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Location Authority - LA. Definition: A cross-community actor which makes available to all authorized communities information about the mapping of some patients to communities which may hold data for that patient.
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Location Authority - LA • Definition: A cross-community actor which makes available to all authorized communities information about the mapping of some patients to communities which may hold data for that patient. • May be co-located with a community (internal) or independent of a community (external) • An LA will add and drop patients for which it has data • An LA must ensure that the mapping it maintains is reasonably up-to-date (no more than a few days old) • There may be more than one LA per patient, but it is preferable to have a small number of LA’s per patient. • An LA may be supported as part of a patient home paradigm.
LA internal to community • When an LA is hosted within a community • Use cases to review • New patient in LA • New patient data in a community • Changes in patients inside and outside LA community • Patient no longer supported by LA
QP to all QP to all QP for patient QIL QIL LA within a community Community LA Community Other • Identifies a new patient for which to be a LA – creates a patient identifier to be used in future QIL transactions • Collates results into local table for the patient • Occasional batch query to update local table (U in future) • Update local table if necessary • Respond with a) local ID & demographics b) indicator that will respond to QIL for this patient and patient identifier to use in QIL (could be same as in a) ) • Respond with local table • Patient no longer supported by this LA, delete from table • Respond with “not LA” and perhaps a “look here” identifier
LA external to community • When an LA is not hosted by a community • Requires shared/voluntary identifier • LA contains only identifiers, no demographics • Need LA feeder which creates shared identifier and feeds to LA and other communities • Use cases to review • New patient identifier in LA • New patient data in a community • Changes in patients • Patient identifier no longer supported by LA
QP for patient QIL LA external to any community LA LA Feeding Community Community Other • Create new shared ID • Return local ID & demographics and LA identifier + shared ID Feed shared ID & homeCommunityId • Create new entry in table • Update table • Return table • Update table Feed shared ID & homeCommunityId Merge/link/delete patient ID
Open Issues • Usefulness of both external and internal LA’s and IHE’s support for such in 2009 • Consider names other than LA • LA needs QP to carry initiators homeCommunityId • New transaction needed to feed external LA carrying only patient identifier and homeCommunityId? Or use restricted form of QP?