Sharing of IPS (sIPS)
1.0.0 - Trial-Implementation
Sharing of IPS (sIPS)
1.0.0 - Trial-Implementation
This page is part of the Sharing of IPS (sIPS) (v1.0.0: Publication) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions
The Sharing of IPS (sIPS) IHE Profile provides for methods of exchanging the HL7 International Patient Summary (IPS), using IHE Document Sharing Health Information Exchange but does not modify the HL7 IPS specification. The International Patient Summary (IPS) content, as defined in the ISO 27269 data model specification, utilizes IHE’s document sharing infrastructure including cross-community, HIE, direct exchange models, and more. It has been designed specifically to remove barriers to adoption, by leveraging architectures that are currently implemented, well-established, and robust. The sIPS Profile provides implementation guidance to vendors and implementers and joins a growing suite of IPS standards artifacts contributed by a variety of Standards Development Organizations (SDOs) and coordinated by the Joint Initiative Council for Global Health Informatics Standardization (JIC).
An HL7 IPS document is an electronic health record extract, taken at a point in time, containing essential healthcare information about a subject of care. It is designed for supporting the use case scenario for planned and unplanned, cross border care. Although it is intended to be used across international borders, it is equally useful to exchange information across any jurisdictional border, including those within a particular region or country. The IPS dataset is minimal and non-exhaustive; specialty-agnostic and condition-independent but still clinically relevant. The HL7 IPS specification is composed of a set of robust, well-defined and potentially reusable sets of core data items (indicated as the IPS library in the figure below).
This profile leverages the HL7 IPS content specification for FHIR. Due to the minimal global uptake of the CDA encoding of the IPS at this time, the focus of the sIPS Profile is currently based on the specification provided in the HL7 FHIR IPS IG. Any document conforming to the HL7 base IPS specification can be exchanged using sIPS.
The sIPS Profile provides guidance to implementers on how a number of important functions may be leveraged to support key IPS use cases. These include:
The IPS, as a current medical summary, is an excellent document for the “On-Demand” capability of the Document Sharing infrastructure. Further details for IPS use of On-Demand are outlined below. IHE Document Sharing also has “Stable” and “Delayed Assembly” document entry types that are further explained in the HIE Whitepaper: Dynamic Documents.
The actors in this profile are described in more detail in the sections below.
The Content Creator creates the IPS content and shares it using one of the methods defined in the IHE Document Sharing Health Information Exchange.
FHIR Capability Statement for Content Creator
The HL7 IPS is serialized into a FHIR Document Bundle and encoded as a document following the PCC Serializing FHIR Documents. The HL7 IPS is mapped to the Document Sharing Metadata according to PCC Volume 2: 4.1. This shows how to map the FHIR Composition resource elements into XDS/XDM/XDR/XCA Document Entry and MHD FHIR DocumentReference elements.
The Content Consumer consumes the IPS content and obtains it using one of the methods defined in the IHE Document Sharing Health Information Exchange.
FHIR Capability Statement for Content Consumer
The HL7 IPS is mapped to the Document Sharing Metadata according to PCC Volume 2: 4.1. This shows how to map the FHIR Composition resource elements into XDS/XDM/XDR/XCA Document Entry and MHD FHIR DocumentReference elements.
The Content Creator and Content Consumer share the IPS content using one of the methods defined in the IHE Document Sharing Health Information Exchange.
The HL7 IPS is mapped to the Document Sharing Metadata according to PCC Volume 2: 4.1. This shows how to map the FHIR Composition resource elements into XDS/XDM/XDR/XCA Document Entry and MHD FHIR DocumentReference elements.
Options that may be selected for each actor in this implementation guide, are listed in Table 3.2-1 below. Dependencies between options when applicable are specified in notes.
| Actor | Option |
|---|---|
| Content Consumer | View |
| Content Consumer | Document Import |
| Content Consumer | Discrete Data Import |
This option defines the processing requirements placed on Content Consumers for providing access, rendering and management of the medical document. See the View Option in IHE PCC TF-2:3.1.1 for more details on this option.
