289514997517;
type="application/xop+xml";
start="<0.urn:uuid:3448B7F8EA6E8B9DFC1289514997518@apache.org>";
start-info="application/soap+xml"
User-Agent: Axis2
Host: ihexds.nist.gov:5000--MIMEBoundaryurn_uuid_3448B7F8EA6E8B9DFC1289514997517
Content-Type: application/xop+xml; charset=UTF-8;
type="application/soap+xml"
Content-Transfer-Encoding: binary
Content-ID: <0.urn:uuid:3448B7F8EA6E8B9DFC1289514997518@apache.org><?xml version='1.0' encoding='UTF-8'?><soapenv:Envelope xmlns:soapenv="http://www.w3.org/2003/05/soap-envelope"><soapenv:Header xmlns:wsa="http://www.w3.org/2005/08/addressing"><wsa:To soapenv:mustUnderstand="1">http://localhost:5000/tf6/services/xdsrepositoryb</wsa:To><wsa:MessageID soapenv:mustUnderstand="1">urn:uuid:3448B7F8EA6E8B9DFC1289514997508</wsa:MessageID><wsa:Action soapenv:mustUnderstand="1">urn:ihe:iti:2007:RetrieveDocumentSet</wsa:Action></soapenv:Header><soapenv:Body><RetrieveDocumentSetRequest xmlns="urn:ihe:iti:xds-b:2007"><DocumentRequest><RepositoryUniqueId>1.19.6.24.109.42.1.5</RepositoryUniqueId><DocumentUniqueId>1.42.20101110141555.15</DocumentUniqueId></DocumentRequest></RetrieveDocumentSetRequest></soapenv:Body></soapenv:Envelope>--MIMEBoundaryurn_uuid_3448B7F8EA6E8B9DFC1289514997517--

This request message is in MTOM/XOP format because request/response message pairs must
always be in the same format (MTOM/XOP vs. SIMPLE SOAP) and the response requires
MTOM/XOP: one part for descriptive metadata and a second part for document contents.
4970

3.43.5.1.1.2 Asynchronous Web Services Exchange<s:Envelope

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4980

xmlns:s="http://www.w3.org/2003/05/soap-envelope"
xmlns:a="http://www.w3.org/2005/08/addressing"><s:Header><a:Action s:mustUnderstand="1">urn:ihe:iti:2007:RetrieveDocumentSet</a:Action><a:MessageID>urn:uuid:0fbfdced-6c01-4d09-a110-2201afedaa02</a:MessageID><a:ReplyTo><a:Address>
http://192.168.2.4:9080/XdsService/DocumentConsumerReceiver.svc</a:Address>

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4995

</a:ReplyTo><a:To
s:mustUnderstand="1">http://localhost:2647/XdsService/DocumentRepositoryReceiver.svc</a:To></s:Header><s:Body><RetrieveDocumentSetRequest xmlns="urn:ihe:iti:xds-b:2007"><DocumentRequest><RepositoryUniqueId>1.3.6.1.4...1000</RepositoryUniqueId><DocumentUniqueId>1.3.6.1.4...2300</DocumentUniqueId></DocumentRequest><DocumentRequest><RepositoryUniqueId>1.3.6.1.4...1000</RepositoryUniqueId><DocumentUniqueId>1.3.6.1.4...2301</DocumentUniqueId></DocumentRequest></RetrieveDocumentSetRequest></s:Body></s:Envelope>3.43.5.1.2 Sample Retrieve Document Set SOAP Response
5000

3.43.5.1.2.1 Synchronous Web Services Exchange
In the following example, the HTTP header Transfer-Encoding: chunked and thecorresponding chunk annotations were removed for readability.

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HTTP/1.1 200 OK
Server: Apache-Coyote/1.1
Content-Type: multipart/related;boundary=MIMEBoundaryurn_uuid_E910375860336E2B8F1289514978310;
type="application/xop+xml";
start="0.urn:uuid:E910375860336E2B8F1289514978311@apache.org";
start-info="application/soap+xml";
Date: Thu, 11 Nov 2010 22:36:15 GMT--MIMEBoundaryurn_uuid_E910375860336E2B8F1289514978310
Content-Type: application/xop+xml; charset=UTF-8;
type="application/soap+xml"
Content-Transfer-Encoding: binary
Content-ID: <0.urn:uuid:E910375860336E2B8F1289514978311@apache.org><?xml version='1.0' encoding='UTF-8'?><soapenv:Envelope xmlns:soapenv="http://www.w3.org/2003/05/soap-envelope"
xmlns:wsa="http://www.w3.org/2005/08/addressing"><soapenv:Header><wsa:Action soapenv:mustUnderstand="1">urn:ihe:iti:2007:RetrieveDocumentSetResponse</wsa:Action><wsa:RelatesTo>urn:uuid:3448B7F8EA6E8B9DFC1289514997508</wsa:RelatesTo></soapenv:Header><soapenv:Body><xdsb:RetrieveDocumentSetResponse xmlns:xdsb="urn:ihe:iti:xds-b:2007"><rs:RegistryResponse xmlns:rs="urn:oasis:names:tc:ebxml-regrep:xsd:rs:3.0"
status="urn:oasis:names:tc:ebxml-regrep:ResponseStatusType:Success"/><xdsb:DocumentResponse><xdsb:RepositoryUniqueId>1.19.6.24.109.42.1.5</xdsb:RepositoryUniqueId><xdsb:DocumentUniqueId>1.42.20101110141555.15</xdsb:DocumentUniqueId><xdsb:mimeType>text/plain</xdsb:mimeType><xdsb:Document><xop:Include

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href="cid:1.urn:uuid:E910375860336E2B8F1289514978312@apache.org"
xmlns:xop="http://www.w3.org/2004/08/xop/include"/></xdsb:Document></xdsb:DocumentResponse></xdsb:RetrieveDocumentSetResponse></soapenv:Body></soapenv:Envelope>--MIMEBoundaryurn_uuid_E910375860336E2B8F1289514978310
Content-Type: text/plain
Content-Transfer-Encoding: binary
Content-ID: <1.urn:uuid:E910375860336E2B8F1289514978312@apache.org>
Four score and seven years ago our fathers brought forth on this continent a new nation,
conceived in Liberty, and dedicated to the proposition that all men are created equal.
--MIMEBoundaryurn_uuid_E910375860336E2B8F1289514978310--

This example shows the ‘wire format’ for MTOM/XOP. The Document element contains a<xop:Include> element that points to the document contents as a separate attachment.
Note:

5060

In some systems, the ‘in memory’ format replaces the <xop:Include> with the Base64 encoded contents of the
document. This is done so the entire message contents fits into an XML parse tree.

A second form of the response is possible, an un-optimized MTOM/XOP message. In this form
the message is still formatted as a multipart but the document contents is not split out into aseparate part of the multipart. Some popular Web Service toolkits generate this form for verysmall documents. The same response in this form looks like:
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HTTP/1.1 200 OK
Server: Apache-Coyote/1.1
Content-Type: multipart/related;boundary=MIMEBoundaryurn_uuid_E910375860336E2B8F1289514978310;
type="application/xop+xml";
start="0.urn:uuid:E910375860336E2B8F1289514978311@apache.org";
start-info="application/soap+xml";
Date: Thu, 11 Nov 2010 22:36:15 GMT--MIMEBoundaryurn_uuid_E910375860336E2B8F1289514978310
Content-Type: application/xop+xml; charset=UTF-8;
type="application/soap+xml"
Content-Transfer-Encoding: binary
Content-ID: <0.urn:uuid:E910375860336E2B8F1289514978311@apache.org><?xml version='1.0' encoding='UTF-8'?><soapenv:Envelope xmlns:soapenv="http://www.w3.org/2003/05/soap-envelope"
xmlns:wsa="http://www.w3.org/2005/08/addressing"><soapenv:Header><wsa:Action soapenv:mustUnderstand="1">urn:ihe:iti:2007:RetrieveDocumentSetResponse</wsa:Action><wsa:RelatesTo>urn:uuid:3448B7F8EA6E8B9DFC1289514997508</wsa:RelatesTo></soapenv:Header><soapenv:Body><xdsb:RetrieveDocumentSetResponse xmlns:xdsb="urn:ihe:iti:xds-b:2007"><rs:RegistryResponse
xmlns:rs="urn:oasis:names:tc:ebxml-regrep:xsd:rs:3.0"
status="urn:oasis:names:tc:ebxml-regrep:ResponseStatusType:Success"/><xdsb:DocumentResponse><xdsb:RepositoryUniqueId>1.19.6.24.109.42.1.5</xdsb:RepositoryUniqueId><xdsb:DocumentUniqueId

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>1.42.20101110141555.15</xdsb:DocumentUniqueId><xdsb:mimeType>text/plain</xdsb:mimeType><xdsb:Document>
Base64 encoded contents of document go here</xdsb:Document></xdsb:DocumentResponse></xdsb:RetrieveDocumentSetResponse></soapenv:Body></soapenv:Envelope>--MIMEBoundaryurn_uuid_E910375860336E2B8F1289514978310--

3.43.5.1.2.2 Asynchronous Web Services Exchange
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5125

5130

5135

<s:Envelope xmlns:s="http://www.w3.org/2003/05/soap-envelope"
xmlns:a="http://www.w3.org/2005/08/addressing"><s:Header><a:Action
s:mustUnderstand="1">urn:ihe:iti:2007:RetrieveDocumentSetResponse</a:Action><a:MessageID>urn:uuid:D6C21225-8E7B-454E-9750-821622C099DB</a:MessageID><a:RelatesTo>urn:uuid:0fbfdced-6c01-4d09-a110-2201afedaa02</a:RelatesTo><a:To
s:mustUnderstand="1">http://localhost:2647/XdsService/DocumentConsumerReceiver.svc</a:To></s:Header><s:Body><RetrieveDocumentSetResponse
xmlns="urn:ihe:iti:xds-b:2007"
xmlns:lcm="urn:oasis:names:tc:ebxml-regrep:xsd:lcm:3.0"
xmlns:query="urn:oasis:names:tc:ebxml-regrep:xsd:query:3.0"
xmlns:rim="urn:oasis:names:tc:ebxml-regrep:xsd:rim:3.0"
xmlns:rs="urn:oasis:names:tc:ebxml-regrep:xsd:rs:3.0"><rs:RegistryResponse status="urn:oasis:names:tc:ebxmlregrep:ResponseStatusType:Success"/><DocumentResponse><RepositoryUniqueId>1.3.6.1.4...1000</RepositoryUniqueId><DocumentUniqueId>1.3.6.1.4...2300</DocumentUniqueId><mimeType>text/xml</mimeType><Document>UjBsR09EbGhjZ0dTQUxNQUFBUUNBRU1tQ1p0dU1GUXhEUzhi</Document></DocumentResponse><DocumentResponse><RepositoryUniqueId>1.3.6.1.4...1000</RepositoryUniqueId><DocumentUniqueId>1.3.6.1.4...2300</DocumentUniqueId><mimeType>text/xml</mimeType>

5140<Document>UjBsR09EbGhjZ0dTQUxNQUFBUUNBRU1tQ1p0dU1GUXhEUzhi</Document></DocumentResponse></RetrieveDocumentSetResponse></s:Body></s:Envelope>5145

3.43.5.1.3 Sample Retrieve Document Set Response from On-Demand Document
Entry
The following example shows the response to retrieval of a dynamic document entry where theresponder supports later retrieval of the document created.

5150<s:Envelope xmlns:s="http://www.w3.org/2003/05/soap-envelope"
xmlns:a="http://www.w3.org/2005/08/addressing"><s:Header><a:Action
s:mustUnderstand="1">urn:ihe:iti:2007:RetrieveDocumentSetResponse</a:Action>
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<a:RelatesTo>urn:uuid:0fbfdced-6c01-4d09-a110-2201afedaa02</a:RelatesTo></s:Header><s:Body><RetrieveDocumentSetResponse
xmlns="urn:ihe:iti:xds-b:2007"
xmlns:lcm="urn:oasis:names:tc:ebxml-regrep:xsd:lcm:3.0"
xmlns:query="urn:oasis:names:tc:ebxml-regrep:xsd:query:3.0"
xmlns:rim="urn:oasis:names:tc:ebxml-regrep:xsd:rim:3.0"
xmlns:rs="urn:oasis:names:tc:ebxml-regrep:xsd:rs:3.0"><rs:RegistryResponse status="urn:oasis:names:tc:ebxmlregrep:ResponseStatusType:Success"/><DocumentResponse><RepositoryUniqueId>1.3.6.1.4...1000</RepositoryUniqueId><DocumentUniqueId>1.3.6.1.4...2300</DocumentUniqueId><NewDocumentUniqueId>1.3.6.1.4...2897</NewDocumentUniqueId><NewRepositoryUniqueId>1.3.6.1.4...1000</NewRepositoryUniqueId><mimeType>text/xml</mimeType><Document>UjBsR09EbGhjZ0dTQUxNQUFBUUNBRU1tQ1p0dU1GUXhEUzhi</Document></DocumentResponse><DocumentResponse><RepositoryUniqueId>1.3.6.1.4...1000</RepositoryUniqueId><DocumentUniqueId>1.3.6.1.4...2300</DocumentUniqueId><mimeType>text/xml</mimeType><Document>UjBsR09EbGhjZ0dTQUxNQUFBUUNBRU1tQ1p0dU1GUXhEUzhi</Document></DocumentResponse></RetrieveDocumentSetResponse></s:Body></s:Envelope>3.43.6 Security Considerations
5185

Relevant XDS Affinity Domain Security background is discussed in the XDS Security
Considerations Section (see ITI TF-1: 10.7).
3.43.6.1 Audit Record Considerations
The Retrieve Document Set transaction is either a PHI-Import event or a PHI-Export event,depending on the actor, as defined in ITI TF-2a: Table 3.20.6-1, with the following exceptions.

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5195

The Document Repository Actor, On-Demand Document Source, and Initiating Gateway shallgenerate an “Export” event. This may be an event for each Retrieve Document transaction, or
multiple transactions for the same patient may be heuristically combined. The heuristics for thiscombination are not specified by IHE. It is intended to reduce the volume of audit records.
Combination is permitted when the active participants and patient are the same, and the timedifference is considered insignificant.
The Document Consumer Actor shall generate an “Import” event. This may be one event pertransaction, or multiple transactions may be reported as a single event using a heuristic for
combining transactions. Combination is permitted when the active participants and patient are
the same, and the time difference is considered insignificant.
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If some documents were retrieved successfully and others were not, the Actors involved shallrecord a “success” audit event for those documents retrieved successfully and a “failure” audit
event for those documents not retrieved successfully.
3.43.6.1.1 Document Consumer audit message:
Field Name
Event
AuditMessage/
EventIdentification

Opt

Value Constraints

EventID

M

EV(110107, DCM, “Import”)

EventActionCodeM“C” (Create)

EventDateTimeM

not specialized

EventOutcomeIndicatorM

not specialized

EventTypeCode

M

EV(“ITI-43”, “IHE Transactions”, “Retrieve Document Set”)

Source (Document Repository) (1)Destination (Document Consumer) (1)
Human Requestor (0..n)
Audit Source (Document Consumer) (1)Patient (0..1)
Document (1..n) (see combining rules above)

Where:
SourceUserID

M

SOAP endpoint URI

AuditMessage/
ActiveParticipant

AlternativeUserIDU

not specialized

UserNameUnot specialized

UserIsRequestorM“false”

RoleIDCodeM

EV(110153, DCM, “Source”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointID

M

The machine name or IP address.

UserIDM

If Asynchronous Web Services Exchange is being used, the content of
the <wsa:ReplyTo/> element. Otherwise, not specialized.

AlternativeUserIDM

the process ID as used within the local operating system in the local
system logs.

UserNameUnot specialized

UserIsRequestorU

not specialized

Destination
AuditMessage/
ActiveParticipant

RoleIDCodeM

EV(110152, DCM, “Destination”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointID

M

The machine name or IP address.

UserID

M

Identity of the human that initiated the transaction.

AlternativeUserIDU

not specialized

UserNameUnot specialized

UserIsRequestorU

not specialized

RoleIDCodeU

Access Control role(s) the user holds that allows this transaction.

NetworkAccessPointTypeCode

NA

5205
Human
Requestor(if known)
AuditMessage/
ActiveParticipant

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NetworkAccessPointID

NA

Audit Source

AuditSourceIDU

not specialized

AuditMessage/
AuditSourceIdentification

AuditEnterpriseSiteIDU

not specialized

AuditSourceTypeCodeU

not specialized

ParticipantObjectTypeCodeM“1” (Person)

ParticipantObjectTypeCodeRole

M“1” (Patient)

ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCodeM

not specialized

ParticipantObjectSensitivityU

not specialized

ParticipantObjectID

M

The patient ID in HL7 CX format.

ParticipantObjectNameU

not specialized

ParticipantObjectQueryU

not specialized

ParticipantObjectDetailUnot specialized

ParticipantObjectTypeCodeM“2” (System)

ParticipantObjectTypeCodeRoleM“3” (report)

ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCodeM

not specialized

ParticipantObjectSensitivityU

not specialized

ParticipantObjectID

M

The value of <ihe:DocumentUniqueId/>

ParticipantObjectNameC

not specialized

ParticipantObjectQueryU

not specialized

M

The ParticipantObjectDetail element may occur more than once.
In one element, the value of <ihe:RepositoryUniqueId/> in value
attribute, “Repository Unique Id” in type attribute
In another element, the value of “ihe:homeCommunityID” as the valueof the attribute type and the value of the homeCommunityID as thevalue of the attribute value

Patient(if-known)(AuditMessage/
ParticipantObjectIdentif
ication)5210
Document(AuditMessage/
ParticipantObjectIdentif
ication)ParticipantObjectDetail3.43.6.1.2 Document Repository, On-Demand Document Source, and Initiating
Gateway audit message:
Field Name
Event
AuditMessage/
EventIdentification

Opt

Value Constraints

EventID

M

EV(110106, DCM, “Export”)

EventActionCodeM“R” (Read)

EventDateTimeM

not specialized

EventOutcomeIndicatorM

not specialized

EventTypeCode

M

EV(“ITI-43”, “IHE Transactions”, “Retrieve Document Set”)

Source (Document Repository) (1)

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Destination (Document Consumer) (1)Audit Source (Document Repository) (1)Document (1..n) (see combining rules above)

Where:
SourceAuditMessage/
ActiveParticipant

Destination
AuditMessage/
ActiveParticipant

UserID

M

SOAP endpoint URI

AlternativeUserIDM

the process ID as used within the local operating system in the local
system logs.

UserNameUnot specialized

UserIsRequestorM“false”

RoleIDCodeM

EV(110153, DCM, “Source”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointID

M

The machine name or IP address.

UserIDM

If Asynchronous Web Services Exchange is being used, the content of
the <wsa:ReplyTo/> element. Otherwise, not specialized.

AlternativeUserIDU

not specialized

UserNameUnot specialized

UserIsRequestorU

not specialized

RoleIDCodeM

EV(110152, DCM, “Destination”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointID

M

The machine name or IP address.

Audit Source

AuditSourceIDU

not specialized

AuditMessage/
AuditSourceIdentification

AuditEnterpriseSiteIDU

not specialized

AuditSourceTypeCodeU

not specialized

ParticipantObjectTypeCodeM“2” (System)

ParticipantObjectTypeCodeRoleM“3” (report)

ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCodeM

not specialized

ParticipantObjectSensitivityU

not specialized

ParticipantObjectID

M

The value of <ihe:DocumentUniqueId/>

ParticipantObjectNameC

not specialized

ParticipantObjectQueryU

not specialized

M

The ParticipantObjectDetail element may occur more than once.
In one element, the value of <ihe:RepositoryUniqueId/> in value
attribute, “Repository Unique Id” in type attribute
In another element, the value of “ihe:homeCommunityID” as the valueof the attribute type and the value of the homeCommunityID as thevalue of the attribute value

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Document
URI(AuditMessage/
ParticipantObjectIdentif
ication)ParticipantObjectDetail

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3.44 Patient Identity Feed HL7 V3This section corresponds to transaction ITI-44 of the IHE IT Infrastructure Technical
Framework. Transaction ITI-44 is used by the Patient Identity Source, Patient Identifier Crossreference Manager and Document Registry Actors.
3.44.1 Scope

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The scope is identical to ITI TF-2a: 3.8.1.
3.44.2 Use Case Roles
Patient Identifier
Cross-referenceManager

Patient Identity
SourceDocument
Registry

Patient Identity
Feed HL7 V3

Actor: Patient Identity Source
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Role: Provides notification to the Patient Identifier Cross-reference Manager and Document
Registry for any patient identification related events including: creation, updates, merges, etc.
Corresponding HL7 v3 Application Roles:
Patient Registry Informer (PRPA_AR201301UV02)
Actor: Patient Identifier Cross-reference Manager

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Role: Serves a well-defined set of Patient Identification Domains. Based on information
provided in each Patient Identification Domain by a Patient Identification Source Actor, it
manages the cross-referencing of patient identifiers across Patient Identification Domains.
Corresponding HL7 v3 Application Roles:
Patient Registry Tracker (PRPA_AR201302UV02)
Actor: Document Registry5240

Role: Uses patient identifiers provided by Patient Identity Source to ensure that XDS Documents
metadata registered is associated with a known patient and updates patient identity in document
metadata by tracking identity change operations (e.g., merge).
Corresponding HL7 v3 Application Roles:
Patient Registry Tracker (PRPA_AR201302UV02)

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3.44.3 Referenced Standards
HL7 Version 3 Edition 2008 Patient Administration DSTU, Patient Topic (found at
http://www.hl7.org/memonly/downloads/v3edition.cfm#V32008).
3.44.4 Interaction Diagrams

Document RegistryorPatient Identifier
Cross-referenceManager

Patient Identity
SourcePatient Registry Record Added
PRPA_IN201301UV02

Patient Registry Record Revised
PRPA_IN201302UV02

Patient Registry Duplicates Resolved
PRPA_IN201304UV02

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Figure 3.44-1: Patient Identity Sequence

3.44.4.1 Patient Identity Management – Add or Revise Patient Record
3.44.4.1.1 Trigger Events
The following events from a Patient Identity Source will trigger one of the Add or Revise Patient
Record messages:
5255

Patient Registry Record Added (PRPA_TE201301UV02)
This trigger event signals that a new patient was added to a Patient Identity Source.
Changes to patient demographics (e.g., change in patient name, patient address, etc.) shall trigger
the following Patient Registry Record Revised message:
Patient Registry Record Revised (PRPA_TE201302UV02)
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This trigger event signals that patient information was revised in a Patient Identity Source.
The Patient Identifier Cross-reference Manager shall only perform cross-referencing logic onmessages received from Patient Identity Source Actors. For a given Patient Identifier Domain
there shall be one and only one Patient Identity Source Actor, but a given Patient Identity Source
Actor may serve more than one Patient Identifier Domain.

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3.44.4.1.2 Message Semantics
The Patient Identity Feed transaction is carried out by the HL7 v3 Patient Activate(PRPA_MT201301UV02) and Patient Revise (PRPA_MT201302UV02) messages, as defined in
the subsequent sections. The Patient Identity Source shall generate the message whenever apatient is registered or when some piece of patient demographic data changes. The componentsof the message listed below are required, and their detailed descriptions are provided in thefollowing subsections.
Each message shall be acknowledged by the HL7 v3 Accept Acknowledgement(MCCI_MT000200UV01), which is described in ITI TF-2x: Appendix O.

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The message information model in Section 3.44.4.1.2.2.describes the relevant data elements forthis transaction. Specific requirements for the particular actors are found in Section 3.44.4.1.3
Expected Actions.
3.44.4.1.2.1 Major Components of the Patient Registry Record Added/Revised
Messages
Patient

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The Patient class is the entry point to the R-MIMs for the Patient Activate(PRPA_RM201301UV02) and Patient Revise (PRPA_RM201302UV02) models. The patient
identifiers are captured using an Instance Identifier (II) data type. Please see ITI TF-2x:
Appendix E for a detailed description about the use of the HL7 V3 II data type for patient
identifiers.

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Provider Organization
The Patient class is scoped by the provider organization where this person is a patient. The HL7
definition of the CMET requires that the provider organization needs to be identified by an id
attribute, and at least one of address, telecommunications address, or contact person to bepresent. The id attribute SHALL have only a root, expressed as an ISO OID.

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PersonThe Person class contains identifying and demographic data elements for the focal person
similar to those in the HL7 v2.x PID segment such as name, gender, date of birth, marital status
and deceased indicator and time.

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Language Communication
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Information about what language(s) should be used to communicate with the focal person can besent in the LanguageCommunication class.
PersonalRelationshipThis is used for sending information pertaining to the mother’s maiden name.
Citizen

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Citizenship information for a person, including citizen identifier and effective time can be sent in
the Citizen class. The nation that scopes the Citizen role, as identified by Nation.code, ismandatory.
Other Identifiers

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The OtherIDs class is used to capture other identifiers associated with the person such as adriver’s license number or social security number. In this transaction the IDs assigned by thescoping provider organization are represented in the id attribute of the Patient class. All other IDs
are represented in the OtherIDs class. For the purposes of interoperability where both HL7 V3and HL7 v2.x based transactions are used, the following requirement is imposed on the
OtherIDs.id attribute and on the scopingOrganization.id attribute:
OtherIDs.id.root SHALL be identical to scopingOrganization.id.root
scopingOrganization.id.extension SHALL NOT have any value
Please see ITI TF-2x: E.2 for details on the use of the II data type for patient identifiers.
3.44.4.1.2.2 Message Information Model of the Patient Registry Record
Added/Revised Messages

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Below is the Message Information Model for both the Patient Activate and Patient Revise
messages, as restricted for this transaction. The purpose of the model is to describe the data
elements relevant for this transaction. It is a strict common subset of the Patient Activate(PRPA_RM201301UV02) and Patient Revise (PRPA_RM201302UV02) RMIMs. While HL7
defines two models for the two messages, a single common subset is sufficient for the purposesof this IHE transaction.
The base RMIMs can be found on the HL7 V3 2008 Edition CD at
Edition2008/domains/uvpa/editable/PRPA_RM201301UV.htm andEdition2008/domains/uvpa/editable/PRPA_RM201302UV.htm. The following restrictions are
made on the original RMIMs to arrive at the restricted model:

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The focal entity choice is restricted to be only a person
The relationship holder of the personal relationship is restricted to be a person (using CMET
COCT_MT030207UV)The provider organization which is scoping the patient role is required in both the Add andRevise messages (it is optional in the original Revise message definition).
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The following roles are omitted:
asPatientOfOtherProvider
guarantor
guardiancontactParty

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asMembercareGiver
asStudent
The following participations are omitted:
subjectOf (administrativeObservation)

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coveredPartyOf (coverage)

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Figure 3.44.4.1.2-1: RMIM Diagram

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The attributes of this model are described in the following table. Note that CMETs are notdiscussed, as the HL7 definitions for them are being used.
Table 3.44.4.1.2-1: Model Attributes
PRPA_HD201301IHE
Patient Activate/Revise

This HMD extract defines the message used toreport that a new patient record was added, or apatient record was updated.
Derived from Figure 3.44.4.1.2-1(PRPA_RM201301IHE)

Patient

The primary record for the focal person in a Patient Identity SourceclassCode [1..1] (M)Patient (CS) {CNE:PAT}

Structural attribute; this is a "patient" roleid [1..*] (M)Identifiers designated by this patient identity source for the focal

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PRPA_HD201301IHE
Patient Activate/Revise

This HMD extract defines the message used toreport that a new patient record was added, or apatient record was updated.
Derived from Figure 3.44.4.1.2-1(PRPA_RM201301IHE)

Patient (SET<II>)personstatusCode [1..1]
Patient (CS) {CNE:active, fixed value= "active"}

A value specifying the state of this record in a patient registry(based on the RIM role class state-machine). This record is active.

confidentialityCode [0..*]Patient (SET<CE>) {CWE:Confidentiality}

Value(s) that control the disclosure of information about this living
subject as a patient

veryImportantPersonCode [0..1]
Patient (CE) {CWE:PatientImportance}

A code specifying the patient's special status granted by the scoperorganization, often resulting in preferred treatment and special
considerations. Examples include board member, diplomat.

PersonA subtype of LivingSubject representing a human being
Either Person.name or Patient.id must be non-nullclassCode [1..1] (M)Person (CS) {CNE:PSN, fixed value= "PSN"}

Structural attribute; this is a "person" entity

determinerCode [1..1] (M)Person (CS) {CNE:INSTANCE, fixed value="INSTANCE"}

Structural attribute; this is a specific personname [1..*]
Person (BAG<PN>)

Name(s) for this person

telecom [0..*]
Person (BAG<TEL>)

Telecommunication address(es) for communicating with this person

administrativeGenderCode [0..1]
Person (CE) {CWE:AdministrativeGender}

A value representing the gender (sex) of this person. Note: this
attribute does not include terms related to clinical gender which is acomplex physiological, genetic and sociological concept that
requires multiple observations in order to be comprehensively
described.

birthTime [0..1]
Person (TS)The date and time this person was born

deceasedInd [0..1]
Person (BL)An indication that this person is deaddeceasedTime [0..1]
Person (TS)The date and time this person diedmultipleBirthInd [0..1]
Person (BL)An indication that this person was part of a multiple birthmultipleBirthOrderNumber [0..1]
Person (INT)The order in which this person was born if part of a multiple birth

addr [0..*]
Person (BAG<AD>)

Address(es) for corresponding with this person

maritalStatusCode [0..1]
Person (CE) {CWE:MaritalStatus}

A value representing the domestic partnership status of this person

religiousAffiliationCode [0..1]
Person (CE) {CWE:ReligiousAffiliation}

A value representing the primary religious preference of this person

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PRPA_HD201301IHE
Patient Activate/Revise

This HMD extract defines the message used toreport that a new patient record was added, or apatient record was updated.
Derived from Figure 3.44.4.1.2-1(PRPA_RM201301IHE)

raceCode [0..*]
Person (SET<CE>) {CWE:Race}

A set of values representing the races of this person

ethnicGroupCode [0..*]
Person (SET<CE>) {CWE:Ethnicity}

A set of values representing the ethnic groups of this person

OtherIDs

Used to capture additional identifiers for the person such as a
Drivers’ license or Social Security Number. Please see notes abovein the Major Components section on the use of OtherIDs.

classCode [1..1] (M)Role (CS) {CNE:ROL}

Structural attribute. This can be any specialization of "role" except
for Citizen, or Employee.

id [1..*] (M)Role (SET<II>)

One or more identifiers issued to the focal person by the associatedscopingOrganization (e.g., a Driver’s License number issued by a
DMV)PersonalRelationship

A personal relationship between the focal living subject and anotherliving subject

classCode [1..1] (M)Role (CS) {CNE:PRS, fixed value= "PRS"}

Structural attribute; this is a "personal relationship" role

id [0..*]
Role (SET<II>)

Identifier(s) for this personal relationshipcode [1..1] (M)Role (CE) {CWE:PersonalRelationshipRoleType}A required value specifying the type of personal relationshipbetween the relationshipHolder and the scoping living subject
drawn from the PersonalRelationshipRoleType domain, forexample, spouse, parent, unrelated friend

statusCode [0..1]
Role (CE){CWE:RoleStatus}

A value specifying the state of this personal relationship (based on
the RIM Role class state-machine), for example, following divorce
a spouse relationship would be "terminated".

effectiveTime [0..1]
Role (IVL<TS>)

An interval of time specifying the period during which this personal
relationship is in effect, if such time is applicable and known.

CitizenUsed to capture person information relating to citizenship.

classCode [1..1] (M)Role (CS) {CNE:CIT, fixed value= "CIT"}

Structural attribute; this is a "citizen" role

id [0..*]
Role (SET<II>)

Identifier(s) for the focal person as a citizen of a nation

effectiveTime [0..1]
Employee (IVL<TS>)

An interval of time specifying the period during which this
employment relationship is in effect, if such time limit is applicableand known.

NationA politically organized body of people bonded by territory andknown as a nation.

classCode [1..1] (M)Organization (CS) {CNE:NAT, fixed value= "NAT"}

Structural attribute; this is a 'nation' type of entity

determinerCode [1..1] (M)Organization (CS) {CNE:INSTANCE, fixed value=

Structural attribute; this is a specific entity

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PRPA_HD201301IHE
Patient Activate/Revise

This HMD extract defines the message used toreport that a new patient record was added, or apatient record was updated.
Derived from Figure 3.44.4.1.2-1(PRPA_RM201301IHE)"INSTANCE"}
code [1..1] (M)Organization (CD) {CWE:NationEntityType}A value that identifies a nation statename [0..1]
Organization (ON)A non-unique textual identifier or moniker for this nation

Employee

A relationship of the focal person with an organization to receive
wages or salary. The purpose of this class is to identify the type of
relationship the employee has to the employer rather than the natureof the work actually performed. For example, it can be used tocapture whether the person is a Military Veteran or not..

classCode [1..1] (M)Employee (CS) {CNE:EMP}

Structural attribute; this is an "employee" role

statusCode [0..1]
Employee (CS) {CNE:RoleStatus}

A value specifying the state of this employment relationship (basedon the RIM Role class state-machine), for example, active,
suspended, terminated.

statusCode [0..1]
Employee (CS) {CNE:RoleStatus}

A value specifying the state of this employment relationship (basedon the RIM Role class state-machine), for example, active,
suspended, terminated.

effectiveTime [0..1]
Employee (IVL<TS>)

An interval of time specifying the period during which this
employment relationship is in effect, if such time limit is applicableand known.

occupationCode [0..1]
Employee (CE) {CWE:EmployeeOccupationCode}A code qualifying the classification of kind-of-work based upon arecognized industry or jurisdictional standard. OccupationCode isused to convey the person's occupation as opposed to jobClassCode(not used in this transaction) which characterizes this particular job.
For example, it can be used to capture whether the person is a
Military Veteran or not.

BirthPlace

The birthplace of the focal living subject.

classCode [1..1] (M)Birthplace (CS) {CNE:BIRTHPL}

Structural attribute; this is a "birthplace" role.

id [0..*]

A living subject's birth place represented by a unique identifier.

addr [0..*]Patient (BAG<AD>)

A living subject's birth place represented as an address. Note: Either
BirthPlace.addr or an associated Place.name must be valued.

classCode [1..1] (M)Birthplace (CS) {CNE:BIRTHPL}

Structural attribute; this is a "birthplace" role.

LanguageCommunication

A language communication capability of the focal person

languageCode [1..1] (M)LanguageCommunication (CE){CWE:HumanLanguage}

A value representing a language for which the focal person has
some level of proficiency for written or spoken communication.
Examples: Spanish, Italian, German, English, American Sign

preferenceInd [0..1]
LanguageCommunication (BL)An indicator specifying whether or not this language is preferred by
the focal person for the associated mode

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3.44.4.1.2.3 Control Act and Transmission Wrappers
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Please see ITI TF-2x: Appendix O for details on the IHE guidelines for implementing thewrappers. Table 3.44.4.1.2-2 contains the Transmission and Control Act wrappers used for thetwo interactions, and the associated constraints.
Table 3.44.4.1.2-2: Wrappers and Constraints
Transmission Wrapper

Trigger Event Control Act Wrapper

MCCI_MT000100UV01 – Send Message Payload

MFMI_MT700701UV01 – Master File / Registry
Notification Control Act, Role Subject

The value of interactionId SHALL be set to
PRPA_IN201301UV02 or PRPA_IN201302UV02
The value of processingModeCode SHALL be set to T
The acceptAckCode SHALL be set to AL
There SHALL be only one receiver Device

The trigger event code in ControlActProcess.code
SHALL be set to PRPA_TE201301UV02 or
PRPA_TE201302UV02 respectively
RegistrationEvent.statusCode SHALL be set to“active”
There SHALL be no InReplacementOf act
relationship for these interactions.

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The composite message schemas which describe the full payload of these interactions, including
the wrappers, can be found online on the IHE FTP site, see ITI TF-2x: Appendix W. The HL7
V3 2008 Normative Edition schemas are at
Edition2008/processable/multicacheschemas/PRPA_IN201301UV02.xsd andEdition2008/processable/multicacheschemas/PRPA_IN201302UV02.xsd).
3.44.4.1.2.4 Web Services Types and Messages
The Patient Registry Record Added/Revised messages will be transmitted using Web Services,
according to the requirements specified in ITI TF-2x: Appendix V.
The following WSDL naming conventions SHALL apply:

5365“add” message-> "PRPA_IN201301UV02_Message"“revise” message -> "PRPA_IN201302UV02_Message"
acknowledgement -> "MCCI_IN000002UV01_Message"

The following WSDL snippet describes the types for these messages:
5370

5375

5380

…
<types><xsd:schema elementFormDefault="qualified" targetNamespace="urn:hl7org:v3"
xmlns:hl7="urn:hl7-org:v3"><!-- Include the message schema --><xsd:import namespace="urn:hl7-org:v3"
schemaLocation="../schema/HL7V3/NE2008/multicacheschemas/PRPA_IN201301UV02.xsd"/><xsd:element name="PRPA_IN201301UV02"/></xsd:schema><xsd:schema elementFormDefault="qualified" targetNamespace="urn:hl7-org:v3"

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5395

xmlns:hl7="urn:hl7-org:v3"><!-- Include the message schema --><xsd:import namespace="urn:hl7-org:v3"
schemaLocation="../schema/HL7V3/NE2008/multicacheschemas/PRPA_IN201302UV02.xsd"/><xsd:element name="PRPA_IN201302UV02"/></xsd:schema><xsd:schema elementFormDefault="qualified" targetNamespace="urn:hl7-org:v3"
xmlns:hl7="urn:hl7-org:v3"><!-- Include the message schema --><xsd:import namespace="urn:hl7-org:v3"
schemaLocation="../schema/HL7V3/NE2008/multicacheschemas/MCCI_IN000002UV01.xsd"/><xsd:element name="MCCI_IN000002UV01"/></xsd:schema></types>…

The messages are described by the following snippet:
5400

5405

5410

…
<message name="PRPA_IN201301UV02_Message"><part element="hl7:PRPA_IN201301UV02" name="Body"/></message><message name="PRPA_IN201302UV02_Message"><part element="hl7:PRPA_IN201302UV02" name="Body"/></message><message name="MCCI_IN000002UV01_Message"><part element="hl7:MCCI_IN000002UV01" name="Body"/></message>…

The port types for the WSDL describing the Patient Identity Feed Service are described together
with the expected actions of the actors which receive these messages in Sections 3.44.4.1.3 and3.44.4.1.4.
3.44.4.1.3 Expected Actions – PIX Manager

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The Patient Identifier Cross-reference Manager shall be capable of accepting attributes specified
in Table 3.44.4.1.2-1 above. This is to ensure that the Patient Identifier Cross-reference Manager
can handle a sufficient set of corroborating information in order to perform its cross-referencing
function.
The Patient Identifier Cross-reference Manager shall only recognize a single Patient Identity
Source per domain.

