# Query Patient-level Clinical Data Workflow

 The transaction queries for previously stored clinical data for a specific patient. The following sequence diagram shows the steps involved in this transaction.

| **Workflow Maturity**         | <p><img src="https://lh5.googleusercontent.com/Vp6XBRGu-U_Dmd5EKNpCZvEEum0CxOcHOj9NgHh8UMMNLMlXHmLcUE_YWueDRr4uqWLzpPfzSBLJ2k33XQIelLypjQ4wyrD17-t33GtLa8fFxW9AYDvXhiJmBl4VaLgKDg" alt=""></p><p>    <strong>Mature</strong></p> | <p></p><ul><li><strong>One or more OpenHIE implementations of this workflow exist  in one or more countries</strong></li><li><strong>Workflow is defined and ARB approved</strong></li><li><strong>Workflow is supported by mature standards</strong></li></ul>                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     |
| ----------------------------- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Standards\*                   |                                                                                                                                                                                                                                  | <p></p><ul><li>XDS.b with the on-demand document option</li><li>CDA documents profiled by IHE PCC</li><li>CSD - Find matching services - ITI-73</li><li>PIX Query - ITI-9</li><li><p><strong>Optionally</strong>, the MHD profile can be supported (in addition or instead of XDS.b) to enable PoC systems to query clinical content using a simpler and more modern FHIR-based approach. This option may be supported in two ways:</p><ul><li>The SHR itself may support the required MHD transactions.</li><li>(<strong>recommended</strong>) The IL can provide an adapter to convert incoming MHD transactions to XDS.b transactions for the SHR to process as normal.</li></ul></li></ul>                                                                                                                                                                                                                                                                                                                                                                                                                                                      |
| Assumptions and Prerequisites |                                                                                                                                                                                                                                  | <p></p><ul><li>The PoS system must ensure the patient they are querying clinical information about already exists. It can do this by querying for the patient (<a href="https://docs.google.com/document/d/1vn46_f0nKDSwiSNfU1JzCat0sFvHe8y3mM5Py2nz4uU/edit#heading=h.i2zmb6glro23">Query patients workflow</a>).</li><li>The PoS system is a trusted application known by the HIE and it is registered with the interoperability layer to be able to send and receive data securely (<a href="https://wiki.ohie.org/display/documents/Common+message+security+workflow">Common message security workflow</a>).</li></ul><p>The SHR <strong>MUST</strong> be able to generate on-demand documents in the <a href="http://wiki.ihe.net/index.php?title=Medical_Summaries_Profile">XDS-MS</a> format using the data it stored in the <a href="https://docs.google.com/document/d/1vn46_f0nKDSwiSNfU1JzCat0sFvHe8y3mM5Py2nz4uU/edit#heading=h.rldiwp20bk7f">save patient-level clinical data workflow</a>. Optionally, any other sections that have been discretely imported and are deemed useful may be added to the generated XDS-MS document.</p> |
| Actors                        |                                                                                                                                                                                                                                  | <p></p><ul><li>PoS - The point of care system that captures a patient's clinical encounter, it is responsible for sending clinical data on to the HIE.</li><li>IL - Mediates the transactions between the PoS system and the infrastructure services to facilitate easier interoperability.</li><li>CR - The source of truth for patient demographic and identifier detail. It is able to be queried using an identifier to find the enterprise identifier for a particular person.</li><li>FR - The source of truth for facility information. It is able to be queried for details about a particular facility by ID.</li><li>SHR - Stored patients clinical information. It is able to receive and store patient clinical documents.</li></ul>                                                                                                                                                                                                                                                                                                                                                                                                    |

## **Interaction Description**&#x20;

The following is a description of the interaction steps.&#x20;

![](https://lh3.googleusercontent.com/pdTH8pA1_8ukXlAAVEYWMWGGdnkfEo2CfGe3_8S8GTMGXG0U6kE92bQIZ59C40w-47VlphCZnw0C0c-rkZD0fiwHvKiG5QKC3jSowHX4QAOx_lnpuyH9HuOyYHLI6MPkeA)

