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  • Record Locator Service:Technical Background from the Massachusetts Prototype Community

    THE CONNECTING FOR HEALTH COMMON FRAMEWORK

    T1 T2 T3 T4 T5 T6

    P1 P2 P3 P4 P5 P6 P7 P8P5 P6 P7 P8

    M1 M2

  • CONNECTING FOR HEALTH COMMON FRAMEWORK

    Record Locator Service Technical Background from the

    Massachusetts Prototype Community

  • The document you are reading is part of The Connecting for Health Common Framework,which is available in full and in its most current version at: http://www.connectingforhealth.org/.The Common Framework will be revised and expanded over time. As of October 2006, theCommon Framework included the following published components:

  • Record Locator Service Technical Background fromthe Massachusetts Prototype Community *

    This document describes the early design process for the Record Locator Service (RLS)as implemented in Massachusetts, and is included here as background on the technicalconversation around the design of the Connecting for Health prototype. It is includedhere as a background guide to the issues surrounding the design of the RLS asconstructed in Massachusetts; as noted in The Common Framework: Technical Issuesand Requirements for Implementation, the placement of aggregation services can varybetween sub-network organizations (SNOs). In this document, aggregation takes placevia a clinical data exchange service; other architectural models are possible. In addition to the overview of the architectural design decisions included inThe Common Framework: Technical Issues and Requirements for Implementation,the technical details surrounding message exchange in the current prototype aredocumented in the Health Information Exchange: Architecture Implementation Guide.

    * Connecting for Health thanks Computer Sciences Corporation (CSC) for drafting this paper.

    2006, Markle Foundation

    This work was originally published as part of The Connecting for Health: Resources for Implementing Private andSecure Health Information Exchange and is made available subject to the terms of a license (License) which may beviewed in its entirety at: http://www.connectingforhealth.org/license.html. You may make copies of this work; however,by copying or exercising any other rights to the work, you accept and agree to be bound by the terms of the License. Allcopies of this work must reproduce this copyright information and notice.

  • Architecture Document Page iii Version 1.1aRecord Locator Service 2005-11-22Confidential CSC, 2006

    Revision History

    Date Version Description Author

    2005-02-18 0.1 Initial (strawman) version where architecture discussionsand design to date are documented for further review

    CSC

    2005-03-01 0.2 Revised draft based on feedback from internal review.Added content on security.

    CSC

    2005-03-23 0.3 Revised based on feedback from reviewers of 0.2 Changed conceptual application architecture to explicitly

    support peer-to-peer messaging and support inter-RLSmessaging

    Moved revised conceptual application architecturediagram from Implementation view to Logical view

    Moved process diagrams from logical to process view.Added content on message exchange patterns to processspecifications

    CSC

    2005-03-25 0.4 Revised content based on internal review. Packaged to publish to Markle Connecting for Health

    Technical Subcommittee Retitled document: Framework Technical Overview

    CSC

    2005-04-12 0.5 Incorporated feedback from review of 0.4 by: MarkleConnecting for Health Technical Subcommittee and MA-SHARE Technical Advisory Board. Comments providedin Appendix with responses.

    Changed architecture diagram to depict RLS and CDXGateway as two solutions that the RLS Prototype projectwill develop to be flexible collection of a loosely-coupledservices. Shows separation of RLS and othercomponents more clearly. Section 5.2

    Added sequence diagrams to process view (Section 6)indicating processing logic for transactions supported byRLS

    CSC

    2005-04-15 0.6 Incorporated comments from internal review Added discussion items 4.5 (patient lookup with local

    MRN) and 4.6 (query-time matching)

    CSC

    2005-05-20 1.0 Language edits: cleaned up references to RLS Exchange Changed Figures: 3 and 4 to align with more precise

    definition of RLS scope (vis--vis clinical data exchange) Modified Figure 13 and added Figure 14 to provide more

    details of security architecture and process

    CSC

    2005-11-22 1.1 Removed implementation specifications pertinent to onlyMassachusetts pilot. Reoriented content to be moregeneric.

    Removed discussion items that were relevant to prototypearchitecture decisions.

    CSC

  • Architecture Document Page iv Version 1.1aRecord Locator Service 2005-11-22Confidential CSC, 2006

    Table of Contents1 INTRODUCTION ........................................................................................................................... 7

    1.1 P URPOSE...................................................................................................................................9 1.2 S COPE ......................................................................................................................................9 1.3 R EFERENCES ............................................................................................................................9 1.4 D OCUMENT O VERVIEW ........................................................................................................... 10 1.5 A RCHITECTURAL R EPRESENTATION.......................................................................................... 11

    2 ARCHITECTURAL GOALS, PRINCIPLES AND CONSTRAINTS ............................................132.1 G OALS ................................................................................................................................... 13 2.2 P RINCIPLES ............................................................................................................................ 13

    3 USE-CASE VIEW ........................................................................................................................173.1 RLS F UNCTIONS..................................................................................................................... 17 3.2 U SE C ASES ............................................................................................................................ 18 3.3 U SE -C ASE R EALIZATIONS ....................................................................................................... 21 3.4 S ECURITY , P ATIENT P RIVACY AND C ONSENT M ANAGEMENT ...................................................... 22

    3.4.1 Identity management ....................................................................................................... 233.4.2 Confidentiality, Authentication, Integrity & Non-repudiation ......................................... 233.4.3 Patient Data Privacy ......................................................................................................... 233.4.4 Consent Management ...................................................................................................... 24

    3.5 P ATIENTS R ECORDS L INKING AND M ATCHING........................................................................... 24

    4 LOGICAL VIEW ..........................................................................................................................264.1 C ONCEPTUAL RLS-S ERVICES V IEW......................................................................................... 26 4.2 RLS A PPLICATION S ERVICES................................................................................................... 28 4.3 G ATEWAY S ERVICES ............................................................................................................... 30 4.4 RLS-B ASED N ETWORKS ......................................................................................................... 33 4.5 R EGIONAL AND N ATIONAL N ETWORK S UPPORT ......................................................................... 35

    5 PROCESS VIEW .........................................................................................................................365.1 P ATIENT L OOKUP AND P EER TO P EER M EDICAL R ECORDS R ETRIEVAL....................................... 36 5.2 P ATIENT I NDEX P UBLISH ......................................................................................................... 37 5.3 C ENTRALLY M EDIATED M EDICAL R ECORDS R ETRIEVAL.........................