5420

The cross-referencing process (algorithm, human decisions, etc.) is performed within the Patient
Identifier Cross-reference Manager, but its specification is beyond the scope of IHE.
Once the Patient Identifier Cross-reference Manager has completed its cross-referencing
function, it shall make the newly cross-referenced identifiers available to PIX queries and sendout notification to any Patient Identifier Cross-reference Consumers that have been configured as

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being interested in receiving such notifications using the PIX Update Notification HL7 V3transaction (see Section 3.46 for the details of that transaction).
3.44.4.1.3.1 Web Services Port Type and Binding Definitions
IHE-WSP201) The attribute /wsdl:definitions/@name SHALL be “PIXManager”.
The following WSDL naming conventions SHALL apply:5430

wsdl:definitions/@name="PIXManager":“add” message-> "PRPA_IN201301UV02_Message"“revise” message -> "PRPA_IN201302UV02_Message"
acknowledgement -> "MCCI_IN000002UV01_Message"
portType-> "PIXManager_PortType"add operation-> "PIXManager_PRPA_IN201301UV02"
revise operation -> "PIXManager_PRPA_IN201302UV02"
SOAP 1.2 binding -> "PIXManager_Binding_Soap12"
SOAP 1.2 port-> "PIXManager_Port_Soap12"

5435

5440

The following WSDL snippets specify the Patient Identity Feed Port Type and Binding
definitions, according to the requirements specified in ITI TF-2x: Appendix V.
3.44.4.1.3.1.1 Port Type

5445

5450

5455

<portType name="PIXManager_PortType"><operation name="PIXManager_PRPA_IN201301UV02"><input message="tns:PRPA_IN201301UV02_Message" wsaw:Action="urn:hl7org:v3:PRPA_IN201301UV02"/><output message="tns:MCCI_IN000002UV01_Message" wsaw:Action="urn:hl7org:v3:MCCI_IN000002UV01"/></operation><operation name="PIXManager_PRPA_IN201302UV02"><input message="tns:PRPA_IN201302UV02_Message" wsaw:Action="urn:hl7org:v3:PRPA_IN201302UV02"/><output message="tns:MCCI_IN000002UV01_Message" wsaw:Action="urn:hl7org:v3:MCCI_IN000002UV01"/></operation></portType>3.44.4.1.3.1.2 Bindings
SOAP 1.2 binding:
5460

…

5465

<binding name="PIXManager_Binding_Soap12" type="PIXManager_PortType"><wsoap12:binding style="document"
transport="http://schemas.xmlsoap.org/soap/http"/><operation name="PIXManager_PRPA_IN201301UV02"><wsoap12:operation soapAction="urn:hl7-org:v3:PRPA_IN201301UV02"/><input><wsoap12:body use="literal"/></input><output>
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5470<wsoap12:body use="literal"/></output></operation><operation name="PIXManager_PRPA_IN201302UV02"><wsoap12:operation soapAction="urn:hl7-org:v3:PRPA_IN201302UV02"/><input><wsoap12:body use="literal"/></input><output><wsoap12:body use="literal"/></output></operation></binding>

5475

5480
…

5485

An informative WSDL for the PIX Manager implementing the PIXV3 Profile is available online
on the IHE FTP site, see ITI TF-2x: Appendix W.
3.44.4.1.3.2 Message Examples
Message examples can be found online on the IHE FTP site, see ITI TF-2x: Appendix W.
3.44.4.1.4 Expected Actions – Document Registry

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5495

The Document Registry shall be capable of accepting attributes in the Patient Registry Record
Added or Patient Registry Record Revised messages as specified in Table 3.44.4.1.2-1. The
Patient Identity Feed transaction contains more than what the XDS Document Registry needs for
its operation.
The Document Registry shall store only the patient identifiers of the patient identification
domain designated by the Affinity Domain for document sharing in the registry. Patient
identifiers of other patient identification domains, if present in a received message, shall beignored.
3.44.4.1.4.1 Web Services Port Type and Binding Definitions
IHE-WSP201) The attribute /wsdl:definitions/@name SHALL be “DocumentRegistry”.
The following WSDL naming conventions SHALL apply:

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wsdl:definitions/@name="DocumentRegistry":"add" message-> "PRPA_IN201301UV02_Message""revise" message -> "PRPA_IN201302UV02_Message"
acknowledgement -> "MCCI_IN000002UV01_Message"
portType-> "DocumentRegistry_PortType"add operation-> "DocumentRegistry_PRPA_IN201301UV02"
revise operation -> "DocumentRegistry_PRPA_IN201302UV02"
SOAP 1.2 binding -> "DocumentRegistry_Binding_Soap12"
SOAP 1.2 port-> "DocumentRegistry_Port_Soap12"

The following WSDL snippets specify the Patient Identity Feed Port Type and Binding
definitions, according to the requirements specified in ITI TF-2x: Appendix V.
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3.44.4.1.3.1.1 Port Type
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<portType name="DocumentRegistry_PortType"><operation name="DocumentRegistry_PRPA_IN201301UV02"><input message="tns:PRPA_IN201301UV02_Message" wsaw:Action="urn:hl7org:v3:PRPA_IN201301UV02"/><output message="tns:MCCI_IN000002UV01_Message" wsaw:Action="urn:hl7org:v3:MCCI_IN000002UV01"/></operation><operation name="DocumentRegistry_PRPA_IN201302UV02"><input message="tns:PRPA_IN201302UV02_Message" wsaw:Action="urn:hl7org:v3:PRPA_IN201302UV02"/><output message="tns:MCCI_IN000002UV01_Message" wsaw:Action="urn:hl7org:v3:MCCI_IN000002UV01"/></operation></portType>3.44.4.1.3.1.2 Bindings
SOAP 1.2 binding:
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…
<binding name="DocumentRegistry_Binding_Soap12"
type="DocumentRegistry_PortType"><wsoap12:binding style="document"
transport="http://schemas.xmlsoap.org/soap/http"/><operation name="DocumentRegistry_PRPA_IN201301UV02"><wsoap12:operation soapAction="urn:hl7-org:v3:PRPA_IN201301UV02"/><input><wsoap12:body use="literal"/></input><output><wsoap12:body use="literal"/></output></operation><operation name="DocumentRegistry_PRPA_IN201302UV02"><wsoap12:operation soapAction="urn:hl7-org:v3:PRPA_IN201302UV02"/><input><wsoap12:body use="literal"/></input><output><wsoap12:body use="literal"/></output></operation></binding>…

An informative WSDL for the Document Registry implementing the XDS.b Profile is available
online on the IHE FTP site, see ITI TF-2x: Appendix W.
3.44.4.1.3.2 Message Examples
Message examples can be found online on the IHE FTP site, see ITI TF-2x: Appendix W.
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3.44.4.2 Patient Identity Management – Patient Identity Merge
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3.44.4.2.1 Trigger Events
When two patients’ records are found to identify the same patient by a Patient Identity Source ina Patient Identifier Domain, the Patient Identity Source shall indicate this information using thefollowing trigger:
Patient Registry Duplicates Resolved (PRPA_TE201304UV02)

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This trigger event signals that duplicate records were resolved in a patient registry.
A Patient Registry Duplicates Resolved message indicates that the Patient Identity Source hasdone a merge within a specific Patient Identification Domain. That is, the surviving identifier(patient ID) has subsumed a duplicate patient identifier.
3.44.4.2.2 Message Semantics

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The Patient Registry Duplicates Resolved interaction is carried out by the HL7 v3 Patient
Demographics message (PRPA_MT201303UV02). The message shall be generated by thesystem (Patient Identity Source) that performs the update whenever two patient records are found
to reference the same person.
The components of the HL7 Merge Patient message listed below are required, and the detailed
description of the message is provided in Sections 3.44.4.2.2.1 to 3.44.4.2.2.4.
Each message shall be acknowledged by the HL7 v3 Accept Acknowledgement(MCCI_MT000200UV01), which is described in ITI TF-2x: Appendix O.

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When two Patient identifiers are to be merged, the subsumed identifier is referenced in theRegistry Trigger Event Control Act Wrapper and the payload is sent for the surviving identifier.
For example, if Patients A, B, and C are all to be merged into Patient B, then two messages aresent. In the first message Patient A’s identifier is referenced in the Registry Trigger EventControl Act Wrapper via the replacementOf act relationship and Patients B’s identifier isreferenced in the Patient class of the payload. In the second message Patient C’s identifier isreferenced in the wrapper, and Patient B’s identifier is, again, in the payload.
The message information model in Section 3.44.4.2.2.2 describes the relevant data elements forthis transaction. Specific requirements for the particular actors are found in Section 3.44.4.2.3
Expected Actions.
3.44.4.2.2.1 Major Components of the Patient Registry Duplicates Resolved
Patient

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The Patient class is the entry point to the R-MIM for the Patient Demographics(PRPA_RM201303UV02) in the Patient Identity Source. The patient identifier is represented
using an Instance Identifier (II) data type. Please see ITI TF-2x: Appendix E for a detailed
description about the use of the HL7 V3 II data type for patient identifiers.

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Provider Organization
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The Patient class is scoped by the provider organization which is the assigning authority for thepatient’s identifier. For this message the provider organization class is optional. The HL7
definition of the CMET requires that the provider organization needs to be identified by an id
attribute, and at least one of address, telecommunications address, or contact person to bepresent. The id attribute SHALL have only a root expressed as an ISO OID, and it shall matchthe root of the Patient.id attribute
PersonThe Person class contains the name for the focal person (similarly to the requirement for the
HL7 v2.x PID segment).

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3.44.4.2.2.2 Message Information Model of the Patient Registry Duplicates
Resolved Message
Below is the Message Information Model for the Duplicates Resolved message, as restricted forthis transaction. The purpose of the model is to describe the data elements relevant for thistransaction. It is a strict subset of the Patient Demographics (PRPA_RM201303UV02) RMIM.

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The base RMIM can be found on the HL7 V3 2008 Edition CD at
Edition2008/domains/uvpa/editable/PRPA_RM201303UV.htm. The following restrictions weremade on the original RMIMs to arrive at the restricted model:•

The focal entity choice is restricted to be only a person•

All optional classes are removed•

All optional attributes in the Patient and Person class are removed

This restricted model makes clear the purpose of this message – it is to inform about the mergeof identities in the Patient Identity Source. If there are any updates to the demographics of thepatient in question, this information shall be relayed via a Patient Registry Record Revised
message. This follows the semantics of the Patient Identity Feed transaction as defined in ITI TF2a: 3.8, and is a restriction on the semantics of this message as defined by HL7 (where any
demographics information can be updated with the Duplicates Resolved message).
The provider organization is also optionally available.

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Figure 3.44.4.2.2-1: Message Information Model for Duplicates Resolved Message

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The attributes of this model are described in the following table.
Table 3.44.4.2.2-1: Model Attributes
PRPA_HD201303IHE
Duplicates Resolved

This HMD extract defines the message used toreport that two patient identifiers were merged (i.e.,a duplicate was resolved).
Derived from Figure 3.44.4.2.2-1(PRPA_RM201303IHE)

Patient

The primary record for the focal person in a Patient Identity SourceclassCode [1..1] (M)Patient (CS) {CNE:PAT}

Structural attribute; this is a "patient" roleid [1..*] (M)Patient (SET<II>)

Identifiers designated by various patient identity sources for the
focal person

statusCode [1..1]
Patient (CS) {CNE:active, fixed value= "active"}

A value specifying the state of this record in a patient registry(based on the RIM role class state-machine). This record is active.

PersonA subtype of LivingSubject representing a human being
Both Person.name and Patient.id must be non-nullclassCode [1..1] (M)Person (CS) {CNE:PSN, fixed value= "PSN"}

Structural attribute; this is a "person" entity

determinerCode [1..1] (M)Person (CS) {CNE:INSTANCE, fixed value=

Structural attribute; this is a specific person

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PRPA_HD201303IHE
Duplicates Resolved

This HMD extract defines the message used toreport that two patient identifiers were merged (i.e.,a duplicate was resolved).
Derived from Figure 3.44.4.2.2-1(PRPA_RM201303IHE)"INSTANCE"}
name [1..*]
Person (BAG<PN>)

Name(s) for this person

3.44.4.2.2.3 Control Act and Transmission Wrappers
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Please see ITI TF-2x: Appendix O for details on the IHE guidelines for implementing thewrappers. Table 3.44.4.1.2-2 contains the Transmission and Control Act wrappers used for thisinteraction, and the associated constraints.
Table 3.44.4.2.2-3: Wrappers and Constraints
Transmission Wrapper

Trigger Event Control Act Wrapper

MCCI_MT000100UV01 – Send Message Payload

MFMI_MT700701UV01 – Master File / Registry
Notification Control Act, Role Subject

The value of interactionId SHALL be set to
PRPA_IN201304UV02
The value of processingModeCode SHALL be set to T
The acceptAckCode SHALL be set to AL
There SHALL be only one receiver Device

The trigger event code in ControlActProcess.code
SHALL be set to PRPA_TE201304UV02
RegistrationEvent.statusCode SHALL be set to“active”
There SHALL be an InReplacementOf act
relationshipThe value of PriorRegistration.statusCode SHALL be“obsolete”
There SHALL be a PriorRegisteredRole role
There SHALL be a single PriorRegisteredRole.id
attribute, representing the subsumed patient
identifier.

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The composite message schemas which describe the full payload of this interaction, including
the wrappers, can be found online on the IHE FTP site, see ITI TF-2x: Appendix W. The
schemas from the HL7 V3 2008 Normative Edition can be found at
Edition2008/processable/multicacheschemas/PRPA_IN201304UV02.xsd).
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3.44.4.2.2.4 Web Services Types and Messages
The Patient Registry Resolve Duplicates message will be transmitted using Web Services,
according to the requirements specified in ITI TF-2x: Appendix V.
The following WSDL naming conventions SHALL apply:"resolve duplicates" message -> "PRPA_IN201304UV02_Message"

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Acknowledgement-> "MCCI_IN000002UV01_Message"

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The following WSDL snippet describes the types for these messages:

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…
<types><xsd:schema elementFormDefault="qualified" targetNamespace="urn:hl7org:v3"
xmlns:hl7="urn:hl7-org:v3"><!-- Include the message schema --><xsd:import namespace="urn:hl7-org:v3"
schemaLocation="../schema/HL7V3/NE2008/multicacheschemas/PRPA_IN201304UV02.xsd"/><xsd:element name="PRPA_IN201304UV02"/></xsd:schema><xsd:schema elementFormDefault="qualified" targetNamespace="urn:hl7-org:v3"
xmlns:hl7="urn:hl7-org:v3"><!-- Include the message schema --><xsd:import namespace="urn:hl7-org:v3"
schemaLocation="../schema/HL7V3/NE2008/multicacheschemas/MCCI_IN000002UV01.xsd"/><xsd:element name="MCCI_IN000002UV01"/></xsd:schema></types>…

The messages are described by the following snippet:
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…
<message name="PRPA_IN201304UV02_Message"><part element="hl7:PRPA_IN201304UV02" name="Body"/></message><message name="MCCI_IN000002UV01_Message"><part element="hl7:MCCI_IN000002UV01" name="Body"/></message>…

The port types for the WSDL describing the Resolved Duplicates Service are described together
with the expected actions of the actors which receive these messages in Section 3.44.4.2.3 and3.44.4.2.4.
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3.44.4.2.3 Expected Actions – PIX Manager
The Patient Identifier Cross-reference Manager shall be capable of accepting attributes in the
Resolve Duplicates message as specified in Table 3.44.4.2.2-1.
The Patient Identifier Cross-reference Manager shall perform the Expected Actions similar to theones specified in ITI TF-2a: 3.8.4.2.3. The particular behavior is described below.

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When the Patient Identifier Cross-reference Manager receives the Resolve Duplicates message
type of the Patient Identity Feed transaction, it shall cross-reference the patient identifiers
provided in the wrapper and the payload of the message by replacing any references it ismaintaining internally to the patient ID provided in the wrapper by the patient ID included in the
payload. After the identifier references are replaced, the Patient Identifier Cross-reference

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Manager shall reapply its internal cross-referencing logic/ policies before providing the updated
information via either the PIX Query or PIX Notification transactions.
3.44.4.2.3.1 Web Services Port Type and Binding Definitions
IHE-WSP201) The attribute /wsdl:definitions/@name SHALL be “PIXManager”.
The following WSDL naming conventions SHALL apply:

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wsdl:definitions/@name="PIXManager":“merge” message -> "PRPA_IN201304UV02_Message"
acknowledgement -> "MCCI_IN000002UV01_Message"
portType-> "PIXManager_PortType"merge operation -> "PIXManager_PRPA_IN201304UV02"
SOAP 1.2 binding -> "PIXManager_Binding_Soap12"
SOAP 1.2 port-> "PIXManager_Port_Soap12"

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The following WSDL snippets specify the Patient Identity Feed Port Type and Binding
definitions, according to the requirements specified in ITI TF-2x: Appendix V.
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3.44.4.2.3.1.1 Port Type<portType name="PIXManager_PortType"><operation name="PIXManager_PRPA_IN201304UV02"><input message="tns:PRPA_IN201304UV02_Message" wsaw:Action="urn:hl7org:v3:PRPA_IN201304UV02"/><output message="tns:MCCI_IN000002UV01_Message" wsaw:Action="urn:hl7org:v3:MCCI_IN000002UV01"/></operation></portType>3.44.4.2.3.1.2 Bindings
SOAP 1.2 binding:
…

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<binding name="PIXManager_Binding_Soap12" type="PIXManager_PortType"><wsoap12:binding style="document"
transport="http://schemas.xmlsoap.org/soap/http"/><operation name="PIXManager_PRPA_IN201304UV02"><wsoap12:operation soapAction="urn:hl7-org:v3:PRPA_IN201304UV02"/><input><wsoap12:body use="literal"/></input><output><wsoap12:body use="literal"/></output></operation></binding>…

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An informative WSDL for the PIX Manager implementing the PIXV3 Profile is available online
on the IHE FTP site, see ITI TF-2x: Appendix W.
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3.44.4.2.3.2 Message Examples
Message examples can be found online on the IHE FTP site, see ITI TF-2x: Appendix W.
3.44.4.2.4 Expected Actions – Document Registry

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The Document Registry shall be capable of accepting attributes in the Resolve Duplicatesmessage as specified in Table 3.44.4.2.2.2-1. Other attributes may exist, but the Document
Registry shall ignore them.
The Document Registry shall perform the Expected Actions similar to the ones specified in ITI
TF-2a: 3.8.4.2.4. The particular behavior is described below.

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When the Document Registry receives the Resolve Duplicates message of the Patient Identity
Feed transaction, it shall merge the patient identity specified in the PriorRegistrationRole.id
attribute of the Control-Act wrapper (subsumed patient identifier) into the patient identity
specified in Patient.id attribute of the message payload (surviving patient identifier) in its
registry. After the merge, all Document Submission Sets (including all Documents and Folders
beneath them) under the secondary patient identity before the merge shall point to the primarypatient identity. The secondary patient identity shall no longer be referenced in the futureservices provided by the Document Registry.
Changes resulting from a Resolve Duplicates message are not reversible. No un-resolve message
is supported by this transaction.

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See ITI TF-2a: 3.18.4.1.2.3.8.1 of the Technical Framework for details of how this message typeaffects results of a Stored Query transaction and the end of ITI TF-2a: 3.14.4.1.2.12 to see how it
affects the Register transaction.
A Resolve Duplicates message contains two attributes of interest:

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•

PriorRegistrationRole.id – subsumed patient identifier: the patient identifier which is tobecome obsolete•

Patient.id – surviving patient identifier: the patient identifier which is to remain active.

After a duplicate resolution, the Patient.id attribute represents all records formerly represented byeither the Patient.id attribute or the PriorRegistrationRole.id attribute. All other attributes may beignored.
The following conditions shall be detected by the Document Registry. Messages containing these
conditions shall not update the state of the Document Registry.

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•

The subsumed patient identifier is not issued by the correct Assigning Authority
according to the Affinity Domain configuration.

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•

The surviving patient identifier is not issued by the correct Assigning Authority
according to the Affinity Domain configuration.

•

The subsumed and surviving patient identifiers are the same.

•

The subsumed patient identifier has already been subsumed by an earlier message.

•

The surviving patient identifier has already been subsumed by and earlier message.

•

The subsumed patient identifier does not convey a currently active patient identifier
known to the Document Registry.

If none of the above conditions occur then the Document Registry shall perform the following
duties:
1. Records the merge. Only the subsumed and surviving patient identifiers need beremembered. A patient identifier merge affects the processing of future Register
Document Set [ITI-14] transactions. See ITI TF-2a: 3.14.4.1.2.12 XDS Registry Adaptor
for details.

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2. Multiple merge transactions can form a recorded merge chain, where the Subsumed
identifier of the current merge is the Surviving identifier of a previous merge.
3. Register Document Set transactions referencing a subsumed identifier are rejected with
an XDSUnknownPatientId error.
4. Stored Query transactions referencing a subsumed identifier return no content.

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5. Stored Query transactions referencing a surviving identifier successfully match the entire
recorded merge chain and return appropriate metadata.
6. No change in the Registry Query transaction.

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Note: This transaction does not specify how the merge is to be implemented. It may or may not change the stored form of
the metadata. It only specifies the observable results from the perspective of the Registry Stored Query
transaction [ITI-18] and the Register Document Set-b transaction [ITI-42].

3.44.4.2.4.1 Web Services Port Type and Binding Definitions
IHE-WSP201) The attribute /wsdl:definitions/@name SHALL be “DocumentRegistry”.
The following WSDL naming conventions SHALL apply:
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wsdl:definitions/@name="DocumentRegistry":"resolve duplicates" message -> "PRPA_IN201304UV02_Message"
acknowledgement-> "MCCI_IN000002UV01_Message"
portType-> "DocumentRegistry_PortType"
resolve duplicates operation -> "DocumentRegistry_PRPA_IN201304UV02"
SOAP 1.2 binding-> "DocumentRegistry_Binding_Soap12"
SOAP 1.2 port-> "DocumentRegistry_Port_Soap12"

The following WSDL snippets specify the Patient Identity Feed Port Type and Binding
definitions, according to the requirements specified in ITI TF-2x: Appendix V.

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3.44.4.2.4.1.1 Port Type
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<portType name="DocumentRegistry_PortType"><operation name="DocumentRegistry_PRPA_IN201304UV02"><input message="tns:PRPA_IN201304UV02_Message" wsaw:Action="urn:hl7org:v3:PRPA_IN201304UV02"/><output message="tns:MCCI_IN000002UV01_Message" wsaw:Action="urn:hl7org:v3:MCCI_IN000002UV01"/></operation></portType>3.44.4.2.4.1.2 Bindings
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SOAP 1.2 binding:
…

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<binding name="DocumentRegistry_Binding_Soap12"
type="DocumentRegistry_PortType"><wsoap12:binding style="document"
transport="http://schemas.xmlsoap.org/soap/http"/><operation name="DocumentRegistry_PRPA_IN201304UV02"><wsoap12:operation soapAction="urn:hl7-org:v3:PRPA_IN201304UV02"/><input><wsoap12:body use="literal"/></input><output><wsoap12:body use="literal"/></output></operation></binding>…

An informative WSDL for the Document Registry implementing the XDS.b Profile is available
online on the IHE FTP site, see ITI TF-2x: Appendix W.
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3.44.4.2.4.2 Message Examples
Message examples can be found online on the IHE FTP site, see ITI TF-2x: Appendix W.
3.44.5 Security Requirements

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This transaction is generally used in profiles that require actors to be grouped with a Secure
Node as defined in the IHE Audit Trail and Node Authentication Integration Profile. This use of
the ATNA Profile in an XDS Affinity Domain does not require a centralized XDS Affinity
Domain Audit Record Repository.
The use of ATNA along with XDS does require that each member of the XDS Affinity Domain
have audit and security mechanisms in place. See ITI TF-1: Appendix G and ITI-TF-2x:
Appendix K.

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The individual actors involved are often members of different secure domains. The data transfers
between different secure domains need different protection than transfers within a secure domain
and shall be encrypted with TLS authentication of both hosts.
Transfers within a single secure domain may choose to omit encryption if it is unnecessary, so it
is recommended that the online transfer security mechanisms be configurable. Certificate
management and exchange is defined as part of the XDS Affinity Domain business relationships
and no IHE Integration Profile is specified at this time, see ITI TF-1: Appendix L.
Each transaction will result in audit records describing the transaction. Each secure domain has
its own audit server to capture the records for the actors that are within that domain. Access toaudit records by other enterprises within the XDS Affinity Domain is managed and controlled by
the business relationship terms of the XDS Affinity Domain. There is no automatic IHE
transaction for such access.
3.44.5.1 Security Audit Record
When grouped with ATNA Secure Node or Secure Application Actors, this transaction is to beaudited as “Patient Record” event, as defined in ITI TF-2a: Table 3.20.6-1. The following tables
show items that are required to be part of the audit record for this transaction.
Logically, a merge operation consists of a delete on one patient record, and an update of another
patient record. Separate audit records shall be written for the delete operation and the update
operation.
3.44.5.1.1 Patient Identity Source audit message
Field Name
Event
AuditMessage/
EventIdentification

Opt

Value Constraints

EventID

M

EV(110110, DCM, “Patient Record”)

EventActionCodeM“C” (create) , “U” (update), or “D” (delete) as appropriate

EventDateTimeM

not specialized

EventOutcomeIndicatorM

not specialized

EventTypeCode

M

EV(“ITI-44”, “IHE Transactions”, “Patient Identity Feed”)

Source (Patient Identity Source Actor) (1)
Human Requestor (0..n)
Destination (Patient Identifier Cross-reference Manager or Document Registry) (1)Audit Source (Patient Identity Source Actor) (1)Patient (1)5865

Where:
SourceAuditMessage/
ActiveParticipant

UserIDU

not specialized

AlternativeUserIDM

the process ID as used within the local operating system in the local
system logs.

UserNameUnot specialized

UserIsRequestorU

not specialized

RoleIDCodeM

EV(110153, DCM, “Source”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointIDM

the machine name or IP address.

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UserIDM

identity of the human that initiated the transaction.

AlternativeUserIDU

not specialized

UserNameUnot specialized

UserIsRequestorU

not specialized

RoleIDCodeU

Access Control role(s) the user holds that allows this transaction.

NetworkAccessPointTypeCode

NA

NetworkAccessPointID

NA

Destination

UserID

M

SOAP endpoint URI.

AuditMessage/
ActiveParticipant

AlternativeUserIDU

not specialized

UserNameUnot specialized

UserIsRequestorU

not specialized

RoleIDCodeM

EV(110152, DCM, “Destination”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointIDM

the machine name or IP address.

Audit Source

AuditSourceIDU

not specialized

AuditMessage/
AuditSourceIdentification

AuditEnterpriseSiteIDU

not specialized

AuditSourceTypeCodeU

not specialized

ParticipantObjectTypeCodeM“1” (person)

ParticipantObjectTypeCodeRole

M“1” (patient)

ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCodeM

not specialized

ParticipantObjectSensitivityU

not specialized

ParticipantObjectIDM

the patient ID in HL7 CX format (see ITI TF-2x: appendix E)

ParticipantObjectNameU

not specialized

ParticipantObjectQueryU

not specialized

ParticipantObjectDetailM

Type=II (the literal string), Value=the value of message.id

Human
Requestor (ifknown)
AuditMessage/
ActiveParticipant

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Patient(AuditMessage/
ParticipantObjectIdentif
ication)5875

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3.44.5.1.2 Patient Identifier Cross-reference Manager audit message
Field Name
Event
AuditMessage/
EventIdentification

Opt

Value Constraints

EventID

M

EV(110110, DCM, “Patient Record”)

EventActionCodeM“C” (create) , “U” (update), or “D” (delete) as appropriate

EventDateTimeM

not specialized

EventOutcomeIndicatorM

not specialized

EventTypeCode

M

EV(“ITI-44”, “IHE Transactions”, “Patient Identity Feed”)

Source (Patient Identity Source Actor) (1)Destination (Patient Identifier Cross-reference Manager or Document Registry) (1)Audit Source (Patient Identifier Cross-reference Manager or Document Registry) (1)Patient(1)Where:
UserIDU

not specialized

AlternativeUserIDU

not specialized

UserNameUnot specialized

UserIsRequestorU

not specialized

RoleIDCodeM

EV(110153, DCM, “Source”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointIDM

the machine name or IP address.

Destination

UserID

M

SOAP endpoint URI

AuditMessage/
ActiveParticipant

AlternativeUserIDM

the process ID as used within the local operating system in the local
system logs.

UserNameUnot specialized

UserIsRequestorM“false”

SourceAuditMessage/
ActiveParticipant

RoleIDCodeM

EV(110152, DCM, “Destination”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointIDM

the machine name or IP address.

Audit Source

AuditSourceIDU

not specialized

AuditMessage/
AuditSourceIdentification

AuditEnterpriseSiteIDU

not specialized

AuditSourceTypeCodeU

not specialized

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Patient(AuditMessage/
ParticipantObjectIdentif
ication)ParticipantObjectTypeCodeM“1” (person)

ParticipantObjectTypeCodeRole

M“1” (patient)

ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCodeM

not specialized

ParticipantObjectSensitivityU

not specialized

ParticipantObjectIDM

the patient ID in HL7 CX format (see ITI TF-2x: appendix E).

ParticipantObjectNameU

not specialized

ParticipantObjectQueryU

not specialized

ParticipantObjectDetailM

Type=II (the literal string), Value=the value of message.id

3.44.5.1.3 Document Registry audit message
5890

Document Registry audit message are the same as Patient Identifier Cross-reference Manager
audit message as presented in Section 3.44.5.1.2.

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3.45 PIXV3 Query
5895

This section corresponds to transaction ITI-45 of the IHE IT Infrastructure Technical
Framework. Transaction ITI-45 is used by the Patient Identifier Cross-reference Consumer andPatient Identifier Cross-reference Manager Actors.
3.45.1 Scope
The scope is identical to ITI TF-2a: 3.9.1, PIX Query Scope.
3.45.2 Use Case Roles
Patient Identifier
Cross-reference
Consumer

Patient Identifier
Cross-referenceManager

PIXV3 Query

5900
Actor: Patient Identifier Cross-reference Consumer
Role: Queries the Patient Identifier Cross-reference Manager for a list of corresponding patient
identifiers, if any
Corresponding HL7 v3 Application Roles:
5905

Patient Registry Query Placer (PRPA_AR201303UV02)
Actor: Patient Identifier Cross-reference Manager
Role: Manages the cross-referencing of patient identifiers across Patient Identification Domains.
Upon request it returns a list of corresponding patient identifiers, if any.
Corresponding HL7 v3 Application Roles:

5910

Patient Registry Query Fulfiller (PRPA_AR201304UV02)
3.45.3 Referenced Standards
HL7 Version 3 Edition 2008 Patient Administration DSTU, Patient Topic (found at
http://www.hl7.org/memonly/downloads/v3edition.cfm#V32008)

5915

Implementers of this transaction shall comply with all requirements described in ITI TF-2x:
Appendix V Web Services for IHE Transactions.

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3.45.4 Interaction Diagrams
Patient Identity
Cross-Reference
Consumer

Patient Identifier
Cross-ReferenceManager

Patient Registry Get Identifiers Query
PRPA_IN201309UV02
Patient Registry Get Identifiers Query Response
PRPA_IN201310UV02

Figure 3.45.4-1: Get Corresponding Identifiers Sequence

3.45.4.1 Get Corresponding Identifiers
5920

3.45.4.1.1 Trigger Events
A Patient Identifier Cross-reference Consumer’s need to get the patient identifier associated witha domain for which it needs patient related information will trigger the request forcorresponding patient identifiers message based on the following HL7 trigger event:
Patient Registry Get Identifiers Query (PRPA_TE201309UV02)

5925

This query requests all other identifiers associated with a particular person identifier.
3.45.4.1.2 Message Semantics

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5935

The Get Corresponding Identifiers transaction is initiated by the HL7 Patient Registry Query by
Identifier (PRPA_MT201307UV02) message. The Patient Identifier Cross-reference Consumer
shall generate the query message whenever it needs to obtain corresponding patient identifier(s)from other Patient Identification Domain(s). The components of the message listed below arerequired, and their detailed descriptions are provided in the following subsections.
The receiver shall respond to the query by sending the Patient Identifiers message(PRPA_MT201304UV02), which uses the Application Level Acknowledgement transmission
wrapper. This satisfies the requirements of original mode acknowledgment; no intermediate
Accept Acknowledgement message is to be sent. All appropriate identifiers shall be returned in asingle response; therefore no continuation queries are allowed in this transaction.

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3.45.4.1.2.1 Major Components of the Patient Registry Query by Identifier
PatientIdentifier Parameter
5940

This required parameter specifies the identifier associated with the person whose information is
being queried. For this parameter item, a single patient identifier is specified in thePatientIdentifier.value attribute. Please see Appendix E for the use of the II data type for patient
identifiers.
DataSource Parameter

5945

This optional parameter specifies the assigning authority/authorities of the Patient Identity
Domain(s) whose identifiers need to be returned. If no such parameter is supplied, the PIXManager is required to return the identifiers from all known Patient Identity Domains.
3.45.4.1.2.2 Message Information Model of the Patient Registry Query by Identifier
Message

5950

5955

5960

Below is the Message Information Model for the Query by Identifier message, as restricted forthis transaction. The purpose of the model is to describe the data elements relevant for thistransaction. It is a strict subset of the Patient Registry Query by Identifier(PRPA_RM201307UV02) RMIM.
The base RMIM can be found on the HL7 V3 2008 Edition CD at
Edition2008/domains/uvpa/editable/PRPA_RM201307UV.htm. The following restrictions weremade on the original RMIMs to arrive at the restricted model:•

Exactly one PatientIdentifier parameter SHALL be present•

Exactly one PatientIdentifier.value attribute SHALL be present•

If one or more DataSource parameters are present, each SHALL contain exactly one
DataSource.value parameter•

The optional attributes ParameterList.id, QueryByParameter responseElementGroupId,
QueryByParameter.modifyCode, and QueryByParameter.executionAndDeliveryTime
were removed from the model•

QueryByParameter.responsePriorityCode is required and is fixed to I (Immediate)•

QueryByParameter.statusCode is defaulted to "new".

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Figure 3.45.4.1.2-1: Message Information Model for the Query by Identifier message

The attributes of this model are described in the following table.
5970
Table 3.45.4.1.2-2: Model Attributes
PRPA_HD201307IHE
Patient Registry Query by IdentifierThis HMD extract defines the message used toquery a patient registry for a list of identifiers.
Derived from Figure 3.45.4.1.2-1(PRPA_RM201307IHE)

QueryByParameter

The entry point for the domain content in this query

queryId [1..1]
QueryByParameter (II)Unique identifier for the query

statusCode [1..1] (M)QueryByParameter (CS) {CNE:QueryStatusCode,

There are no continuations necessary for this type of query, so thestatus is always "new"

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PRPA_HD201307IHE
Patient Registry Query by IdentifierThis HMD extract defines the message used toquery a patient registry for a list of identifiers.
Derived from Figure 3.45.4.1.2-1(PRPA_RM201307IHE)

fixed value="new"}responsePriorityCode [1..1]
QueryByParameter (CS) {CNE:QueryPriority, fixedvalue="I"}

The PIX manager is required to send an immediate response.

DataSource

Optional parameter specifying the assigning authority of a Patient
Identity Domain

value [1..1]
ParameterItem (II)The identifier for the Patient Identity Domain's assigning authority.
IHE restriction:
The value.root attribute SHALL be a valid ISO OID
The value.extension attribute SHALL NOT be present

semanticsText [1..1]
ParameterItem (ST){default= "DataSource.id"}
PatientIdentifier
value [1..1] (M)ParameterItem (II)The patient identifier known to the PIX Consumer

semanticsText [1..1]
ParameterItem (ST){default= "Patient.id"}

The Patient Identifier Cross-reference Consumer shall provide the patient identifier in thePatientIdentifier.value attribute according to the rules specified in ITI TF-2x: Appendix E.
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5985

If the requesting system wishes to select the Patient Identity Domains from which patient
identifiers are returned, it does so by sending as many DataSource parameters as domains forwhich it wants to receive patient identifiers. Each instance of the DataSource parameter shallprovide the Assigning Authority identifier for a specific domain using the DataSource.value
attribute. Note that the DataSource.value.extension attribute shall not be provided, and the
DataSource.value.root attribute shall contain a valid ISO OID. The responding system shallreturn the Patient.id value for each requested domain, if a value is known. Note that the value ofPatient.id.root attribute shall match the DataSource.value.root attribute representing thecorresponding Assigning Authority.
If no DataSource parameter is specified the Patient Identifier Cross-reference Manager shallreturn patient identifiers for all domains for which it possesses a corresponding identifier (subject
to local publication restrictions).
3.45.4.1.2.3 Control Act and Transmission Wrappers

5990

Please see ITI TF-2x: Appendix O for details on the IHE guidelines for implementing thewrappers. Table 3.44.4.1.2-2 contains the Transmission and Control Act wrappers used for thisinteraction, and the associated constraints.

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Table 3.45.4.1.2-4: Wrappers and Constraints
Transmission Wrapper

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Trigger Event Control Act Wrapper

MCCI_MT000100UV01 – Send Message Payload

QUQI_MT021001UV01 – Query Control Act
Request: Query By Parameter

The value of interactionId SHALL be set to
PRPA_IN201309UV02
The value of processingModeCode SHALL be set to T
The acceptAckCode SHALL be set to AL
There SHALL be only one receiver Device

The value of ControlActProcess.moodCode SHALL
be set to EVN
The trigger event code in ControlActProcess.code
SHALL be set to PRPA_TE201309UV02
The value of authorOrPerformer.typeCode SHALL
be set to AUT

The composite message schemas which describe the full payload of this interaction, including
the wrappers, can be found online on the IHE FTP site, see ITI TF-2x: Appendix W. The
schemas from the HL7 V3 2008 Normative Edition are at
Edition2008/processable/multicacheschemas/PRPA_IN201309UV02.xsd).
3.45.4.1.2.4 Web Services Types and Messages

6000

The Patient Registry Query by Identifier message and response will be transmitted using Web
Services, according to the requirements specified in ITI TF-2x: Appendix V.
The following WSDL naming conventions SHALL apply:
Query by Identifier -> "PRPA_IN201309UV02_Message"
Query Response-> "PRPA_IN201310UV02_Message"

The following WSDL snippet describes the types for these messages:
6005

6010

6015

6020

6025

…
<types><xsd:schema elementFormDefault="qualified" targetNamespace="urn:hl7org:v3"
xmlns:hl7="urn:hl7-org:v3"><!-- Include the message schema --><xsd:import namespace="urn:hl7-org:v3"
schemaLocation="../schema/HL7V3/NE2008/multicacheschemas/PRPA_IN201309UV02.xsd"/><xsd:element name="PRPA_IN201309UV02"/></xsd:schema><xsd:schema elementFormDefault="qualified" targetNamespace="urn:hl7-org:v3"
xmlns:hl7="urn:hl7-org:v3"><!-- Include the message schema --><xsd:import namespace="urn:hl7-org:v3"
schemaLocation="../schema/HL7V3/NE2008/multicacheschemas/PRPA_IN201310UV02.xsd"/><xsd:element name="PRPA_IN201310UV02"/></xsd:schema></types>…

The messages are described by the following snippet:…
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6035

<message name="PRPA_IN201309UV02_Message"><part element="hl7:PRPA_IN201309UV02" name="Body"/></message><message name="PRPA_IN201310UV02_Message"><part element="hl7:PRPA_IN201310UV02" name="Body"/></message>

The port types for the WSDL describing the Resolved Duplicates Service are described together
with the expected actions of the actors which receive these messages in Section 3.45.4.1.3.
3.45.4.1.3 Expected Actions
The Patient Identifier Cross-reference Manager shall be capable of accepting attributes as
specified in Table 3.45.4.1.2-1 above.

