NHS North West Genomics, published by NHS North West Genomics. This guide is not an authorized publication; it is the continuous build for version 0.2.2 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/nw-gmsa/nw-gmsa.github.com/ and changes regularly. See the Directory of published versions

Health Document Sharing (MHDS) and Sharing Laboratory Reports (XD-LAB)

References

1. IHE Pathology and Laboratory Medicine (PaLM) Technical Framework - Volume 1 XD-LAB
2. IHE Mobile Health Document Sharing (MHDS)
3. IHE Cross Enterprise Document Sharing (XDS.b)
4. IHE Mobile access to Health Documents (MHD)
5. NHS England National Record Locator (NRL) for National Imaging Registry this is related to IHE MHDS

Actors and Transactions

Actor	Definition
Document Consumer
Document Source
Document Registry
Document Repository
Content Creator
Content Consumer

Scenarios

Provide and Register Document - Sharing Documents via a central Document Registry + Repository

Often used with Electronic Document Management Systems (EDMS) and IHE XDS systems where the interaction is known as Provide and Register Document Set-b [ITI-41].

graph LR

subgraph DocumentResponder;
    DocumentRegistry
    DocumentRepository
end;  

DocumentSource --> |e.g. HL7 v2 MDM_T02| DocumentResponder

This interaction is available for use in NW Genomics MDM_T02 Original document notification and content

Register Document - Sharing Documents via a central Document Registry + distributed Repositories

This is the design pattern used by IHE MHDS and NHS England National Record Locator.

graph LR


DocumentSource --> |e.g. HL7 v2 MDM_T01<br/>HL7 FHIR POST /DocumentReference| DocumentRegistry
DocumentSource --> |Store Document| DocumentRepository

Finding Documents

This is the design pattern used by IHE MHDS and NHS England National Record Locator.

graph LR


DocumentConsumer --> |"Search Document Metadata<br/>Find Document References [ITI-67]"| DocumentRegistry
DocumentConsumer --> |"Retrieve Document<br/>Retrieve Document [ITI-68]"| DocumentRepository

This FHIR/IHE API is available for use in NW Genomics Mobile Access to Health Documents [MHD]

Structured Clinical Document (Clinical Document Architecture)

XD-LAB uses HL7 Clinical Document Architecture (CDA), it is believed NHS England and HL7 EU/EHDS will adoption FHIR Document as the replacement format of clinical documents. Example: EU Laboratory Report

The exchange interactions (Share Content) in the diagram below, are the same as above.

graph LR

GDR["Share Content"]

ContentCreator --> |Provide and Register Document| GDR
ContentConsumer --> |Finding Documents| GDR

Data Model

FHIR Document Reference (XDS Document Entry)

The data models in HL7 MDM (FHIR), FHIR and IHE XDS are effectively the same, this can be found in NW Genomics FHIR DocumentReference. NRL currently implements a subset which may be improved by National Imaging Registry (which is the source of the NW Genomcis model).

Genomic Report

Will be defined by NHS England FHIR Genomics