Actor Mapping to Interoperability Specification


The Use Case Actors and the Services they support are described at a functional level in the Use Cases and Definitions section of the CA:FeX Interoperability Specifications. Services may be Required or Optional. The Use Case Actor, Service(s) and optionality are conveyed in the first three columns of the tables in the section below. The second part of the table (columns 4-7) provides the mapping for the Use Case Actor to the detailed specifications (such as Technical Actors and Optionality) that systems shall implement to exchange healthcare information in the context of these use cases. The purpose of the tables below is to map the use case actors to the technical actors and the services they are supporting. These tables are aligned with the flow captured in the sequence diagrams which are included in the Sequence Diagram section.  

For a selected Use Case Actor (a single row in the table), the system shall implement all of the requirements (some optionality when allowed) listed in the second part of the table (columns 4-7). This includes the referenced healthcare profiles, the standards specified and terminology standards. For Technical Actors, which map to CA:FeX or an IHE Profile (CA:FeX, PDQm, PMIR, etc.), the last column provides the reference location of the specification. Links for these referenced specifications have been included in the tables below. Additionally, the below table does not showcase all of the possible combinations of IHE profiles and transactions that can be used for a particular implementation pattern. For example, 'Identify Patient' service can use PIXm in place of PDQm if the preferred implementation pattern is PIXm/PMIR.

Note: Patient Identifier is used below to generically describe identification of the patient. Examples of Patient Identifier are patient.id and patient.identifier. 

Versioning

This is an evolving specification; the release cycle assumes some degree of change will happen across versions. (Read more about the versioning protocol here.) There will be a process in place to monitor changes in the current versions of the IHE profiles which will be incorporated in future versions of the CA:FeX Interoperability Specifications based on our interoperability roadmap.

Published Versions 

The following describes the published versions in scope for the required and optional IHE Profiles that have been referenced in this specification. Refer to the Reference Architecture RA v0.2.0 DFT-preBallot for details:

  • IUA:  Revision 2.1 - Trial Implementation
  • PDQmv2.3.0: Trial Implementation based on FHIR R4
  • PMIR:  Revision 1.3 – Trial Implementation 

Legend

R = Required

O = Optional

Table 1 Interoperability Conformance Requirements for Use Case 1: Create and Submit Document

USE CASE 1: Create and Submit Document

MAPPING TO SECTIONS FROM THIS AND REFERENCED INTEROPERABILITY SPECIFICATIONS

USE CASE ACTOR

SERVICE SUPPORTED 

OPT

TECHNICAL ACTOR

OPT

PROFILE/

STANDARD

REFERENCED SPECIFICATION AND STANDARDS

Producer  

Authenticate User

O

Client (e.g. EMR)

O

Internet User Authorization (IUA)

Refer to the Cross Profile Considerations section: Internet User Authorization (IUA) Grouping. 

Identify Patient

O

Client (e.g. EMR)

O

Use Existing Standards Employed by the Clinical System

N/A

O

Patient Demographic Consumer

O

PDQm

Refer to PDQm within the RA v0.2.0 DFT-preBallot.

Retrieve Clinical Data  (Patient Identifier) 

R

Client (e.g. EMR)

R

Use Existing Standards Employed by the Clinical System

N/A

Assemble and Review Document

R

Client (e.g. EMR)

R

Use Existing Standards Employed by the Clinical System

N/A

Omit or Mask Data based on Jurisdictional Policy

O

Client (e.g. EMR)

O

Jurisdictional Requirement

N/A

Save Document to Clinical Data Repository

R

Client (e.g. EMR)

R

Use Existing Standards Employed by the Clinical System

N/A

R

Data Source

R

CA:FeX

Refer to CA:FeX 1A: Submit a Document section in the CA:FeX FHIR Implementation Guide.

Recipient

Save Bundle to Clinical Data Repository

R

Data Recipient  

R

CA:FeX

Refer to CA:FeX 1A: Submit a Document section in the CA:FeX FHIR Implementation Guide.

Central Infrastructure

Identify Patient

O

Patient Identity Registry

O

PMIR

Refer to PMIR within the RA v0.2.0 DFT-preBallot.

Table 2 Interoperability Conformance Requirements for Use Case 2: Query and Retrieve Document

USE CASE 2: Query and Retrieve Document

MAPPING TO SECTIONS FROM THIS AND REFERENCED INTEROPERABILITY SPECIFICATIONS

USE CASE ACTOR

SERVICE SUPPORTED

OPT

TECHNICAL ACTOR

OPT

PROFILE/

STANDARD

REFERENCED SPECIFICATION AND STANDARDS

Consumer

Authenticate User

O

Client (e.g. EMR)

O

Internet User Authorization (IUA)

Refer to the Cross Profile Considerations section: Internet User Authorization (IUA) Grouping.

Identify Patient

O

Client (e.g. EMR)

O

Use Existing Standards Employed by the Clinical System

N/A

O

Patient Demographic Consumer

O

PDQm

Refer to PDQm within the RA v0.2.0 DFT-preBallot.