6040

The Patient Identifier Cross-reference Manager shall be capable of accepting multiple concurrent
PIX Query requests (Get Corresponding Identifiers messages) and responding correctly using the
Return Corresponding Identifiers message.
3.45.4.1.3.1 Web Services Port Type and Binding Definitions
IHE-WSP201) The attribute /wsdl:definitions/@name SHALL be “PIXManager”.
The following WSDL naming conventions SHALL apply:

6045

wsdl:definitions/@name="PIXManager":"get identifiers" query-> "PRPA_IN201309UV02_Message""get identifiers" response -> "PRPA_IN201310UV02_Message"
portType-> "PIXManager_PortType"get identifiers operation -> "PIXManager_PRPA_IN201309UV02"
SOAP 1.2 binding-> "PIXManager_Binding_Soap12"
SOAP 1.2 port-> "PIXManager_Port_Soap12"

6050

The following WSDL snippets specify the PIXV3 Query Port Type and Binding definitions,according to the requirements specified in ITI TF-2x: Appendix V.
6055

6060

6065

3.45.4.1.3.1.1 Port Type<portType name="PIXManager_PortType"><operation name="PIXManager_PRPA_IN201309UV02"><input message="tns:PRPA_IN201309UV02_Message" wsaw:Action="urn:hl7org:v3:PRPA_IN201309UV02"/><output message="tns:PRPA_IN201310UV02_Message" wsaw:Action="urn:hl7org:v3:PRPA_IN201310UV02"/></operation></portType>3.45.4.1.3.1.2 Bindings
SOAP 1.2 binding:…
<binding name="PIXManager_Binding_Soap12" type="PIXManager_PortType">
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<wsoap12:binding style="document"
transport="http://schemas.xmlsoap.org/soap/http"/><operation name="PIXManager_PRPA_IN201309UV02"><wsoap12:operation soapAction="urn:hl7-org:v3:PRPA_IN201309UV02"/><input><wsoap12:body use="literal"/></input><output><wsoap12:body use="literal"/></output></operation></binding>…

An informative WSDL for the PIX Manager implementing the PIXV3 Profile is available online
on the IHE FTP site, see ITI TF-2x: Appendix W.
6085

3.45.4.1.3.2 Message Examples
Message examples can be found online on the IHE FTP site, see ITI TF-2x: Appendix W.
3.45.4.2 Return Corresponding Identifiers
3.45.4.2.1 Trigger Events

6090

The Patient Identifier Cross-reference Manager’s response to the Get Corresponding Identifiers
message will trigger the following message:
Patient Registry Get Identifiers Query Response (PRPA_TE201310UV02)
This query response returns all other identifiers associated with a particular person identifier.
3.45.4.2.2 Message Semantics

6095

The Return Corresponding Identifiers message is conducted by the HL7 Patient Identifiers
message. The Patient Identifier Cross-reference Manager shall generate this message in direct
response to the Patient Registry Query by Identifier message previously received. This message
satisfies the Application Level, Original Mode Acknowledgement for the query message.
3.45.4.2.2.1 Major Components of the Get Corresponding Identifiers Query
Response

6100

Patient
The Patient class is the entry point to the R-MIM for the Patient Identifiers(PRPA_RM201304UV02). This is where at least one of the requested patient IDs will be listed.
PersonThe Person class contains the name of the patient for additional verification purposes.
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6110

Provider Organization
The Patient class is optionally scoped by the provider organization where this person is a patient.
The HL7 definition of the CMET requires that the provider organization needs to be identified
by an id attribute, and at least one of address, telecommunications address, or contact person to
be present. The id attribute SHALL have only a root, expressed as an ISO OID, and at least oneof the id attributes of the Patient class SHALL have a matching root component. See ITI TF-2x:
Appendix E on the use of the II data type for patient identifiers.
Other Identifiers

6115

6120

The OtherIDs class can optionally be used to capture other identifiers associated with the personsuch as driver’s license number or social security number). It is important to recognize that the
HL7 RIM distinguishes between person-level IDs and patient-level IDs. In this transaction,
however, the Patient Identity Cross-Reference Manager has the option to send all identifiers in
the id attributes of the Patient class. If that is the case, the OtherIDs class shall not be used. For
the purposes of interoperability where both HL7 V3 and HL7 v2.x based transactions are used,
and the OtherIDs class is present, the following requirement is imposed on the OtherIDs.id
attribute and on the scopingOrganization.id attribute:
OtherIDs.id.root SHALL be identical to scopingOrganization.id.root
scopingOrganization.id.extension SHALL NOT have any value
3.45.4.2.2.2 Message Information Model of the Patient Identifiers Message

6125

Below is the Message Information Model for the Patient Identifiers message, as restricted for thistransaction. The purpose of the model is to describe the data elements relevant for thistransaction. It is a strict subset of the Patient Identifiers (PRPA_RM201304UV02) RMIM.
The base RMIM can be found on the HL7 V3 2008 Edition CD at
Edition2008/domains/uvpa/editable/PRPA_RM201304UV.htm. The following restrictions weremade on the original RMIMs to arrive at the restricted model:

6130

•

The focal entity choice is restricted to be only a person•

All optional classes are removed, except for the provider organization, and otheridentifiers•

All optional attributes in the Patient and Person class are removed

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Figure 3.45.4.2.2-1: Message Information Model for the Patient Identifiers Message

The attributes of this model are described in the following table.
6140
Table 3.45.4.2.2-3: Model Attributes
PRPA_HD201304IHE
PatientIdentifiersThis HMD extract defines the message used torespond to the Patient Registry Query By Identifier
Derived from Figure 3.45.4.2.2-1(PRPA_RM201304IHE)

Patient

The primary record for the focal person in a Patient Identity CrossReference Manager

classCode [1..1] (M)Patient (CS) {CNE:PAT}

Structural attribute; this is a "patient" roleid [1..*] (M)Patient (SET<II>)

Linked patient identifiers from one or more Patient Identity
Domains

statusCode [1..1]
Patient (CS) {CNE:active, fixed value= "active"}

A value specifying the state of this record in a patient registry(based on the RIM role class state-machine). This record is active.

PersonA subtype of LivingSubject representing a human being
Both Person.name and Patient.id must be non-nullclassCode [1..1] (M)Structural attribute; this is a "person" entity

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PRPA_HD201304IHE
PatientIdentifiersThis HMD extract defines the message used torespond to the Patient Registry Query By Identifier
Derived from Figure 3.45.4.2.2-1(PRPA_RM201304IHE)

Person (CS) {CNE:PSN, fixed value= "PSN"}
determinerCode [1..1] (M)Person (CS) {CNE:INSTANCE, fixed value="INSTANCE"}

Structural attribute; this is a specific personname [1..*]
Person (BAG<PN>)

Name(s) for this person

OtherIDs

Used to capture additional identifiers for the person such as a
Drivers’ license or Social Security Number.

classCode [1..1] (M)Role (CS) {CNE:ROL}

Structural attribute. This can be any specialization of "role"id [1..*] (M)Role (SET<II>)

One or more identifiers issued to the focal person by the associatedscopingOrganization (e.g., a Driver’s License number issued by aDMV)

3.45.4.2.2.3 Control Act and Transmission Wrappers

6145

Please see ITI TF-2x: Appendix O for details on the IHE guidelines for implementing thewrappers. Table 3.44.4.1.2-2 contains the Transmission and Control Act wrappers used for thisinteraction, and the associated constraints.
Table 3.45.4.4.2-5: Wrappers and Constraints
Transmission Wrapper

6150

Trigger Event Control Act Wrapper

MCCI_MT000300UV01 – Send Application
Acknowledgement

MFMI_MT700711UV01 – Master File/Registry
Query Response Control Act (Role Subject)

The value of interactionId SHALL be set to
PRPA_IN201310UV02
The value of processingModeCode SHALL be set to T
The acceptAckCode SHALL be set to NE
There SHALL be only one receiver Device

The value of ControlActProcess.moodCode SHALL
be set to EVN
The trigger event code in ControlActProcess.code
SHALL be set to PRPA_TE201310UV02
There SHALL be zero or one RegistrationEvents
present in this message.
If a RegistrationEvent is part of the message, there
SHALL be exactly one Patient role present in the
payload.
There SHALL be no replacementOf act-relationshippresent in this message
There SHALL be a QueryByParameter copy of theoriginal query.

The composite message schemas which describe the full payload of this interaction, including
the wrappers, can be found online on the IHE FTP site, see ITI TF-2x: Appendix W. The

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schema from the HL7 V3 2008 Normative Edition are at
Edition2008/processable/multicacheschemas/PRPA_IN201310UV02.xsd).
3.45.4.2.2.4 Web Services Types and Messages
6155

Since this is a response to a query, please see Section 3.45.4.1.2.4 for the web services
components of this message.
3.45.4.2.3 Expected Actions - Patient Identifier Cross-reference Manager
The Patient Identifier Cross-reference Manager shall return the attributes within the message thatare required by the HL7 standard, as shown in Figure 3.45.4.2.2-1.

6160

6165

6170

6175

6180

6185

A RegistrationEvent, and the associated Patient class are returned only when the Patient
Identifier Cross-reference Manager recognizes the specified Patient ID in the query parameter,
and an identifier exists for the specified patient in at least one other domain. The Patient
Identifier Cross-reference Manager shall use at one or more Patient.id attributes (and, optionally,
zero or more OtherIDs.id attributes) to convey the patient IDs which uniquely identify the patient
within each Patient Identification Domain. The identifiers are captured using an Instance
Identifier (II) data type. See ITI TF-2x: Appendix E for a detailed description of the use of the IIdata type for patient identifiers.
It is wholly the responsibility of the Patient Identifier Cross-reference Manager to perform thematching of patient identifiers based on the patient identifier it receives. The information
provided by the Patient Identifier Cross-reference Manager to the Patient Identifier Crossreference Consumer is a list of cross-referenced identifiers in one or more of the domains
managed by the Patient Identifier Cross-reference Manager, in addition to the original identifier
used in the query. The identifier used in the query is returned only in the copy of theQueryByParameter parameter list. The list of cross-references is not made available until the setof policies and processes for managing the cross-reference function have been completed. The
policies of administering identities adopted by the cooperating domains are completely internal
to the Patient Identifier Cross-reference Manager and are outside of the scope of this framework.
Possible matches should not be communicated until the healthcare institution policies andprocesses embodied in the Patient Identifier Cross-reference Manager reach a positive matchingdecision.
The Patient Identifier Cross-reference Manager shall respond to the query request as describedby the following 6 cases:
Case 1: The Patient Identifier Cross-reference Manager recognizes the specified Patient ID sentby the Patient Identifier Cross-reference Consumer in PatientIdentifier.value, and corresponding
identifiers exist for the specified patient in at least one of the domains requested in
DataSource.value (one identifier per domain). (See Case 6 below for the required behavior if
there are multiple identifiers recognized within a given Identifier Domain by the Patient
Identifier Cross-reference Manager.)
AA (application accept) is returned in Acknowledgement.typeCode (transmission wrapper).
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IHE IT Infrastructure Technical Framework, Volume 2b (ITI TF-2b): Transactions Part B______________________________________________________________________________OK (data found, no errors) is returned in QueryAck.queryResponseCode (control act wrapper).
6190

A single RegistrationEvent class is returned, where at least one of the identifiers, which thePatient Identifier Cross-reference Manager did recognize as belonging to a requested domain, isreturned in Patient.id. Subsequent such identifiers, if any, are returned in either Patient.id or
OtherIDs.id, not including the queried-for patient identifier that is returned in theQueryByParameter parameter list (control act wrapper).

6195

Case 2: The Patient Identifier Cross-reference Manager recognizes the specified Patient ID sentby the Patient Identifier Cross-reference Consumer in PatientIdentifier.value, there are no
specific domains requested in the query (no DataSource parameters are present), andcorresponding identifiers exist for the specified patient in at least one other domain known to thePatient Identifier Cross-reference Manager (one identifier per domain).

6200

AA (application accept) is returned in Acknowledgement.typeCode (transmission wrapper).
OK (data found, no errors) is returned in QueryAck.queryResponseCode (control act wrapper).

6205

6210

A single RegistrationEvent class is returned, where at least one of the identifiers, which thePatient Identifier Cross-reference Manager did recognize as belonging to a domain different fromthe domain of the queried-for patient identifier, is returned in Patient.id. Subsequent such
identifiers, if any, are returned in either Patient.id or OtherIDs.id, not including the queried-for
patient identifier, which is returned in the QueryByParameter parameter list (control act
wrapper).
Case 3: The Patient Identifier Cross-reference Manager recognizes the specified Patient ID sent
in PatientIdentifier.value, but no identifier exists for that patient in any of the domains sent in
DataSource.value.
AA (application accept) is returned in Acknowledgement.typeCode (transmission wrapper).
NF (no data found, no errors) is returned in QueryAck.queryResponseCode (control act
wrapper).
No RegistrationEvent is returned.

6215

The queried-for patient identifier is returned in the QueryByParameter parameter list (control act
wrapper).
Case 4: The Patient Identifier Cross-reference Manager does not recognize the Patient ID sent in
the PatientIdentifier.value.

6220

AE (application error) is returned in Acknowledgement.typeCode (transmission wrapper) and in
QueryAck.queryResponseCode (control act wrapper).
No RegistrationEvent is returned.
The queried-for patient identifier is returned in the QueryByParameter parameter list (control act
wrapper).

6225

An AcknowledgmentDetail class is returned in which the attributes typeCode, code, and location
are valued as follows.
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Attribute

VALUE

typeCodeEcode

204 (Unknown Key Identifier)location

XPath expression for the value element of the PatientIdentifier parameter

Case 5: The Patient Identifier Cross-reference Manager does not recognize one or more of thePatient Identification Domains for which an identifier has been requested.
6230

AE (application error) is returned in Acknowledgement.typeCode (transmission wrapper) and in
QueryAck.queryResponseCode (control act wrapper).
No RegistrationEvent is returned.
The queried-for patient identification domains are returned in the QueryByParameter parameter
list (control act wrapper).

6235

For each domain that was not recognized, an AcknowledgmentDetail class is returned in which
the attributes typeCode, code, and location are valued as follows:
Attribute

6240

VALUE

typeCodeE

Code

204 (Unknown Key Identifier)Location

XPath expression for the value element of the DataSource parameter(which includes the repetition number of the parameter)

Case 6: The Patient Identifier Cross-reference Manager recognizes the specified Patient ID sentby the Patient Identifier Cross-reference Consumer in PatientIdentifier.value, and corresponding
identifiers exist for the specified patient in at least one of the domains requested in
DataSource.value, and there are multiple identifiers within at least one of the requested domains.
AA (application accept) is returned in Acknowledgement.typeCode (transmission wrapper).
OK (data found, no errors) is returned in QueryAck.queryResponseCode (control act wrapper)

6245

6250

A single RegistrationEvent class is returned, where at least one of the identifiers, which thePatient Identifier Cross-reference Manager did recognize as belonging to a requested domain, isreturned in Patient.id. Subsequent such identifiers, if any, are returned in either Patient.id or
OtherIDs.id, not including the queried-for patient identifier that is returned in theQueryByParameter parameter list (control act wrapper).
If the Patient Identifier Cross-reference Manager chooses to return multiple identifiers
associated with the same domain, it shall return these identifiers either grouped in a single
instance of the OtherIDs class, or all represented via repetitions of the Patient.id attribute.
3.45.4.2.3.1 Web Services Port Type and Binding Definitions
The WSDL snippets for this message are shown in Section 3.45.4.1.3.1
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3.45.4.2.3.2 Message Examples
Message examples can be found online on the IHE FTP site, see ITI TF-2x: Appendix W.
6255

3.45.4.2.4 Expected Actions - Patient Identifier Cross-reference Consumer

6260

The Patient Identifier Cross-reference Consumer will use the list of patient identifier aliases
provided by the Patient Identifier Cross-reference Manger to perform the functions, for which it
requested the list. The identifiers found in both Patient.id and OtherIDs.id attributes shall beconsidered together to form a complete list of patient identifiers from the different Patient
Identity domains (either requested or available).
In the case where the returned list of identifiers contains multiple identifiers for a single domain,
the Patient Identifier Cross-reference Consumer shall either use ALL of the multiple identifiers
from the given domain or it shall ignore ALL of the multiple identifiers from the given domain.

6265

6270

This allows Patient Identifier Cross-reference Consumers capable of handling multiple identities
for a single patient within a single domain (i.e., those that can correctly aggregate theinformation associated with the different identifiers) to do so. For those Patient Identifier Crossreference Consumers not capable of handling this situation, ignoring the entire list of different
identifiers prevents the consumer from presenting incomplete data.
3.45.5 Security Requirements
No transaction specific security considerations.
3.45.5.1 Audit Record Considerations
When grouped with ATNA Secure Node or Secure Application Actors, this transaction is to beaudited as “Query Information” event, as defined in ITI TF-2a: Table 3.20.6-1. The following
tables show items that are required to be part of the audit record for this transaction.

6275

3.45.5.1.1 Patient Identifier Cross-reference Consumer audit message:
Field Name

Event
AuditMessage/
EventIdentification

Opt

Value Constraints

EventID

M

EV(110112, DCM, “Query”)

EventActionCodeM“E” (Execute)

EventDateTimeM

not specialized

EventOutcomeIndicatorM

not specialized

EventTypeCode

M

EV(“ITI-45”, “IHE Transactions”, “PIX Query”)

Source (Patient Identifier Cross-reference Consumer) (1)
Human Requestor (0..n)
Destination (Patient Identifier Cross-reference Manager) (1)Audit Source (Patient Identity Cross-reference Consumer) (1)Patient (0..n)Query Parameters(1)HL7, HEALTH LEVEL SEVEN and CDA are the registered trademarks of Health Level Seven International.

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Where:
SourceAuditMessage/
ActiveParticipant

UserIDU

not specialized

AlternativeUserIDM

the process ID as used within the local operating system in the local
system logs.

UserNameUnot specialized

UserIsRequestorU

not specialized

RoleIDCodeM

EV(110153, DCM, “Source”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointIDM

the machine name or IP address.

UserIDM

identity of the human that initiated the transaction.

AlternativeUserIDU

not specialized

UserNameUnot specialized

UserIsRequestorU

not specialized

RoleIDCodeU

Access Control role(s) the user holds that allows this transaction.

NetworkAccessPointTypeCode

NA

NetworkAccessPointID

NA

Destination

UserID

M

AuditMessage/
ActiveParticipant

AlternativeUserIDU

not specialized

UserNameUnot specialized

UserIsRequestorM“false”

Human
Requestor(if known)
AuditMessage/
ActiveParticipant

6280
SOAP endpoint URI

RoleIDCodeM

EV(110152, DCM, “Destination”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointIDM

the machine name or IP address.

Audit Source

AuditSourceIDU

not specialized

AuditMessage/
AuditSourceIdentification

AuditEnterpriseSiteIDU

not specialized

AuditSourceTypeCodeU

not specialized

ParticipantObjectTypeCodeM“1” (Person)

ParticipantObjectTypeCodeRole

M“1” (Patient)

ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCodeM

not specialized

ParticipantObjectSensitivityU

not specialized

ParticipantObjectID

M

The patient ID in HL7 CX format (see ITI TF-2x: appendix E).

ParticipantObjectNameU

not specialized

Patient(AuditMessage/
ParticipantObjectIdentif
ication)ParticipantObjectQueryU

not specialized

ParticipantObjectDetailUnot specialized

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6285

Query
Parameters

ParticipantObjectTypeCodeM“2” (system object)

ParticipantObjectTypeCodeRole

M“24” (query)(AuditMessage/
ParticipantObjectIdentif
ication)ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCode

M

EV(“ITI-45”, “IHE Transactions”, “PIX Query”)

ParticipantObjectSensitivityU

not specialized

ParticipantObjectIDU

not specialized

ParticipantObjectNameU

not specialized

ParticipantObjectQueryM

the QueryByParameter segment of the query, base64 encoded

ParticipantObjectDetailUnot specialized

3.45.5.1.2 Patient Identifier Cross-reference Manager audit message:
Event
AuditMessage/
EventIdentification

Field Name

Opt

Value Constraints

EventID

M

EV(110112, DCM, “Query”)

EventActionCodeM“E” (Execute)

EventDateTimeM

not specialized

EventOutcomeIndicatorM

not specialized

EventTypeCode

M

EV(“ITI-45”, “IHE Transactions”, “PIX Query”)

Source (Patient Identifier Cross-reference Manager) (1)Destination (Patient Identifier Cross-reference Consumer) (1)Audit Source (Patient Identifier Cross-reference Manager) (1)Patient (0..n)Query Parameters(1)Where:
UserIDU

not specialized

AlternativeUserIDU

not specialized

UserNameUnot specialized

UserIsRequestorU

not specialized

RoleIDCodeM

EV(110153, DCM, “Source”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointIDM

the machine name or IP address.

Destination

UserID

M

SOAP endpoint URI

AuditMessage/
ActiveParticipant

AlternativeUserIDM

the process ID as used within the local operating system in the local
system logs.

UserNameUnot specialized

UserIsRequestorM“false”

RoleIDCodeM

EV(110152, DCM, “Destination”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointIDM

the machine name or IP address.

Audit Source

AuditSourceIDU

not specialized

AuditMessage/
AuditSourceIdentification

AuditEnterpriseSiteIDU

not specialized

AuditSourceTypeCodeU

not specialized

SourceAuditMessage/
ActiveParticipant

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Patient(AuditMessage/
ParticipantObjectIdentif
ication)ParticipantObjectTypeCodeM“1” (Person)

ParticipantObjectTypeCodeRole

M“1” (Patient)

ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCodeM

not specialized

ParticipantObjectSensitivityU

not specialized

ParticipantObjectID

M

The patient ID in HL7 CX format (see ITI TF-2x: appendix E).

ParticipantObjectNameU

not specialized

ParticipantObjectQueryU

not specialized

ParticipantObjectDetailUnot specialized

ParticipantObjectTypeCodeM“2” (system object)

ParticipantObjectTypeCodeRole

M“24” (query)

ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCode

M

EV(“ITI-45”, “IHE Transactions”, “PIX Query”)

ParticipantObjectSensitivityU

not specialized

ParticipantObjectIDU

not specialized

ParticipantObjectNameU

not specialized

ParticipantObjectQueryM

the QueryByParameter segment of the query, base64 encoded

ParticipantObjectDetailUnot specialized

6290
Query
Parameters(AuditMessage/
ParticipantObjectIdentif
ication)

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3.46 PIXV3 Update Notification
6295

This section corresponds to transaction ITI-46 of the IHE IT Infrastructure Technical
Framework. Transaction ITI-46 is used by the Patient Identifier Cross-reference Consumer andPatient Identifier Cross-reference Manager Actors.
3.46.1 Scope
The scope is identical to the scope of transaction ITI-10, described in ITI TF-2a: 3.10.1.
3.46.2 Use Case Roles
Patient Identifier
Cross-reference
Consumer

Patient Identifier
Cross-referenceManager

PIXV3 Update
Notification

6300
Actor: Patient Identifier Cross-reference Manager

6305

Role: It serves a well-defined set of Patient Identification Domains. The Patient Identifier Crossreference Manager manages the cross-referencing of patient identifiers across Patient
Identification Domains by providing a list of patient ID “aliases” via notification to a configured
list of interested Patient Identifier Cross-reference Consumers.
Corresponding HL7 v3 Application Roles:
Patient Registry Informer (PRPA_AR201301UV02)
Actor: Patient Identifier Cross-reference Consumer

6310

Role: Receives notifications from the Patient Identifier Cross-reference Manager of changes topatient ID aliases. Typically the Patient Identifier Cross-reference Consumer uses thisinformation to maintain information links about patients in a different patient ID domain.
Corresponding HL7 v3 Application Roles:
Patient Registry Tracker (PRPA_AR201302UV02)
3.46.3 Referenced Standards

6315

HL7 Version 3 Edition 2008 Patient Administration DSTU, Patient Topic (found at
http://www.hl7.org/memonly/downloads/v3edition.cfm#V32008)
Implementers of this transaction shall comply with all requirements described in ITI TF-2x:
Appendix V Web Services for IHE Transactions.

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3.46.4 Interaction Diagrams

Patient Identifier
Cross-Reference
Consumer

Patient Identifier
Cross-ReferenceManager

Patient Registry Record Revised
PRPA_IN201302UV02

6320
Figure 3.46-1: Update Patient Information Sequence

3.46.4.1 Update Patient Information
3.46.4.1.1 Trigger Events
6325

6330

The Patient Identifier Cross-reference Manager shall notify a Patient Identifier Cross-reference
Consumer when there is a change in a set of cross-referenced patient identifiers for any of thepatient identifiers belonging to Patient Identifier Domains of interest to the consumer. The
configuration of the domains of interest to a Patient Cross-reference Consumer is maintained by
the Patient Cross-reference Manager.
Several notifications may have to be issued to communicate a single update to a set of crossreference patient identifiers as required to reflect all the changes on the resulting sets of crossreference patient Identifiers belonging to Patient Identifier Domains of interest to the Patient
Identifier Cross-referencing Consumer.
The following HL7 trigger event will be used to update to the list of patient identifiers:
Patient Registry Record Revised (PRPA_TE201302UV02)

6335

This trigger event signals that patient information was revised in a patient registry.
3.46.4.1.2 Message Semantics
The PIX Update Notification transaction is conducted by the Patient Revise(PRPA_MT201302UV02) message. The Patient Identifier Cross-reference Manager initiates thistransaction whenever identifier list information is updated for a patient.

6340

Each message shall be acknowledged by the HL7 V3 Accept Acknowledgement(MCCI_MT000200UV01), which is described in ITI TF-2x: Appendix O.
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6345

6350

It is wholly the responsibility of the Patient Identifier Cross-reference Manager to perform thematching of patient identifiers based on the patient traits it receives. The information provided by
the Patient Identifier Cross-reference Manager to Patient Identifier Cross-reference Consumer
Actors shall only contain a list of cross-referenced identifiers for the domains of interest as
configured with the Patient Identifier Cross-reference Manager in two or more of the domains
managed by the Patient Identifier Cross-reference Manager. Multiple notifications may need to
be sent. For example:
Consumer CON_A is configured to receive update notifications for domains DOM_A and
DOM_AD. Notifications are sent as follows:
A PIXV3 Patient Registry Record Add message is sent for a patient for DOM_A. The
update notification shall contain the patient identifier for DOM_A.

6355

6360

6365

6370

6375

A PIXV3 Patient Registry Record Add message is processed for DOM_AD. The Patient
Identifier Cross-reference Manager cross references this patient with DOM_A. The
update notification shall contain the patient identifiers for both DOM_A and
DOM_AD.
A PIXV3 Patient Registry Record Revise message is processed for DOM_AD changing
the patient address. The Patient Identifier Cross-reference Manager cross references
determines this patient is no longer the same patient as DOM_A. Two update
notifications shall be sent. One containing the patient identifier for DOM_A. The
other one containing the patient identifier for DOM_AD.
The list of cross-references is not made available until the set of policies and processes for
managing the cross-reference function have been completed. The policies of administering
identities adopted by the cooperating domains are completely internal to the Patient Identifier
Cross-reference Manager and are outside of the scope of this transaction. Possible matches
should not be communicated until the healthcare institution policies and processes embodied in
the Patient Identifier Cross-reference Manager reach a positive matching decision.
The Patient Identifier Cross-reference Manager shall have configuration indicating which
Identity Consumers are interested in receiving the PIXV3 Update Notification transactions. Thisconfiguration information shall include identification of the identity consumer systems interested
in receiving notifications and, for each of those systems, a list of the patient identifier domains ofinterest. The Patient Identifier Cross-reference Manager should account for consumers interested
in all domains.
Each message shall be acknowledged by the Accept Acknowledgment message sent by thereceiver of the Patient Registry Record Revise message to its sender.
3.46.4.1.2.1 Major Components of the Patient Registry Record Revised
Patient
The Patient class is the entry point to the R-MIM for the Patient Revise(PRPA_RM201302UV02). This is where the updated list of patient identifiers will be present.
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6380

PersonThe Person class contains the name of the patient for additional verification purposes.
Provider Organization

6385

The Patient class is optionally scoped by the provider organization where this person is a patient.
The HL7 definition of the CMET requires that the provider organization needs to be identified
by an id attribute, and at least one of address, telecommunications address, or contact person to
be present. The id attribute SHALL have only a root, expressed as an ISO OID, and at least oneof the id attributes of the Patient class SHALL have a matching root component (see ITI TF-2x:
Appendix E on the use of the II data type for patient identifiers).
Other Identifiers

6390

6395

The OtherIDs class can be optionally used to capture other identifiers associated with the personsuch as driver’s license number or social security number). It is important to recognize that the
HL7 RIM distinguishes between person-level IDs and patient-level IDs. In this transaction,
however, the Patient Identity Cross-Reference Manager has the option to send all identifiers in
the id attributes of the Patient class. If that is the case, the OtherIDs class shall not be used. For
the purposes of interoperability where both HL7 V3 and HL7 v2.x based transactions are used,
and the OtherIDs class is present, the following requirement is imposed on the OtherIDs.id
attribute and on the scopingOrganization.id attribute:
OtherIDs.id.root SHALL be identical to scopingOrganization.id.root
scopingOrganization.id.extension SHALL NOT have any value

6400

3.46.4.1.2.2 Message Information Model of the Patient Registry Record Revise
Message
Below is the Message Information Model for the Patient Identifiers message, as restricted for thistransaction. The purpose of the model is to describe the data elements relevant for thistransaction. It is a strict subset of the Patient Revise (PRPA_RM201302UV02) RMIM.

6405

The base RMIM can be found on the HL7 V3 2008 Edition CD at
Edition2008/domains/uvpa/editable/PRPA_RM201302UV.htm. The following restrictions weremade on the original RMIMs to arrive at the restricted model (note that the resulting model is
identical to the one described in Section 3.45.4.2.2.2):
The focal entity choice is restricted to be only a person

6410

All optional classes are removed, except for the provider organization, and otheridentifiers
All optional attributes in the Patient and Person class are removed

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6415

Figure 3.46.4.1.2-1: Message Information Model for the Patient Identifiers Message

The attributes of this model are described in the following table.
Table 3.46.4.1.2-4: Model Attributes
PRPA_HD201302IHE
PatientRevise

This HMD extract defines the message used tosend a Patient Update Notification
Derived from Figure 3.46.4.1.2-1(PRPA_RM201302IHE)

Patient

The primary record for the focal person in a Patient Identity CrossReference Manager

classCode [1..1] (M)Patient (CS) {CNE:PAT}

Structural attribute; this is a "patient" roleid [1..*] (M)Patient (SET<II>)

Linked identifiers from one or more Identity Domains

statusCode [1..1]
Patient (CS) {CNE:active, fixed value= "active"}

A value specifying the state of this record in a patient registry(based on the RIM role class state-machine). This record is active.

PersonA subtype of LivingSubject representing a human being
Both Person.name and Patient.id must be non-nullclassCode [1..1] (M)Person (CS) {CNE:PSN, fixed value= "PSN"}

Structural attribute; this is a "person" entity

determinerCode [1..1] (M)Structural attribute; this is a specific person

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PRPA_HD201302IHE
PatientRevise

This HMD extract defines the message used tosend a Patient Update Notification
Derived from Figure 3.46.4.1.2-1(PRPA_RM201302IHE)

Person (CS) {CNE:INSTANCE, fixed value="INSTANCE"}

6420

name [1..*]
Person (BAG<PN>)

Name(s) for this person

OtherIDs

Used to capture additional identifiers for the person such as a
Drivers’ license or Social Security Number.

classCode [1..1] (M)Role (CS) {CNE:ROL}

Structural attribute. This can be any specialization of "role"id [1..*] (M)Role (SET<II>)

One or more identifiers issued to the focal person by the associatedscopingOrganization (e.g., a Driver’s License number issued by aDMV)

3.46.4.1.2.3 Control Act and Transmission Wrappers
Please see ITI TF-2x: Appendix O for details on the IHE guidelines for implementing thewrappers. Table 3.46.4.1.2-2 contains the Transmission and Control Act wrappers used for thetwo interactions, and the associated constraints.

6425

Table 3.46.4.1.2-6: Wrappers and Constraints
Transmission Wrapper

6430

Trigger Event Control Act Wrapper

MCCI_MT000100UV01 – Send Message Payload

MFMI_MT700701UV01 – Master File / Registry
Notification Control Act, Role Subject

The value of interactionId SHALL be set to
PRPA_IN201302UV02
The value of processingModeCode SHALL be set to T
The acceptAckCode SHALL be set to AL
There SHALL be only one receiver Device

The trigger event code in ControlActProcess.code
SHALL be set to PRPA_TE201302UV02
RegistrationEvent.statusCode SHALL be set to“active”
There SHALL be no InReplacementOf act
relationship for these interactions.

The composite message schemas which describe the full payload of these interactions, including
the wrappers, can be found online on the IHE FTP site, see ITI TF-2x: Appendix W. The
schema from the HL7 V3 2008 Normative Edition can be found at
Edition2008/processable/multicacheschemas/PRPA_IN201302UV02.xsd)
3.46.4.1.2.4 Web Services Types and Messages
The Patient Registry Record Revised message will be transmitted using Web Services, according
to the requirements specified in ITI TF-2x: Appendix V.
The following WSDL naming conventions SHALL apply:

6435“revise” message -> "PRPA_IN201302UV02_Message"

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acknowledgement-> "MCCI_IN000002UV01_Message"

The following WSDL snippet describes the types for these messages:
6440

6445

6450

6455

…
<types><xsd:schema elementFormDefault="qualified" targetNamespace="urn:hl7-org:v3"
xmlns:hl7="urn:hl7-org:v3"><!-- Include the message schema --><xsd:import namespace="urn:hl7-org:v3"
schemaLocation="../schema/HL7V3/NE2008/multicacheschemas/PRPA_IN201302UV02.xsd"/><xsd:element name="PRPA_IN201302UV02"/></xsd:schema><xsd:schema elementFormDefault="qualified" targetNamespace="urn:hl7-org:v3"
xmlns:hl7="urn:hl7-org:v3"><!-- Include the message schema --><xsd:import namespace="urn:hl7-org:v3"
schemaLocation="../schema/HL7V3/NE2008/multicacheschemas/MCCI_IN000002UV01.xsd"/><xsd:element name="MCCI_IN000002UV01"/></xsd:schema></types>…

The messages are described by the following snippet:
6460

6465

…
<message name="PRPA_IN201302UV02_Message"><part element="hl7:PRPA_IN201302UV02" name="Body"/></message><message name="MCCI_IN000002UV01_Message"><part element="hl7:MCCI_IN000002UV01" name="Body"/></message>…

The port types for the WSDL describing the Patient Identity Feed Service are described together
with the expected actions of the actors which receive these messages in Section 3.46.4.1.3.
3.46.4.1.3 Expected Actions - Patient Identifier Cross-reference Consumer
6470

6475

Whenever the Patient Identifier Cross-reference Consumer receives updated identifier
information in a Patient Revise message that results in a change to the cross-referencing of apatient, the actor shall update its internal identifier information for the affected patient(s) in all
domains in which it is interested. The identifiers found in both Patient.id and OtherIDs.id
attributes shall be considered together to form a complete list of patient identifiers from thedifferent Patient Identity domains in which this actor is interested.
In the case where the returned list of identifiers contains multiple identifiers for a single domain,
the Patient Identifier Cross-reference Consumer shall either use ALL of the multiple identifiers
from the given domain or it shall ignore ALL of the multiple identifiers from the given domain.

6480

This allows Patient Identifier Cross-reference Consumers capable of handling multiple identities
for a single patient within a single domain (i.e., those that can correctly aggregate the
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information associated with the different identifiers) to do so. For those Patient Identifier Crossreference Consumers not capable of handling this situation, ignoring the entire list of different
identifiers prevents the consumer from presenting incomplete data.
3.46.4.1.3.1 Web Services Port Type and Binding Definitions
6485

IHE-WSP201) The attribute /wsdl:definitions/@name SHALL be “PIXConsumer”.
The following WSDL naming conventions SHALL apply:
wsdl:definitions/@name="PIXConsumer":PIX update message-> "PRPA_IN201302UV02_Message"
acknowledgement-> "MCCI_IN000002UV01_Message"
portType-> "PIXConsumer_PortType"get identifiers operation -> "PIXConsumer_PRPA_IN201302UV02"
SOAP 1.2 binding-> "PIXConsumer_Binding_Soap12"
SOAP 1.2 port-> "PIXConsumer_Port_Soap12"

6490

6495

The following WSDL snippets specify the Patient Update Port Type and Binding definitions,according to the requirements specified in ITI TF-2x: Appendix V.
3.46.4.1.3.1.1 Port Type

6500

6505

<portType name="PIXConsumer_PortType"><operation name="PIXConsumer_PRPA_IN201302UV02"><input message="tns:PRPA_IN201302UV02_Message" wsaw:Action="urn:hl7org:v3:PRPA_IN201302UV02"/><output message="tns:MCCI_IN000002UV01_Message" wsaw:Action="urn:hl7org:v3:MCCI_IN000002UV01"/></operation></portType>3.46.4.1.3.1.2 Bindings
SOAP 1.2 binding:
…

6510

6515

6520

3 <binding name="PIXConsumer_Binding_Soap12" type="PIXConsumer_PortType"><wsoap12:binding style="document"
transport="http://schemas.xmlsoap.org/soap/http"/><operation name="PIXConsumer_PRPA_IN201302UV02"><wsoap12:operation soapAction="urn:hl7-org:v3:PRPA_IN201302UV02"/><input><wsoap12:body use="literal"/></input><output><wsoap12:body use="literal"/></output></operation></binding>…

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An informative WSDL for the PIX Consumer implementing the PIXV3 Profile is available
online on the IHE FTP site, see ITI TF-2x: Appendix W.
3.46.4.1.3.2 Message Examples
Message examples can be found online on the IHE FTP site, see ITI TF-2x: Appendix W.
3.46.5 Security Requirements
No transaction specific security considerations.

6530

3.46.5.1 Audit Record Considerations
When grouped with ATNA Secure Node or Secure Application Actors, this transaction is to beaudited as “Patient Record” event, as defined in ITI TF-2a: Table 3.20.6-1. The following tables
show items that are required to be part of the audit record for this transaction.
3.46.5.1.1 Patient Identifier Cross-reference Manager audit message:
Field Name
Event
AuditMessage/
EventIdentification

Opt

Value Constraints

EventID

M

EV(110110, DCM, “Patient Record”)

EventActionCodeM“R” (Read)

EventDateTimeM

not specialized

EventOutcomeIndicatorM

not specialized

EventTypeCode

M

EV(“ITI-46”, “IHE Transactions”, “PIX Update Notification”)

Source (Patient Identifier Cross-reference Manager) (1)
Human Requestor (0..n)
Destination (Patient Identifier Cross-reference Consumer) (1)Audit Source (Patient Identifier Cross-reference Manager) (1)Patient IDs(1..n) (represents the components of PID-3)

6535

Where:
SourceAuditMessage/
ActiveParticipant

Human
Requestor (ifknown)
AuditMessage/
ActiveParticipant

UserIDU

not specialized

AlternativeUserIDM

the process ID as used within the local operating system in the local
system logs.

