HIE – Terminology definitions

This Blog is about explaining Jargons in the IHE terminology

Enterprise:

The word “Enterprise” is used in IHE / HIE manuals to mean a separate hospital or separate medical clinic. If HIE is receiving patient data form 7 different medical clinics, 4 different lab facilities and 3 different hospitals.

In this scenario, we will refer that this HIE has 14 enterprises inside it. So, basically the term “Enterprise” is used to refer the entities (labs, hospitals or clinics) registered with a HIE, regardless of them being an enterprise hospital group or not.

MPI:

MPI is simply abbreviated as Master Patient Index.

generally provided by a software/database used by hospitals/organization to maintain single source of medical record across multiple departments for a patient.

Imagine a patient named patient-x entering to the hospital.

Where each department of the hospital is using different software of their ease. The patient visits an outpatient clinic inside the hospital where the physician provides a unique patient id (MM565465) for the patient-x.

Then patient-x enters to the radiology area where a different software is used and the radiology people assigns a different id for the patient (1234), the same patient-x goes to the lab to take some more tests and lab uses another lab software and provides him with the patient id (4567).

Now the single patient-x is assigned with multiple patient Id’s based on different software used in different department of the same hospital. As shown in the picture below

here, hospital with multiple departments are expected to have single software or the master Database where the patient-x’s different Id’s from different departments will be provided with one unique id, this ID is called Master Patient Index (MPI) and the software used for this is called PIX manager.

Community & Cross-Community:

we come across terminology “Community” in HIE/ IHE manuals. The word “Community” is an alias name for single HIE.

The communication across the HIE entities are represented in the below picture.
when HIE B has to communicate with HIE F for patient data, it is referred as “Cross Community Access”. Here the cross-community gateway is basically a software that connects, transfers the data from one HIE to another HIE.

XDS:

The abbreviation of this simple three letter word is “Cross Enterprise Document Sharing” and one can notice that this terminology is used across multiple places of any HIE document.

Imagine  if an HIE has 7 (Eg: 3 hospital, 3 clinics & 1 lab) enterprises bound with it. This HIE is storing the patient named X from all these 7 hospital or clinics or labs (i.e) 7 different enterprises, then it is referred as XDS.

If suppose as referred in the picture above, if the HIE A wants to send a patient information with HIE F, this cannot be called “Cross Enterprise Access”. This  is called as “Cross Community Gateway” as mentioned above. Since, each HIE has multiple enterprises and one HIE is considered as one community when one HIE communicates with another it is termed as cross community access. But within one HIE when communication takes place the term Enterprise comes to picture.

Data Source:

The most common terminology used in the definition document of several IHE profile ITI messages. Consider the QPD segment of the QBP^Q23 message, this is bound to the ITI version 9

QPD | IHE PIX Query | QRY124518648946312 | 14583058^^^NIST2010&2.16.840.1.113883.3 .72.5.9.1&ISO | ^^^&2.16.840.1.113883.3.72.5.9.2&ISO |

Here QPD 3.4 refers the Assigning Authority and QPD 4 refers to the Data source. Imagine if 14583058 is a  Medical Record Number used by EHR named EHR-x by the clinic “Good Health Medical Clinic”.

The OID for “Good Health Medical Clinic” is 2.16.840.1.113883.3 .72.5.9.1. The physician from the Good Health Medical Clinic wants to search for the patient in St.Joseph hospital.

The OID provided for the St.Joseph Hospital is 2.16.840.1.113883.3.72.5.9.2, so basically the Data Source here specifies the St.Joseph Hospital that is the location of the hospital upon which the patient has to be searched for. This target search location is often termed as Data source.