Architecture Views specify the software architecture. Views specify elements of software and the relationships between them. A view is a representation of one or more structures present in the software. This document comprises a multi-view approach of the architecture. However, unlike the prescribed set of views advocated by models such as the "4+1 View Model" [Kruchten 1995; see Referenced Materials section], it follows a more modern trend of selecting the most useful views to describe the system at hand. As with much of the architectural documentation of successful open source projects, these views concentrate on components-and-connectors diagrams and sequence diagrams.
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A patient query is initiated from one HIE to another to determine whether that patient is known to it. This query includes the patient ID and demographic information about the patient as it is known to the sending HIE. The receiving HIE in turn searches its patient index for matches, using the demographic information sent to it and its own matching algorithms, criteria, and policy. If a match is found, and sharing that patient ID with the other HIE is allowed by policy and patient preferences, the receiving system sends its patient ID and the demographic information as it is known to that system back to the querying organization. Finally, the querying system compares the demographic information returned to it, using its matching algorithms, criteria, and policy, to determine whether it agrees with the match. Fundamental to the Patient Discovery service is that both systems must agree on a match for an exchange to proceed. Authorization assertion(s) are included in the query message as specified by the Authorization Framework specification.
When queried for a match, an HIE can return one of three responses. It can return a match with a patient ID and demographics, a message that there was an ambiguous match and request additional information that might result in a single matching patient, or no match. Returning no match might correspond to a failure to identify any matches or an ambiguous match to multiple patients when a more exact match cannot be expected. An HIE can only return multiple matches if they represent exact matches to multiple institutions within the HIE that are believed to represent a single patient.
This document does not describe the details of implementation of an MPI. Architectural decisions regarding the MPI, such as whether it is centralized or decentralized, are left up to the implementing HIE. At a minimum, it is assumed that whatever the implementation, the MPI can make a match based on a set of demographic data and return an identifier. CONNECT includes a reference implementation of an MPI that may be used by an organization utilizing CONNECT.
CONNECT also supports deferred processing for Patient Discovery. The processing is the same as synchronous, with the exception that the timing of the processing can be delayed after the initial request comes in. According to the Nationwide Health Information Network specifications, deferred processing will introduce introduces a new set of services on both the responding gateway and initiating gateway side. On the responding gateway, the new service will support supports the receiving of a deferred patient discovery Patient Discovery request message, and it will return returns an application acknowledgment of the receipt of the message. At a later time, the responding gateway will process the request and send out the response on a waiting web service on the initiating gateway that is responsible for receiving these delayed responses. That service will send back an application acknowledgment that it has received the response.
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Service View - Document Data Submission
The Document Data Submission (DDS) service provides a mechanism to send document metadata information to a target organization without the target organization having to run a Query for Document request on the source organization. This allows organizations to push document metadata, without the document binaries, towards other organizations without having to query for the entire document.
Document Data Submission Interface Catalog
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