UserNameUnot specialized

UserIsRequestorU

not specialized

RoleIDCodeM

EV(110153, DCM, “Source”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointIDM

the machine name or IP address.

UserIDM

identity of the human that initiated the transaction.

AlternativeUserIDU

not specialized

UserNameUnot specialized

UserIsRequestorU

not specialized

RoleIDCodeU

Access Control role(s) the user holds that allows this transaction.

NetworkAccessPointTypeCode

NA

NetworkAccessPointIDNA

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Destination

UserID

M

SOAP endpoint URI.

AuditMessage/
ActiveParticipant

AlternativeUserIDU

not specialized

UserNameUnot specialized

UserIsRequestorM“false”

RoleIDCodeM

EV(110152, DCM, “Destination”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointIDM

the machine name or IP address.

Audit Source

AuditSourceIDU

not specialized

AuditMessage/
AuditSourceIdentification

AuditEnterpriseSiteIDU

not specialized

AuditSourceTypeCodeU

not specialized

ParticipantObjectTypeCodeM“1” (Person)

ParticipantObjectTypeCodeRole

M“1” (Patient)

ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCodeM

not specialized

ParticipantObjectSensitivityU

not specialized

ParticipantObjectIDM

the patient ID in HL7 CX format (see ITI TF-2x: appendix E).

ParticipantObjectNameU

not specialized

ParticipantObjectQueryU

not specialized

ParticipantObjectDetailM

Type=II (the literal string), Value=the value of message.id

Patient IDs(AuditMessage/
ParticipantObjectIdentif
ication)6540

3.46.5.1.2 Patient Identifier Cross-reference Consumer audit message:
Event
AuditMessage/
EventIdentification

Field Name

Opt

Value Constraints

EventID

M

EV(110110, DCM, “Patient Record”)

EventActionCodeM“U” (update)

EventDateTimeM

not specialized

EventOutcomeIndicatorM

not specialized

EventTypeCode

M

EV(“ITI-46”, “IHE Transactions”, “PIX Update Notification”)

Source (Patient Identifier Cross-reference Manager) (1)Destination (Patient Identifier Cross-reference Consumer) (1)Audit Source (Patient Identifier Cross-reference Consumer) (1)Patient IDs(1..n) (represents the components of PID-3)

Where:
SourceAuditMessage/
ActiveParticipant

UserIDU

not specialized

AlternativeUserIDU

not specialized

UserNameUnot specialized

UserIsRequestorU

not specialized

RoleIDCodeM

EV(110153, DCM, “Source”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointIDM

the machine name or IP address.

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Destination

UserID

M

SOAP endpoint URI.

AuditMessage/
ActiveParticipant

AlternativeUserIDM

the process ID as used within the local operating system in the local
system logs.

UserNameUnot specialized

UserIsRequestorM“false”

RoleIDCodeM

EV(110152, DCM, “Destination”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointIDM

the machine name or IP address.

Audit Source

AuditSourceIDU

not specialized

AuditMessage/
AuditSourceIdentification

AuditEnterpriseSiteIDU

not specialized

AuditSourceTypeCodeU

not specialized

ParticipantObjectTypeCodeM“1” (Person)

ParticipantObjectTypeCodeRole

M“1” (Patient)

ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCodeM

not specialized

ParticipantObjectSensitivityU

not specialized

ParticipantObjectIDM

the patient ID in HL7 CX format (see ITI TF-2x: appendix E).

ParticipantObjectNameU

not specialized

ParticipantObjectQueryU

not specialized

ParticipantObjectDetailM

Type=II (the literal string), Value=the value of message.id

6545
Patient IDs(AuditMessage/
ParticipantObjectIdentif
ication)3.47 Patient Demographics Query HL7 V36550

This section corresponds to transaction ITI-47 of the IHE Technical Framework. Transaction
ITI-47 is used by the Patient Demographics Consumer and Patient Demographics Supplier
Actors. Additional components to be included if the Pediatric Demographics Option is supported
are also indicated in Sections 3.47.4.1.2.1 to 3.47.4.1.2.4.
3.47.1 Scope
The scope is identical to ITI TF-2a: 3.21.1.

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3.47.2 Use Case Roles
Patient
Demographics
Consumer

Patient
Demographics
Supplier

Patient
Demographics
Query HL7 V36555
Actor: Patient Demographics Consumer
Role: Requests a list of patients matching a minimal set of demographic criteria (e.g., ID or
partial name) from the Patient Demographics Supplier. Populates its attributes with demographic
information received from the Patient Demographics Supplier.
6560

Corresponding HL7 v3 Application Roles:
Person Registry Query Placer (PRPA_AR201303UV02)
Actor: Patient Demographics SupplierRole: Returns demographic information for all patients matching the demographic criteria
provided by the Patient Demographics Consumer.

6565

Corresponding HL7 v3 Application Roles:
Person Registry Query Fulfiller (PRPA_AR201304UV02)
3.47.3 Referenced Standards
HL7 Version 3 Edition 2008, Patient Administration DSTU, Patient Topic (found at
http://www.hl7.org/memonly/downloads/v3edition.cfm#V32008)

6570

Implementers of this transaction shall comply with all requirements described in ITI TF-2x:
Appendix V Web Services for IHE Transactions.

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3.47.4 Interaction Diagrams
Patient
Demographics
Consumer

Patient
Demographics
Supplier

Patient Registry Find Candidates Query
PRPA_IN201305UV02
Patient Registry Find Candidates Query Response
PRPA_IN201306UV02

General Query Activate Query Continue
QUQI_IN000003UV01
Patient Registry Find Candidates Query Response
PRPA_IN201306UV02
6575

Figure 3.46.4-1: Find Candidates Query

3.47.4.1 Patient Demographics Query
3.47.4.1.1 Trigger Events

6580

A Patient Demographics Consumer’s need to select a patient based on demographic information
about patients whose information matches a set of known data will trigger the Patient
Demographics Query based on the following HL7 trigger event:Find Candidates Query (PRPA_TE201305UV02)
An application, in the role of Query Placer, sends a query-by-parameter message to request thatthe application return all person records that match the demographic information sent in thequery parameters.

6585

3.47.4.1.2 Message Semantics
The Find Candidates Query is supported by the Patient Registry Query by Demographics(PRPA_MT201306UV02) message. The Patient Demographics Consumer shall generate thequery message whenever it needs to select from a list of patients whose information matches a
set of demographic data.

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The components of the Patient Registry Query by Demographics message with cardinality
greater than 0 (as shown below) are required, and the detailed description of the message isprovided in Sections 3.47.4.1.2.1 to 3.47.4.1.2.4. Additional components to be included if thePediatric Demographics Option is supported are also indicated in Section 3.47.4.1.2.1 to3.47.4.1.2.4.

6595

The receiver shall respond to the query by sending the Patient Registry Find Candidates
Response message (PRPA_MT201310UV02), which uses the Application Level
Acknowledgement transmission wrapper. This satisfies the requirements of original mode
acknowledgment; no intermediate Accept Acknowledgement is to be sent. The response message
shall contain demographic records that reflect the best fit to all of the search criteria received in
the Patient Registry Query by Demographics message.

6600

3.47.4.1.2.1 Major Components of the Patient Registry Query by Demographics
LivingSubjectName Parameter

6605

6610

6615

This optional parameter specifies the name of the person whose information is being queried. For
this parameter item, a single person name (PN) data item shall be specified in the
LivingSubjectName.value attribute. Only certain name parts within the PN data type (e.g., familyname) may be specified. If the sender needs to indicate that the name parts specified are notlimited to an exact match, then the use attribute of the value element shall be set to "SRCH".
Handling of phonetic issues, alternate spellings, upper and lower case, partial matching, accented
characters, etc. if deemed appropriate, is to be supported by the Patient Demographics Supplierrather than by the Patient Demographics Consumer. The Supplier shall return at least all exact
matches to the query parameters sent by the Consumer. IHE does not further specify matchingrequirements, however, the MatchAlgorithm parameter may be used to indicate more specificrequirements for the Supplier, based on an existing agreement on allowable values for
MatchAlgorithm.value.
LivingSubjectAdministrativeGender Parameter
This optional parameter specifies the administrative gender of the person whose information is
being queried. For this parameter item, a single administrative gender code shall be specified in
the LivingSubjectAdministrativeGender.value attribute.
LivingSubjectBirthTime Parameter

6620

This optional parameter specifies the birth data and time of the person whose information is
being queried. This parameter can convey an exact moment (e.g., January 1, 1960 @ 03:00:00
EST), an approximate date (e.g., January 1960), or even a range of dates (e.g., December 1, 1959
through March 31, 1960).
PatientAddress Parameter

6625

This optional parameter specifies one or more addresses associated with the person whose
information is being queried.

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LivingSubjectId Parameter

6630

This optional repeating parameter specifies an identifier associated with the patient whose
information is being queried (e.g., a local identifier, or an account identifier). If multiple
instances of this parameter are provided in the query, all of the associated identifiers must match.
The identifier specified in the LivingSubjectId.value attribute is expressed using the II data type.
Please see Appendix E for the use of the II data type for patient identifiers.
OtherIDsScopingOrganization Parameter

6635

6640

This optional repeating parameter specifies the assigning authority/authorities of the Patient
Identity Domain(s) for which identifiers are to be returned. The identifier specified in the
OtherIDsScopingOrganization.value attribute shall be expressed using the II data type, where theroot element contains a valid ISO OID, and there is no extension element. If no such parameter is
supplied, the patient demographics supplier is required to return the identifiers from all Patient
Identity Domains known to it. Any parameter value which is not recognized by the target patient
information source shall cause an error condition.
Additional components to be included if the Pediatric Demographics Option is supported are also
indicated below:
MothersMaidenName Parameter

6645

This optional parameter specifies the maiden name of the mother of the person whose
information is being queried. For this parameter item, a single person name (PN) data item shallbe specified in the Person.value attribute. Within the PN data type, the given name and familyname may be specified. If the sender needs to indicate that the name parts specified are notlimited to an exact match, then the use attribute of the value element shall be set to "SRCH".
PatientTelecom Parameter

6650

This optional parameter specifies the primary telephone number or email address of the person
whose information is being queried.
Additional components to be included if the Pediatric Demographics Option is supported are also
indicated below:
MothersMaidenName Parameter

6655

This optional parameter specifies the maiden name of the mother of the person whose
information is being queried. For this parameter item, a single person name (PN) data item shallbe specified in the Person.value attribute. Within the PN data type, the given name and familyname may be specified. If the sender needs to indicate that the name parts specified are notlimited to an exact match, then the use attribute of the value element shall be set to "SRCH".

6660

PatientTelecom Parameter
This optional parameter specifies the primary telephone number or email address of the person
whose information is being queried.

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3.47.4.1.2.2 Message Information Model of the Patient Registry Query by
Demographics Message
6665

Below is the Message Information Model for the Query by Demographics message, as restricted
for this transaction. The purpose of the model is to describe the data elements relevant for thistransaction. It is a strict subset of the Patient Registry Query by Demographics(PRPA_RM201306UV02) RMIM. If the Pediatric Demographics Option is supported, there aresomewhat fewer constraints on the RMIM; these are also indicated.

6670

The base RMIM can be found on the HL7 V3 2008 Edition CD at
Edition2008/domains/uvpa/editable/PRPA_RM201306UV.htm. The following restrictions weremade on the original RMIMs to arrive at the restricted model:•

Exactly one value attribute shall be present in each parameter•

Only the LivingSubjectId, OtherIDsScopingOrganization, and LivingSubjectName
parameters can have more than one instance•

The optional attributes ParameterList.id, MatchCriterionList.id, QueryByParameter
responseElementGroupId, QueryByParameter.modifyCode, andQueryByParameter.executionAndDeliveryTime were omitted from the model•

QueryByParameter.responsePriorityCode is required and is fixed to I (Immediate)•

QueryByParameter.responseModalityCode is required and is fixed to R (Real Time)•

QueryByParameter.statusCode is defaulted to "new".

•

The data type of MatchAlgorithm.value is constrained to ST•

The data type of MinimumDegreeMatch.value is constrained to INT•

The data type of LivingSubjectName.value is constrained to PN•

The optional SortControl was omitted from the model•

The optional MatchWeight was omitted from the model•

The following optional parameters were omitted from the model:

6675

6680

6685

6690

•

PatientTelecom (not omitted if Pediatric Demographics Option is supported)•

PrincipalCareProviderId•

PrinicpalCareProvisionId•

MothersMaidenName (not omitted if Pediatric Demographics Option is supported)•

LivingSubjectDeceasedTime•

PatientStatusCode•

LivingSubjectBirthPlaceName

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6695•

LivingSubjectBirthPlaceAddress

Figure 3.47.4.1.2-1: Message Information Model for the Query by Demographics Message

The attributes of this model are described in the following table:
6700
Table 3.47.4.1.2-1: Model Attributes
PRPA_HD201306IHE
Patient Registry Query by Demographics

This HMD extract defines the message used toquery a patient registry for records matching a setof demographics information.
Derived from Figure 3.47.4.1.2-1(PRPA_RM201306IHE)

QueryByParameter

The entry point for the domain content in this query

queryId [1..1]
QueryByParameter (II)Unique identifier for the query

statusCode [1..1] (M)QueryByParameter (CS) {CNE:QueryStatusCode,default="new"}

The status of the query, default is "new"responseModalityCode [1..1]
QueryByParameter (CS) {CNE:ResponseModality,
fixed value="R"}

The mode of the response – always real-time.

responsePriorityCode [1..1]
QueryByParameter (CS) {CNE:QueryPriority, fixedvalue="I"}

The Patient Demographics Supplier is required to send an
immediate response.

initialQuantity [0..1]
QueryByParameter (INT)

Defines the maximum size of the response that can be accepted by
the requesting application

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PRPA_HD201306IHE
Patient Registry Query by Demographics

This HMD extract defines the message used toquery a patient registry for records matching a setof demographics information.
Derived from Figure 3.47.4.1.2-1(PRPA_RM201306IHE)

initialQuantityCode [0..1]
QueryByParameter (CE) {CWE:QueryRequestLimit,
default="RD"}Defines the units associated with the initialQuantity; default is"records".

MatchAlgorithm

This parameter conveys instructions to the patient demographics
supplier specifying the preferred matching algorithm to use

value [1..1]
ParameterItem (ST)The name of the algorithm

semanticsText [1..1]
ParameterItem (ST){default= "MatchAlgorithm"}
MinimumDegreeMatch

This parameter conveys instructions to the patient demographics
supplier specifying minimum degree of match to use in filteringresultsvalue [1..1]
ParameterItem (INT)The numeric value of the degree of match

semanticsText [1..1]
ParameterItem (ST){default= "MatchAlgorithm"}
This query parameter is a code representing the administrative
gender of a person in a patient registry.

LivingSubjectAdministrativeGender
value [1..1]
ParameterItem (CE) {CWE:AdministrativeGender}
semanticsText [1..1]
ParameterItem (ST){default="LivingSubject.administrativeGender"}LivingSubjectBirthTime

This query parameter is the birth date of a living subject.

value [1..1]
ParameterItem (IVL<TS>)

A date or date range. This parameter can convey an exact moment(e.g., January 1, 1960 @ 03:00:00 EST), an approximate date (e.g.,January 1960), or even a range of dates (e.g., December 1, 1959
through March 31, 1960).

semanticsText [1..1]
ParameterItem (ST){default="LivingSubject.birthTime"}
LivingSubjectId
value [1..1] (M)ParameterItem (II)A patient identifier, used to assist in finding a match for the query.

semanticsText [1..1]
ParameterItem (ST){default= "LivingSubject.id"}
LivingSubjectName

This query parameter is the name of a person. If multiple instancesof LivingSubjectName are provided, the receiver must consider
them as possible alternatives, logically connected with an "or".

value [1..1]
ParameterItem (PN)

The name "use" attribute can convey that a name is to be matchedusing "fuzzy" matching, and does not require exact match. Onlysome of the name parts may be populated. If, for example, only afamily name part of a person's name is sent, then the query would
match all persons with that family name regardless of their given

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PRPA_HD201306IHE
Patient Registry Query by Demographics

This HMD extract defines the message used toquery a patient registry for records matching a setof demographics information.
Derived from Figure 3.47.4.1.2-1(PRPA_RM201306IHE)
names or initials.

semanticsText [1..1]
ParameterItem (ST){default= "LivingSubject.name"}
PatientAddressThis query parameter is a postal address for corresponding with apatient. There shall be only a single PatientAddress element

value [1..*]
ParameterItem (AD)Multiple instances of the value element within a Patient Address
may be specified and are combined with OR logic.

semanticsText [1..1]
ParameterItem (ST){default= "Patient.addr"}
OtherIDsScopingOrganization

Optional parameter specifying the assigning authority of a Patient
Identity Domain

value [1..1]
ParameterItem (II)The identifier for a Patient Identity Domain's assigning authority.
IHE restriction:
The value.root attribute SHALL be a valid ISO OID
The value.extension attribute SHALL NOT be present

semanticsText [1..1]
ParameterItem (ST){default="OtherIDs.scopingOrganization.id"}

When Pediatric Demographics Option is supported, the following sections may be included.
MothersMaidenName

Design Comments: This query parameter is the maiden name of a
focal person's mother. It is included as a parameter because it is acommon attribute for confirming the identity of persons in someregistries. This parameter does not map to a single RIM attribute,instead, in RIM terms Mother's maiden name is the person namepart of "family" with an EntityNamePartQualifier of "birth" for the
person who is the player in a PersonalRelationship of type of"mother" to the focal person.

value [1..1]
ParameterItem (PN)

Design Comments: A person name. In this case it may consist of
only the given name part, the family name part, or both.

semanticsText [1..1]
ParameterItem (ST){default="Person.MothersMaidenName"}
PatientTelecom

Design Comments: This query parameter is a telecommunications
address for communicating with a living subject in the context ofthe target patient registry. It could be a telephone number, fax
number or even an email address. There shall be only a single
PatientTelecom element.

value [1..*]
ParameterItem (TEL)

Design Comments: A telecommunications address. The scheme
attribute specifies whether this is a telephone number, fax number,email address, etc. Multiple instances of the value element within a
PatientTelecom may be specified and are combined with OR logic.

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3.47.4.1.2.3 Control Act and Transmission Wrappers
6705

Please see ITI TF-2x: Appendix O for details on the IHE guidelines for implementing thewrappers. Table 3.44.4.1.2-2 contains the Transmission and Control Act wrappers used for thisinteraction, and the associated constraints.
Table 3.47.4.1.2-7: Wrappers and Constraints
Transmission Wrapper

6710

Trigger Event Control Act Wrapper

MCCI_MT000100UV01 – Send Message Payload

QUQI_MT021001UV01 – Query Control Act
Request: Query By Parameter

The value of interactionId SHALL be set to
PRPA_IN201305UV02
The value of processingModeCode SHALL be set to T
The acceptAckCode SHALL be set to AL
There SHALL be only one receiver Device

The value of ControlActProcess.moodCode SHALL
be set to EVN
The trigger event code in ControlActProcess.code
SHALL be set to PRPA_TE201305UV02
If an authorOrPerformer participation is present, thevalue of authorOrPerformer.typeCode SHALL be set
to AUTThe composite message schemas which describe the full payload of this interaction, including
the wrappers, can be found online on the IHE FTP site, see ITI TF-2x: Appendix W. The
schemas from the HL7 V3 2008 Normative Edition can be found at
Edition2008/processable/multicacheschemas/PRPA_IN201305UV02.xsd)
3.47.4.1.2.4 Web Services Types and Messages

6715

The Patient Registry Query by Demographics message will be transmitted using Web Services,
according to the requirements specified in ITI TF-2x: Appendix V.
The following WSDL naming conventions SHALL apply:
query message-> "PRPA_IN201305UV02_Message"

The following WSDL snippet describes the type for this message:
6720

6725

6730

…
<types><xsd:schema elementFormDefault="qualified" targetNamespace="urn:hl7-org:v3"
xmlns:hl7="urn:hl7-org:v3"><!-- Include the message schema --><xsd:import namespace="urn:hl7-org:v3"
schemaLocation="../schema/HL7V3/NE2008/multicacheschemas/PRPA_IN201305UV02.xsd"/><xsd:element name="PRPA_IN201305UV02"/></xsd:schema></types>…

The message is described by the following snippet:6735…
<message name="PRPA_IN201305UV02_Message"><part element="hl7:PRPA_IN201305UV02" name="Body"/>
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The port types for the WSDL describing the Patient Demographics Service are described
together with the expected actions of the actors which receive these messages in Section
3.47.4.2.3.
3.47.4.1.3 Expected Actions
3.47.4.1.3.1 Immediate Response

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The Patient Demographics Supplier shall immediately return a Find Candidates Response
message as specified below in Section 3.47.4.2. The response message uses the Application
Acknowledgement transmission wrapper, as specified in ITI TF-2x: Appendix O.1.3, and noother acknowledgments are part of this transaction.
3.47.4.1.3.2 Query Parameter Processing
The Patient Demographics Supplier shall be capable of accepting, searching on, and responding
with attributes in the Query Person by Demographics message.

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Handling of phonetic issues, alternate spellings, upper and lower case, partial matching, accented
characters, etc., if deemed appropriate, is to be supported by the Patient Demographics Supplierrather than by the Patient Demographics Consumer. The Supplier shall return at least all exact
matches to the query parameters sent by the Consumer; IHE does not further specify matchingrequirements, except as already discussed in the LivingSubjectName parameter description.

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3.47.4.1.3.3 Incremental Response Processing
The Patient Demographics Supplier, which supports the Continuation Option, shall be capable ofaccepting and processing the QueryByParameter.responsePriorityCode attribute. In particular,
the Patient Demographics Supplier shall respond in immediate mode.

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Also, the Patient Demographics Supplier shall be able to interpret
QueryByParameter.initialQuantity to return successive responses of partial lists of records.
When processing incremental responses, the Patient Demographics Consumer shall request
additional responses using the Query Control Act Request Continue/Cancel message(QUQI_MT000001UV01), as described in Section 3.47.4.3.
3.47.4.1.3.4 Web Services Port Type and Binding Definitions

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These definitions are part of the query response message. Please see Section 3.47.4.2.3 for more
information.
3.47.4.1.3.5 Message Examples
Message examples can be found online on the IHE FTP site, see ITI TF-2x: Appendix W.

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3.47.4.2 Patient Demographics Query Response
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3.47.4.2.1 Trigger Events
The Patient Demographics Supplier’s response to the Find Candidates Query message istriggered by the following trigger:
Find Candidates Response (PRPA_TE201306UV02)

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An application returns a Patient Registry Find Candidates Response message populated withinformation it holds for each person whose record matches the demographic information sent asparameters in a query-by-parameter message.
3.47.4.2.2 Message Semantics

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The Patient Registry Find Candidates Response message (PRPA_MT201310UV02) is sent by
the Patient Demographics Supplier in direct response to the query (PRPA_MT201306UV02) or,
if the Continuation Option is supported, the query continuation (QUQI_MT000001UV01)
message previously received. The components of the message with cardinality greater than 0 (asshown below) are required, and the detailed description of the message is provided in Sections
3.47.4.2.2.1 to 3.47.4.2.2.4. All other attributes of the message are optional.
3.47.4.2.2.1 Major Components of the Patient Registry Find Candidates Response
Message
This message shares all the major components of the Patient Activate/Revise messages, as
described in Section 3.44.4.1.2.1. The only additional component is the QueryMatchObservation
class.
Query Match Observation

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The QueryMatchObservation class is used to convey information about the quality of the matchfor each record returned by the query response.
3.47.4.2.2.2 Message Information Model of the Patient Registry Find Candidates
Response Message

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Below is the Message Information Model for the Patient Registry Find Candidates Response
message, as restricted for this transaction. The purpose of the model is to describe the data
elements relevant for this transaction. It is a strict common subset of the Patient Registry Find
Candidates Response (PRPA_RM201310UV02) RMIM.
The base RMIM can be found on the HL7 V3 2008 Edition CD at
Edition2008/domains/uvpa/editable/PRPA_RM201310UV.htm. The following restrictions weremade on the original RMIMs to arrive at the restricted model:•

The focal entity choice is restricted to be only a person•

The relationship holder of the personal relationship is restricted to be a person (using
CMET COCT_MT030207UV)

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•
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•

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The following roles are omitted:•

asPatientOfOtherProvider•

birthPlace•

guarantor•

guardian•contactParty•

asMember•careGiver•

asStudent

The following participations are omitted:•

subjectOf (administrativeObservation)•

coveredPartyOf (coverage)

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Figure 3.47.4.2.2-1: Message Information Model for the Patient Registry Find Candidates
Response Message

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The attributes of this model are described in the following table. Note that CMETs are notdiscussed, as the HL7 definitions for them are being used.
Table 3.47.4.2.2-8: Model Attributes
PRPA_HD201310IHE
Patient Registry Find Candidates Response

This HMD extract defines themessage used to return records
from a patient registry in response
to a Find Candidates Query.
Derived from Figure 3.47.4.2.2-1(PRPA_RM201310IHE)

Patient

The primary record for the focal person in a
Patient Demographics SupplierclassCode [1..1] (M)Patient (CS) {CNE:PAT}

Structural attribute; this is a "patient" role

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PRPA_HD201310IHE
Patient Registry Find Candidates Response

This HMD extract defines themessage used to return records
from a patient registry in response
to a Find Candidates Query.
Derived from Figure 3.47.4.2.2-1(PRPA_RM201310IHE)

id [1..*] (M)Patient (SET<II>)

Patient identifiers. Patient Identifiers fromdifferent Identity Domains may be contained
either here, or in the OtherIDs.id attributes, but
not in both places. At least one Patient Identifier
shall be present in this attributestatusCode [1..1]
Patient (CS) {CNE:active, fixed value= "active"}

A value specifying the state of this record in apatient registry (based on the RIM role classstate-machine). This record is active.

confidentialityCode [0..*]Patient (SET<CE>) {CWE:Confidentiality}

Value(s) that control the disclosure of
information about this living subject as a patient

veryImportantPersonCode [0..1]
Patient (CE) {CWE:PatientImportance}

A code specifying the patient's special status
granted by the scoper organization, often
resulting in preferred treatment and special
considerations. Examples include board
member, diplomat.

PersonA subtype of LivingSubject representing ahuman being
Either Person.name or Patient.id must be nonnull

classCode [1..1] (M)Person (CS) {CNE:PSN, fixed value= "PSN"}

Structural attribute; this is a "person" entity

determinerCode [1..1] (M)Person (CS) {CNE:INSTANCE, fixed value= "INSTANCE"}

Structural attribute; this is a specific personname [1..*]
Person (BAG<PN>)

Name(s) for this person

telecom [0..*]
Person (BAG<TEL>)

Telecommunication address(es) for
communicating with this person

administrativeGenderCode [0..1]
Person (CE) {CWE:AdministrativeGender}

A value representing the gender (sex) of thisperson. Note: this attribute does not include
terms related to clinical gender which is acomplex physiological, genetic and sociologicalconcept that requires multiple observations inorder to be comprehensively described.

birthTime [0..1]
Person (TS)The date and time this person was born

deceasedInd [0..1]
Person (BL)An indication that this person is deaddeceasedTime [0..1]
Person (TS)The date and time this person diedmultipleBirthInd [0..1]
Person (BL)An indication that this person was part of amultiple birthmultipleBirthOrderNumber [0..1]

The order in which this person was born if part

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PRPA_HD201310IHE
Patient Registry Find Candidates Response

This HMD extract defines themessage used to return records
from a patient registry in response
to a Find Candidates Query.
Derived from Figure 3.47.4.2.2-1(PRPA_RM201310IHE)

Person (INT)of a multiple birth

addr [0..*]
Person (BAG<AD>)

Address(es) for corresponding with this person

maritalStatusCode [0..1]
Person (CE) {CWE:MaritalStatus}

A value representing the domestic partnershipstatus of this person

religiousAffiliationCode [0..1]
Person (CE) {CWE:ReligiousAffiliation}

A value representing the primary religious
preference of this person

raceCode [0..*]
Person (SET<CE>) {CWE:Race}

A set of values representing the races of thispersonethnicGroupCode [0..*]
Person (SET<CE>) {CWE:Ethnicity}

A set of values representing the ethnic groups ofthis person

OtherIDs

Used to capture additional identifiers for the
person such as a Drivers’ license or Social
Security Number.

classCode [1..1] (M)Role (CS) {CNE:ROL}

Structural attribute. This can be any
specialization of "role" except for Citizen, or
Employee.,id [1..*] (M)Role (SET<II>)

One or more identifiers issued to the focal
person by the associated scopingOrganization(e.g., identifiers from a different Patient Identity
Domain).

PersonalRelationship

A personal relationship between the focal living
subject and another living subject

classCode [1..1] (M)Role (CS) {CNE:PRS, fixed value= "PRS"}

Structural attribute; this is a "personal
relationship" role

id [0..*]
Role (SET<II>)

Identifier(s) for this personal relationshipcode [1..1] (M)Role (CE) {CWE:PersonalRelationshipRoleType}A required value specifying the type of personal
relationship between the relationshipHolder andthe scoping living subject drawn from the
PersonalRelationshipRoleType domain, forexample, spouse, parent, unrelated friend

CitizenUsed to capture person information relating tocitizenship.

classCode [1..1] (M)Role (CS) {CNE:CIT, fixed value= "CIT"}

Structural attribute; this is a "citizen" role

id [0..*]
Role (SET<II>)

Identifier(s) for the focal person as a citizen of anationNationA politically organized body of people bonded
by territory and known as a nation.

classCode [1..1] (M)Structural attribute; this is a 'nation' type of

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PRPA_HD201310IHE
Patient Registry Find Candidates Response

This HMD extract defines themessage used to return records
from a patient registry in response
to a Find Candidates Query.
Derived from Figure 3.47.4.2.2-1(PRPA_RM201310IHE)

Organization (CS) {CNE:NAT, fixed value= "NAT"}

entitydeterminerCode [1..1] (M)Organization (CS) {CNE:INSTANCE, fixed value= "INSTANCE"}

Structural attribute; this is a specific entity

code [1..1] (M)Organization (CD) {CWE:NationEntityType}A value that identifies a nation statename [0..1]
Organization (ON)A non-unique textual identifier or moniker forthis nation

Employee

A relationship of the focal person with anorganization to receive wages or salary. The
purpose of this class is to identify the type of
relationship the employee has to the employer
rather than the nature of the work actually
performed. For example, it can be used tocapture whether the person is a Military Veteranor not..

classCode [1..1] (M)Employee (CS) {CNE:EMP}

Structural attribute; this is an "employee" role

statusCode [0..1]
Employee (CS) {CNE:RoleStatus}

A value specifying the state of this employment
relationship (based on the RIM Role class statemachine), for example, active, suspended,
terminated.

occupationCode [0..1]
Employee (CE) {CWE:EmployeeOccupationCode}A code qualifying the classification of kind-ofwork based upon a recognized industry or
jurisdictional standard. OccupationCode is used
to convey the person's occupation as opposed to
jobClassCode (not used in this transaction)
which characterizes this particular job. For
example, it can be used to capture whether the
person is a Military Veteran or not.

LanguageCommunication

A language communication capability of the
focal person

languageCode [1..1] (M)LanguageCommunication (CE) {CWE:HumanLanguage}

A value representing a language for which the
focal person has some level of proficiency for
written or spoken communication. Examples:
Spanish, Italian, German, English, AmericanSign

preferenceInd [0..1]
LanguageCommunication (BL)An indicator specifying whether or not thislanguage is preferred by the focal person for the
associated mode

QueryMatchObservation

Used to convey information about the quality ofthe match for each record.

classCode [1..1] (M)Observation (CS)
{CNE:http://hl7.org/v3ballot2007may/html/infrastruc

Structural attribute – this is an observation

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PRPA_HD201310IHE
Patient Registry Find Candidates Response

This HMD extract defines themessage used to return records
from a patient registry in response
to a Find Candidates Query.
Derived from Figure 3.47.4.2.2-1(PRPA_RM201310IHE)

ture/vocabulary/ActClass.htm - ActClass, default="OBS"}
moodCode [1..1] (M)Observation (CS)
{CNE:http://hl7.org/v3ballot2007may/html/infrastruc

Structural attribute – this is an event

ture/vocabulary/ActMood.htm - ActMood, default="EVN"}
code [1..1] (M)Observation (CD) {CWE:QueryMatchObservationType}A code, identifying this observation as a querymatch observation.

value [1..1] (M)QueryMatchObservation (INT)

A numeric value indicating the quality of matchfor this record. It shall correspond to the
MinimumDegreeMatch.value attribute of theoriginal query, and it shall have the same
meaning (e.g., percentage, indicating confidence
in the match).

3.47.4.2.2.3 Control Act and Transmission Wrappers
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Please see ITI TF-2x: Appendix O for details on the IHE guidelines for implementing thewrappers. Table 3.44.4.1.2-2 contains the Transmission and Control Act wrappers used for thisinteraction, and the associated constraints.
Table 3.47.4.4.2-9: Wrappers and Constraints
Transmission Wrapper

Trigger Event Control Act Wrapper

MCCI_MT000300UV01 – Send Application
Acknowledgement

MFMI_MT700711UV01 – Master File/Registry Query
Response Control Act (Role Subject)

The value of interactionId SHALL be set to
PRPA_IN201306UV02
The value of processingModeCode SHALL be set
to T
The acceptAckCode SHALL be set to NE
There SHALL be only one receiver Device

The value of ControlActProcess.moodCode SHALL be set
to EVNThe trigger event code in ControlActProcess.code SHALL
be set to PRPA_TE201306UV02
There SHALL be zero or more RegistrationEvents present
in this message.
For each matching record returned, there SHALL be exactly
one RegistrationEvent present in this message.
If a RegistrationEvent is part of the message, there SHALL
be exactly one Patient role present in the payload.
There SHALL be no replacementOf act-relationship present
in this message
There SHALL be a QueryByParameter copy of the original
query.
The QueryAck.resultTotalQuantity,
QueryAck.resultCurrentQuantity, andHL7, HEALTH LEVEL SEVEN and CDA are the registered trademarks of Health Level Seven International.

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Transmission Wrapper

Trigger Event Control Act Wrapper
QueryAck.resultRemainingQuantity attributes SHALL havethe appropriate values populated.

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The composite message schemas which describe the full payload of this interaction, including
the wrappers, can be found online on the IHE FTP site, see ITI TF-2x: Appendix W. The
schemas from the HL7 V3 2008 Normative Edition can be found at
Edition2008/processable/multicacheschemas/PRPA_IN201306UV02.xsd).
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3.47.4.2.2.4 Web Services Types and Messages
The Patient Registry Query by Demographics message will be transmitted using Web Services,
according to the requirements specified in ITI TF-2x: Appendix V.
The following WSDL naming conventions SHALL apply:
response message

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-> "PRPA_IN201306UV02_Message"

The following WSDL snippet describes the type for these message:…
<types><xsd:schema elementFormDefault="qualified" targetNamespace="urn:hl7-org:v3"
xmlns:hl7="urn:hl7-org:v3"><!-- Include the message schema --><xsd:import namespace="urn:hl7-org:v3"
schemaLocation="../schema/HL7V3/NE2008/multicacheschemas/PRPA_IN201306UV02.xsd"/><xsd:element name="PRPA_IN201306UV02"/></xsd:schema></types>…

The message is described by the following snippet:
6855…
<message name="PRPA_IN201306UV02_Message"><part element="hl7:PRPA_IN201306UV02" name="Body"/></message>…

3.47.4.2.3 Expected Actions
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The Patient Demographics Supplier shall perform the matching of patient data based on thequery parameter values it receives. The information provided by the Patient Demographics
Supplier to Patient Demographics Consumers is a list of possible matching patients from thepatient information source associated with the value that the Consumer sent in the Device classof the transmission wrapper of the query message.
If OtherIDsScopingOrganization parameters were part of the query, and they were recognized by
the Patient Demographics Supplier as identifying known Patient Identity Domains, the response
will also, for each patient, contain any Patient ID values found in the specified domains.
The mechanics of the matching algorithms used are internal to the Patient Demographics
Supplier and are outside of the scope of this framework.
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The Patient Demographics Supplier shall respond to the query request as described by thefollowing 3 cases:
Case 1 The Patient Demographics Supplier finds (in the patient information source associatedwith Receiver.Device in the query transmission wrapper) at least one patient record matching thecriteria sent in the query parameters. There were no OtherIDsScopingOrganization parameters in
the query.

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AA (application accept) is returned in Acknowledgement.typeCode (transmission wrapper).
OK (data found, no errors) is returned in QueryAck.queryResponseCode (control act wrapper)

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One RegistrationEvent (and the associated Patient role, subject of that event) is returned from thepatient information source for each patient record found. If the Patient Demographics Supplier
returns data for multiple patients, it shall return these data in successive occurrences of theRegistrationEvent class within the transmission wrapper.
For each patient, one or more identifiers from the Patient ID Domain associated with the target
patient information source identified by Receiver.Device are represented as Patient.id attributes.

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If an incremental number of records are specified in QueryByParamter.initialQuantity (i.e., theConsumer supports the Continuation Option), and the number of records to be sent exceeds that
incremental number, the Supplier shall return only up to the incremental number of records. If
the Supplier supports the Continuation Option, it shall correctly populate theresultTotalQuantity, resultCurrentQuantity, and resultRemainingQuantity attributes of theQueryAck class in the control act wrapper. If the Supplier does not support the Continuation
Option, in addition to returning only up to the incremental number of records requested, it shallreturn AE (application error in the Acknowledgement.typeCode (transmission wrapper) and AE(application error) is returned in QueryAck.queryResponseCode (control act wrapper).
The Consumer may then send a query continuation message as a subsequent query request for
the next increment of responses.

