On-Demand Documents and Deferred Document Assembly

1. On-Demand Documents and Deferred Document Assembly Karen Witting – IBM Co-chair ITI Technical Committee

2. On-Demand Documents Use Case • Useful for sources of healthcare data which prefer to find and assemble most up-to-date document content at the time of requests for content • Finding and assembling data upon retrieve request Documents On-Demand • On-Demand Supplement Supports: • Registration of On-Demand Documents • Single Consumer Query lists stable documents and on-demand data sources • Consumer Retrieve from on-demand data sources causes document content to be dynamically identified and assembled

3. XDS On-Demand Documents Actors/Transactions

4. XDS Document Entry types • XDS Document Entry types defined • Stable Document Entry – metadata about a specific and static set of healthcare content formed into a document. The source registers a Stable Document Entry when a meaningful collection of data should be published based on clinical events. • On-Demand Document Entry – metadata describing the characteristics of a set of on-demand content and a unique identifier which can be used to create a document which collects the latest, most recent available information at the time of retrieval.

5. XDS On-Demand Workflow

6. XCA workflow (no XDS)

7. Deferred Document Assembly Use Case • Allows some sources of healthcare data to operate in a more efficient way • Allows source systems to register the existence of stable document content but defer actually assembling the document content only if and when it is retrieved. • Preferred in an application architecture where a great deal of content is available for sharing but saved as a set of distinct elementary records in a clinical database and not as documents. To convert all this content to documents is considered a waste of resources for any document which is never requested. Thus, only content that is specifically requested is formed into a document.

8. Deferred Document Assembly • Deferred Document Assembly - Small enhancement XDS • Content for a document identified and internally labeled • Register documents with special hash/size 0 indicating deferred assembly • Size = 0 (zero) • hash = da39a3ee5e6b4b0d3255bfef95601890afd80709 (SHA1 hash of a zero length file) • At retrieve previously identified content is assembled into document and hash/size updated • Repeated retrieve requests always returns the exact same content • Actors • Integrated Document Source/Repository grouped with Document Administrator declares Deferred Documents Option • Document Registry with Document Metadata Option • Document Consumer with Deferred Documents Option • Workflow • Integrated Document Source/Repository registers Stable Entry with: • Size = 0 (zero) • hash = da39a3ee5e6b4b0d3255bfef95601890afd80709 (SHA1 hash of a zero length file) • Document Consumer retrieves document causing Document Source/Repository to assemble content, update size/hash in Document Registry and return complete content

9. XDS Deferred Workflow