| #  | Interaction                                                                                                    | Data                                                                                                                                                                                                                                                  | Transaction Options                                                                                                                                                                                                                                                                                                                                                                                                                    |
| -- | -------------------------------------------------------------------------------------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| 1  | Query for clinical documents by patient ID and/or date                                                         | <p>XDS.b/MHD metadata</p><p>Option 1 (must be supported): XDS.b Registry Stored Query (ITI-18) - Find Documents query</p><p>OR</p><p>Option 2 (may additionally choose to support): MHD Find document references (ITI-67) - RESTful query<br><br></p> | <p><a href="http://www.ihe.net/Technical_Frameworks/#IT">IHE IT Infrastructure</a></p><p>Vol. 1 - Section 10, Appendix E, J, K</p><p>Vol. 2a - Sections 3.18</p><p>Vol. 2b - Sections 3.41, 3.42, 3.43</p><p>Vol. 2x - Appendix A, B, K, L, M, N, V, W</p><p>Vol. 3 - Section 4.1, 4.2, 4.3If supporting the MHD Option: <a href="http://www.ihe.net/uploadedFiles/Documents/ITI/IHE_ITI_Suppl_MHD.pdf">MHD profile supplement</a></p> |
| 2  | Resolve client identifier                                                                                      | HL7 QBP^Q23 message                                                                                                                                                                                                                                   | <p>PIX Query (ITI-9)       <a href="http://www.ihe.net/Technical_Frameworks/#IT">IHE IT Infrastructure</a></p><p>Vol. 1 - Section 5</p><p>Vol. 2 - Sections 3.9</p>                                                                                                                                                                                                                                                                    |
| 3  | Return person record                                                                                           | HL7 RSP^K23 message                                                                                                                                                                                                                                   |                                                                                                                                                                                                                                                                                                                                                                                                                                        |
| 4  | Extract ECID and enrich message with ECID                                                                      |                                                                                                                                                                                                                                                       |                                                                                                                                                                                                                                                                                                                                                                                                                                        |
| 5  | Query for clinical documents by ECID                                                                           | <p>XDS.b/MHDmetadata</p><p>XDS.b Registry Stored Query (ITI-18) - Find Documents query</p><p>and optionally (only if SHR support MHD directly)</p><p>MHD Find document references (ITI-67) - RESTful query<br><br></p>                                | <p><a href="http://www.ihe.net/Technical_Frameworks/#IT">IHE IT Infrastructure</a></p><p>Vol. 1 - Section 10, Appendix E, J, K</p><p>Vol. 2a - Sections 3.18</p><p>Vol. 2b - Sections 3.41, 3.42, 3.43</p><p>Vol. 2x - Appendix A, B, K, L, M, N, V, W</p><p>Vol. 3 - Section 4.1, 4.2, 4.3MHD: <a href="http://www.ihe.net/uploadedFiles/Documents/ITI/IHE_ITI_Suppl_MHD.pdf">MHD profile supplement</a></p>                          |
| 6  | Return list of document IDs                                                                                    | <p>XDS.b Registry Stored Query response - list of document IDs</p><p>or optionally (only if SHR support MHD directly)</p><p>MHD Find document references response - list of document IDs</p>                                                          |                                                                                                                                                                                                                                                                                                                                                                                                                                        |
| 7  | Return list of document IDs                                                                                    | <p>XDS.b Registry Stored Query response - list of document IDs</p><p>or optionally</p><p>MHD Find document references response - list of document IDs</p>                                                                                             |                                                                                                                                                                                                                                                                                                                                                                                                                                        |
| 8  | Request the content of the document by document ID                                                             | <p>XDS.b/MHDmetadata</p><p>XDS.b Retrieve Document Set (ITI-43)</p><p>and optionally</p><p>MHD Retrieve document (ITI-68)<br><br></p>                                                                                                                 | <p><a href="http://www.ihe.net/Technical_Frameworks/#IT">IHE IT Infrastructure</a></p><p>Vol. 1 - Section 10, Appendix E, J, K</p><p>Vol. 2a - Sections 3.18</p><p>Vol. 2b - Sections 3.41, 3.42, 3.43</p><p>Vol. 2x - Appendix A, B, K, L, M, N, V, W</p><p>Vol. 3 - Section 4.1, 4.2, 4.3MHD: <a href="http://www.ihe.net/uploadedFiles/Documents/ITI/IHE_ITI_Suppl_MHD.pdf">MHD profile supplement</a></p>                          |
| 9  | Request the content of the document by document ID                                                             | <p>XDS.b/MHDmetadata</p><p>XDS.b Retrieve Document Set (ITI-43)</p><p>and optionally (only if SHR support MHD directly)</p><p>MHD Retrieve document (ITI-68)<br><br></p>                                                                              | <p><a href="http://www.ihe.net/Technical_Frameworks/#IT">IHE IT Infrastructure</a></p><p>Vol. 1 - Section 10, Appendix E, J, K</p><p>Vol. 2a - Sections 3.18</p><p>Vol. 2b - Sections 3.41, 3.42, 3.43</p><p>Vol. 2x - Appendix A, B, K, L, M, N, V, W</p><p>Vol. 3 - Section 4.1, 4.2, 4.3MHD: <a href="http://www.ihe.net/uploadedFiles/Documents/ITI/IHE_ITI_Suppl_MHD.pdf">MHD profile supplement</a></p>                          |
| 10 | <p>If this document is a static document retrieve it</p><p>else if it is an on-demand document generate it</p> |                                                                                                                                                                                                                                                       | For ODD: [XDS-MS Specification](http://wiki.ihe.net/index.php?title=Medical_Summaries_Profile)                                                                                                                                                                                                                                                                                                                                         |
| 11 | Return clinical document                                                                                       | XDS.b/MHDresponse - with CDA document content                                                                                                                                                                                                         |                                                                                                                                                                                                                                                                                                                                                                                                                                        |
| 12 | Return clinical document                                                                                       | XDS.b/MHDresponse - with CDA document content                                                                                                                                                                                                         |                                                                                                                                                                                                                                                                                                                                                                                                                                        |

{% hint style="success" %}
References:  [WHO DDCC Workflows](https://worldhealthorganization.github.io/ddcc/workflows.html)
{% endhint %}


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# Agent Instructions: Querying This Documentation

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```
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```

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