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Case 2: The Patient Demographics Supplier finds (in the patient information source associatedwith Receiver.Device in the query transmission wrapper) at least one patient record matching thecriteria sent in the query parameters. One or more OtherIDsScopingOrganization parameters arepresent in the query; the Supplier recognizes all the requested domains.
AA (application accept) is returned in Acknowledgement.typeCode (transmission wrapper).
OK (data found, no errors) is returned in QueryAck.queryResponseCode (control act wrapper)

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One RegistrationEvent (and the associated Patient role, subject of that event) is returned fromthe patient information source for each patient record found. If the Patient Demographics
Supplier returns data for multiple patients, it shall return these data in successive occurrences of
the RegistrationEvent class within the transmission wrapper.
For each patient, the identifiers from all the Patient ID Domains requested via the
OtherIDsScopingOrganization parameter are returned either as values of the Patient.id attribute,or as values of the OtherIDs.id attribute. The same patient identifier value shall not appear in
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both the Patient.id and OtherIDs.id attributes. The Patient Demographics consumer shallconsider the identifiers from both places as equivalently valid. If the Patient Demographics
supplier cannot provide a patient ID for some of the requested Patient ID Domains, then an
OtherIDs.id attribute shall have an appropriate null value, and the ScopingOrganization classshall identify the corresponding domain.
If an incremental number of records are specified in QueryByParamter.initialQuantity, and thenumber of records to be sent exceeds that incremental number, and the Patient Demographics
Supplier supports the Continuation Option, the Supplier returns only the incremental number ofrecords, correctly populating the resultTotalQuantity, resultCurrentQuantity, andresultRemainingQuantity attributes of the QueryAck class in the control act wrapper. The
consumer will sent a query continuation message as a subsequent query request for the next
increment of responses. If the Supplier does not support the Continuation Option, then AE(application error) is returned in the Acknowledgement.typeCode (transmission wrapper) and AE(application error) is returned in QueryAck.queryResponseCode (control act wrapper).
Case 3: The Patient Demographics Supplier does not recognize one or more
OtherIDsScopingOrganization parameters as representing valid Patient Identity Domains.
AE (application error) is returned in Acknowledgement.typeCode (transmission wrapper) and in
QueryAck.queryResponseCode (control act wrapper).

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No RegistrationEvent is returned.
The queried-for patient identification domains are returned in the QueryByParameter parameter
list (control act wrapper).
For each domain that was not recognized, an AcknowledgmentDetail class is returned in which
the attributes typeCode, code, and location are valued as follows:

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Attribute

VALUE

typeCodeEcode

204 (Unknown Key Identifier)location

XPath expression for the value element of the OtherIDsScopingOrganization parameter(which includes the repetition number of the parameter)3.47.4.2.3.1 Web Services Port Type and Binding Definitions
IHE-WSP201) The attribute /wsdl:definitions/@name SHALL be “PDSupplier”.
The following WSDL naming conventions SHALL apply:
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wsdl:definitions/@name="PDSupplier":
patient demographics query-> "PRPA_IN201305UV02_Message"
patient demographics response -> "PRPA_IN201306UV02_Message"
continuation query-> "QUQI_IN000003UV01_Message"
accept acknowledgement-> "MCCI_IN000002UV01_Message"
portType-> "PDSupplier_PortType"get candidates operation-> "PDSupplier_PRPA_IN201305UV02"

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continuation operation->"PDSupplier_PRPA_IN201305UV02_Continue"
cancel operation-> "PDSupplier_PRPA_IN201305UV02_Cancel"
SOAP 1.2 binding-> "PDSupplier_Binding_Soap12"
SOAP 1.2 port-> "PDSupplier_Port_Soap12"

The following WSDL snippets specify the Patient Demographics Query Port Type and Binding
definitions, according to the requirements specified in ITI TF-2x: Appendix V.
3.47.4.2.3.1.1 Port Type
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<portType name="PDSupplier_PortType"><operation name="PDSupplier_PRPA_IN201305UV02"><input message="tns:PRPA_IN201305UV02_Message" wsaw:Action="urn:hl7org:v3:PRPA_IN201305UV02"/><output message="tns:PRPA_IN201306UV02_Message" wsaw:Action="urn:hl7org:v3:PRPA_IN201306UV02"/></operation><operation name="PDSupplier_QUQI_IN000003UV01_Continue"><input message="tns:QUQI_IN000003UV01_Message" wsaw:Action="urn:hl7org:v3:QUQI_IN000003UV01_Continue"/><output message="tns:PRPA_IN201306UV02_Message" wsaw:Action="urn:hl7org:v3:PRPA_IN201306UV02"/></operation><operation name="PIXManager_QUQI_IN000003UV01_Cancel"><input message="tns:QUQI_IN000003UV01_Message" wsaw:Action="urn:hl7-org:v3:
QUQI_IN000003UV01_Cancel"/><output message="tns:MCCI_IN000002UV01_Message" wsaw:Action="urn:hl7org:v3:MCCI_IN000002UV01"/></operation></portType>3.47.4.2.3.1.2 Bindings
SOAP 1.2 binding:
…

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<binding name="PDSupplier_Binding_Soap12" type="PDSupplier_PortType"><wsoap12:binding style="document"
transport="http://schemas.xmlsoap.org/soap/http"/><operation name="PDSupplier_PRPA_IN201305UV02"><wsoap12:operation soapAction="urn:hl7-org:v3:PRPA_IN201305UV02"/><input><wsoap12:body use="literal"/></input><output><wsoap12:body use="literal"/></output></operation><operation name="PDSupplier_QUQI_IN000003UV01_Continue"><wsoap12:operation soapAction="urn:hl7org:v3:QUQI_IN000003UV01_Continue"/>
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<input><wsoap12:body use="literal"/></input><output><wsoap12:body use="literal"/></output></operation><operation name="PDSupplier_QUQI_IN000003UV01_Cancel"><wsoap12:operation soapAction="urn:hl7-org:v3:
QUQI_IN000003UV01_Cancel"/><input><wsoap12:body use="literal"/></input><output><wsoap12:body use="literal"/></output></operation></binding>…

An informative WSDL for the Patient Demographics Supplier implementing the PDQV3 Profile
is available online on the IHE FTP site, see ITI TF-2x: Appendix W.
3.47.4.2.3.2 Message Examples
Message examples can be found online on the IHE FTP site, see ITI TF-2x: Appendix W.
3.47.4.3 Patient Demographics Query HL7V3 Continuation
3.47.4.3.1 Trigger Events

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A Patient Demographics Consumer’s need to get another set of matching records to a previously
sent Patient Demographics query will trigger the Patient Demographics Query Continuation
based on the following HL7 trigger event:
Query General Activate Query Continuation (QUQI_TE000003UV01)

7020

An application, in the role of Query Placer, sends a query continuation message to request thatthe application return up to a specified number of matching records based on a previous
demographics query.
3.47.4.3.2 Message Semantics

7025

The Query continuation is supported by the Query Control Act Request Continue / Cancel(QUQI_MT000001UV01) message. The Patient Demographics Consumer shall generate thecontinuation message whenever it needs to receive another set of matching records based on the
results of a previously sent query.
If the Supplier supports the Continuation Option, it shall respond to the continuation request bysending the Patient Registry Find Candidates Response message (PRPA_MT201310), which
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uses the Application Level Acknowledgement transmission wrapper. This satisfies therequirements of original mode acknowledgment; no intermediate Accept Acknowledgement is tobe sent.
If a cancellation request is sent by the Patient Demographics Consumer, then the receiver shall
respond by sending an Accept Acknowledgement (see ITI TF-2x: Appendix O for thedescriptions of the Accept Acknowledgement transmission wrapper).

7035

3.47.4.3.2.1 Major Components of the Query Continuation Message
This message contains no domain payload, it is built from a transmission and control act
wrappers.
3.47.4.3.2.2 Message Information Model of the Query Continuation Message

7040

Please see ITI TF-2x: Appendix O for the description of the transmission and control act
wrappers used by this message. The next section discusses the wrappers, and the specificconstraints relevant to this transaction.
3.47.4.3.2.3 Control Act and Transmission Wrappers

7045

Please see ITI TF-2x: Appendix O for details on the IHE guidelines for implementing thewrappers. Table 3.47.4.3.2-1 contains the Transmission and Control Act wrappers used for thisinteraction, and the associated constraints.
Table 3.47.4.3.2-1: Wrappers and Constraints
Transmission Wrapper

7050

Trigger Event Control Act Wrapper

MCCI_MT000300UV01 – Send Application
Acknowledgement

QUQI_MT000001UV01 – Query Control Act
Request Continue / Cancel

The value of interactionId SHALL be set to
QUQI_IN000003UV01
The value of processingModeCode SHALL be set to T
The acceptAckCode SHALL be set to AL
There SHALL be only one receiver Device
The Acknowledgement.typeCode SHALL be set to AA
The TargetMessage.id SHALL be the message ID of
the immediately preceding Query response message

The trigger event code in ControlActProcess.code
SHALL be set to PRPA_TE000003UV01
QueryContinuation.queryId SHALL be set to theoriginal query identifier

The composite message schemas which describe the full payload of this interaction, including
the wrappers, can be found online on the IHE FTP site, see ITI TF-2x: Appendix W. The
schemas from the HL7 V3 2008 Normative Edition can be found at
Edition2008/processable/multicacheschemas/QUQI_IN000003UV01.xsd)

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3.47.4.3.2.4 Web Services Types and Messages
The Query Continuation message will be transmitted using Web Services, according to therequirements specified in ITI TF-2x: Appendix V.
7055

The following WSDL naming conventions SHALL apply:
query continuation-> "QUQI_IN000003UV01_Message"

The following WSDL snippet describes the type for this message:
7060

7065

…
<types><xsd:schema elementFormDefault="qualified" targetNamespace="urn:hl7-org:v3"
xmlns:hl7="urn:hl7-org:v3"><!-- Include the message schema --><xsd:import namespace="urn:hl7-org:v3"
schemaLocation="../schema/HL7V3/NE2008/multicacheschemas/QUQI_IN000003UV01.xsd"/><xsd:element name="QUQI_IN000003UV01"/></xsd:schema></types>…

7070

The message is described by the following snippet:

7075…
<message name="QUQI_IN000003UV01_Message"><part element="hl7:QUQI_IN000003UV01" name="Body"/></message>…

The port types for the WSDL describing the Patient Demographics Service are described
together with the expected actions of the actors which receive these messages in Section
3.47.4.2.3.
3.47.4.3.3 Expected Actions
7080

7085

7090

If a number of records is specified in the initialQuantity of the original quantity, and the Patient
Demographics Supplier supports the Continuation Option, the Patient Demographics Supplier
Actor shall return an incremental response of that number of records when the number ofmatching records it finds exceeds the number of records specified. In subsequent querycontinuation messages, the Patient Demographics Consumer may specify a different number ofrecords to be returned from now on for this query session by populating the continuationQuantity
attribute. In addition, the consumer may specify from which record the next set of matches
should start by populating the startResultNumber attribute. If the Patient Demographics Supplierdoes not support the Continuation Option and the number of matching records to the original
query exceeds the number specified, then, in addition to returning up to that number of records,
the Supplier shall return AE (application error) in the Acknowledgement.typeCode (transmission
wrapper) and AE (application error) in QueryAck.queryResponseCode (control act wrapper).
The Patient Demographics Supplier shall always populate the resultTotalQuantity,
resultCurrentQuantity, and resultRemainingQuantity in the QueryAck class. This information
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will indicate to the Patient Demographics Consumer whether there are any remaining records tobe returned in subsequent continuations.
The Patient Demographics Consumer shall indicate a query session cancellation by sending acontinuation message, and setting the continuationQuantity attribute to 0, and setting thestatusCode to "aborted". In such case, the Patient Demographics Supplier shall respond with an
Accept Acknowledgement (as described in ITI TF-2x: Appendix O).

7100

Sending a query cancellation message is optional. The Patient Demographics Supplier may
simply not send any continuation messages once a record has been selected. How long thePatient Demographic Supplier retains query results (for incremental response) is an
implementation decision and therefore beyond the scope of IHE.
3.47.4.3.3.1 Web Services Port Type and Binding Definitions

7105

This information is part of the specification of the Patient Demographics Query response in
Section 3.47.4.2.3.1.
An informative WSDL for the Patient Demographics Supplier implementing the PDQV3 Profile
is available online on the IHE FTP site, see ITI TF-2x: Appendix W.
3.47.4.2.3.2 Message Examples

7110

Message examples can be found online on the IHE FTP site, see ITI TF-2x: Appendix W.
3.47.5 Security Requirements
No transaction specific security considerations.
3.47.5.1 Audit Record Considerations

7115

When grouped with ATNA Secure Node or Secure Application Actors, this transaction is to beaudited as “Query Information” event, as defined in ITI TF-2a: Table 3.20.6-1. The following
tables show items that are required to be part of the audit record for this transaction.

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3.47.5.1.1 Patient Demographics Consumer audit message:
Field Name

Opt

Value Constraints

EventID

M

EV(110112, DCM, “Query”)

EventActionCodeM“E” (Execute)

EventDateTimeM

not specialized

EventOutcomeIndicatorM

not specialized

EventTypeCode

M

EV(“ITI-47”, “IHE Transactions”, “Patient Demographics Query”)

UserIDU

not specialized

AlternativeUserIDM

the process ID as used within the local operating system in the local
system logs.

UserNameUnot specialized

UserIsRequestorU

not specialized

RoleIDCodeM

EV(110153, DCM, “Source”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointIDM

the machine name or IP address.

UserIDM

identity of the human that initiated the transaction.

AlternativeUserIDU

not specialized

UserNameUnot specialized

UserIsRequestorU

not specialized

RoleIDCodeU

Access Control role(s) the user holds that allows this transaction.

NetworkAccessPointTypeCode

NA

NetworkAccessPointID

NA

Destination

UserID

M

SOAP endpoint URI

AuditMessage/
ActiveParticipant

AlternativeUserIDU

not specialized

UserNameUnot specialized

Event
AuditMessage/
EventIdentification

Source (Patient Demographics Consumer) (1)
Human Requestor (0..n)
Destination (Patient Demographics Supplier) (1)Audit Source (Patient Demographics Consumer) (1)Patient (0..n)Query Parameters(1)Where:
SourceAuditMessage/
ActiveParticipant

Human
Requestor(if known)
AuditMessage/
ActiveParticipant

UserIsRequestorM“false”

RoleIDCodeM

EV(110152, DCM, “Destination”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointIDM

the machine name or IP address.

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Audit Source

AuditSourceIDU

not specialized

AuditMessage/
AuditSourceIdentification

AuditEnterpriseSiteIDU

not specialized

AuditSourceTypeCodeU

not specialized

ParticipantObjectTypeCodeM“1” (Person)

ParticipantObjectTypeCodeRole

M“1” (Patient)

ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCodeM

not specialized

ParticipantObjectSensitivityU

not specialized

ParticipantObjectID

M

The patient ID in HL7 CX format (see ITI TF-2x: appendix E).

ParticipantObjectNameU

not specialized

ParticipantObjectQueryU

not specialized

ParticipantObjectDetailUnot specialized

Query
Parameters

ParticipantObjectTypeCodeM“2” (system object)

ParticipantObjectTypeCodeRole

M“24” (query)(AuditMessage/
ParticipantObjectIdentif
ication)ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCode

M

EV(“ITI-47”, “IHE Transactions”, “Patient Demographics Query”)

Patient(AuditMessage/
ParticipantObjectIdentif
ication)ParticipantObjectSensitivityU

not specialized

ParticipantObjectIDU

not specialized

ParticipantObjectNameU

not specialized

ParticipantObjectQueryM

the QueryByParameter segment of the query, base64 encoded

ParticipantObjectDetailUnot specialized

7135
3.47.5.1.2 Patient Demographics Source audit message:
Field Name
Event
AuditMessage/
EventIdentification

Opt

Value Constraints

EventID

M

EV(110112, DCM, “Query”)

EventActionCodeM“E” (Execute)

EventDateTimeM

not specialized

EventOutcomeIndicatorM

not specialized

EventTypeCode

M

EV(“ITI-47”, “IHE Transactions”, “Patient Demographics Query”)

Source (Patient Demographics Consumer) (1)Destination (Patient Demographics Supplier) (1)Audit Source (Patient Demographics Supplier) (1)Patient (0..n)Query Parameters(1)HL7, HEALTH LEVEL SEVEN and CDA are the registered trademarks of Health Level Seven International.

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Where:
SourceAuditMessage/
ActiveParticipant

Destination

UserIDU

not specialized

AlternativeUserIDU

not specialized

UserNameUnot specialized

UserIsRequestorU

not specialized

RoleIDCodeM

EV(110153, DCM, “Source”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointIDM

the machine name or IP address.

UserID

M

SOAP endpoint URI

AlternativeUserIDM

the process ID as used within the local operating system in the local
system logs.

UserNameUnot specialized

UserIsRequestorM“false”

RoleIDCodeM

EV(110152, DCM, “Destination”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointIDM

the machine name or IP address.

Audit Source

AuditSourceIDU

not specialized

AuditMessage/
AuditSourceIdentification

AuditEnterpriseSiteIDU

not specialized

AuditSourceTypeCodeU

not specialized

ParticipantObjectTypeCodeM“1” (Person)

ParticipantObjectTypeCodeRole

M“1” (Patient)

ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCodeM

Not specialized

ParticipantObjectSensitivityU

not specialized

ParticipantObjectID

M

The patient ID in HL7 CX format (see ITI TF-2x: appendix E).

ParticipantObjectNameU

not specialized

ParticipantObjectQueryU

not specialized

ParticipantObjectDetailUnot specialized

Query
Parameters

ParticipantObjectTypeCodeM“2” (system object)

ParticipantObjectTypeCodeRole

M“24” (query)(AuditMessage/
ParticipantObjectIdentif
ication)ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCode

M

EV(“ITI-47”, “IHE Transactions”, “Patient Demographics Query”)

ParticipantObjectSensitivityU

not specialized

ParticipantObjectIDU

not specialized

ParticipantObjectNameU

not specialized

ParticipantObjectQueryM

the QueryByParameter segment of the query, base64 encoded

Patient(AuditMessage/
ParticipantObjectIdentif
ication)

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ParticipantObjectDetailUnot specialized

7145

3.48 Retrieve Value Set
This section corresponds to transaction ITI-48 of the IHE IT Infrastructure Technical
Framework. The Value Set Consumer and Value Set Repository Actors use transaction ITI-48.
3.48.1 Scope
7150

This transaction is used by the Value Set Consumer to retrieve an Expanded Value Set from theValue Set Repository. The Value Set Consumer has previously obtained the Expanded Value Set
OID by means outside of the scope of this transaction. ITI TF-2x: Appendix B has further
information about obtaining and managing OIDs which are used as the Value Set Unique ID.
3.48.2 Use case roles

7155
Value Set
Consumer

Value Set Repository

Retrieve
Expanded Value
Set

Figure 3.48.2-1: Use Case RolesSVS Actors:
7160

Actor: Value Set Consumer
Role: Obtains an Expanded Value Set
Actor: Value Set Repository
Role: Provides an Expanded Value Set

7165

3.48.3 Referenced Standards
The referenced standard can be seen in Table 3.48.3-1 Referenced Standards.

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Table 3.48.3-1: Referenced Standards

7170

Appendix V

ITI TF-2x: Appendix V Web Services for IHE Transactions
Contains references to all Web Services standards and requirements of use

HL7 v3 Data
Type XMLITS

HL7 Version 3 Standard: XML Implementation Technology Specifications – Data Types, R1

HTTP 1.1

IETF RFC 2616: Hypertext Transfer Protocol – HTTP 1.1

3.48.4 Interaction Diagram

Value Set
Repository

Value Set
Consumer

Retrieve Value Set Request

Retrieve Value Set Response

Figure 3.48.4-1: Interaction Diagram

3.48.4.1 Retrieve Value Set Request
7175

3.48.4.1.1 Trigger Events
Having obtained the Value Set OID, the Value Set Consumer will send the Retrieve Value Set
Request to the Value Set Repository.
3.48.4.1.2 Message Semantics
The Retrieve Value Set Request shall carry the following information:

7180

7185

•

A required id, representing the Value Set OID that identifies the Expanded Value Set
within the Repository.

•

An optional version that identifies a specific version of the Expanded Value Set. If no
version is specified, the Value Set Consumer is requesting the most recent version of theValue Set•

An optional lang parameter indicating the requested language locale for the
displayName of the Value Set Concepts. (Note: in the SOAP binding, this parameteris represented via the xml:lang XML attribute)

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Section 3.48.5 describes the Web Services protocol requirements and the format of the message
in full detail.
7190

3.48.4.1.3 Expected Actions
When receiving a Retrieve Value Set Request, a Value Set Repository shall generate a Retrieve
Value Set Response containing the Expanded Value Set that corresponds to the request
parameters or an error code if the Value Set could not be retrieved. If no version is specified in
the Request, then the most recent version shall be returned.

7195

The Value Set Repository shall support both the SOAP and HTTP bindings for this transaction.
If the Value Set Consumer sends the request using the SOAP binding, the Value Set Repository
shall respond using the SOAP binding. If the Value Set Consumer sends the request using the
HTTP binding, the Value Set Repository shall respond using the HTTP binding.
3.48.4.2 Retrieve Value Set Response

7200

3.48.4.2.1 Trigger Events
This message will be triggered by a Retrieve Value Set Request Message.
3.48.4.2.2 Message Semantics
The Retrieve Value Set Response Message shall carry the following information for the returned
Expanded Value Set:

7205

•

A required id, representing the Value Set OID that identifies the Value Set within the
Value Set Repository. This OID shall be the same as the Value Set OID in the received
Retrieve Value Set Request Message.

•

A required displayName that can be used for display purposes.

•

An optional version that shall be present if the Expanded Value Set has a version, that
identifies the specific version of the Value Set returned.

•

An optional cacheExpirationHint indicating that the Value Set Consumer is notexpected to change before this date and time. If the request and the response use the
HTTP binding, this information shall be also present in the HTTP Expire header of the
response. For details, please see Sec. 14.21 of IETF RFC 2616.

•

One or more ConceptList, which provides the Concepts of the Expanded Value Set.
If there are multiple translations of the Value Set, each translation is returned as aseparate ConceptList, where only the displayName of each Concept, and thelanguage locale represented by xml:lang are different.

7210

7215

7220

For each Value Set Concept, the following is returned. These requirements override therequirements of the HL7 schema rules for the CE data type where they conflict.

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•

A required code (a code that uniquely identifies a class or concept within the context ofa code system)•

A required displayName (the name of the concept)•

A required codeSystem (the terminology the concept comes from)•

An optional codeSystemVersion. (the version of the terminology the concept comesfrom)

Section 3.48.5 describes the Web Services requirements and the format of the message in fulldetail.
3.48.4.2.3 Expected Actions
7230

7235

A Value Set Repository shall return the Expanded Value Set indicated in the request.
If the Value Set Consumer requested a specific language locale, the Value Set Repository shallreturn only the requested translation of the Expanded Value Set. If the Value Set Consumer did
not request a specific language locale, the Value Set Repository shall return all known
translations of the Expanded Value Set. This is the only case where more than one
ConceptList XML element shall be permitted. The ConceptList shall have the same codevalues for the Value Set in question; the displayName may have a different value appropriate to
the locale.
The Value Set Repository shall return the Expanded Value Set or an error code in case the Value
Set could not be expanded. The following error responses may be returned:

7240

1. For the SOAP binding:a. A SOAP fault, whose code value is NAV, with the reason being: “Unknown valueset”.
b. A SOAP fault, whose code value is VERUNK, with the reason being: “Version
unknown”.

7245

2. For the HTTP binding:a. An HTTP status code of 404, with an HTTP Warning header containing warncode of 111, and warn-text of “NAV: Unknown value set”. See sections 10.4.5
and 14.46 of IETF RFC 2616 for more information.

7250

b. An HTTP status code of 404, with an HTTP Warning header containing warncode of 112, and warn-text of “VERUNK: Version unknown”. See sections 10.4.5
and 14.46 of IETF RFC 2616 for more information.
3.48.5 Protocol Requirements

7255

The protocol for the Retrieve Value Set transaction describes two bindings. The first is based on
SOAP 1.2, and the second is an HTTP binding. The relevant XML namespace definitions can beseen in Table 3.48.5-1 WSDL Namespace Definitions.
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Table 3.48.5-1: WSDL Namespace Definitions
soap12

http://schemas.xmlsoap.org/wsdl/soap12/

wsaw

http://www.w3.org/2006/05/addressing/wsdl/

xsd

http://www.w3.org/2001/XMLSchema

ihe

urn:ihe:iti:svs:2008

3.48.5.1 SOAP Binding

7260

Value Set Consumers which support the SOAP Binding Option shall follow the rules for Web
Services transactions outlined in ITI TF-2x: Appendix V. These are the requirements for the
Retrieve Value Set transaction presented in the order in which they would appear in the WSDL
definition:
The following types shall be imported (xsd:import) in the /definitions/types section:namespace="urn:ihe:iti:svs:2008", schema="SVS.xsd"

7265

The /definitions/message/part/@element attribute of the Retrie3ve Value Set
Request message shall be defined as “ihe:RetrieveValueSetRequest”
The /definitions/message/part/@element attribute of the Retrieve Value Set
Response message shall be defined as “ihe:RetrieveValueSetResponse”

7270

The /definitions/portType/operation/input/@wsaw:Action attribute for the
Retrieve Value Set Request message shall be defined as“urn:ihe:iti:2008:RetrieveValueSet”
The /definitions/portType/operation/output/@wsaw:Action attribute for the
Retrieve Value Set Response message shall be defined as“urn:ihe:iti:2008:RetrieveValueSetResponse”

7275

The /definitions/binding/operation/soap12:operation/@soapAction
attribute shall be defined as “urn:ihe:iti:2008:RetrieveValueSet”
These are the requirements that affect the wire format of the SOAP message. The other WSDL
properties are only used within the WSDL definition and do not affect interoperability. Fullsample request and response messages are in Section 3.48.5.3 Sample SOAP Message.

7280

7285

Within the request message payload the <ihe:RetrieveValueSetRequest/> element isdefined as:•

A required /ihe:RetrieveValueSetRequest/ihe:ValueSet element•

A required /ihe:RetrieveValueSetRequest/ihe:ValueSet@id attributethat contains the ID of the requested Value Set within the Value Set Repository. The
Value Set ID shall be formatted as an ISO OID.

•

An optional/ihe:RetrieveValueSetRequest/ihe:ValueSet@displayName attribute

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An optional /ihe:RetrieveValueSetRequest/ihe:ValueSet@version
attribute.

•An optional /ihe:RetrieveValueSetRequest/ihe:ValueSet@xml:lang
attribute.

7290

Value Set Repositories shall include within the response message payload for the SOAP Binding
Option the <ihe:RetrieveValueSetResponse/> element which contains:An optional /ihe:RetrieveValueSetResponse@cacheExpirationHint attribute,indicating that the Value Set Consumer should obtain a new copy before this date and time.
7295

A required /ihe:RetrieveValueSetResponse/ihe:ValueSet element, containing•

a required /ihe:RetrieveValueSetResponse/ihe:ValueSet@id attribute•a required/ihe:RetrieveValueSetResponse/ihe:ValueSet@displayName attribute•an optional /ihe:RetrieveValueSetResponse/ihe:ValueSet@version
attribute•one or more/ihe:RetrieveValueSetResponse/ihe:ValueSet/ihe:ConceptList
element, containing:•/ihe:RetrieveValueSetResponse/ihe:ValueSet/ihe:ConceptList/
xml:lang attribute, representing the language locale of the Concept’s display names•

one or more/ihe:RetrieveValueSetResponse/ihe:ValueSet/ihe:ConceptList/
ihe:Concept elements, representing the concepts within the value set.

7300

7305

The <ihe:Concept/> element is defined as being of the HL7 V3 CE data type.
7310

The only occurrence of more than one ConceptList element in a response message shall be
for the purpose of returning multiple language representations of the same value set.
A full XML Schema Document for the SVS types is available on the IHE ftp site (see ITI TF-2x:
Appendix W).
3.48.5.2 HTTP Binding

7315

Value Set Consumers which support the HTTP Binding Option shall use the GET method as
defined in IETF RFC 2616 for the Retrieve Value Set Request.

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3.48.5.2.1 Request Parameters

7320

There are three input parameters, to be provided as part of the URL in the GET request. The
parameter values have identical meaning to the ones described in the SOAP binding. These aredescribed in Table 3.48.5.2.1-1.
Table 3.48.5.2.1-1: The Request Parameters in the RetrieveMultipleValueSets request
Parameter

Optionality

Note

Id

Required

Unique identifier of the Value Set.

VersionOptional

The Value Set version.

lang

Optional

The language locale of the Value Set. If present, it shall be encoded as astring from the set of languages listed in IETF RFC 5646 (identical to thevalues of xml:lang, described in the SOAP binding). If present, theAccept-Language field of the HTTP Header may also contain the samevalue (see Section 14.4 of IETF RFC 2616).

The full URL for the HTTP binding looks as follows:7325

https://example.com/RetrieveValueSet?id=1.2.840.10008.6.1.3
08&version=20061023&lang=en-US
Note:

7330

“en-US” will not match “en”. For applications that need a more sophisticated user sensitive language matchingcapability, omitting the lang parameter will return all languages so that the application can make a determinationof which language best fits the current user.

3.48.5.2.2 HTTP Response
Value Set Repositories shall format the response to the HTTP GET operation as an HTTP
response message as defined in IETF RFC 2616.
The Content-Type field of the HTTP header shall be “text/xml” (see Section 14.4 of IETF RFC
2616).

7335

The content of the HTTP response message shall be an XML encoded Expanded Value Set thatcomplies with the SVS schema. The XML format shall be identical to the body of the SOAP
response described in the SOAP binding. The Expanded Value Set shall correspond to the
Values Set identified by the Value Set Unique ID in the id parameter, the Value Set Version in
the version parameter, and the language in the lang parameter.

7340

An informative WSDL file containing both SOAP and HTTP bindings for the Value Set
Repository Actor can be found on the IHE ftp site (see ITI TF-2x: Appendix W).
3.48.5.3 Sample SOAP Messages

7345

The samples in the following two sections show a typical SOAP request and its corresponding
SOAP response. The sample messages also show the WS-Addressing headers <Action/>,<MessageID/>, <ReplyTo/>…; these WS-Addressing headers are populated according to the
W3C WS-Addressing standard.
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IHE IT Infrastructure Technical Framework, Volume 2b (ITI TF-2b): Transactions Part B______________________________________________________________________________All of the samples presented in this section are also available online on the IHE FTP site (see ITI
TF-2x: Appendix W).
3.48.5.3.1 Sample Retrieve Value Set SOAP Request
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<?xml version="1.0" encoding="UTF-8"?><s:Envelope xmlns:s="http://www.w3.org/2003/05/soap-envelope"
xmlns:a="http://www.w3.org/2005/08/addressing"><s:Header><a:Action s:mustUnderstand="1">urn:ihe:iti:2008:RetrieveValueSet</a:Action><a:MessageID>urn:uuid:0fbfdced-6c01-4d09-a110-2201afedaa02</a:MessageID><a:ReplyTo><a:Address>http://www.w3.org/2005/08/addressing/anonymous</a:Address></a:ReplyTo><a:To s:mustUnderstand="1">http://valuesetrepository/</a:To></s:Header><s:Body><RetrieveValueSetRequest xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
xmlns="urn:ihe:iti:svs:2008"><ValueSet id="1.2.840.10008.6.1.308" xml:lang="en-EN"/></RetrieveValueSetRequest></s:Body></s:Envelope>

3.48.5.3.2 Sample Retrieve Value Set SOAP Response
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<?xml version="1.0" encoding="UTF-8"?><s:Envelope xmlns:a="http://www.w3.org/2005/08/addressing"
xmlns:s="http://www.w3.org/2003/05/soap-envelope"><s:Header><a:Action
s:mustUnderstand="1">urn:ihe:iti:2008:RetrieveValueSetResponse</a:Action><a:RelatesTo>urn:uuid:0fbfdced-6c01-4d09-a110-2201afedaa02</a:RelatesTo></s:Header><s:Body><RetrieveValueSetResponse xmlns:xsi="http://www.w3.org/2001/XMLSchemainstance"
xmlns="urn:ihe:iti:svs:2008" cacheExpirationHint="2008-08-15T00:00:0005:00"><ValueSet id="1.2.840.10008.6.1.308"
displayName="Common Anatomic Regions Context ID 4031"
version="20061023"><ConceptList xml:lang="en-US"><Concept code="T-D4000" displayName="Abdomen"
codeSystem="2.16.840.1.113883.6.5"/><Concept code="R-FAB57" displayName="Abdomen and Pelvis"
codeSystem="2.16.840.1.113883.6.5"/><Concept code="T-15420" displayName="Acromioclavicular joint"
codeSystem="2.16.840.1.113883.6.5"/><Concept code="T-15750" displayName="Ankle joint "codeSystem="2.16.840.1.113883.6.5"/><Concept code="T-280A0" displayName="Apex of Lung"
codeSystem="2.16.840.1.113883.6.5"/><Concept code="T-D8200" displayName="Arm"codeSystem="2.16.840.1.113883.6.5"/>

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<Concept code="T-60610" displayName="Bile Duct"
codeSystem="2.16.840.1.113883.6.5"/><Concept code="T-74000" displayName="Bladder"
codeSystem="2.16.840.1.113883.6.5"/><Concept code="T-04000" displayName="Breast"
codeSystem="2.16.840.1.113883.6.5"/><Concept code="T-26000" displayName="Bronchus"
codeSystem="2.16.840.1.113883.6.5"/><Concept code="T-12770" displayName="Calcaneus"
codeSystem="2.16.840.1.113883.6.5"/><Concept code="T-11501" displayName="Cervical spine"
codeSystem="2.16.840.1.113883.6.5"/></ConceptList></ValueSet></RetrieveValueSetResponse></s:Body></s:Envelope>

3.48.6 Security Requirements
For security considerations please consult ITI TF-1: 21.4.
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Audit trails shall be configurable to record access to a selected list of Value Sets.
3.48.6.1 Audit Record Considerations
The Retrieve Value Set transaction is an Import/Export event, as defined in Section 3.48.6.1.1
Value Set Consumer audit message and in Section 3.48.6.1.2 Value Set Repository audit
message, with the following exceptions.

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3.48.6.1.1 Value Set Consumer audit message:
Field Name
Event
AuditMessage/
EventIdentification

Opt

Value Constraints

EventID

M

EV(110107, DCM, “Import”)

EventActionCodeM“C” (Create) or “U” (Update)

EventDateTimeM

not specialized

EventOutcomeIndicatorM

not specialized

M

EV(“ITI-48”, “IHE Transactions”, “Retrieve Value Sets”) or
EV(“ITI-60”,”IHE Transactions”,”Retrieve Multiple Value Sets”)

EventTypeCode
Source (Value Set Repository) (1)
Human Requestor (0..n)
Destination (Value Set Consumer) (1)Audit Source (Value Set Consumer) (1)ValueSetInstance (1)HL7, HEALTH LEVEL SEVEN and CDA are the registered trademarks of Health Level Seven International.

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Where:
UserID

M

Repository HTTP or SOAP endpoint URI

AlternativeUserIDU

not specialized

UserNameUnot specialized

UserIsRequestorM“false”

RoleIDCodeM

EV(110153, DCM, “Source”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointID

M

The machine name or IP address.

Destination

UserIDU

not specialized.

AuditMessage/
ActiveParticipant

AlternativeUserIDM

the process ID as used within the local operating system inthe local system logs.

UserNameUnot specialized

UserIsRequestorU

not specialized

RoleIDCodeM

EV(110152, DCM, “Destination”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointID

M

The machine name or IP address.

UserID

M

Identity of the human that initiated the transaction.

AlternativeUserIDU

not specialized

UserNameUnot specialized

UserIsRequestorM“false”

RoleIDCodeU

Access Control role(s) the user holds that allows thistransaction.

SourceAuditMessage/
ActiveParticipant

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Human
Requestor(if known)
AuditMessage/
ActiveParticipant

Audit Source

AuditSourceIDU

not specialized

AuditMessage/
AuditSourceIdentification

AuditEnterpriseSiteIDU

not specialized

AuditSourceTypeCodeU

not specialized

ParticipantObjectTypeCodeM“2” (System)

ParticipantObjectTypeCodeRoleM“3” (Report)

ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCodeM

not specialized

ParticipantObjectSensitivityU

not specialized

ParticipantObjectID

M

The value of <Value Set Unique ID>

ParticipantObjectNameO

The value of <Value Set name>

ParticipantObjectQueryU

not specialized

ParticipantObjectDetailO

The value of <Value Set Version>

Value Set
Instance(AuditMessage/
ParticipantObjectIdentif
ication)7435
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3.48.6.1.2 Value Set Repository audit message:
Field Name
Event
AuditMessage/
EventIdentification

Opt

Value Constraints

EventID

M

EV(110106, DCM, “Export”)

EventActionCodeM“R” (Read)

EventDateTimeM

not specialized

EventOutcomeIndicatorM

not specialized

EventTypeCode

M

EV(“ITI-48”, “IHE Transactions”, “Retrieve Value Sets”) or
EV(“ITI-60”,”IHE Transactions”,”Retrieve Multiple Value Sets”)

Source (Value Set Repository) (1)
Human Requestor (0..n)
Destination (Value Set Consumer) (1)Audit Source (Value Set Source) (1)ValueSetInstance (1)Where:
SourceAuditMessage/
ActiveParticipant

UserIDM

the process ID as used within the local operating system in thelocal system logs.

AlternativeUserID

U

Repository HTTP or SOAP endpoint URIUserNameUnot specialized

UserIsRequestorM“false”

RoleIDCodeM

EV(110153, DCM, “Source”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointID

M

The machine name or IP address.

Destination

UserIDU

not specialized

AuditMessage/
ActiveParticipant

AlternativeUserIDU

not specialized

UserNameUnot specialized

UserIsRequestorU

not specialized

RoleIDCodeM

EV(110152, DCM, “Destination”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointID

M

The machine name or IP address.

UserID

M

Identity of the human that initiated the transaction.

AlternativeUserIDU

not specialized

UserNameUnot specialized

UserIsRequestorM“false”

RoleIDCodeU

Access Control role(s) the user holds that allows thistransaction.

Human
Requestor(if knownsuch asthrough
XUA)
AuditMessage/
ActiveParticipant

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Audit Source

AuditSourceID

AuditMessage/
AuditSourceIdentificati
on

AuditEnterpriseSiteIDU

not specialized

AuditSourceTypeCodeU

not specialized

ParticipantObjectTypeCodeM“2” (System)

ParticipantObjectTypeCodeRoleM“3” (Report)

ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCodeM

not specialized

ParticipantObjectSensitivityU

not specialized

ParticipantObjectID

M

The value of <Value Set Unique ID>

ParticipantObjectNameO

The value of <Value Set name>

ParticipantObjectQueryU

not specialized

ParticipantObjectDetailM

The value of <Value Set Version>

Value Set
Instance(AuditMessage/
ParticipantObjectIde
ntification)U

not specialized

3.49 Convey Printed Referral Request
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This transaction has been retired in favor of use of the Cross-Enterprise Document Workflow(XDW) Profile.

3.50 Request Referral
This transaction has been retired in favor of use of the Cross-Enterprise Document Workflow(XDW) Profile.

