40 PART I Healthcare Content Management: The Holistic View on Medical Data
process. In some scenarios, patient identification can be automated by using a
master patient index. The solution offered by the HCM system must be as flexible
as external data sources are diverse.
An HCM system can also optimize the processes around the »dirty archive«, as
it can, for example, help with the incorporation of data into the in-house patient
and case number ranges. At the very least, however, it must be able to accept the
data and record the origin of the data.
For those who are not familiar with it, the term dirty archive is often
used to describe the data pot into which external data enters unseen
before a decision is made as to whether it is medically relevant and
whether it flows into one’s own archives.
HCM and IHE-XDS
The family of IHE-XDS profiles is a hot topic these days when data exchange
between
institutions is discussed. Therefore, the HCM system has to support IHE-
XDS based interfaces as well. Because the IHE-XDS world is quite complicated,
here is a short introduction.
The Integrating the Healthcare Enterprise (IHE) initiative has defined numerous
technical guidelines (profiles) on how healthcare IT systems can interact.
Numerous
portals are based on these IHE profiles, which provide a framework
for the retrieval and receipt of external data. In many cases, the profiles related to
IHE
XDS are used. They govern the exchange of the relevant files between the following
actors:
✔✔ the in-house source archive for documents or images (so-called Document
or Image Source)
✔✔ the retainer of the files (repository)
✔✔ the directory of all files and their locations (registry)
✔✔ the user of the files (consumer)
How do these actors interact with each other? Medical documents such as findings
are, for example, provided by one or more document sources. The source transfers
its documents to a document repository. The repository in turn publishes
information about the received document to the document registry. This
registry knows the data not only from one repository but from several. Now it is
the turn of the consumer who requests medical data from the registry and then