About the IHE Technical Framework

Integrating the Healthcare Enterprise (IHE) is an organization whose aim is to improve how electronic patient information is shared among healthcare systems and, by doing so, to make sure that current and accurate data is readily available to both patients and healthcare professionals. IHE has developed technical frameworks that define how to process healthcare events, how data is shared, how security is handled, how audit records are generated, and how components interact with one another. The frameworks are made up of integration profiles that provide specifications of how each type of event is processed and how the audit message should be generated for each type of event. The profiles also define standards for security, communication, and time synchronization. These profiles are designed to ensure that data is transmitted securely and accurately among systems, and that data handling is coordinated according to communication and security standards. Having this common framework gives the various participants in a healthcare system a common base for integrating disperse systems.

Sun's PIX/PDQ Manager focuses on the following IT Infrastructure profiles of the IHE framework:

• Audit Trail and Node Authentication (ATNA): This profile describes authenticating systems and transmitting audit events to a repository. The PIX/PDQ Manager provides a complete audit log of events processed through the PIX/PDQ system in the prescribed ATNA format. You can view a complete log of audit events on the PIX Console. The format varies according to the type of event being processed.

• Patient Identifier Cross Referencing (PIX): This profile describes cross-referencing patient identifiers between the various systems that register and store healthcare information. This allows domains to correlate information about a patient from multiple sources that use different identifiers. Sun Master Index maintains a complete cross-reference of patient identifiers using probabilistic matching to identify records. When updates are made to key information in the master index database, Master Index generates PIX outbound notifications, which can then be broadcast to interested domains. The PIX/PDQ Manager supports PIX queries for patient identifiers associated with a given identifier.

• Patient Demographics Query (PDQ): This profile describes system queries against a central repository of patient information to obtain a patient's demographic information, allowing multiple domains to query a central source of patient information to retrieve demographic data for matching patients. Sun Master Index maintains this central repository for the PIX/PDQ Manager, and processes patient demographic queries.

Each healthcare participant registers identifiers for patients in their own computer system, also known as a domain in the IHE framework. Participants maintain control over their own domain's index, but sometimes need access to information in a different domain. They can access the central repository of the PIX/PDQ Manager to find additional local identifiers for their patients. Domains can also be automatically notified when other systems update patient information.

As per IHE standards, Sun's PIX/PDQ Manager cross-references patient IDs (PIX) and supports patient demographic queries (PDQ). It also supports PIX queries for local IDs that are associated with a given local ID from a domain and patient identity feeds, such as when a record is added or updated in a domain. The PIX/PDQ Manager can broadcast notifications to interested domains when certain updates occur in the master patient index.

The Audit Trail and Node Authentication (ATNA) profile defines how audit messages are generated and formatted. The audit repository helps ensure that patient information remains confidential, data integrity is maintained, and users are accountable for accessing data. The Sun PIX/PDQ Manager supports the ATNA profile by maintaining an audit repository that stores information about each event processed through the system, including the source type and source ID, event type, event ID, event action, and event outcome. It also stores the date and time the event occurred and the date and time it was received by the PIX/PDQ system.