3.51 Multi-Patient Stored Query
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This section corresponds to transaction ITI-51 of the IHE Technical Framework. Transaction
ITI-51 is used by the Document Consumer and Document Registry Actors.
3.51.1 Scope

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The Multi-Patient Stored Query supports a variety of queries for multiple patients. It is based on
the Registry Stored Query transaction [ITI-18]. The main difference is the set of queries, whichis specified in this transaction.
3.51.2 Use Case Roles
Document
ConsumerDocument
Registry

Multi-patientStored Query

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Actor: Document Consumer
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Role: Issues a Multi-Patient Stored Query to retrieve metadata based on criteria common tomultiple patients
Actor: Document Registry
Role: Responds to a Multi-Patient Stored Query by providing the metadata or object referencesof registry objects which satisfy the query parameters3.51.3 Referenced Standard

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Implementers of this transaction shall comply with all requirements described in ITI TF-2x:
Appendix V Web Services for IHE Transactions.
ebRIM

OASIS ebXML Registry Information Model v3.0

ebRS

OASIS ebXML Registry Services Specifications v3.0

ITI TF-2a: 3.18 ITI-18 Registry Stored Query
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ITI TF-3: 4

Metadata used in Document Sharing profiles

3.51.4 Interaction Diagram
Document
Registry

Document
SourceMulti-Patient Stored
Query Request
Multi-Patient Stored
Query Response

3.51.4.1 Multi-Patient Stored Query Request
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This is a query request from the Document Consumer to the Document Registry. The query
request contains:•

A reference to a pre-defined query stored on the Document Registry Actor•

Parameters to the query

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3.51.4.1.1 Trigger Events
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The message is initiated when a Document Consumer wants to query for metadata based on
criteria spanning multiple patients (multiple Patient IDs).
3.51.4.1.2 Message Semantics
The message semantics are identical to those documented for the Registry Stored Query [ITI-18]
transaction except where noted below. The following sections document the differences.

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Document Source and Document Registry Actors that support the Asynchronous Web Services
Exchange Option shall support Asynchronous Web Services requirements as defined in ITI TF2x: V.5.
3.51.4.1.2.1 Query Definitions
This transaction defines the following Stored Queries that may query for multiple Patient Ids.
3.51.4.1.2.1.1 FindDocumentsForMultiplePatients

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This Multi-Patient Query is semantically identical to the FindDocuments Stored Query (see ITI
TF-2a: 3.18.4.1.2.3.7.1) except:•$XDSDocumentEntryPatientId is optional (may have zero values).

•$XDSDocumentEntryPatientId may contain multiple values.

•

At least one of the ClassCode, EventCodeList, or HealthcareFacilityTypeCode shall be
specified in the provided set of parameters.

Returns: XDSDocumentEntry or ObjectRef objects matching the query parameters
Parameter Name

Attribute$XDSDocumentEntryPatientId

Opt

Mult

XDSDocumentEntry. patientId

O

M

12

XDSDocumentEntry. classCode

O

M

1

$XDSDocumentEntryTypeCode

XDSDocumentEntry.typeCodeO

M$XDSDocumentEntryPracticeSettingCode1

XDSDocumentEntry.
practiceSettingCode

O

M

Lower value of
XDSDocumentEntry.
creationTimeO--$XDSDocumentEntryCreationTimeFrom

Upper value of
XDSDocumentEntry.
creationTimeO--$XDSDocumentEntryCreationTimeTo

Lower value of
XDSDocumentEntry.
serviceStartTimeO--$XDSDocumentEntryServiceStartTimeFrom$XDSDocumentEntryServiceStartTimeTo

Upper value of
XDSDocumentEntry.

O--$XDSDocumentEntryClassCode

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Parameter Name

Attribute

Opt

Mult

serviceStartTime
Lower value of
XDSDocumentEntry.
serviceStopTimeO--$XDSDocumentEntryServiceStopTimeFrom

Upper value of
XDSDocumentEntry.
serviceStopTimeO--$XDSDocumentEntryServiceStopTimeTo$XDSDocumentEntryHealthcareFacilityTypeCode1 2

XDSDocumentEntry.
healthcareFacilityTypeCodeO

M$XDSDocumentEntryEventCodeList1 2

XDSDocumentEntry.
eventCodeList3O

M$XDSDocumentEntryConfidentialityCode1

XDSDocumentEntry.
confidentialityCode3O

M$XDSDocumentEntryAuthorPerson4

XDSDocumentEntry. author

O

M$XDSDocumentEntryFormatCode

XDSDocumentEntry. formatCodeO

M$XDSDocumentEntryStatus

XDSDocumentEntry. statusR

M

XDSDocumentEntry.objectType

O

M

1

5

$XDSDocumentEntryType
1

Shall be coded according to specification in ITI TF-2a: 3.18.4.1.2.3.4 Coding of Code/CodeScheme.
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2

At least one of $XDSDocumentEntryClassCode, $XDSDocumentEntryEventCodeList, or$XDSDocumentEntryHealthcareFacilityTypeCode shall be specified.
3

Supports AND/OR semantics as specified in ITI TF-2a: 3.18.4.1.2.3.5.

4

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The value for this parameter is a pattern compatible with the SQL keyword LIKE which allows
the use of the following wildcard characters: % to match any (or no) characters and _ to match asingle character. The match shall be applied to the text contained in the Value elements of theauthorPerson Slot on the author Classification (value strings of the authorPerson sub-attribute)5

See ITI TF-2a:3.18.4.1.2.3.6.2

3.51.4.1.2.1.2 FindFoldersForMultiplePatients
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This Multi-Patient Query is semantically identical to the FindFolders Stored Query (see ITI TF2a: 3.18.4.1.2.3.7.3) except:
1. $XDSFolderPatientId is optional (may have zero values).
2. $XDSFolderPatientId may contain multiple values.
3. $XDSFolderCodeList shall be a required parameter.
Returns: XDSFolder or ObjectRef objects matching the query parameters

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Parameter Name

Attribute

Opt

Mult

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Opt

Mult

$XDSFolderPatientId

Parameter NameXDSFolder.patientId

AttributeO

M$XDSFolderLastUpdateTimeFrom

XDSFolder. lastUpdateTime
lower valueO--$XDSFolderLastUpdateTimeTo

XDSFolder. lastUpdateTime
upper boundO--$XDSFolderCodeList1,3

XDSFolder. codeList

R

M$XDSFolderStatus

XDSFolder.status

R

M

1

Shall be coded according to specification in ITI TF-2a: 3.18.4.1.2.3.4 Coding of Code/CodeScheme.
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Supports AND/OR semantics as specified in ITI TF-2a: 3.18.4.1.2.3.5.

3.51.4.1.2.2 Multi-Patient Stored Query IDs
The following Query Ids shall be used to represent these queries.
Query Name

Query ID

FindDocumentsForMultiplePatients

urn:uuid:3d1bdb10-39a2-11de-89c22f44d94eaa9f

FindFoldersForMultiplePatients

urn:uuid:50d3f5ac-39a2-11de-a1cab366239e58df

3.51.4.1.2.3 Web Services Transport
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The query request and response shall be transmitted using Web Services, according to therequirements specified in ITI TF-2x: Appendix V. The specific values for the WSDL describing
the Multi-Patient Stored Query Service are described in this section.
The Document Registry Actor shall accept a Multi-Patient Stored Query Request formatted as a
SIMPLE SOAP message and respond with a Multi-Patient Stored Query Response formatted asa SIMPLE SOAP message. The Document Consumer Actor shall generate the Multi-PatientStored Query Request formatted as a SIMPLE SOAP message and accept a Multi-Patient Stored
Query Response formatted as a SIMPLE SOAP message.
IHE-WSP201) The attribute /wsdl:definitions/@name shall be “DocumentRegistry”.
The following WSDL naming conventions shall apply:

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wsdl:definitions/@name="DocumentRegistry":
query message-> "MultiPatientStoredQuery_Message"
query response-> "MultiPatientStoredQueryResponse_Message"
portType-> "DocumentRegistry_PortType"operation-> "DocumentRegistry_MultiPatientStoredQuery"
SOAP 1.2 binding -> "DocumentRegistry_Binding_Soap12"
SOAP 1.2 port-> "DocumentRegistry_Port_Soap12"

IHE-WSP202) The targetNamespace of the WSDL shall be “urn:ihe:iti:xds-b:2007”

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These are the requirements for the Multi-Patient Stored Query transaction presented in the orderin which they would appear in the WSDL definition:
1. The following types shall be imported (xsd:import) in the /definitions/types section:
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4. namespace=" urn:oasis:names:tc:ebxml-regrep:xsd:query:3.0",
schemaLocation="query.xsd"
2. The /definitions/message/part/@element attribute of the Multi-Patient Stored Query
Request message shall be defined as “query:AdhocQueryRequest”

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3. The /definitions/message/part/@element attribute of the Multi-Patient Stored Query
Response message shall be defined as “query:AdhocQueryResponse”
4. The /definitions/portType/operation/input/@wsaw:Action attribute for the Multi-PatientStored Query Request message shall be defined as“urn:ihe:iti:2009:MultiPatientStoredQuery”

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5. The /definitions/portType/operation/output/@wsaw:Action attribute for the Multi-PatientStored Query Response message shall be defined as“urn:ihe:iti:2009:MultiPatientStoredQueryResponse”
6. The /definitions/binding/operation/soap12:operation/@soapAction attribute should be
defined as “urn:ihe:iti:2009:MultiPatientStoredQuery”

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The following WSDL fragment shows an example of Multi-Patient Stored Query transaction
definition:<?xml version="1.0" encoding="utf-8"?><definitions ...>...
<types><xsd:schema elementFormDefault="qualified" targetNamespace="urn:ihe:iti:xds-b:2007"><xsd:importnamespace="urn:oasis:names:tc:ebxml-regrep:xsd:query:3.0"
schemaLocation="schema\query.xsd"/>...
</xsd:schema></types><message name="RegistryStoredQuery_Message"><documentation>Multi-Patient Stored Query</documentation><part name="body" element="query:AdhocQueryRequest"/></message><message name="RegistryStoredQueryResponse_Message"><documentation>Multi-Patient Stored Query Response</documentation><part name="body" element="query:AdhocQueryResponse"/></message>...
<portType name="MPQRegistry_PortType"><operation name="MultiPatientStoredQuery"><input message="ihe:RegistryStoredQuery_Message"
wsaw:Action="urn:ihe:iti:2009:MultiPatientStoredQuery"/><output message="ihe:RegistryStoredQueryResponse_Message"
wsaw:Action="urn:ihe:iti:2009:MultiPatientStoredQueryResponse"/></operation>...
</portType>...
</definitions>

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A full WSDL for the Document Consumer and Document Registry Actors is found in ITI TF-2x:
Appendix W.
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3.51.4.1.2.4 Sample SOAP Messages
The samples in the following two sections show a typical SOAP request and its relative SOAP
response. The sample messages also show the WS-Addressing headers <a:Action/>,<a:MessageID/>, <a:ReplyTo/>…; these WS-Addressing headers are populated according to ITI
TF-2x: Appendix V: Web Services for IHE Transactions. The body of the SOAP message isomitted for brevity; in a real scenario the empty element will be populated with the appropriate
metadata.
Samples presented in this section are also available online on the IHE FTP site, see ITI TF-2x:
Appendix W.
3.51.4.1.2.4.1 Sample Multi-Patient Stored Query SOAP Request

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<s:Envelope xmlns:s="http://www.w3.org/2003/05/soap-envelope"
xmlns:a="http://www.w3.org/2005/08/addressing"><s:Header><a:Action s:mustUnderstand="1">urn:ihe:iti:2009:MultiPatientStoredQuery</a:Action><a:MessageID>urn:uuid:def119ad-dc13-49c1-a3c7-e3742531f9b3</a:MessageID><a:ReplyTo s:mustUnderstand="1">><a:Address>http://www.w3.org/2005/08/addressing/anonymous</a:Address></a:ReplyTo><a:To>http://localhost/service/IHEMPQRegistry.svc</a:To></s:Header><s:Body><query:AdhocQueryRequest
xmlns:query="urn:oasis:names:tc:ebxml-regrep:xsd:query:3.0"
xmlns:rim="urn:oasis:names:tc:ebxml-regrep:xsd:rim:3.0"
xmlns:rs="urn:oasis:names:tc:ebxml-regrep:xsd:rs:3.0"><query:ResponseOption returnComposedObjects="true" returnType="LeafClass"/><!-- FindDocumentsForMultiplePatients --><rim:AdhocQuery id="urn:uuid:3d1bdb10-39a2-11de-89c2-2f44d94eaa9f"><rim:Slot name="$XDSDocumentEntryStatus"><rim:ValueList><rim:Value>('urn:oasis:names:tc:ebxmlregrep:ResponseStatusType:Approved')</rim:Value></rim:ValueList></rim:Slot><!-- Note the lack of a specification of the $XDSDocumentEntryPatientId parameter

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-->

</rim:AdhocQuery></query:AdhocQueryRequest></s:Body></s:Envelope>

3.51.4.1.2.4.2 Sample Multi-Patient Stored Query SOAP Response
7645<s:Envelope xmlns:s="http://www.w3.org/2003/05/soap-envelope"
xmlns:a="http://www.w3.org/2005/08/addressing">

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<s:Header><a:Action
s:mustUnderstand="1">urn:ihe:iti:2009:MultiPatientStoredQueryResponse</a:Action><a:RelatesTo>urn:uuid:def119ad-dc13-49c1-a3c7-e3742531f9b3</a:RelatesTo></s:Header><s:Body><query:AdhocQueryResponse
xmlns:query="urn:oasis:names:tc:ebxml-regrep:xsd:query:3.0"
status="urn:oasis:names:tc:ebxml-regrep:ResponseStatusType:Success"><rim:RegistryObjectList xmlns:rim="urn:oasis:names:tc:ebxml-regrep:xsd:rim:3.0"><!-- Internal details of ExtrinsicObjects are not shown -->

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<rim:ExtrinsicObject/><rim:ExtrinsicObject/><rim:ExtrinsicObject/><rim:ExtrinsicObject/><rim:ExtrinsicObject/><rim:ExtrinsicObject/></rim:RegistryObjectList></query:AdhocQueryResponse></s:Body></s:Envelope>

3.51.4.1.3 Expected Actions
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See Registry Stored Query [ITI-18] for Expected Actions.
3.51.5 Security Considerations
All of the Security Considerations found in ITI-18 apply with the following further profiling.

7675

It is expected that the ATNA Secure Node authentication would be used to restrict access to the
MPQ transaction. It is expected that few systems would be allowed to request the LeafClass
return result.
3.51.5.1 Security Audit Considerations

7680

The actors involved shall record one audit event for each patient identity that has been includedin the query according to the following. It is important for security auditing that the audit
message contain only one patient identity to better handle these messages in the Audit Record
Repository. If the query includes no patient identities, both Actors shall record a single audit
event with no Patient participant.
3.51.5.1.1 Document Consumer audit message:
Field Name
Event
AuditMessage/
EventIdentification

Opt

Value Constraints

EventID

M

EV(110112, DCM, “Query”)

EventActionCodeM“E” (Execute)

EventDateTimeM

not specialized

EventOutcomeIndicatorM

not specialized

EventTypeCode

M

EV(“ITI-51”,“IHE Transactions”,“Multi-Patient Query”)

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Source (Document Consumer) (1)
Human Requestor (0..n)
Destination (Document Registry) (1)Audit Source (Document Consumer) (1)Patient (0..1)
Query Parameters(1)SourceAuditMessage/
ActiveParticipantU

not specialized

AlternativeUserIDM

the process ID as used within the local operating system in the local
system logs.

UserNameUnot specialized

UserIsRequestorM“true”

RoleIDCodeM

EV(110153, DCM, “Source”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointID

M

The machine name or IP address.

UserID

M

Identity of the human that initiated the transaction.

AlternativeUserIDU

not specialized

UserNameUnot specialized

UserIsRequestorM“true”

RoleIDCodeU

Access Control role(s) the user holds that allows this transaction.

NetworkAccessPointTypeCode

NA

NetworkAccessPointID

NA

Destination

UserID

M

SOAP endpoint URI.

AuditMessage/
ActiveParticipant

AlternativeUserIDU

not specialized

UserNameUnot specialized

UserIsRequestorM“false”

RoleIDCodeM

EV(110152, DCM, “Destination”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointID

M

The machine name or IP address.

AuditSourceIDU

not specialized

AuditEnterpriseSiteIDU

not specialized

AuditSourceTypeCodeU

not specialized

Patient (ifParticipantObjectTypeCodeM“1” (Person)

included inquery)

ParticipantObjectTypeCodeRole

M“1” (Patient)

ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCodeM

not specialized

ParticipantObjectSensitivityU

not specialized

Human
Requestor(if known)
AuditMessage/
ActiveParticipant

7685

UserID

Where:

Audit Source
AuditMessage/
AuditSourceIdentification(AuditMessage/
ParticipantObjectIdentif
ication)

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Query
Parameters(AuditMessage/
ParticipantObjectIdentif
ication)ParticipantObjectID

M

The patient ID in HL7 CX format.

ParticipantObjectNameU

not specialized

ParticipantObjectQueryU

not specialized

ParticipantObjectDetailUnot specialized

ParticipantObjectTypeCodeM“2” (system object)

ParticipantObjectTypeCodeRole

M“24” (query)

ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCode

M

EV(“ITI-51”, “IHE Transactions”, “Multi-Patient Query”)

ParticipantObjectSensitivityU

not specialized

ParticipantObjectID

M

Stored Query ID (UUID)

ParticipantObjectNameU

not specialized

ParticipantObjectQueryM

the AdhocQueryRequest, base64 encoded.3

ParticipantObjectDetailUnot specialized

3.51.5.1.2 Document Registry audit message:
Event
AuditMessage/
EventIdentification

Field Name

Opt

Value Constraints

EventID

M

EV(110112, DCM, “Query”)

EventActionCodeM“E” (Execute)

EventDateTimeM

not specialized

EventOutcomeIndicatorM

not specialized

EventTypeCode

M

EV(“ITI-51”, “IHE Transactions”, “Multi-Patient Query”)

U

not specialized

AlternativeUserIDU

not specialized

UserNameUnot specialized

UserIsRequestorM“true”

RoleIDCodeM

EV(110153, DCM, “Source”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointID

M

The machine name or IP address.

Source (Document Consumer) (1)Destination (Document Registry) (1)Audit Source (Document Registry) (1)Patient (0..1)
Query Parameters(1)7690
Where:
SourceAuditMessage/
ActiveParticipant

UserID7695
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Destination

UserID

M

SOAP endpoint URI.

AuditMessage/
ActiveParticipant

AlternativeUserIDM

the process ID as used within the local operating system in the local
system logs.

UserNameUnot specialized

UserIsRequestorM“false”

RoleIDCodeM

EV(110152, DCM, “Destination”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP addressUnot specialized

Audit Source

AuditSourceID

AuditMessage/
AuditSourceIdentificati
on

AuditEnterpriseSiteIDU

not specialized

AuditSourceTypeCodeU

not specialized

Patient (ifParticipantObjectTypeCodeM“1” (Person)

included inquery)

ParticipantObjectTypeCodeRole

M“1” (Patient)

ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCodeM

not specialized

ParticipantObjectSensitivityU

not specialized

ParticipantObjectID

M

The patient ID in HL7 CX format.

ParticipantObjectNameU

not specialized

ParticipantObjectQueryU

not specialized

ParticipantObjectDetailUnot specialized

ParticipantObjectTypeCodeM“2” (system object)

ParticipantObjectTypeCodeRole

M“24” (query)

ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCode

M

EV(“ITI-51”, “IHE Transactions”, “Multi-Patient Query”)

ParticipantObjectSensitivityU

not specialized

ParticipantObjectID

M

Stored Query ID (UUID)

ParticipantObjectNameU

not specialized

ParticipantObjectQueryM

the AdhocQueryRequest, base64 encoded.

ParticipantObjectDetailUnot specialized(AuditMessage/
ParticipantObjectIdentif
ication)Query
Parameters(AuditMessage/
ParticipantObjectIdentif
ication)7700

3.55 Cross Gateway Patient Discovery
This section corresponds to transaction ITI-55 of the IHE ITI Technical Framework. Transaction
ITI-55 is used by the Initiating Gateway and Responding Gateway Actors.
3.55.1 Scope

7705

The Cross Gateway Patient Discovery transaction supports the ability for Initiating Gateways
and Responding Gateways to discover mutually known patients. This transaction assumes anenvironment where patient data is well described and high quality demographic data is available.
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Because the transaction supports the mutual discovery of patients it can be seen as having dual
purposes.
•

To support a query by the Initiating Gateway requesting a demographically matching
patient from within the Responding Gateway’s community.

•

To support a feed to Responding Gateway announcing that the patient is known by theInitiating Gateway’s community.

7710

7715

This dual nature of the transaction is chosen for scalability purposes, as demographic matchingalgorithms are expensive on a large scale and once a match is identified it is important that boththe initiating and responding sides of the transaction can use the results of that successful match.
The Cross Gateway Patient Discovery transaction has several modes, useful in different
environments:•

Demographic Query only mode – in this mode only the demographics of the patient areincluded in the request. The initiating community does not have, or does not choose to
specify, a patient identifier for use by the Responding Gateway.

•

Demographic Query and Feed – in this mode both the demographic and initiating
community identifier are included in the request.

•

Shared/national Patient Identifier Query and Feed – in this mode only a shared/national
identifier is specified. Demographics are not necessary because matching can be done on
the identifier alone.

7720

7725

This transaction can be used synchronously and asynchronously.

7730

7735

The Cross Gateway Patient Discovery request asks for information about patients whose
demographic data match data provided in the query message. The request is received by the
Responding Gateway Actor. The Responding Gateway Actor indicates in its response whether
the community has knowledge of a patient matching the set of demographic data and, if a match
is found, returns the demographics known by the responding community. If more than one match
is found the Responding Gateway has the option of providing a list 1 of matching patients orreturning nothing. When nothing is returned the Responding Gateway may include in the
response a set of additional demographic attributes which, if supplied, would aid in
disambiguating the multiple matches.
In the case of a match, the Responding Gateway may further update its own cache to indicatethat the initiating community knows this patient and should be queried if data for this patient isdesired.

1

Returning a list of matches may potentially expose information that is unrelated to the patient requested.
Implementers are encouraged to consider ways to keep the number of elements in a list to a minimum. Deployment
organizations may choose to declare a limit to the number of elements allowed to be returned.
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The criteria used for demographic matching is defined by policy and not specified here, but fully
enabled by the transaction.
3.55.2 Use Case Roles
Initiating
Gateway

Responding
Gateway

Cross Gateway
Patient Discovery

Actor: Initiating Gateway
7745

Role: Requests the Responding Gateway to indicate whether the community has knowledge of apatient matching a set of demographic criteria.
Corresponding HL7 v3 Application Roles:
Person Registry Query Placer (PRPA_AR201303UV02)
Actor: Responding Gateway

7750

7755

Role: If a demographics match is found, returns demographics known by the responding
community. If more than one match is found the Responding Gateway has the option ofproviding a small list of matching patients or returning no match. In the case of no match, theResponding Gateway may provide a list of additional demographic attributes needed todisambiguate multiple matches.
Corresponding HL7 v3 Application Roles:
Person Registry Query Fulfiller (PRPA_AR201304UV02)
3.55.3 Referenced Standard
HL7 Version 3 Edition 2008, Patient Administration DSTU, Patient Topic (found at
http://www.hl7.org/memonly/downloads/v3edition.cfm#V32008)

7760

Implementers of this transaction shall comply with all requirements described in ITI TF-2x:
Appendix V Web Services for IHE Transactions

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3.55.4 Interaction Diagram
Initiating
Gateway

Responding
Gateway

Cross Gateway Patient
Discovery Request
Cross Gateway Patient
Discovery Response

7765

3.55.4.1 Cross Gateway Patient Discovery Request
The Cross Gateway Patient Discovery Request is implemented using the HL7 Patient Registry
Query by Demographics (PRPA_MT201306UV02) message.
3.55.4.1.1 Trigger Events

7770

7775

The initiating community needs to determine whether a patient is known by another community.
Specific possible trigger events include, but are not limited to:•

The initiating community registers a new patient who has permitted sharing of healthcare
data with external communities.

•

A healthcare provider within the community requests that records regarding a particularpatient be accessed from a particular external community or all external communities
known.

3.55.4.1.2 Message Semantics
The components of the Patient Registry Query by Demographics message with cardinality
greater than 0 (as shown below) are required, and the detailed description of the message isprovided in Sections 3.55.4.1.2.1 to 3.55.4.1.2.3.
7780

For each element which is required, the element shall be specified by the Initiating Gateway inthe request and shall be used by the Responding Gateway as part of its demographic matchingalgorithm.

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7790

7795

7800

For each element which is optional the element does not need to be specified by the Initiating
Gateway in the request but, if specified, shall be used by the Responding Gateway as part of its
demographic matching algorithm.
The Responding Gateway shall support Asynchronous Web Services Exchange as described in
ITI TF-2x: V.5, Synchronous and Asynchronous Web Services Exchange. If the Initiating
Gateway declares the Asynchronous Web Services Exchange Option it shall also support
Asynchronous Web Services Exchange as described in ITI TF-2x: V.5. Use of Asynchronous
Web Services Exchange is necessary when transactions scale to large numbers of communities
because it allows for more efficient handling of latency and scale.
The Initiating Gateway may specify a duration value in the SOAP Header element of the request.
This value suggests to the Responding Gateway a length of time that the Initiating Gateway
recommends caching any correlation resulting from the interaction. The duration value isspecified in the SOAP Header using the CorrelationTimeToLive element and contains a value
conformant with the xs:duration type defined in http://www.w3.org/TR/xmlschema-2/#duration.
If no CorrelationTimeToLive element is specified in the SOAP Header the Responding Gateway
shall interpret this as a recommendation against caching, unless a mutually agreed policy statesotherwise.
An example of specifying the CorrelationTimeToLive element follows, which recommends
caching of 7 days.
<xcpd:CorrelationTimeToLive>P0Y0M7D</xcpd:CorrelationTimeToLive>3.55.4.1.2.1 Major Components of the Patient Registry Query by Demographics
LivingSubjectName Parameter
7805

7810

This required parameter specifies the name of the person whose information is being queried. If
multiple instances of LivingSubjectName are provided, the receiver shall consider them as
possible alternatives, logically connected with an "or". Within each LivingSubjectName element,a single person name (PN) data item shall be specified in the LivingSubjectName.value attribute.
An Initiating Gateway may specify all, or only a subset of the name parts within the PN data type(e.g., family name). The use attribute of the value element shall not be set to "SRCH".
LivingSubjectAdministrativeGender Parameter
This optional parameter specifies the administrative gender of the person whose information is
being queried. For this parameter item, a single administrative gender code shall be specified in
the LivingSubjectAdministrativeGender.value attribute.

7815

LivingSubjectBirthTime Parameter
This required parameter specifies the birth data and time of the person whose information is
being queried. This parameter can convey an exact moment (e.g., January 1, 1960 @ 03:00:00
EST), an approximate date (e.g., January 1960), or even a range of dates (e.g., December 1, 1959
through March 31, 1960).

7820

PatientAddress Parameter
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This optional parameter specifies one or more addresses associated with the person whose
information is being queried.
LivingSubjectId Parameter
7825

7830

This optional repeating parameter specifies an identifier associated with the patient whose
information is being queried (e.g., a local identifier, or an account identifier). If this parameter is
specified, LivingSubjectName and LivingSubjectBirthTime are optional. This feature allows thisquery to be used when a national/shared patient identifier is known. The identifier specified in
the LivingSubjectId.value attribute is expressed using the II data type. Please see ITI TF-2x:
Appendix E for the use of the II data type for patient identifiers.
The Initiating Gateway has the option of designating one of the identifiers in LivingSubjectId as
the patient identifier that the Responding Gateway may use in an XCA Cross Gateway Query to
the community represented by the Initiating Gateway (see Section 3.55.4.1.2.4) .
LivingSubjectBirthPlaceAddress Parameter
This optional parameter specifies the birth address of the patient.

7835

LivingSubjectBirthPlaceName Parameter
This optional parameter specifies the name of the entity (like hospital name) where the patient
was born.
MothersMaidenName Parameter

7840

This optional parameter specifies the maiden name of the mother of the person whose
information is being queried. For this parameter item, a single person name (PN) data item shallbe specified in the Person.value attribute. Within the PN data type, the given name and familyname may be specified. The use attribute of the value element shall not be set to "SRCH"
PatientTelecom

7845This optional parameter specifies a telecommunication address or addresses for communication
with the patient.
PrincipalCareProviderId

7850

This optional parameter specifies the care provider identifier of a person who has been assigned
as the principal care provider of this patient. The requestor may specify multiple
PrincipalCareProviderId elements which the responder shall consider as possible alternatives,
logically connected with an "or". Within each PrincipalCareProviderId element, a single
identifier shall be specified in the PrincipalCareProviderId.value attribute.
3.55.4.1.2.2 Message Information Model of the Patient Registry Query by
Demographics Message

7855

Below is the Message Information Model for the Query by Demographics message, as restricted
for this transaction. The purpose of the model is to describe the data elements relevant for this

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transaction. It is a strict subset of the Patient Registry Query by Demographics(PRPA_RM201306UV02) RMIM.

7860

The base RMIM can be found on the HL7 V3 2008 Edition CD at
Edition2008/domains/uvpa/editable/PRPA_RM201306UV.htm. The following restrictions weremade on the original RMIMs to arrive at the restricted model:•

The optional attributes ParameterList.id, MatchCriterionList.id, QueryByParameter
responseElementGroupId, QueryByParameter.modifyCode, andQueryByParameter.executionAndDeliveryTime were omitted from the model.

•

QueryByParameter.responsePriorityCode is required and is either I (Immediate) or D
(Deferred). See Section 3.55.6.2 for use of Deferred.

•

QueryByParameter.responseModalityCode is required and is fixed to R (Real Time).

•

QueryByParameter.statusCode is defaulted to "new".

•

The data type of MatchAlgorithm.value is constrained to ST.

•

The data type of MinimumDegreeMatch.value is constrained to INT between 0 and 100.

•

The data type of LivingSubjectName.value is constrained to PN.

•

The optional SortControl was omitted from the model.

•

The optional MatchWeight was omitted from the model.

•

The following optional parameters were omitted from the model:

7865

7870

7875

•

PatientStatusCode•

LivingSubjectDeceaseTime•

OtherIDsScopingOrganization•

initialQuantity•

initialQuantityCode

The attributes of this model are described in the following table:

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Figure 3.55.4.1.2-1: Patient Registry Query by Demographics Message
Table 3.55.4.1.2-1:
PRPA_HD201306IHE
Patient Registry Query by Demographics

This HMD extract defines the message used to query acommunity for patients matching a set of demographics
information.
Derived from Figure 3.55.4.1.2-1(PRPA_RM201306IHEXCPD)

QueryByParameter

The entry point for the domain content in this query

queryId [1..1]
QueryByParameter (II)Unique identifier for the query

statusCode [1..1] (M)QueryByParameter (CS) {CNE:QueryStatusCode, fixedvalue="new"}

The status of the query, shall be "new"responseModalityCode [1..1]
QueryByParameter (CS) {CNE:ResponseModality, fixedvalue="R"}

The mode of the response – always real-time.

responsePriorityCode [1..1]
QueryByParameter (CS) {CNE:QueryPriority}

Either “I” or “D” shall be specified. “I” (Immediate)
indicates that the Responding Gateway is required to send an
immediate response. “D” (Deferred) indicates the
Responding Gateway is required to send a deferred response,
see Section 3.55.6.2.

initialQuantity [0..1]

Not supported, any value will be ignored by responder.

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PRPA_HD201306IHE
Patient Registry Query by Demographics

This HMD extract defines the message used to query acommunity for patients matching a set of demographics
information.
Derived from Figure 3.55.4.1.2-1(PRPA_RM201306IHEXCPD)

QueryByParameter (INT)
initialQuantityCode [0..1]
QueryByParameter (CE) {CWE:QueryRequestLimit,
default="RD"}Not supported, any value will be ignored by responder.

MatchAlgorithm

This parameter conveys instructions to the Responding
Gateway specifying the preferred matching algorithm touse and may be ignored

value [1..1]
ParameterItem (ST)The name of the algorithm

semanticsText [1..1]
ParameterItem (ST){default= "MatchAlgorithm"}
MinimumDegreeMatch

This parameter conveys instructions to the Responding
Gateway specifying minimum degree of match to use in
filtering results and may be ignored

value [1..1]
ParameterItem (INT)The numeric value of the degree of match. Shall be value
between 0 and 100 .

semanticsText [1..1]
ParameterItem (ST){default= "MinimumDegreeMatch"}
This query parameter is a code representing theadministrative gender of a person in a patient registry.

LivingSubjectAdministrativeGender
value [1..1]
ParameterItem (CE) {CWE:AdministrativeGender}
semanticsText [1..1]
ParameterItem (ST){default="LivingSubject.administrativeGender"}LivingSubjectBirthTime

This query parameter is the birth date of a living subject.

value [1..1]
ParameterItem (IVL<TS>)

A date or date range. This parameter can convey an exact
moment (e.g., January 1, 1960 @ 03:00:00 EST), an
approximate date (e.g., January 1960), or even a range ofdates (e.g., December 1, 1959 through March 31, 1960).

semanticsText [1..1]
ParameterItem (ST){default= "LivingSubject.birthTime"}
LivingSubjectId
value [1..*] (M)ParameterItem (II)A patient identifier, used to assist in finding a match for thequery and, when so designated by the Initiating Gateway,
used by the Responding Gateway in a XCA Cross Gateway
Query directed to the Community designated by thehomeCommunityId value specified in the Control Act
Wrapper – see Section 3.55.4.1.2.4.

semanticsText [1..1]
ParameterItem (ST){default= "LivingSubject.id"}
This query parameter is the name of a person. If multiple
instances of LivingSubjectName are provided, the receivermust consider them as possible alternatives, logically

LivingSubjectName

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PRPA_HD201306IHE
Patient Registry Query by Demographics

This HMD extract defines the message used to query acommunity for patients matching a set of demographics
information.
Derived from Figure 3.55.4.1.2-1(PRPA_RM201306IHEXCPD)
connected with an "or".

value [1..1]
ParameterItem (PN)

Only one instance of the value element is allowed. Onlysome of the name parts may be populated. If, for example,
only the family and given name parts of a person's name aresent, then the query would match all persons with that familyname and given name regardless of their initials. The use
attribute of the value element shall not be set to "SRCH".

semanticsText [1..1]
ParameterItem (ST){default= "LivingSubject.name"}
PatientAddressThis query parameter is a postal address for corresponding
with a patient. There shall be only a single PatientAddresselement.

value [1..*]
ParameterItem (AD)Multiple instances of the value element within a Patient
Address may be specified and are combined with OR logic.

semanticsText [1..1]
ParameterItem (ST){default= "Patient.addr"}
This query parameter is a patient's birthplace represented as
an address

LivingSubjectBirthPlaceAddress
value [1..*]
ParameterItem (SET<AD>)semanticsText [1..1]
ParameterItem (ST){default="LivingSubject.BirthPlace.Addr"}

This query parameter is a patient's birthplace represented as aplace name

LivingSubjectBirthPlaceName
value [1..*]
ParameterItem (SET<EN>)
semanticsText [1..1]
ParameterItem (ST){default="LivingSubject.BirthPlace.Place.Name"}
PrincipalCareProviderId

This query parameter is the care provider identifier of aperson who has been assigned as the principal care providerof this patient. The requestor may specify multiple
PrincipalCareProviderId elements which responder shallconsider as possible alternatives, logically connected with an"or".

value [1..1]
ParameterItem (II)There shall have only one id in the “value” attribute.

semanticsText [1..1]
ParameterItem (ST){default= "AssignedProvider.id"}
This query parameter is the maiden name of a focal person's
mother. It is included as a parameter because it is a common
attribute for confirming the identity of persons in someregistries. This parameter does not map to a single RIM
attribute, instead, in RIM terms Mother's maiden name is theMothersMaidenName

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PRPA_HD201306IHE
Patient Registry Query by Demographics

This HMD extract defines the message used to query acommunity for patients matching a set of demographics
information.
Derived from Figure 3.55.4.1.2-1(PRPA_RM201306IHEXCPD)
person name part of "family" with an
EntityNamePartQualifier of "birth" for the person who is theplayer in a PersonalRelationship of type of "mother" to the
focal person.

value [1..1]
ParameterItem (PN)

A person name. In this case it may consist of only the given
name part, the family name part, or both.

semanticsText [1..1]
ParameterItem (ST){default="Person.MothersMaidenName"}
PatientTelecom

This query parameter is a telecommunications address forcommunicating with a living subject in the context of thetarget patient registry. It could be a telephone number, fax
number or even an email address. There shall be only asingle PatientTelecom element.

value [1..*]
ParameterItem (TEL)

A telecommunications address. The scheme attribute
specifies whether this is a telephone number, fax number,email address, etc. Multiple instances of the value element
within a PatientTelecom may be specified and are combinedwith OR logic.

semanticsText [1..1]
ParameterItem (ST){default= "Patient.telecom"}

7885
3.55.4.1.2.3 Control Act and Transmission Wrappers
Please see ITI TF-2x: Appendix O for details on the IHE guidelines for implementing thewrappers. Table 3.55.4.1.2-2 contains the Transmission and Control Act wrappers used for thisinteraction, and the associated constraints.
7890
Table 3.55.4.1.2-2: Wrappers and Constraints
Transmission Wrapper

Trigger Event Control Act Wrapper

MCCI_MT000100UV01 - Send Message Payload

QUQI_MT021001UV01 - Query Control Act Request :Query By Parameter

The value of interactionId shall be set to
PRPA_IN201305UV02
The value of processingModeCode shall be set to T
The acceptAckCode shall be set to AL
There shall be only one receiver Device

The value of ControlActProcess.moodCode shall be set to
EVN
The trigger event code in ControlActProcess.code shall be
set to PRPA_TE201305UV02
If an authorOrPerformer participation is present, the valueof authorOrPerformer.typeCode SHALL be set to AUT

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7895

The composite message schemas which describe the full payload of this interaction, including
the wrappers, can be found online on the IHE FTP site, see ITI TF-2x: Appendix W. The
schemas from the HL7 V3 2008 Normative Edition can be found at:
Edition2008/processable/multicacheschemas/PRPA_IN201305UV02.xsd)
3.55.4.1.2.4 Values used by Responding Gateway for a reverse Cross Gateway
Query

7900

7905

The Initiating Gateway shall specify two values in the request which allow the responding
community to generate a reverse Cross Gateway Query in search of data about the patient
identified in the Cross Gateway Patient Discovery request. The two values are
homeCommunityId and community patient id assigning authority.
homeCommunityId – this value is a globally unique identifier for a community – further
defined in Section 3.38.4.1.2.1. The Initiating Gateway shall specify this value in the Cross
Gateway Patient Discovery request unless the Initiating Gateway is not grouped with a
Responding Gateway.
The Responding Gateway uses the homeCommunityId to obtain the Web Services endpoint ofservices that provide access to data in the Initiating Gateway’s community.

7910

The homeCommunityId is specified as the id element within the Organization associated withthe device of the sender. The id element designating the homeCommunityId shall have only theroot element the contents of which is the homeCommunityId.

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Figure 3.55.4.1.2.4-1: Send Message Payload

7915
An example of specifying the homeCommunityId element follows, where
homeCommunityId=1.2.3.
7920<sender typeCode="SND"><device classCode="DEV" determinerCode="INSTANCE"><id root="1.2.840.114350.1.13.999.567"/><asAgent classCode="AGNT"><representedOrganization classCode="ORG" determinerCode="INSTANCE"><!-- homeCommunityId=urn:oid:1.2.3 -->7925<id root="1.2.3"/></representedOrganization></asAgent></device></sender>7930

Community patient id assigning authority – this value designates the assigning authority forthe patient identifier to be used within a reverse Cross Gateway Query. This value is not theassigning authority for all patient identifiers used by that community, but only the patient
identifier used for the patient identified in the query. The Initiating Gateway shall be capable ofspecifying this value in the Cross Gateway Patient Discovery request.

