Concept of Operations: Relating to the introduction of a Personally Controlled Electronic Health Record System
6.4.3 Index Service
Purpose
If the individual chooses to participate, the index will associate an individual with a range of his/her clinical documents already stored within the PCEHR-conformant repositories.The index stores metadata (i.e. data that serves to provide contextual information about other data) about each clinical document; the actual content of the clinical document is stored within a PCEHR-conformant repository.
Functionality
Key functions of this service include the ability to:- Clinical document registry functions:
- Register a new clinical document.
- Update an existing clinical document index entry.
- Deregister a clinical document.
- Search the index.
- Execute quality functions to assess the integrity of the data.
- Repository management:
- Register new conformant repository.
- List available conformant repositories.
- Update conformant repository details.
- Deregister conformant repository.
In order to support this functionality, for each registered clinical document, the index service stores:
- The individual’s IHI.
- The clinical document ID (a unique identifier for the information).
- The template ID (see Section 6.5.1).
- The type of clinical document (e.g. Discharge Summary, Event Summary).
- A keyword list for search function.
- The location where the clinical document can be retrieved.
- The date and time at which when the clinical document was created.
- The name, speciality / sub speciality27 and HPI-I of the healthcare provider that created the Clinical document.
- The name and HPI-O of the healthcare organisation where the clinical document was created.
- The name and HPI-O of the participating healthcare organisation that created the record.
- Versioning information about the clinical document.
- Management information about the integrity of the link (e.g. last time the link was checked, flag to indicate potential duplicate, etc.).
- A label indicating if the information is ‘general access’ or ‘limited access’.
- A flag indicating the clinical document had to be ‘effectively removed’ and a reason why it was removed (e.g. removal request by individual, incorrectly identified individual, error in clinical information) and the date/time of removal.
- An annotation indicating if the clinical document has been archived or disposed of in the conformant repository.
The index service will also maintain information about available conformant repositories and manage the registration process.
Related standards and specifications
IHE Cross Enterprise Document Sharing (XDS.b) [IHE2010a] or HL7 Retrieve, Locate and Update Service (RLUS) [HL72010a] (recommended).27 As per HI Service Provider classifications.
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