Patient Care Coordination (PCC) Implementation Guide
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Patient Care Coordination (PCC) Implementation Guide - Local Development build (v0.1.1-current) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Health Information Exchange (HIE)

Reference

Actors and Transactions

Actor Description  
Data Consumer A system/user that wants patient information.  
Health Information Exchange (HIE) Mediates between the consumer and healthcare data sources.  
Patient Demographic Query (PDS) Looks up patient demographics (like NHS number, date of birth, etc.).  
Care Directory Service (CSD / Spine) Finds where patient records are stored (service directory).  
Data Sources The actual systems storing patient data: Primary Care System and Clinical Data Repository  

Process Flow

Data ConsumerHealth Information Exchange (HIE)Patient Demographic Query (PDS)Care Directory Service (CSD)Data SourceData SourceData ConsumerHealth Information Exchange (HIE)Patient Demographic Query (PDS)(includes Personnal Demographic Service API)Care Directory Service (CSD)(includes Spine API)Data Source(Primary Care System)Data Source(Clinical Data Repository)Query for Patient:Query for Patient (ITI-78)(FHIR RESTful API)Query for Patient(FHIR R4 RESTful API)Search resultsSearch results(FHIR R4)opt[(GP Connect) national patient and consumer is practitioner]Patient SummaryGP Connect Access Record HTMLIPS Query(FHIR R4 RESTful API)Endpoint Endpoint lookup (ITI-90)(FHIR RESTfull API)Search Results(FHIR R4)GP Connect AR html(FHIR STU3 bespoke API)Search Results(FHIR STU3 Document)Convert toInternational Patient SummaryFHIR R4 DocumentSearch Results(FHIR R4 Document)opt[(Not GP Connect) local patient or patient is data consumer]Patient Record DetailedIM1 Transaction API, local record or IM1 PFSMobile Query Existing Data (PCC-44)(FHIR R4 RESTful API)IM1 Transaction API or PFS APISearch resultsConvert toInternational Patient AccessFHIR R4Mobile Query Existing Data (PCC-44)(FHIR R4 RESTful API)Search ResultsAggregate resultsSearch Results(FHIR R4)

Health Information Exchange (HIE)


  • Patient Search
    • The Data Consumer queries the HIE for a patient (ITI-78, FHIR R4 API).
    • HIE queries PDS to confirm patient demographics.
    • Results are returned to the Data Consumer.
  • Patient Summary (GP Connect scenario). This path is used when the Data Consumer is a GP/practitioner.
    • IPS Query sent (FHIR R4).
    • Endpoint Lookup (ITI-90) via Care Directory Service to find where the patient’s data is held.
    • GP Connect Access Record HTML is requested (FHIR STU3 bespoke API).
    • Data returned as an HTML record (DSTU2 format).
    • Converted into a standardised IPS FHIR R4 Document.
    • Final FHIR R4 Search Results sent back to the Data Consumer.
  • Patient Record Detailed (Non-GP Connect scenario). This path is used when the Data Consumer is not a GP or the patient themselves is requesting data.
    • Mobile Query Existing Data (PCC-44) request sent.
    • Request forwarded to IM1 Transaction API / PFS API.
    • Search results returned and converted to FHIR R4.
    • Another PCC-44 query sent to Data Source(s).
    • Multiple search results returned and aggregated.
    • Final FHIR R4 Search Results sent back to Data Consumer.

Security Considerations

Authentication and Authorization

All users will be authenticated using CIS2. All API calls will follow IHE Internet User Authentication (IUA)

Audits

All API calls will be audited following IHE Basic Audit Log Patterns (BALP)