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7935

7940

7945

7950

The Responding Gateway may use the specified assigning authority to identify which of the
LivingSubjectID values to use in a reverse Cross Gateway Query.
The community patient id assigning authority is specified as the id element within theassignedDevice associated with the authorOrPerformer element. The id element designating thecommunity patient id assigning authority shall have only the root element, the contents of which
designate the assigning authority of the LivingSubjectId to be used in the reverse Cross Gateway
Query.
An example of specifying the community patient id assigning authority element follows, where
the assigning authority specified is 1.2.840.114350.1.13.99997.2.3412 (see highlighted text)
which identifies the first LivingSubjectID ( root="1.2.840.114350.1.13.99997.2.3412"
extension="1234") as the patient identifier to be used in a reverse Cross Gateway Query. In
essence, the highlighted text must match to designate the patient identifier.
<controlActProcess classCode="CACT" moodCode="EVN"><code code="PRPA_TE201305UV02" codeSystem="2.16.840.1.113883.1.6"/><!-- Identifies the first LivingSubjectID in the parameterList as the patient
Identifier to be used by responder in a reverse Cross Gateway Query --><authorOrPerformer typeCode="AUT"><assignedDevice><id root="1.2.840.114350.1.13.99997.2.3412"/>7955</assignedDevice></authorOrPerformer><queryByParameter><queryId root="1.2.840.114350.1.13.28.1.18.5.999" extension="18204"/>7960<statusCode code="new"/><parameterList><livingSubjectBirthTime><value value="19630804"/>7965<semanticsText>LivingSubject..birthTime</semanticsText></livingSubjectBirthTime><livingSubjectName><value><given>Jimmy</given><family>Jones</family>

7970</value><semanticsText>LivingSubject.name</semanticsText></livingSubjectName><LivingSubjectId>

7975<value root="1.2.840.114350.1.13.99997.2.3412" extension="1234"/><semanticsText>LivingSubject.id</semanticsText></LivingSubjectId><LivingSubjectId><value root="2.16.840.1.113883.4.1" extension="58910"/><semanticsText>LivingSubject.id</semanticsText>

7980</LivingSubjectId></parameterList>

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IHE IT Infrastructure Technical Framework, Volume 2b (ITI TF-2b): Transactions Part B______________________________________________________________________________</queryByParameter></controlActProcess>

7985

7990

7995

8000

Comparison of homeCommunityId and assigning authority
The value of homeCommunityId is an OID which may, or may not, also be an assigningauthority. An assigning authority is designated by an OID and issues identifiers, in this casepatient identifiers. A community’s patient identifier assigning authority issues patient identifiers
for patients managed by the community. It is possible for there to be more than one patient
identifier assigning authority in a community. The Initiating Gateway must specify the rightpatient identifier assigning authority for the patient being described. There is only one
homeCommunityId per community. This OID may also be used by the community as the patient
identifier assigning authority, but this is not required and should not be expected. While both
values are OID’s they have no necessary relationship. In general it is expected that the
homeCommunityId will be assigned by an organization which governs the interaction amongcommunities. In many countries this will be facilitated by the government who will manage thecommunity level agreements necessary for sharing and also assign homeCommunityIds. An
assigning authority has no expected level of management, and there may be multiple patient
identifier assigning authorities within a community.
3.55.4.1.3 Expected Actions
If responsePriorityCode is “I” the Responding Gateway shall return a Find Candidates Response
message as specified in Section 3.55.4.2. The response message uses the Application
Acknowledgement transmission wrapper, as specified in ITI TF-2x: O.1.3, and no otheracknowledgments are part of this the transaction.

8005

8010

If responsePriorityCode is “D” and the Responding Gateway does not support the Deferred
Response Option, it shall return an application error in the HL7 V3 Accept Acknowledgementwith acknowledgeDetail to indicate Unsupported Processing Mode.
<MCCI_IN000002UV01 …
( . . . )<acknowledgement><typeCode code="AE"/><targetMessage><id root="22a0f9e0-4454-11dc-a6be-3603d6866807"/>8015</targetMessage><acknowledgementDetail typeCode="E"><code code="NS250" displayName="Unsupported processing mode"/><text>Deferred Response not supported.</text></acknowledgementDetail>8020</acknowledgement></MCCI_IN000002UV01>

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If the Responding Gateway supports the Deferred Response Option, it shall respond as describedin Section 3.55.6.2.
8025

8030

If the Responding Gateway is unable to process the request due to an internal error, such as the
local Master Patient Index system is offline, the Responding Gateway shall return an application
error as described in Section 3.55.4.2.3 Case 5.
The community associated with the Responding Gateway may make use of thehomeCommunityId and community patient identifier assigning authority by initiating a Cross
Gateway Query. See Section 3.55.4.1.2.4 for more information. This provisioning of the
Responding Gateway community may be cached indefinitely, but efforts are needed to ensurethat changes are properly reflected. For more detail about this issue refer to Section 3.55.4.2.3.1.
3.55.4.1.3.1 Query Parameter Processing

8035

8040

The Responding Gateway Actor shall be capable of accepting, searching on, and responding withattributes in the Query Person by Demographics message.
Handling of phonetic issues, alternate spellings, upper and lower case, accented characters, etc.,
if deemed appropriate, is to be supported by the Responding Gateway rather than by theInitiating Gateway. The Responding Gateway shall return any matches to the query parametersthat reflect a high degree of match, after consideration of all policy constraints; IHE does notfurther specify matching requirements, except as already discussed in the LivingSubjectName
parameter description.
3.55.4.2 Cross Gateway Patient Discovery Response
The Cross Gateway Patient Discovery Response is implemented using the HL7 Patient Registry
Find Candidates Response PRPA_MT201310UV02) message.

8045

3.55.4.2.1 Trigger Events
The Patient Registry Find Candidates Response message (PRPA_MT201310UV02) is sent by
the Responding Gateway Actor in response to the query (PRPA_MT201306UV02) message
previously received.
3.55.4.2.2 Message Semantics

8050

8055

The components of the message with cardinality greater than 0 (as shown below) are required,
and the detailed description of the message is provided in Sections 3.55.4.2.2.1 to 3.55.4.2.2.7.
All other attributes of the message are optional.
For each element that is required this means that it shall be provided by Responding Gateway,
unless not available, and shall be accepted by requestor but requestor is not required to process
the value in any way, only accept it without any error.
The Responding Gateway shall support Asynchronous Web Services Exchange as described in
ITI TF-2x: V.5, Synchronous and Asynchronous Web Services Exchange. If the Initiating
Gateway declares the Asynchronous Web Services Exchange Option it shall also support
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8060

8065

8070

Asynchronous Web Services Exchange as described in ITI TF-2x: V.5. Use of Asynchronous
Web Services Exchange is necessary when transactions scale to large numbers of communities
because it allows for more efficient handling of latency and scale.
The Responding Gateway may specify a duration value in the SOAP Header element of the
response. This value suggests to the Initiating Gateway a length of time that the Responding
Gateway recommends caching any correlation resulting from the interaction. The duration valueis specified in the SOAP Header using the CorrelationTimeToLive element and contains a value
conformant with the xs:duration type defined in http://www.w3.org/TR/xmlschema-2/#duration.
If no CorrelationTimeToLive element is specified in the SOAP Header the Initiating Gateway
shall interpret this as a recommendation against caching, unless a mutually agreed policy statesotherwise.
An example of specifying the CorrelationTimeToLive element follows, which recommends
caching of 7 days.
<xcpd:CorrelationTimeToLive>P0Y0M7D</xcpd:CorrelationTimeToLive>3.55.4.2.2.1 Major Components of the Patient Registry Find Candidates Response
Message
8075

This message shares all the major components of the Patient Activate/Revise messages, as
described in Section 3.44.4.1.2.1. The only additional component is the QueryMatchObservation
class.
Query Match Observation

8080

The QueryMatchObservation class is used to convey information about the quality of thematch for each record returned by the query response.
3.55.4.2.2.2 Message Information Model of the Patient Registry Find Candidates
Response Message

8085

Below is the Message Information Model for the Patient Registry Find Candidates Response
message, as restricted for this transaction. The purpose of the model is to describe the data
elements relevant for this transaction. It is a strict common subset of the Patient Registry Find
Candidates Response (PRPA_RM201310UV02) RMIM.
The base RMIM can be found on the HL7 V3 2008 Edition CD at
Edition2008/domains/uvpa/editable/PRPA_RM201310UV.htm. The following restrictions weremade on the original RMIMs to arrive at the restricted model:

8090

•

The focal entity choice is restricted to be only a person•

The relationship holder of the personal relationship is restricted to be a person (using
CMET COCT_MT030207UV)•The following roles are omitted:•

asPatientOfOtherProvider

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8095

8100

•

guarantor•

guardian•contactParty•

asMember•careGiver•

asStudent

The following participations are omitted:•

subjectOf2 (administrativeObservation)•

coveredPartyOf (coverage)

8105
Figure 3.55.4.2.2-1: Patient Registry Find Candidates Response Message

The attributes of this model are described in the following table. Note that CMETs are notdiscussed, as the HL7 definitions for them are being used.
8110

Table 3.55.4.2.2-1: Attributes
PRPA_HD201310IHE
Patient Registry Find Candidates Response

This HMD extract defines the message used
to return records from a patient registry in
response to a Find Candidates Query.
Derived from Figure 3.55.4.2.2-1(PRPA_RM201310IHE)

Patient

The primary record for the focal personclassCode [1..1] (M)Structural attribute; this is a "patient" role

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PRPA_HD201310IHE
Patient Registry Find Candidates Response

This HMD extract defines the message used
to return records from a patient registry in
response to a Find Candidates Query.
Derived from Figure 3.55.4.2.2-1(PRPA_RM201310IHE)

Patient (CS) {CNE:PAT}
id [1..1] (M)Patient (SET<II>)

The Patient Identifier to be used in subsequent
XCA Cross Gateway Query transactions related
to this patient when sent to the Responding
Gateway sending the response. All other patient
identifiers shall be specified in the OtherIDs.id
attribute.

statusCode [1..1]
Patient (CS) {CNE:active, fixed value= "active"}

A value specifying the state of this record in apatient registry (based on the RIM role classstate-machine). This record is active.

confidentialityCode [0..*]Patient (SET<CE>) {CWE:Confidentiality}

Value(s) that control the disclosure of
information about this living subject as a patient

veryImportantPersonCode [0..1]
Patient (CE) {CWE:PatientImportance}

A code specifying the patient's special status
granted by the scoper organization, often
resulting in preferred treatment and special
considerations. Examples include board
member, diplomat.

PersonA subtype of LivingSubject representing ahuman being
Either Person.name or Patient.id must be nonnull

classCode [1..1] (M)Person (CS) {CNE:PSN, fixed value= "PSN"}

Structural attribute; this is a "person" entity

determinerCode [1..1] (M)Person (CS) {CNE:INSTANCE, fixed value= "INSTANCE"}

Structural attribute; this is a specific personname [1..*]
Person (BAG<PN>)

Name(s) for this person. May be null i.e.,<name nullFlavor=”NA”/> only if the request
contained only a patient identifier and no
demographic data.

telecom [0..*]
Person (BAG<TEL>)

Telecommunication address(es) for
communicating with this person

administrativeGenderCode [0..1]
Person (CE) {CWE:AdministrativeGender}

A value representing the gender (sex) of thisperson. Note: this attribute does not include
terms related to clinical gender which is acomplex physiological, genetic and sociologicalconcept that requires multiple observations inorder to be comprehensively described.

birthTime [0..1]
Person (TS)The date and time this person was bornbirthPlace
deceasedInd [0..1]
Person (BL)An indication that this person is deaddeceasedTime [0..1]
Person (TS)The date and time this person died

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PRPA_HD201310IHE
Patient Registry Find Candidates Response

This HMD extract defines the message used
to return records from a patient registry in
response to a Find Candidates Query.
Derived from Figure 3.55.4.2.2-1(PRPA_RM201310IHE)

multipleBirthInd [0..1]
Person (BL)An indication that this person was part of amultiple birthmultipleBirthOrderNumber [0..1]
Person (INT)The order in which this person was born if partof a multiple birth

addr [0..*]
Person (BAG<AD>)

Address(es) for corresponding with this person

maritalStatusCode [0..1]
Person (CE) {CWE:MaritalStatus}

A value representing the domestic partnershipstatus of this person

religiousAffiliationCode [0..1]
Person (CE) {CWE:ReligiousAffiliation}

A value representing the primary religious
preference of this person

raceCode [0..*]
Person (SET<CE>) {CWE:Race}

A set of values representing the races of thispersonethnicGroupCode [0..*]
Person (SET<CE>) {CWE:Ethnicity}

A set of values representing the ethnic groups ofthis person

OtherIDs

Used to capture additional identifiers for the
person such as a Drivers’ license or Social
Security Number.

classCode [1..1] (M)Role (CS) {CNE:ROL}

Structural attribute. This can be any
specialization of "role" except for Citizen, or
Employee.,id [1..*] (M)Role (SET<II>)

One or more identifiers issued to the focal
person by the associated scopingOrganization(e.g., identifiers from a different Patient Identity
Domain).

PersonalRelationship

A personal relationship between the focal living
subject and another living subject

classCode [1..1] (M)Role (CS) {CNE:PRS, fixed value= "PRS"}

Structural attribute; this is a "personal
relationship" role

id [0..*]
Role (SET<II>)

Identifier(s) for this personal relationshipcode [1..1] (M)Role (CE) {CWE:PersonalRelationshipRoleType}A required value specifying the type of personal
relationship between the relationshipHolder andthe scoping living subject drawn from the
PersonalRelationshipRoleType domain, forexample, spouse, parent, unrelated friend

CitizenUsed to capture person information relating tocitizenship.

classCode [1..1] (M)Role (CS) {CNE:CIT, fixed value= "CIT"}

Structural attribute; this is a "citizen" role

id [0..*]
Role (SET<II>)

Identifier(s) for the focal person as a citizen of anationNationA politically organized body of people bonded

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PRPA_HD201310IHE
Patient Registry Find Candidates Response

This HMD extract defines the message used
to return records from a patient registry in
response to a Find Candidates Query.
Derived from Figure 3.55.4.2.2-1(PRPA_RM201310IHE)
by territory and known as a nation.

classCode [1..1] (M)Organization (CS) {CNE:NAT, fixed value= "NAT"}

Structural attribute; this is a 'nation' type ofentitydeterminerCode [1..1] (M)Organization (CS) {CNE:INSTANCE, fixed value= "INSTANCE"}

Structural attribute; this is a specific entity

code [1..1] (M)Organization (CD) {CWE:NationEntityType}A value that identifies a nation statename [0..1]
Organization (ON)A non-unique textual identifier or moniker forthis nation

Employee

A relationship of the focal person with anorganization to receive wages or salary. The
purpose of this class is to identify the type of
relationship the employee has to the employer
rather than the nature of the work actually
performed. For example, it can be used tocapture whether the person is a Military Veteranor not..

classCode [1..1] (M)Employee (CS) {CNE:EMP}

Structural attribute; this is an "employee" role

statusCode [0..1]
Employee (CS) {CNE:RoleStatus}

A value specifying the state of this employment
relationship (based on the RIM Role class statemachine), for example, active, suspended,
terminated.

occupationCode [0..1]
Employee (CE) {CWE:EmployeeOccupationCode}A code qualifying the classification of kind-ofwork based upon a recognized industry or
jurisdictional standard. OccupationCode is used
to convey the person's occupation as opposed to
jobClassCode (not used in this transaction)
which characterizes this particular job. For
example, it can be used to capture whether the
person is a Military Veteran or not.

LanguageCommunication

A language communication capability of the
focal person

languageCode [1..1] (M)LanguageCommunication (CE) {CWE:HumanLanguage}

A value representing a language for which the
focal person has some level of proficiency for
written or spoken communication. Examples:
Spanish, Italian, German, English, AmericanSign

preferenceInd [0..1]
LanguageCommunication (BL)An indicator specifying whether or not thislanguage is preferred by the focal person for the
associated mode

QueryMatchObservation

Used to convey information about the quality ofthe match for each record.

classCode [1..1] (M)Observation (CS)

Structural attribute – this is an observation

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PRPA_HD201310IHE
Patient Registry Find Candidates Response

This HMD extract defines the message used
to return records from a patient registry in
response to a Find Candidates Query.
Derived from Figure 3.55.4.2.2-1(PRPA_RM201310IHE){CNE:http://hl7.org/v3ballot2007may/html/infrastru

cture/vocabulary/ActClass.htm - ActClass, default="OBS"}
moodCode [1..1] (M)Observation (CS)
{CNE:http://hl7.org/v3ballot2007may/html/infrastru

Structural attribute – this is an event

cture/vocabulary/ActMood.htm - ActMood, default="EVN"}
code [1..1] (M)Observation (CD) {CWE:QueryMatchObservationType}A code, identifying this observation as a querymatch observation.

value [1..1] (M)QueryMatchObservation (INT)

A numeric value indicating the quality of matchfor this record. It shall correspond to the
MinimumDegreeMatch.value attribute of theoriginal query, and it shall have the same
meaning (e.g., percentage, indicating confidence
in the match).

3.55.4.2.2.3 Control Act and Transmission Wrappers

8115

Please see ITI TF-2X: Appendix O for details on the IHE guidelines for implementing thewrappers. Table 3.44.4.1.2-2 contains the Transmission and Control Act wrappers used for thisinteraction, and the associated constraints.
Table 3.55.4.4.2-2: Wrappers and Constraints
Transmission Wrapper

Trigger Event Control Act Wrapper

MCCI_MT000300UV01 – Send Application
Acknowledgement

MFMI_MT700711UV01 – Master File/Registry Query
Response Control Act (Role Subject)

The value of interactionId shall be set to
PRPA_IN201306UV02
The value of processingModeCode shall be set to T
The acceptAckCode shall be set to NE
There shall be only one receiver Device

The value of ControlActProcess.moodCode shall be set to
EVN
The trigger event code in ControlActProcess.code shall be
set to PRPA_TE201306UV02
There shall be zero or more RegistrationEvents present inthis message.
For each matching record returned, there shall be exactly
one RegistrationEvent present in this message.
If a RegistrationEvent is part of the message, there shall be
exactly one Patient role present in the payload.
There shall be no replacementOf act-relationship present inthis message
The QueryAck.resultTotalQuantity,
QueryAck.resultCurrentQuantity, andQueryAck.resultRemainingQuantity attributes shall not be

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Transmission Wrapper

Trigger Event Control Act Wrapper
populated.
There shall be a QueryByParameter copy of the original
query which shall be in the control act wrapper following
the queryAck element.

8120

The composite message schemas which describe the full payload of this interaction, including
the wrappers, can be found online on the IHE FTP site, see Appendix W. The schemas from the
HL7 V3 2008 Normative Edition can be found at:
Edition2008/processable/multicacheschemas/PRPA_IN201306UV02.xsd).
3.55.4.2.2.4 Specifying homeCommunityId in Response

8125

The homeCommunityId is a globally unique identifier for a community – further defined in
Section 3.38.4.1.2.1. The Responding Gateway shall specify this value within every
RegistrationEvent element in the Cross Gateway Patient Discovery response.
The Responding Gateway may specify the same homeCommunityId in every RegistrationEvent,or may specify different homeCommunityId’s. The Initiating Gateway shall interpret multiple
RegistrationEvents as follows:

8130

8135

8140

•

Multiple RegistrationEvents with the same homeCommunityId represent multiple
matches within the homeCommunityId identified community. The Initiating Gateway
may choose one of the matches to use for subsequent processing.

•

Each set of RegistrationEvents with the same homeComunityId represents a different
possible source for documents, so in order to get the complete list of relevant documents
for the patient, the Initiating Gateway shall select at least one RegistrationEvent fromeach set with the same homeCommunityId and use the resulting collection of patient
identifiers for subsequent processing. See ITI TF-1: 27.3.2.2 for an introduction to thisenvironment.

The homeCommunityId is specified as the id element within the assignedEntity of the custodianof the RegistrationEvent. The id element designating the homeCommunityId shall have only theroot element, the contents of which is the homeCommunityId.
The following example shows part of a response specifying a homeCommunityId value of
urn:oid:1.2.840.114350.1.13.99998.8734.

8145<subject typeCode="SUBJ"><registrationEvent classCode="REG" moodCode="EVN"><id nullFlavor="NA"/><statusCode code="active"/><subject1 typeCode="SBJ">

8150

…

(details of the matching patient)

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IHE IT Infrastructure Technical Framework, Volume 2b (ITI TF-2b): Transactions Part B______________________________________________________________________________</subject1><custodian typeCode="CST"><assignedEntity classCode="ASSIGNED"><id root="1.2.840.114350.1.13.99998.8734"/>

8155<code code="SupportsHealthDataLocator"
codeSystem="1.3.6.1.4.1.19376.1.2.27.2"/></assignedEntity></custodian></registrationEvent>

8160</subject>

3.55.4.2.2.5 Specifying support as a Health Data Locator

8165

The Responding Gateway shall specify its support for this patient as a Health Data Locator. This
specification is a coded value within the assignedEntity of the custodian of theRegistrationEvent. The valid codes for this designation are described in Table 3.55.4.4.2-3. The
codeSystem for these code elements is 1.3.6.1.4.1.19376.1.2.27.2.
Table 3.55.4.4.2-3: Coded values for codeSystem=1.3.6.1.4.1.19376.1.2.27.2
Value for code
NotHealthDataLocator

Meaning of code
This community does not maintain externally available location
information about this patient and will respond with no data to a Patient
Location Query transaction related to this patient.

The following example shows part of a response specifying no support for Health Data Locator:
8170<subject typeCode="SUBJ"><registrationEvent classCode="REG" moodCode="EVN"><id nullFlavor="NA"/><statusCode code="active"/><subject1 typeCode="SBJ">

8175… (details of the matching patient)</subject1><custodian typeCode="CST"><assignedEntity classCode="ASSIGNED"><id root="1.2.840.114350.1.13.99998.8734"/><code code="NotHealthDataLocator"

8180

codeSystem="1.3.6.1.4.1.19376.1.2.27.2"/></assignedEntity></custodian></registrationEvent>

8185</subject>

3.55.4.2.2.6 Special handling for more attributes requested
The Responding Gateway has the option of informing the Initiating Gateway when additional
demographic attributes may result in a match. This would most often be used in cases where thesecurity and privacy policies do not allow release of patient data unless and until there is a level
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8190

8195

of assurance that the same patient is referenced. In this case the Responding Gateway cannot
return a matching patient or patients because the level of assurance is not great enough. If theInitiating Gateway were able to specify further demographic attributes the Responding Gateway
might have greater assurance of the match and thus be able to return the match information.
To indicate this situation in its response the Responding Gateway codes a DetectedIssueEvent
within the controlActProcess element, where the code in the actOrderRequired element
references one of the coded elements described in Table 3.55.4.4.2-4. There may be as many
triggerFor elements, each of them containing an ActOrderRequired element, as needed to code
the attributes which would increase the assurance of the match. The codeSystem for these code
elements is 1.3.6.1.4.1.19376.1.2.27.1.

8200

Figure 3.55.4.2.2-2: RMIM for DetectedIssueEvent
Table 3.55.4.4.2-4: Coded values for codeSystem=1.3.6.1.4.1.19376.1.2.27.1
Value for code
LivingSubjectAdministrativeGenderRequested

8205

8210

8215

Meaning of code
Requests the LivingSubjectAdministrativeGender attribute be specified

PatientAddressRequested

Requests the PatientAddress attribute be specified

PatientTelecomRequested

Requests the PatientTelecom attribute be specified

LivingSubjectBirthPlaceNameRequested

Requests the LivingSubjectBirthPlaceName attribute be specified

LivingSubjectBirthPlaceAddressRequested

Requests the LivingSubjectBirthPlaceAddress attribute be specified

MothersMaidenNameRequested

Requests the MothersMaidenName attribute be specified

The following example shows part of a response requesting the PatientAddress andPatientTelecom attributes.
<detectedIssueEvent classCode="ALRT" moodCode="EVN"><code code="ActAdministrativeDetectedIssueCode" codeSystem="2.16.840.1.113883.5.4"/><triggerFor typeCode="TRIG"><actOrderRequired classCode="ACT" moodCode="RQO"><code code="PatientAddressRequested” codeSystem="1.3.6.1.4.1.19376.1.2.27.1"/></actOrderRequired></triggerFor><triggerFor typeCode="TRIG"><actOrderRequired classCode="ACT" moodCode="RQO"><code code="PatientTelecomRequested” codeSystem="1.3.6.1.4.1.19376.1.2.27.1"/></actOrderRequired>
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IHE IT Infrastructure Technical Framework, Volume 2b (ITI TF-2b): Transactions Part B______________________________________________________________________________</triggerFor></detectedIssueEvent>3.55.4.2.2.7 Specify details about problems handling request
8220

8225

The Responding Gateway has the option of informing the Initiating Gateway with some detailregarding a problem handling the request.
The Responding Gateway may code a DetectedIssueEvent within the controlActProcess element,
where the code in the detectedIssueManagement element references one of the coded elements
described in Table 3.55.4.4.2-5. The codeSystem for these code elements is
1.3.6.1.4.1.19376.1.2.27.3.
Table 3.55.4.4.2-5: Coded values for codeSystem=1.3.6.1.4.1.19376.1.2.27.3
Value for code

Meaning of code

ResponderBusy

The responder was not able to process the request because it is currently
overloaded.

AnswerNotAvailable

The answer is not available. Human intervention may be needed.

InternalError

The responder was not able to respond due to an internal error orinconsistency.

The following example shows part of a response specifying that the responder is busy.
8230<detectedIssueEvent classCode="ALRT" moodCode="EVN"><code code="ActAdministrativeDetectedIssueCode" codeSystem="2.16.840.1.113883.5.4"/><mitigatedBy typeCode="MITGT">

8235<detectedIssueManagement classCode="ACT" moodCode="EVN"><code code="ResponderBusy” codeSystem="1.3.6.1.4.1.19376.1.2.27.3"/></detectedIssueManagement></mitigatedBy></detectedIssueEvent>3.55.4.2.3 Expected Actions
8240

The Initiating Gateway shall accept a SOAP fault representing a transmission error. An internal
error in the Responding Gateway is covered under Case 5. The Initiating Gateway Actor shall act
on a valid query response as described by the following 5 cases:
Case 1: The Responding Gateway Actor finds exactly one patient record matching the criteria
sent in the query parameters.

8245

AA (application accept) is returned in Acknowledgement.typeCode (transmission wrapper).
OK (data found, no errors) is returned in QueryAck.queryResponseCode (control act wrapper)
One RegistrationEvent (and the associated Patient role, subject of that event) is returned from thepatient information source for the patient record found. The community associated with the
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8250

Initiating Gateway may use the patient demographics and identifiers to: a) run an independentmatching algorithm to ensure the quality of the match b) use the designated patient identifier in a
Cross Gateway Query to get information about records related to the patient c) cache thecorrelation for future use (see Section 3.55.4.2.3.1 for more information about caching).
Case 2: The Responding Gateway Actor finds more than one patient close to matching thecriteria sent in the query parameters and the policy allows returning multiple.

8255

AA (application accept) is returned in Acknowledgement.typeCode (transmission wrapper).
OK (data found, no errors) is returned in QueryAck.queryResponseCode (control act wrapper)

8260

8265

One RegistrationEvent (and the associated Patient role, subject of that event) is returned for eachpatient record found. The community associated with the Initiating Gateway may run its own
matching algorithm to select from the list of returned patients. If a correlation is found the
Responding Gateway may continue as if only one entry had been returned. If a correlation is still
not clear it is expected that human intervention is required, depending on the policies of theInitiating Gateway’s community.
Case 3: The Responding Gateway Actor finds more than one patient close to matching thecriteria sent in the query parameters but no matches close enough for the necessary assurance
level and more attributes might allow the Responding Gateway to return a match.
AA (application accept) is returned in Acknowledgement.typeCode (transmission wrapper).
OK (data found, no errors) is returned in QueryAck.queryResponseCode (control act wrapper)

8270

No RegistrationEvent is returned in the response, but the Responding Gateway provides asuggestion in terms of demographics that may help identify a match. The mechanism forspecifying the suggestion is detailed in Section 3.55.4.2.2.6 for description of coding of the
response. The Initiating Gateway may use this feedback to initiate a new Cross Gateway Patient
Discovery request including the requested additional attributes.
Case 4: The Responding Gateway Actor finds no patients anywhere close to matching thecriteria sent in the query parameters.

8275

AA (application accept) is returned in Acknowledgement.typeCode (transmission wrapper).
NF (data found, no errors) is returned in QueryAck.queryResponseCode (control act wrapper)

8280

There is no RegistrationEvent returned in the response. The Initiating Gateway can assume thispatient has no healthcare information held by the community represented by the Responding
Gateway. This lack of correlation may be cached, see Section 3.55.4.2.3.1 for more information
about caching.
Case 5: The Responding Gateway Actor is unable to satisfy the request. This may be because therequest came synchronously and an asynchronous request may be feasible, or because the
Responding Gateway Actor is overloaded with other requests and does not expect to answer for asignificant period of time. It may also be that the Responding Gateway may need some manual

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8285

configuration update to authorize responder or another error occurred while the Responding
Gateway Actor was processing the message payload.
AE (application error) is returned in Acknowledgement.typeCode (transmission wrapper).
AE (application error) is returned in QueryAck.queryResponseCode (control act wrapper)

8290

There is no RegistrationEvent returned in the response. See Section 3.55.4.2.2.7 for more
information about coding errors for this case.
3.55.4.2.3.1 Caching (Informative)

8295

8300

This section presents some considerations regarding caching of information learned through the
Cross Gateway Patient Discovery transaction. There are no requirements regarding caching of
the information, as this is a complex issue and must be addressed as part of deployment. The
caching resulting from receiving and responding to the query is not updating any local
information but only saving a record in a cache if so desired.
Both the requesting and responding side of the Cross Gateway Patient Discovery transaction gain
knowledge through this transaction. That knowledge may be used immediately, by sending a
Cross Gateway Query transaction, or may be cached for use at some other time (or both). Thissection addresses caching considerations when the Cross Gateway Patient Discovery transaction
is used in the Demographic Query and Feed mode. Other modes are a simplification of this modewith corresponding simplifications of the considerations presented.
The knowledge gained on both sides can be represented as a tuple:

8305

8310

1.

LocalPid – Local patient identifier and demographics associated with that identifier

2.

ExternalCommunityId – The homeCommunityId of another community.

3.

ExternalPid – The patient identifier for the same patient as LocalPid within thecommunity identified by ExternalCommunityId. This identifier also has associateddemographics

For the Initiating Gateway the ExternalPid may be null indicating that the community
represented by ExternalCommunityId has no correlating patient identifier available.
The tuple represents a correlation, or lack thereof, of patients in a pair of communities. The
validity of this correlation may degrade over time, as changes in demographics, merge/link
events and new patient registrations affect the correlation.
Local changes in demographics, merge/link

8315

When a local change in demographics or a merge/link event affects the LocalPid, the community
may initiate a Cross Gateway Patient Discovery request to validate the correlation.
External changes in demographics, merge/link

8320

When an external change in demographics or merge/link event occurs, the external community
may initiate a Cross Gateway Patient Discovery request which, when received, can be used to reassess the correlation and adjust accordingly. Mutually agreed policies for use of the
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CorrelationTimeToLive SOAP header may enable greater assurance that changes are reflected
when needed.
New patient registrations
8325

When the Initiating Gateway’s community discovers the lack of correlation to its local patient(ExternalPid null) it may monitor incoming Cross Gateway Patient Discovery transactions inorder to discover later if that patient has arrived in the Responding Gateway’s community.
3.55.5 Security Considerations
No transaction specific security considerations.
3.55.5.1 Security Audit Considerations

8330

The Cross Gateway Patient Discovery transaction is a Query Information event as defined inTable ITI TF-2a: 3.20.6-1.
The actors involved shall record audit events according to the following:
3.55.5.1.1 Initiating Gateway audit message:
Event
AuditMessage/
EventIdentification

Field Name

Opt

EventID

M

Value Constraints
EV(110112, DCM, “Query”)

EventActionCodeM“E” (Execute)

EventDateTimeM

not specialized

EventOutcomeIndicatorM

not specialized

EventTypeCode

M

EV(“ITI-55”, “IHE Transactions”, “Cross Gateway Patient
Discovery”)

Source (Initiating Gateway) (1)
Human Requestor (0..n)
Destination (Responding Gateway) (1)Audit Source (Initiating Gateway) (1)Patient (0) No patient identifiers are included in this audit message.
Query Parameters(1)Where:
SourceUserIDM

If Asynchronous Web Services Exchange is being used, the content of
the <wsa:ReplyTo/> element. Otherwise, not specialized.

AlternativeUserIDM

the process ID as used within the local operating system in the local
system logs.

UserNameUnot specialized

UserIsRequestorU

not specialized

RoleIDCodeM

EV(110153, DCM, “Source”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointID

M

The machine name or IP address.

AuditMessage/
ActiveParticipant

8335

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UserID

M

AlternativeUserIDU

not specialized

UserNameUnot specialized

UserIsRequestorU

not specialized

RoleIDCodeU

Access Control role(s) the user holds that allows this transaction.

NetworkAccessPointTypeCodeU

not specialized

NetworkAccessPointIDU

not specialized

Destination

UserID

M

SOAP endpoint URI.

AuditMessage/
ActiveParticipant

AlternativeUserIDU

not specialized

UserNameUnot specialized

UserIsRequestorM“false”

RoleIDCodeM

EV(110152, DCM, “Destination”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointID

M

The machine name or IP address.

Audit Source

AuditSourceIDU

not specialized

AuditMessage/
AuditSourceIdentificati
on

AuditEnterpriseSiteIDU

not specialized

AuditSourceTypeCodeU

not specialized

Query
Parameters

ParticipantObjectTypeCodeM“2” (system object)

ParticipantObjectTypeCodeRole

M“24” (query)(AuditMessage/
ParticipantObjectIde
ntification)

ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCode

M

EV(“ITI-55, “IHE Transactions”, “Cross Gateway Patient Discovery”)

ParticipantObjectSensitivityU

not specialized

Human
Requestor(if known)
AuditMessage/
ActiveParticipant

Identity of the human that initiated the transaction.

ParticipantObjectIDU

not specialized

ParticipantObjectNameU

not specialized

ParticipantObjectQueryM

the QueryByParameter segment of the query, base64 encoded.

ParticipantObjectDetailM

The value of “ihe:homeCommunityID” as the value of the attributetype and the value of the homeCommunityID as the value of theattribute value.

8340

8345

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3.55.5.1.2 Responding Gateway audit message:
Event
AuditMessage/
EventIdentification

Field Name

Opt

Value Constraints

EventID

M

EV(110112, DCM, “Query”)

EventActionCodeM“E” (Execute)

EventDateTimeM

not specialized

EventOutcomeIndicatorM

not specialized

EventTypeCode

M

EV(“ITI-55”, “IHE Transactions”, “Cross Gateway Patient
Discovery”)

Source (Initiating Gateway) (1)Destination (Responding Gateway) (1)Audit Source (Responding Gateway) (1)Patient (0..n) one for each patient whose demographic information was returned in the response.
Query Parameters(1)Where:
SourceAuditMessage/
ActiveParticipant

If Asynchronous Web Services Exchange is being used, the content of
the <wsa:ReplyTo/> element. Otherwise, not specialized.

UserID

M

AlternativeUserIDU

not specialized

UserNameUnot specialized

UserIsRequestorU

not specialized

RoleIDCodeM

EV(110153, DCM, “Source”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointID

M

The machine name or IP address.

Destination

UserID

M

SOAP endpoint URI.

AuditMessage/
ActiveParticipant

AlternativeUserIDM

the process ID as used within the local operating system in the local
system logs.

UserNameUnot specialized

UserIsRequestorM“false”

RoleIDCodeM

EV(110152, DCM, “Destination”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointID

M

The machine name or IP address.

Audit Source

AuditSourceIDU

not specialized

AuditMessage/
AuditSourceIdentificati
on

AuditEnterpriseSiteIDU

not specialized

AuditSourceTypeCodeU

not specialized

8350

8355
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ParticipantObjectTypeCode

M

ParticipantObjectTypeCodeRole

M“1” (Patient)

ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCodeM

not specialized

ParticipantObjectSensitivityU

not specialized

ParticipantObjectID

M

The patient ID in HL7 CX format.

ParticipantObjectNameU

not specialized

ParticipantObjectQueryU

not specialized

ParticipantObjectDetailUnot specialized

Query
Parameters

ParticipantObjectTypeCodeM“2” (system object)

ParticipantObjectTypeCodeRole

M“24” (query)(AuditMessage/
ParticipantObjectIde
ntification)

ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCode

M

EV(“ITI-55”, “IHE Transactions”, “Cross Gateway Patient Discovery”)

ParticipantObjectSensitivityU

not specialized

ParticipantObjectIDU

not specialized

ParticipantObjectNameU

not specialized

ParticipantObjectQueryM

the QueryByParameter segment of the query, base64 encoded.

ParticipantObjectDetailM

The value of “ihe:homeCommunityID” as the value of the attributetype and the value of the homeCommunityID as the value of theattribute value.