The Content Consumer Actor shall be able to present a view of the document. Minimal view guidance following FHIR core Document Presentation.
This option defines the processing requirements placed on Content Consumers for providing access, and importing the entire medical document and managing it as part of the patient record. See the Document Import Option in IHE PCC TF-2:3.1.2 for more details on this option.
This option defines the processing requirements placed on Content Consumers for providing access, and importing discrete data from selected sections of the medical document and managing them as part of the patient record. See the Discrete Data Import Option in IHE PCC TF-2:3.1.4 for more details on this option.
The Content Creator and Content Consumer communicate the content using the IHE Document Sharing Health Information Exchange.
The Content Creator shall be grouped with a Document Source actor from one of the Document Sharing Implementation Guides (e.g. XDS, XCA, XDM, XDR, MHD, MHDS, etc).
The Content Consumer shall be grouped with a Document Consumer actor from one of the Document Sharing Implementation Guides (e.g. XDS, XCA, XDM, XDR, MHD, MHDS, etc).
Document Sharing Health Information Exchange Whitepaper includes additional HIE functionalities that are covered in the following sections:
This Implementation Guide simply hooks HL7 IPS to IHE Document Sharing (XDS, XCA, XDR, XDM, MHD, MHDS), using existing Content Creator / Content Consumer actors that already support this binding.
The Concepts of Document Sharing Health Information Exchange are defined in the IHE Whitepaper, and ITI Profiles.
The Concepts of the HL7 International Patient Summary (IPS) are defined in the HL7 Implementation Guide.
The IHE Document Sharing infrastructures define a common set of Document Metadata, Submission Set, and Folders. There are defined methods of communicating documents including push, centralized registry, and federated discovery and retrieval. The metadata model is designed to be content agnostic so can support any past or future document specification, which enables all existing networks to support the IPS without modification.
A Document Entry (aka FHIR DocumentReference) is metadata about a document. This metadata is designed to support provenance, lifecycle, authenticity, patient identity, privacy, and exchange of the document that is described. The document can be any kind of format, in this content module we are focused on the International Patient Summary (IPS) document and the format of JSON or XML. Submission Set is the metadata about the publication event, who published these documents, why, when, where, etc. The Folder is an adhoc grouping mechanism that can be used for purposes like grouping a clinical episode. Further explanation of the Value of Metadata is covered in the HIE Whitepaper.
Given that the HL7 FHIR IPS Implementation Guide provides a Medical Summary in FHIR format
And that IHE Document Sharing is a recognized document sharing infrastructure
When a FHIR IPS is published
And there is a need to make it discoverable
Then I need to have clear specification on how I express in Document Sharing the existence of a FHIR IPS sources
Note: the above use-case is written in Gherkin, a use-case language optimized for automated testing.
See further discussion:
Given that the HL7 FHIR IPS Implementation Guide provides a Medical Summary in FHIR format
And that IHE Document Sharing is a recognized document sharing infrastructure
When an FHIR IPS could be made available on-demand
And there is a need to make it discoverable
Then I need to have clear specification on how I express in Document Sharing the existence of a FHIR IPS sources
See further discussion:
Given that the HL7 FHIR IPS Implementation Guide provides a Medical Summary in FHIR format
And that IHE Document Sharing is a recognized document sharing infrastructure
When an application needs access to a FHIR IPS
Then I need to have clear specification on how I use Document Sharing to find FHIR IPS sources
See further discussion:
Given that the HL7 FHIR IPS Implementation Guide provides a Medical Summary in FHIR format
And that IHE Document Sharing is a recognized document sharing infrastructure
When an FHIR IPS needs to be sent to a specific recipient
Then I need to have clear specification on how I use Document Sharing to find FHIR IPS sources
See further discussion:
See Security and Privacy Solutions: Handbooks, Profiles, and Content.
All cross-profile considerations are discussed elsewhere.
IG © 2023+ IHE IT Infrastructure Technical Committee. Package ihe.iti.sips#1.0.0 based on FHIR 4.0.1. Generated 2023-11-17
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