BS EN ISO 13606-5:2010

BS EN ISO 13606-5:2010 Health informatics. Electronic health record communication. Interface specification

BS EN ISO 13606 consists of the following parts, under the general title Health informatics. Electronic health record communication:

Part 1: Reference model

Part 2: Archetype interchange specification

Part 3: Reference archetypes and term lists

Part 4: Security [Technical Specification]

Part 5: Interface specification

This part of BS EN ISO 13606 defines three interfaces, one for each of a) to c) above, as a communication between an EHR_requester (wishing to and authorizing the communication of the artefact), an EHR_provider (a repository service that contains and can return the requested artefact) and an EHR_recipient who is intended and authorized to receive the artefact (usually but not always the same as the EHR_requester). In terms of the HISA standard, ISO 12967, these interfaces are all specializations of the Detail Basic Methods defined in ISO 12967-3.

These interfaces are all expressed as ODP Computational Viewpoint specifications, and aim to support implementation through many different Engineering Viewpoint (transport) formalisms, such as message protocols (e.g. EDIFACT, HL7 3) or service protocols (e.g. SOAP, Java RMI). This part of ISO 13606 therefore specifies only the “payload” information to be communicated at each interface. Attributes such as message identifiers, message time-stamping and message version management are normally defined and handled by each kind of transport protocol in particular ways, and this part of ISO 13606 therefore does not define its own duplication of this kind of information. It should be noted that the EHR_EXTRACT defined in ISO 13606-1, the ARCHETYPE defined in ISO 13606-2, and the EHR_AUDIT_LOG_EXTRACT defined in ISO 13606-4 all include time-stamping, authorship and version management information of the payload data as part of their information models.

Request acknowledgements and system/communication error messages are routinely handled by most engineering transport protocols. It is therefore not appropriate that this part of ISO 13606 duplicate these. An optional exception is defined to communicate back to the EHR_requester a reason why a request has been received but refused, if it is legitimate to reveal this without breaching confidentiality.

The EHR_requester will need to authenticate to the EHR_provider in ways that are to be locally determined, and will present authorization credentials that are also beyond the scope of this part of ISO 13606 but are specified in ISO/TS 22600 (PMAC). It is recognised that there may be times when an EHR_requester wishes the EHR_provider to “send” the EHR_EXTRACT to a third party. This part of ISO 13606 may be used within a delegation architecture, in which an EHR_requester acts on behalf of another party, but the representation and communication of the hierarchy of authorizations involved in delegation is a matter for the privilege management and access control architecture and does not directly impact on this part of ISO 13606.

Alternatively, local arrangements may be made to securely communicate to a third party a unique reference for any particular RECORD_COMPONENT (e.g. for a particular letter or discharge summary, via the ehr-id and rc_id of the COMPOSITION) that the third party is recommended to and has permission to access directly, without therefore requiring the use of delegation.

This part of ISO 13606 defines the interfaces by which an EHR_EXTRACT, an ARCHETYPE or an EHR_AUDIT_LOG_EXTRACT may be requested and provided.

The scope of this part of ISO 13606 has been considered carefully in order to achieve several objectives:

To specify those interfaces that are unique to the ISO 13606 context, and not to include more generic health information communication interfaces that might be the scope of other standards and specifications

To specify the interfaces in ways that are compatible with the HISA standard (ISO 12967) and, in particular, to define these interfaces as specializations of HISA ISO 12967-3 interfaces

To specify the interfaces as a pure RM-ODP Computational Viewpoint, in order to support the wide range of engineering viewpoints that might be adopted by individual vendors or eHealth programmes; (it should be noted that ISO 13606-1, ISO 13606-2 and ISO 13606-4 define the corresponding Information Viewpoints, and that ISO/TS 18308 defines the corresponding Enterprise Viewpoint)

To construct these interfaces such that they might easily be implemented as specializations of standard interfaces within the commonly used engineering languages such as Java, Visual Basic, dotnet, SOAP, ebXML, etc.

To work through the Joint SDO Initiative and Council on the production of Engineering Viewpoint Implementation Guides, that will define more specifically how to implement these interfaces; (e.g. in HL7 3); these guides will be published separately from this part of ISO 13606, to enable them to be maintained and updated more frequently (to reflect implementation experience) than is possible for a standard

To recognise that EHR communication will be implemented within a healthcare communications infrastructure, usually nationally, that will define a generalized approach to many other complementary and necessary services such as patient demographics registries, provider registries, authentication and authorization policies and services, etc.; these are therefore not part of the formal scope of this part of ISO 13606 but are referred to as being assumed and necessary complementary services

To assume that an ISO/TS 22600 (PMAC) compatible architecture or its equivalent will be used for managing security services, and not to duplicate or conflict with these services in this part of ISO 13606

To further support the protection of patient privacy by avoiding the need to reveal whether any EHR data have been withheld by the provider when responding to a request

To enable each interface and term set to be extended locally to cater for specialized circumstances of EHR communication, in which additional requirement constraints might apply.

This part of ISO 13606 defines a set of interfaces by which the artefacts defined in ISO 13606-1, ISO 13606-2 and ISO 13606-4 can be requested and provided:

a) ISO 13606-1 defines a reference model for an EHR_EXTRACT: part or all of the EHR of a subject of care

b) ISO 13606-2 defines an information model for an ARCHETYPE, and optionally a serialized form represented using Archetype Definition Language

c) ISO 13606-4 defines an EHR_AUDIT_LOG_EXTRACT to communicate the audit log activity history pertaining to part or all of an EHR.

(ISO 13606-3 defines term lists and reference archetypes, to which a direct interface is not required. ISO 13606-4 defines an access policy model to which a direct interface is also not required.)

• Scope
• Conformance
• Terms and definitions
• Abbreviated terms
• Interactions
• Interfaces
• Interface: REQUEST_EHR_EXTRACT
• Interface: REQUEST_ARCHETYPES
• Interface: REQUEST_EHR_AUDIT_LOG_EXTRACT.
• Term lists
• Bibliography