Patient(AuditMessage/
ParticipantObjectIde
ntification)“1” (Person)

3.55.6 Protocol Requirements
8360

The Cross Gateway Patient Discovery request and response will be transmitted using
Synchronous or Asynchronous Web Services Exchange, according to the requirements specified
in ITI TF-2x: Appendix V. If the Deferred Response Option is being used the request andresponse will be transmitted as described in Section 3.55.6.2.
The following WSDL naming conventions shall apply:
query message

8365-> "PRPA_IN201305UV02_Message"

The following WSDL snippet describes the type for this message:…
<types><xsd:schema elementFormDefault="qualified" targetNamespace="urn:hl7-org:v3"

8370

xmlns:hl7="urn:hl7-org:v3"><!-- Include the message schema --><xsd:import namespace="urn:hl7-org:v3"
schemaLocation="../schema/HL7V3/NE2008/multicacheschemas/PRPA_IN201305UV02.xsd"/><xsd:element name="PRPA_IN201305UV02"/></xsd:schema>

8375</types>…
The message is described by the following snippet:…

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8380<message name="PRPA_IN201305UV02_Message"><part element="hl7:PRPA_IN201305UV02" name="Body"/></message>…

3.55.6.1 Web Services Port Type and Binding Definitions
Responding Gateway:
8385

IHE-WSP201) The attribute /wsdl:definitions/@name SHALL be “RespondingGateway”.
The following WSDL naming conventions shall apply:

8390

8395

wsdl:definitions/@name="RespondingGateway":
ITI-55 query-> "PRPA_IN201305UV02_Message"
ITI-55 response-> "PRPA_IN201306UV02_Message"
accept acknowledgement-> "MCCI_IN000002UV01_Message"
portType-> "RespondingGateway_PortType"
ITI-55 operation-> "RespondingGateway_PRPA_IN201305UV02"
ITI-55 Deferred Response operation ->“RespondingGateway_Deferred_PRPA_IN201305UV02”
SOAP 1.2 binding-> "RespondingGateway_Binding_Soap12"
SOAP 1.2 port-> "RespondingGateway_Port_Soap12"

Initiating Gateway:
IHE-WSP201) The attribute /wsdl:definitions/@name SHALL be “InitiatingGateway”.
8400

8405

8410

The following WSDL naming conventions shall apply:
wsdl:definitions/@name="InitiatingGateway":
ITI-55 response-> "PRPA_IN201306UV02_Message"
accept acknowledgement-> "MCCI_IN000002UV01_Message"
portType-> "InitiatingGateway_PortType"
ITI-55 Deferred Response operation ->“InitiatingGateway_Deferred_PRPA_IN201306UV02”
SOAP 1.2 binding-> "InitiatingGateway_Binding_Soap12"
SOAP 1.2 port-> "InitiatingGateway_Port_Soap12"

The following WSDL snippets specify the Cross Gateway Patient Discovery Query Port Typeand Binding definitions, according to the requirements specified in ITI TF-2x: Appendix V.
3.55.6.1.1 Port Type
Responding Gateway:

8415

8420

<portType name="RespondingGateway_PortType"><operation name="RespondingGateway_PRPA_IN201305UV02"><input message="tns:PRPA_IN201305UV02_Message" wsaw:Action="urn:hl7org:v3:PRPA_IN201305UV02:CrossGatewayPatientDiscovery"/><output message="tns:PRPA_IN201306UV02_Message" wsaw:Action="urn:hl7org:v3:PRPA_IN201306UV02:CrossGatewayPatientDiscovery"/></operation>

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8425<operation name="RespondingGateway_Deferred_PRPA_IN201305UV02"><input message="tns:PRPA_IN201305UV02_Message" wsaw:Action="urn:hl7org:v3:PRPA_IN201305UV02:Deferred:CrossGatewayPatientDiscovery"/><output message="tns:MCCI_IN000002UV01_Message" wsaw:Action="urn:hl7-org:v3:MCCI_IN000002UV01"/></operation></portType>

8430

Initiating Gateway:<portType name="InitiatingGatewayDeferredResponse_PortType"><operation name="InitiatingGateway_Deferred_PRPA_IN201306UV02">

8435<input message="tns:PRPA_IN201306UV02_Message" wsaw:Action="urn:hl7org:v3:PRPA_IN201306UV02:Deferred:CrossGatewayPatientDiscovery"/><output message="tns:MCCI_IN000002UV01_Message" wsaw:Action="urn:hl7org:v3:MCCI_IN000002UV01"/></operation></portType>8440
3.55.6.1.2 Bindings
SOAP 1.2 binding:
Responding Gateway:…

8445<binding name="RespondingGateway_Binding_Soap12" type="RespondingGateway_PortType"><wsoap12:binding style="document" transport="http://schemas.xmlsoap.org/soap/http"/><operation name="RespondingGateway_PRPA_IN201305UV02"><wsoap12:operation soapAction="urn:hl7org:v3:PRPA_IN201305UV02:CrossGatewayPatientDiscovery"/>8450<input><wsoap12:body use="literal"/></input><output><wsoap12:body use="literal"/></output>

8455</operation><operation name="RespondingGateway_Deferred_PRPA_IN201305UV02"><wsoap12:operation soapAction="urn:hl7org:v3:PRPA_IN201305UV02:Deferred:CrossGatewayPatientDiscovery"/>8460<input><wsoap12:body use="literal"/></input><output><wsoap12:body use="literal"/></output>

8465</operation></binding>…

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8470

Initiating Gateway:…
<binding name="InitiatingGatewayDeferredResponse_Binding"
type="tns:InitiatingGatewayDeferredResponse_PortType"><soap12:binding style="document" transport="http://schemas.xmlsoap.org/soap/http"/>

8475<operation name="InitiatingGateway_Deferred_PRPA_IN201306UV02"><soap12:operation soapAction="urn:hl7org:v3:PRPA_IN201306UV02:Deferred:CrossGatewayPatientDiscovery"/><input><soap12:body use="literal"/></input>

8480<output><soap12:body use="literal"/></output><operation>

8485</binding>…

Informative WSDL for the Responding Gateway Actor is available online on the IHE FTP site,
see ITI TF-2x: Appendix W.
8490

8495

3.55.6.2 Deferred Response Option
The Deferred Response Message pattern is a message exchange pattern where therequest/response web service message exchange has been converted into two request/response
message exchange patterns, where the original request and response messages are used as therequest portion of each message and an application acknowledgement is the response. Figure
3.55.6.2-1 illustrates this pattern as it is used for the Cross Gateway Patient Discovery [ITI-55]
transaction.

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Responding
Gateway

Initiating
Gateway(Deferred
Response
RequestInvocation)

Cross Gateway Patient
Discovery Request Message
Request Application Acknowledgement(Deferred
Processing by
Responding
Gateway)(Deferred
Response
Response
Invocation)

Cross Gateway Patient
Discovery Response Message

Response Application Acknowledgement

Figure 3.55.6.2-1: Deferred Response Message Pattern

8500
Cross Gateway Patient Discovery Request Message
The Initiating Gateway that supports the Deferred Response Option may request the use ofDeferred Response message exchange by specifying the following in the Cross Gateway Patient
Discovery Request Message:
8505

8510

•

The WS-Addressing Action value shall be urn:hl7org:v3:PRPA_IN201305UV02:Deferred: CrossGatewayPatientDiscovery•

The responsePriorityCode element shall be set to a value of ‘D’ to represent the deferred
processing mode.

•

The respondTo element of the transmission wrapper, see the figure in Section
3.55.4.1.2.4, shall contain a telecom element with the Web Services Endpoint where theresponse shall be sent.

Example of specifying the respondTo element:
8515<respondTo typeCode="RSP"><telecom value="service entry point url"
<entityRsp classCode="ENT" determinerCode="INSTANCE" xsi:nil="true"/></respondTo>

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Cross Gateway Patient Discovery Request Application Acknowledgement Message
8520

If the Responding Gateway supports the Deferred Response Option it shall respond with an HL7
V3 Accept Acknowledgement message (MCCI_IN000002UV01). The WS-Addressing Action
value shall be urn:hl7-org:v3:MCCI_IN000002UV01.
Cross Gateway Patient Discovery Response Message

8525

8530

8535

The Responding Gateway will process the Cross Gateway Patient Discovery Request Message
and generate a Cross Gateway Patient Discovery Response Message following all the applicablerequirements for the transaction. If the Responding Gateway supports the Deferred Response
Option, the Cross Gateway Patient Discovery Response Message will be sent as a new request as
follows:•

The Responding Gateway shall direct the response message to the address specified in
the respondTo element in the transmission wrapper.

•

The WS-Addressing RelatesTo element of the response message shall be populated withthe message identifier from the WS-Addressing MessageID element of the request
message•

The WS-Addressing Action value shall be urn:hl7org:v3:PRPA_IN201306UV02:Deferred:CrossGatewayPatientDiscovery•

Correlation with the request message is also supplied through the queryID element fromthe request message which shall be the same as the queryID element of the Response
message.

Cross Gateway Patient Discovery Response Application Acknowledgement Message
8540

The Initiating Gateway that supports the Deferred Response Option shall respond with an HL7
V3 application acknowledgement message (MCCI_IN000002UV01). The WS-Addressing
Action value shall be urn:hl7-org:v3:MCCI_IN000002UV01.

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3.60 Retrieve Multiple Value Sets
This section corresponds to transaction ITI-60 of the IHE IT Infrastructure Technical
Framework. The Value Set Consumer and Value Set Repository Actors use transaction ITI-60.
3.60.1 Scope

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This transaction is used by the Value Set Consumer to retrieve Value Sets from the Value Set
Repository.
3.60.2 Use case roles

Value Set
Consumer

Value Set Repository

Retrieve Multiple
Value Sets

Figure 3.60.2-1: Use Case Roles

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Actors:Actor: Value Set Consumer
Role: Requests all Value Sets that match request parameters
Actor: Value Set Repository
Role: Provides matching Value Sets and associated metadata8560
3.60.3 Referenced Standards
The referenced standards are:Table 3.60.3-1: Referenced Standards
Appendix V

ITI TF-2x: Appendix V Web Services for IHE Transactions
Contains references to all Web Services standards and requirements of use

HL7 v3 Data
Type XMLITS

HL7 Version 3 Standard: XML Implementation Technology Specifications – Data Types, R1

HTTP 1.1

IETF RFC 2616: Hypertext Transfer Protocol – HTTP 1.1

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IEEE Std 1003.2 IEEE Standard for Information Technology — Portable Operating System Interface(POSIX®) — Part 2: Shell and Utilities — Amendment 1: Batch Environment -Description

3.60.4 Interaction Diagram

Value Set
Repository

Value Set
Consumer

Retrieve Multiple Value Sets
RequestRetrieve Multiple Value Sets
Response

Figure 3.60.4-1: Interaction Diagram

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3.60.4.1 Retrieve Multiple Value Sets Request
3.60.4.1.1 Trigger Events

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The Value Set Consumer wants to retrieve value sets and has one or more element values to bematched in the metadata that describes value sets. This could be from pre-configuration or user
input. The value sets that match these element values are needed for processing by the Value Set
Consumer. The Value Set Consumer sends a Retrieve Multiple Value Sets Request to the Value
Set Repository. Table 3.60.4.1.1-1 summarizes the metadata elements. See the schema for
precise encoding details.
Table 3.60.4.1.1-1: Metadata Summary
Metadata Element

Description

Mandatory
withinMetadata
returned

Usableas
Selection
Criterion

idThis is the unique identifier of the value set

MandatoryY

displayName

This is the name of the value set

MandatoryY

SourceThis is the source of the value set,
identifying the originator or publisher of theinformation

MandatoryY

PurposeBrief description about the general purposeof the value set

Optional

Y

Definition

A text definition describing how concepts inthe value set were selected

OptionalY

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Metadata Element

Description

Mandatory
withinMetadata
returned

Usableas
Selection
Criterion

Source URI

Most sources also have a URL or document
URI that provides further details regarding
the value set.

Optional

N

VersionA string identifying the specific version of
the value set.

MandatoryN

StatusActive, Inactive, local extensions

MandatoryN

Type

This describes the type of the value set. It
shall be:•Intensional,•
Extensional, or•Expanded

Mandatory

N

OptionalN

Note:

Binding

This is the type of the value set in
the repository. The ConceptList thatwill also be returned is the current
expansion of the value set.
Shall be “Static” or “Dynamic”

Effective Date

The date when the value set is expected tobe effective

Optional

Y

Expiration Date

The date when the value set is no longer
expected to be used

OptionalY

Creation Date

The date of creation of the value set

Optional

Y

Revision Date

The date of revision of the value set

OptionalYGroup

The identifiers and keywords of the groups
that include this value set. A group may also
have an OID assigned.

Optional

Y

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3.60.4.1.2 Message Semantics
The Retrieve Multiple Value Sets Request shall specify retrieval selection parameters as shownin the Table 3.60.4.1.2-1. It requests retrieval of all concept lists that have metadata matching theparameters used. At least one request parameter shall be provided.
8585
Table 3.60.4.1.2-1: The Request Parameters in the RetrieveMultipleValueSets Request
Parameter

Parameter
FormatMetadata
Element

Match
Type
OID

Match
Rules

Note

id

OID

id

equals

DisplayNameContains

string

Name

Regex

regex

POSIX rules

SourceContains

stringSource

Regex

regex

POSIX rules

PurposeContains

stringPurpose

Regex

regex

POSIX rules

DefinitionContains

stringDefinition

Regex

regex

POSIX rules

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Parameter

Parameter
FormatMetadata
Element

Match
Type

Match
Rules

Note

GroupContains

string

Group

Regex

regex

POSIX rules

GroupOID

OID

Group

OID

equalsEquality match for
OID attribute of aGroup element

EffectiveDateBefore

http-date

EffectiveDate

date

Before or
equal

Date comparison to
the day

EffectiveDateAfter

http-date

EffectiveDate

date

Equal or after

Date comparison to
the day

ExpirationDateBefore

http-date

ExpirationDate

date

Before or
equal

Date comparison to
the day

ExpirationDateAfter

http-date

ExpirationDate

date

Equal or after

Date comparison to
the day

CreationDateBefore

http-date

CreationDate

date

Before or
equal

Date comparison to
the day

CreationDateAfter

http-date

CreationDate

date

Equal or after

Date comparison to
the day

RevisionDateBefore

http-date

RevisionDate

date

Before or
equal

Date comparison to
the day

RevisionDateAfter

http-date

RevisionDate

date

Equal or after

Date comparison to
the dayFormatString

n/a

n/a

n/a

This specifies theformat for the
returned
information. Shall be“CE-List” if present.

3.60.4.1.3 Expected Actions
The Value Set Repository shall perform matching in accordance with the rules in Table
3.60.4.1.2-1.
8590•

Regex matches shall compare the contents of the referenced metadata field with theregex using the POSIX matching rules. If the regex matches the field, the value set
matches.

•

OID matching compares only for equal OIDs, ignoring leading zeroes.

•

Date comparisons convert the argument into a date, and compare it with the dates in
the metadata using a date comparison. Equality means the same day.

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Any value set that matches all of the request parameters shall be included in the response.
Note:

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Multiple queries will sometimes be needed. Rather than specify a complex query mechanism, the Retrieve
Multiple Value Sets request expects the client or user to locally eliminate any extra value sets and makeadditional queries. Value sets are relatively small and compress very well, so these extras are not a significant
communications burden. Performing the final steps of selecting the value sets based on having the full metadata
present locally allows a much richer and potentially interactive selection process. It also allows a simpler andmore robust server.

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3.60.4.2 Retrieve Multiple Value Sets Response
3.60.4.2.1 Trigger Events
8605

This message will be triggered by completion of matching for a Retrieve Multiple Value Sets
Request Message.
3.60.4.2.2 Message Semantics

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The response shall be a Retrieve Multiple Value Sets Response as specified in the XML schema
defining RetrieveMultipleValueSetsResponse which can be accessed on the IHE FTP site, see
ITI TF-2x: Appendix W. The RetrieveMultipleValueSetsResponse element shall have one
DescribedValueSet element for each matching value set found. If no matching elements arefound, it shall be empty.
Each DescribedValueSet element contains:

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•

An id attribute, a mandatory OID, the OID for this value set•

A displayName attribute, a mandatory string, the name of this value set•

Source, an optional string, the source organization for this value set•

SourceURI, an optional URI, a URI providing more description of this value set,•

Purpose, an optional string, a description of the intended use of this value set•

Definition, an optional string, a definition of the value set provided by the source•

A version attribute, a mandatory string, a version in the format used by the source,•

Status, an optional string, the status at time of retrieval (e.g., Active or Inactive)•

Type, a mandatory string that indicates whether this is an intensional, extensional, or
expanded value set.

•

Binding, an optional string, either static or dynamic.

•

EffectiveDate, an optional XML-date, the initial effective date for this value set•

ExpirationDate, an optional XML-date, the intended expiration date for this value set•

CreationDate, an optional XML-date, the creation date of this value set,•

RevisionDate, an optional XML-date, the revision date of this value set,•

Zero or more Group elements, where each Group element has•

an optional id attribute containing the OID for the group.

•

An optional displayName attribute, containing the name for the group,•

An optional sourceOrganization attribute, containing the name of the organizationthat defined the group.

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•
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•

Zero or more Keyword elements that contain keywords associated with the group.

One ConceptList, that contains•

One or more Concept, encoded using the HL7 CE datatype. These are the codes thatare members of the expanded form of the value set.

•

With an optional attribute xml:lang to indicate the language for the displayname forthese concepts.

The ConceptList element and structure is the same in both the ITI-48 and ITI-60 transactions.
The Identifier OID in the ITI-60 response is the OID used in the ITI-48 transaction when thevalue set is an expanded value set. It will not match in other cases.
A sample RetrieveMultipleValueSetsResponse is shown below:

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<?xml version="1.0" encoding="UTF-8"?><RetrieveMultipleValueSetsResponse xmlns="urn:ihe:iti:svs:2008"
xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
xsi:schemaLocation="urn:ihe:iti:svs:2008:SVS.xsd"><DescribedValueSet id="1.2.3" displayName="placeholder" version="version1"><ConceptList xml:lang="en-US"><Concept code="code1" codeSystem="2.3.4"
codeSystemName="codeSystemName1" codeSystemVersion="codeSystemVersion1"
displayName="displayName1"></Concept><Concept code="code7" codeSystem="2.3.4"
codeSystemName="codeSystemName1" codeSystemVersion="codeSystemVersion1"
displayName="displayName7"></Concept></ConceptList><Source>Codingsource</Source><SourceURI>http://www.codingsource.com/placeholder</SourceURI><Purpose>Purpose0</Purpose><Definition>Definition0</Definition><Type>Expanded</Type><Binding>Static</Binding><Status>Status0</Status><EffectiveDate>2006-05-04</EffectiveDate><ExpirationDate>2011-09-04</ExpirationDate><CreationDate>2006-05-04</CreationDate><RevisionDate>2006-05-04</RevisionDate><Group id="2.4.5" sourceOrganization="sourceOrganization1"
displayName="displayName15"><Keyword>Keyword0</Keyword><Keyword>Keyword1</Keyword></Group><Group id="2.4.54" sourceOrganization="sourceOrganization3"
displayName="displayName17"><Keyword>Keyword2</Keyword><Keyword>Keyword3</Keyword></Group></DescribedValueSet></RetrieveMultipleValueSetsResponse>

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3.60.5 Protocol Requirements
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The protocol for the Retrieve Value Set transaction describes two bindings. The first is based on
SOAP 1.2, and the second is an HTTP binding. The relevant XML namespace definitions can beseen in Table 3.48.5-1 WSDL Namespace Definitions.
Table 3.60.5-1: WSDL Namespace Definitions
soap12

http://schemas.xmlsoap.org/wsdl/soap12/

wsaw

http://www.w3.org/2006/05/addressing/wsdl/

xsd

http://www.w3.org/2001/XMLSchema

ihe

urn:ihe:iti:svs:2008

3.60.5.1 SOAP Binding
8690

Value Set Consumers which support the SOAP Binding Option shall follow the rules for Web
Services transactions outlined in ITI TF-2x: Appendix V. These are the requirements for the
RetrieveMultipleValueSets transaction presented in the order in which they would appear in the
WSDL definition:
The following types shall be imported (xsd:import) in the /definitions/types section:

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namespace="urn:ihe:iti:svs:2008", schema="SVS.xsd"
The /definitions/message/part/@element attribute of the Retrieve Value Set
Request message shall be defined as “ihe:RetrieveMultipleValueSetsRequest”
The /definitions/message/part/@element attribute of the Retrieve Value Set
Response message shall be defined as “ihe:RetrieveMultipleValueSetsResponse”

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8705

The /definitions/portType/operation/input/@wsaw:Action attribute for the
Retrieve Multiple Value Sets Request message shall be defined as“urn:ihe:iti:2010:RetrieveMultipleValueSets”
The /definitions/portType/operation/output/@wsaw:Action attribute for the
Retrieve Value Set Response message shall be defined as“urn:ihe:iti:2010:RetrieveMultipleValueSetsResponse”
The /definitions/binding/operation/soap12:operation/@soapAction
attribute shall be defined as “urn:ihe:iti:2010:RetrieveMultipleValueSets”
These are the requirements that affect the wire format of the SOAP message. The other WSDL
properties are only used within the WSDL definition and do not affect interoperability.

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Within the request message payload the<ihe:RetrieveMultipleValueSetsRequest/> element is defined as:

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•

A optional /ihe:RetrieveMultipleValueSetsRequest@id element that
contains the ID of the requested Value Set within the Value Set Repository. The Value
Set ID shall be formatted as an ISO OID.

•

An optional/ihe:RetrieveMultipleValueSetsRequest@DisplayNameContains
element•

An optional/ihe:RetrieveMultipleValueSetsRequest@SourceContains element•

An optional/ihe:RetrieveMultipleValueSetsRequest@PurposeContains element•

An optional/ihe:RetrieveMultipleValueSetsRequest@DefinitionContains
element•

An optional /ihe:RetrieveMultipleValueSetsRequest@GroupContains
element•

An optional /ihe:RetrieveMultipleValueSetsRequest@GroupOID
element•

An optional/ihe:RetrieveMultipleValueSetsRequest@EffectiveDateBefore
element•

An optional/ihe:RetrieveMultipleValueSetsRequest@EffectiveDateAfterelement•

An optional/ihe:RetrieveMultipleValueSetsRequest@ExpirationDateBefore
element•

An optional/ihe:RetrieveMultipleValueSetsRequest@ExpirationDateAfterelement•

An optional/ihe:RetrieveMultipleValueSetsRequest@CreationDateBefore
element•

An optional/ihe:RetrieveMultipleValueSetsRequest@CreationDateAfterelement

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•

An optional/ihe:RetrieveMultipleValueSetsRequest@RevisionDateBefore
element•

An optional/ihe:RetrieveMultipleValueSetsRequest@RevisionDateAfterelement

Value Set Repositories shall include within the response message payload for the SOAP Binding
Option the <ihe:RetrieveMultipleValueSetsResponse/> element which is
described above in 3.60.4.2.2.
3.60.5.2 HTTP Binding
Value Set Consumers which support the HTTP Binding Option shall use the GET method as
defined in IETF RFC 2616 for the Retrieve Value Set Request. Each parameter to be used forselection shall be encoded as an HTTP Get parameter.

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A sample URL for the HTTP binding for a query to retrieve all value sets for a reporting
purpose, with either “stroke” or “JCAHO” in the value set name looks as follows:
https://example.com/RetrieveMultipleValueSets?DisplayNameContains=”stroke|JCAHO”&PurposeContains=”report”

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Value Set Repositories shall format the response to the HTTP GET operation as an HTTP
response message as defined in IETF RFC 2616.
The Content-Type field of the HTTP header shall be “text/xml” (see Section 14.4 of IETF RFC
2616).
The content of the HTTP response message shall be an XML encoded
RetrieveMultipleValueSetsResponse, as described in Section 3.60.4.2.2.

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The Value Set Repository shall return an error code in case there are invalid request parameters.
It shall return an HTTP status code of 404, with an HTTP Warning header containing warn-codeof 111, and warn-text of “INV: Invalid search parameters”. See sections 10.4.5 and 14.46 of
IETF RFC 2616 for more information. A search with valid request parameters that finds nomatching value sets is not an error. It will return an empty QueryRetrievedValueSets

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3.60.6 Security Requirements

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The value sets do not contain personal information. In some cases, the value sets are created bystandards organizations with the intention that they be or publicly shared. In other cases, there
may be licensing or other proprietary restrictions on their disclosure. These licenses or
restrictions are at the organizational level, not at the level of individual users. This greatly
reduces the security needs and eliminates privacy concerns.
For further security considerations please consult ITI TF-1: Appendix G.
Audit trails shall be configurable to record access to a selected list of Value Sets. In most cases,
there is no need to audit the value set request activity, but there may be some exceptional cases
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where auditing will be needed. See Section 3.48.6.1 for audit record recommendations in thosecases.
This profile does not attempt to establish rules for managing security on proprietary value setswith licensing or access restrictions.

3.61 Register On-Demand Document Entry
8790

This section corresponds to transaction ITI-61 of the IHE ITI Technical Framework. Transaction
ITI-61 is used by the On-Demand Document Source and Document Registry Actors.
3.61.1 Scope
The Register On-Demand Document Entry transaction passes a Submission Request from an OnDemand Document Source Actor to a Document Registry Actor. The Submission Request
contains metadata describing one or more On-Demand Document Entries.

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3.61.2 Use Case Roles
On-Demand
Document
SourceDocument
Registry

Register On-Demand
Document Entry

Actor: On-Demand Document Source
Role: A Provider of On-Demand Documents that registers a patient specific on-demand
document to the Document Registry.
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Actor: Document Registry
Role: A document indexing system that receives and stores metadata about available ondemand documents.
3.61.3 Referenced Standard

8805

Implementors of this transaction shall comply with all requirements described in ITI TF-2x:
Appendix V: Web Services for IHE Transactions.
ebRIM

OASIS/ebXML Registry Information Model v3.0

ebRS

OASIS/ebXML Registry Services Specifications v3.0

HL7V2

HL7 Version 2.5

ITI TF-3:4

Metadata used in Document Sharing profiles

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3.61.4 Interaction Diagram
On-Demand
Document
SourceDocument
Registry

Register On-Demand
Document Entry Request
Register On-Demand
Document Entry Response

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3.61.4.1 Register On-Demand Document Entry Request
The On-Demand Document Source sends metadata about one or more patient specific n-demand
documents to the Document Registry.
3.61.4.1.1 Trigger Events

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The Register On-Demand Document Entry Request message is triggered when the On-Demand
Document Source chooses to make available an on-demand document for a particular patient.
3.61.4.1.2 Message Semantics
The sections in ITI TF-3: 4.2 specify the mapping of XDS concepts to ebRS and ebRIM
semantics and document metadata. In its use of metadata the On-Demand Document Entry
follows the same conventions and requirements as a Document Entry except for the following.

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•

creationTime – Not Applicable, shall not be specified in a Register On-Demand
Document Entry request.

•

Hash – Not Applicable, shall not be specified in a Register On-Demand Document Entry
Request.

•legalAuthenticator – Recommend this not be specified as having no clear meaning in thecontext of an On-Demand Document Entry.

•

repositoryUniqueId – The globally unique identifier of the On-Demand Document Source
which providers the on-demand document. This unique identifier for the On-Demand
Document Source may be used to identify and connect to the specific On-Demand
Document Source where a current instance of the on-demand document may be retrieved.
The repositoryUniqueId represents an immutable id for the On-Demand Document
Source.

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Size – Not Applicable, shall not be specified in a Register On-Demand Document Entry
Request.

•serviceStartTime and serviceStopTime - For On-Demand Document Entries this attribute
represents the earliest time(serviceStartTime)/most recent time(serviceStopTime) healthservice was rendered for which data is available on-demand. For some On-Demand
Document Sources this attribute is not applicable and so would not be present.

•

uniqueId – The globally unique identifier assigned by the On-Demand Document Source
to this On-Demand Document Entry. It is used in the Retrieve Document Set transaction
to identify the correct on-demand document to access. The use of uniqueId in OnDemand Document Entries is different as this value will never represent an actual
document. See ITI TF-3:4.1.1 for more details regarding use of uniqueId by On-Demand
Document Entries

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The Registry Actor shall store, and later include in metadata returned in a query response, the
XDSDocumentEntry.repositoryUniqueId attribute along with other metadata attributes received
in the Register On-Demand Document Entry [ITI-61] transaction.
The SubmitObjectsRequest may include any of the XDS concepts described in ITI TF-3: 4
except Stable Document Entries. Specifically, the message may include:

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•

XDS Submission Set – exactly one shall be present.

•

XDS Folder – zero or more may be present.

•

Document Relationships – zero or more may be present. See ITI TF-3: Table 4.2.2.2-1for a complete list of associations.

•

On-Demand Document Entry – one or more shall be present.

There are no restrictions on the use of Document Relationship Associations within thistransaction or as part of other transactions which may add or modify Document Relationship
Associations with an On-Demand Document Entry. In particular, workflows which replace an
On-Demand Document Entry with a Stable Document Entry, replace a Stable Document Entrywith an On-Demand Document Entry, add an On-Demand Document Entry to a Folder,deprecate an On-Demand Document Entry or replace an On-Demand Document Entry with a
new On-Demand Document Entry are all valid.
3.61.4.1.3 Expected Actions
Upon receipt of a Register On-Demand Document Entry Request message, the Document
Registry with the aid of the Registry Adaptor shall:

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•

Accept all valid SubmitObjectsRequests•

Perform metadata validations•

Update the registry with the contained metadata

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Return a RegistryResponse message given the status of the operation

If the registry rejects the metadata, then the Document Registry shall:•

Return an error and indicate in the details of the response the type of error, see ITI TF-3:
4.2.4

•

Roll back the request to register the document

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3.61.4.1.4.1 Basic Patient Privacy Enforcement Option
If the Basic Patient Privacy Enforcement Option is implemented:•

The On-Demand Document Source Actor shall populate the confidentialityCode in the
document metadata with the list of OID values that identify the Patient Privacy Consent
Policies that apply to the associated on-demand document. The confidentiality codes fordifferent On-Demand Document Entries in the same submission may be different.

•

The On-Demand Document Source Actor shall be able to be configured with the Patient
Privacy Consent Policies, Patient Privacy Consent Policy Identifiers (OIDs) andassociated information necessary to understand and enforce the XDS Affinity Domain
Policy. The details of this are product specific and not specified by IHE.

•The On-Demand Document Source Actor may have a user interface or business rulecapabilities to determine the appropriate confidentiality codes for each On-Demand
Document Entry. The details of this are product specific and not specified by IHE.
However, the information about how confidentiality codes are assigned must be part ofthe published policy for the XDS Affinity Domain.

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3.61.4.1.5 Protocol Requirements
The Register On-Demand Document Entry transaction shall use SOAP12. Furthermore:•

The Document Registry Actor shall accept the Register On-Demand Document Entry
Request formatted as a SIMPLE SOAP message and respond with the Register OnDemand Document Entry Response formatted as a SIMPLE SOAP message.

•

The On-Demand Document Source Actor shall generate the Register On-Demand
Document Entry Request formatted as a SIMPLE SOAP message and accept the Register
On-Demand Document Entry formatted as a SIMPLE SOAP message.

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See ITI TF-2x: Appendix V for details.
3.61.4.2 Register On-Demand Document Entry Response
The Document Registry sends the result of processing the On-Demand Document Entry
metadata to the On-Demand Document Source.

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3.61.4.2.1 Trigger Events
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The Document Registry finishes processing a Register On-Demand Document Entry Message
and shall return a Register On-Demand Document Entry Response.
3.61.4.2.2 Message Semantics
The Register On-Demand Document Entry Response message shall carry the status of therequested operation and an error message if the requested operation failed.

8905

If creationTime, hash or size metadata attributes are received in a Register On-Demand
Document Entry [ITI-61] transaction the Document Registry shall return an
XDSRegistryMetadataError.
Other conditions of failure and possible error messages are given in the ebRS standard anddetailed in ITI TF-3: 4.2.4 Error Reporting.

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3.61.4.2.3 Expected Actions
The On-Demand Document Source now knows that the transaction succeeded/failed and cancontinue. The metadata added to the registry as a result of this transaction is now available fordiscovery.
3.61.5 Protocol Requirements

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Implementors of this transaction shall comply with all requirements described in ITI TF-2x:
Appendix V: Web Services for IHE Transactions.
WSDL Namespace Definitions

8920

ihe

urn:ihe:iti:xds-b:2007rs

urn:oasis:names:tc:ebxml-regrep:xsd:rs:3.0

lcm

urn:oasis:names:tc:ebxml-regrep:xsd:lcm:3.0

query

urn:oasis:names:tc:ebxml-regrep:xsd:query:3.0

These are the requirements for the Register On-Demand Document Entry transaction presented
in the order in which they would appear in the WSDL definition:•

The following types shall be imported (xsd:import) in the /definitions/types section:•namespace="urn:oasis:names:tc:ebxml-regrep:xsd:rs:3.0", schema=" rs.xsd"•

namespace="urn:oasis:names:tc:ebxml-regrep:xsd:lcm:3.0", schema=" lcm.xsd"•

The /definitions/message/part/@element attribute of the Register On-Demand Document
Entry Request message shall be defined as “lcm:SubmitObjectsRequest”•

The /definitions/message/part/@element attribute of the Register Document Set-b
Response message shall be defined as “rs:RegistryResponse”

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IHE IT Infrastructure Technical Framework, Volume 2b (ITI TF-2b): Transactions Part B______________________________________________________________________________•The /definitions/portType/operation/input/@wsaw:Action attribute for the Register OnDemand Document Entry Request message shall be defined as“urn:ihe:iti:2010:RegisterOnDemandDocumentEntry”•

The /definitions/portType/operation/output/@wsaw:Action attribute for the Register OnDemand Document Entry Response message shall be defined as“urn:ihe:iti:2010:RegisterOnDemandDocumentResponse”•

The /definitions/binding/operation/soap12:operation/@soapAction attribute shall bedefined as “urn:ihe:iti:2010:RegisterOnDemandDocumentEntry”

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These are the requirements that affect the wire format of the SOAP message. The other WSDL
properties are only used within the WSDL definition and do not affect interoperability.
For informative WSDL for the Document Registry Actor see ITI TF-2x: Appendix W.
3.61.7 Security Considerations
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Relevant XDS Affinity Domain Security background is discussed in the XDS Security
Considerations Section (see ITI TF-1: 10.7).
3.61.7.1 Audit Record Considerations
The Register On-Demand Document Entry transaction is PHI-Export event, as defined in ITI TF2a: Table 3.20.6-1 with the following exceptions.

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3.61.7.1.1 On-Demand Document Source audit message:
Field Name
Event
AuditMessage/
EventIdentification

Opt

Value Constraints

EventID

M

EV(110106, DCM, “Export”)

EventActionCodeM“R” (Read)

EventDateTimeM

not specialized

EventOutcomeIndicatorM

not specialized

EventTypeCode

M

EV(“ITI-61”, “IHE Transactions”, “Register On-Demand Document
Entry”)

Source (On-Demand Document Source) (1)
Human Requestor (0..n)
Destination (Document Registry) (1)Audit Source (On-Demand Document Source) (1)Patient (1)SubmissionSet (1)Where:
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IHE IT Infrastructure Technical Framework, Volume 2b (ITI TF-2b): Transactions Part B______________________________________________________________________________
SourceUserIDM

If Asynchronous Web Services Exchange is being used, the content of
the <wsa:ReplyTo/> element. Otherwise, not specialized.

AlternativeUserIDM

the process ID as used within the local operating system in the local
system logs.

UserNameUnot specialized

UserIsRequestorU

not specialized

AuditMessage/
ActiveParticipant

RoleIDCodeM

EV(110153, DCM, “Source”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointID

M

The machine name or IP address.

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Human
Requestor(if known)

UserID

M

Identity of the human that initiated the transaction.

AlternativeUserIDU

not specialized

UserNameUnot specialized

AuditMessage/
ActiveParticipant

UserIsRequestorM“true”

RoleIDCodeU

Access Control role(s) the user holds that allows this transaction.

NetworkAccessPointTypeCodeU

not specialized

NetworkAccessPointIDU

not specialized

Destination

UserID

M

SOAP endpoint URI.

AuditMessage/
ActiveParticipant

AlternativeUserIDU

not specialized

UserNameUnot specialized

UserIsRequestorM“false”

RoleIDCodeM

EV(110152, DCM, “Destination”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointID

M

The machine name or IP address.

Audit Source

AuditSourceIDU

not specialized

AuditMessage/
AuditSourceIdentificati
on

AuditEnterpriseSiteIDU

not specialized

AuditSourceTypeCodeU

not specialized

ParticipantObjectTypeCodeM“1” (person)

ParticipantObjectTypeCodeRole

M“1” (patient)

ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCodeM

not specialized

ParticipantObjectSensitivityU

not specialized

Patient(AuditMessage/
ParticipantObjectIde
ntification)

ParticipantObjectIDM

the patient ID in HL7 CX format..

ParticipantObjectNameU

not specialized

ParticipantObjectQueryU

not specialized

ParticipantObjectDetailUnot specialized

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IHE IT Infrastructure Technical Framework, Volume 2b (ITI TF-2b): Transactions Part B______________________________________________________________________________
Submission
Set(AuditMessage/
ParticipantObjectIde
ntification)

ParticipantObjectTypeCodeM“2” (System)

ParticipantObjectTypeCodeRole

M“20” (job)ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCode

M

EV(“urn:uuid:a54d6aa5-d40d-43f9-88c5-b4633d873bdd”, “IHE XDS
Metadata”, “submission set classificationNode”)

ParticipantObjectSensitivityU

not specialized

ParticipantObjectID

M

The submissionSet unique ID

ParticipantObjectNameU

not specialized

ParticipantObjectQueryU

not specialized

ParticipantObjectDetailUnot specialized

3.61.7.1.2 Document Registry audit message:
Field Name

Opt

Value Constraints

EventID

M

EV(110107, DCM, “Import”)

EventActionCodeM“C” (Create)

EventDateTimeM

not specialized

EventOutcomeIndicatorM

not specialized

EventTypeCode

M

EV(“ITI-61”, “IHE Transactions”, “Register On-Demand Document
Entry”)

UserIDM

If Asynchronous Web Services Exchange is being used, the content of
the <wsa:ReplyTo/> element. Otherwise, not specialized.

AlternativeUserIDU

not specialized

UserNameUnot specialized

UserIsRequestorU

not specialized

RoleIDCodeM

EV(110153, DCM, “Source”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointID

M

The machine name or IP address.

Destination

UserID

M

SOAP endpoint URI

AuditMessage/
ActiveParticipant

AlternativeUserIDM

the process ID as used within the local operating system in the local
system logs.

UserNameUnot specialized

UserIsRequestorM“false”

Event
AuditMessage/
EventIdentification

Source (On-Demand Document Source) (1)Destination (Document Registry ) (1)Audit Source (Document Registry) (1)Patient (1)SubmissionSet (1)Where:
SourceAuditMessage/
ActiveParticipant

RoleIDCodeM

EV(110152, DCM, “Destination”)

NetworkAccessPointTypeCodeM“1” for machine (DNS) name, “2” for IP address

NetworkAccessPointID

M

The machine name or IP address.

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IHE IT Infrastructure Technical Framework, Volume 2b (ITI TF-2b): Transactions Part B______________________________________________________________________________

Audit Source

AuditSourceIDU

not specialized

AuditMessage/
AuditSourceIdentificati
on

AuditEnterpriseSiteIDU

not specialized

AuditSourceTypeCodeU

not specialized

ParticipantObjectTypeCodeM“1” (person)

ParticipantObjectTypeCodeRole

M“1” (patient)

ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCodeM

not specialized

ParticipantObjectSensitivityU

not specialized

ParticipantObjectIDM

the patient ID in HL7 CX format..

ParticipantObjectNameU

not specialized

ParticipantObjectQueryU

not specialized

ParticipantObjectDetailUnot specialized

Submission
Set

ParticipantObjectTypeCodeM“2” (System)

ParticipantObjectTypeCodeRole

M“20” (job)(AuditMessage/
ParticipantObjectIde
ntification)

ParticipantObjectDataLifeCycle

U

not specialized

ParticipantObjectIDTypeCode

M

EV(“urn:uuid:a54d6aa5-d40d-43f9-88c5-b4633d873bdd”, “IHE XDS
Metadata”, “submission set classificationNode”)

ParticipantObjectSensitivityU

not specialized

ParticipantObjectID

M

The submissionSet unique ID

ParticipantObjectNameU

not specialized

Patient(AuditMessage/
ParticipantObjectIde
ntification)

8965

ParticipantObjectQueryU

not specialized

ParticipantObjectDetailUnot specialized

3.62 Reserved for Delete Document Set
3.63 Reserved for Cross Gateway Fetch
3.64 Reserved for Notify XAP-PID Link Change

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