Request Search Document (Patient Identifier)

R

Client (e.g. EMR)

R

Use Existing Standards Employed by the Clinical System

N/A

Request Document  (Resource ID)

R

Client (e.g. EMR)

R

Use Existing Standards Employed by the Clinical System

N/A

Return searchset Bundle RData ConsumerRCA:FeXRefer to CA:FeX 2A: Search For a Document section in the CA:FeX FHIR Implementation Guide.
Return document BundleRData ConsumerRCA:FeXRefer to CA:FeX 3A: Retrieve a Document section  in the CA:FeX FHIR Implementation Guide.

Responder

Retrieve Resources from Clinical Data Repository

R

Data Responder

R

CA:FeX

Refer to CA:FeX 2A: Search For a Document section in the CA:FeX FHIR Implementation Guide.

Retrieve Bundle from Clinical Data Repository

R

Data Responder

R

CA:FeX

Refer to CA:FeX 3A: Retrieve a Document section  in the CA:FeX FHIR Implementation Guide.

Central Infrastructure

Identify Patient

O

Patient Identity Registry

O

PMIR

Refer to PMIR within the RA v0.2.0 DFT-preBallot.


Table 3 Interoperability Conformance Requirements for Use Case 3: Create and Submit Data

USE CASE 3: Create and Submit Data

MAPPING TO SECTIONS FROM THIS AND REFERENCED INTEROPERABILITY SPECIFICATIONS

USE CASE ACTOR

SERVICE SUPPORTED 

OPT

TECHNICAL ACTOR

OPT

PROFILE/

STANDARD

REFERENCED SPECIFICATION AND STANDARDS

Producer  

Authenticate User

O

Client (e.g. EMR)

O

Internet User Authorization (IUA)

Refer to the Cross Profile Considerations section: Internet User Authorization (IUA) Grouping. 

Identify Patient

O

Client (e.g. EMR)

O

Use Existing Standards Employed by the Clinical System

N/A

O

Patient Demographic Consumer

O

PDQm

Refer to PDQm within the RA v0.2.0 DFT-preBallot.

Retrieve Clinical Data  (Patient Identifier) 

R

Client (e.g. EMR)

R

Use Existing Standards Employed by the Clinical System

N/A

Assemble and Review Data

O

Client (e.g. EMR)

O

Use Existing Standards Employed by the Clinical System

N/A

Omit or Mask Data based on Jurisdictional Policy

O

Client (e.g. EMR)

O

Jurisdictional Requirement

N/A

Save Data to Clinical Data Repository

R

Client (e.g. EMR)

R

Use Existing Standards Employed by the Clinical System

N/A

R

Data Source

R

CA:FeX

Refer to the CA:FeX 1C: Submit Resource in the CA:FeX FHIR Implementation Guide.

Recipient

Save Data to Clinical Data Repository

R

Data Recipient  

R

CA:FeX

Refer to the CA:FeX 1C: Submit Resource in the CA:FeX FHIR Implementation Guide.

Central Infrastructure

Identify Patient

O

Patient Identity Registry

O

PMIR

Refer to PMIR within the RA v0.2.0 DFT-preBallot.


Table 4 Interoperability Conformance Requirements for Use Case 4: Query and Retrieve Data

USE CASE 4: Query and Retrieve Data

MAPPING TO SECTIONS FROM THIS AND REFERENCED INTEROPERABILITY SPECIFICATIONS

USE CASE ACTOR

SERVICE SUPPORTED

OPT

TECHNICAL ACTOR

OPT

PROFILE/

STANDARD

REFERENCED SPECIFICATION AND STANDARDS

Consumer

Authenticate User

O

Client (e.g. EMR)

O

Internet User Authorization (IUA)

Refer to the Cross Profile Considerations section: Internet User Authorization (IUA) Grouping.

Identify Patient

O

Client (e.g. EMR)

O

Use Existing Standards Employed by the Clinical System

N/A

O

Patient Demographic Consumer

O

PDQm

Refer to PDQm within the RA v0.2.0 DFT-preBallot.

 

Request Query and Retrieve (Patient Identifier)

R

Client (e.g. EMR)

R

Use Existing Standards Employed by the Clinical System

N/A

Return Data Bundle RData ConsumerRCA:FeXRefer to the CA:FeX 2C: Search Resource in the CA:FeX FHIR Implementation Guide as well as the Response Handling page.

Responder

Return Data Bundle 

R

Data Responder

R

CA:FeX

Refer to the CA:FeX 2C: Search Resource in the CA:FeX FHIR Implementation Guide.

Central Infrastructure

Identify Patient

O

Patient Identity Registry

O

PMIR

Refer to PMIR within the RA v0.2.0 DFT-preBallot.


Table 5 Interoperability Conformance Requirements for Use Case 5: Fetch Document References

USE CASE 5: Fetch Document References

MAPPING TO SECTIONS FROM THIS AND REFERENCED INTEROPERABILITY SPECIFICATIONS

USE CASE ACTOR

SERVICE SUPPORTED

OPT

TECHNICAL ACTOR

OPT

PROFILE/

STANDARD

REFERENCED SPECIFICATION AND STANDARDS

Consumer



Authenticate User

O

Client (e.g. EMR)

O

Internet User Authorization (IUA)

Refer to the Cross Profile Considerations section: Internet User Authorization (IUA) Grouping.

Identify Patient

O

Client (e.g. EMR)

O

Use Existing Standards Employed by the Clinical System

N/A

O

Patient Demographic Consumer

O

PDQm

Refer to PDQm within the RA v0.2.0 DFT-preBallot.


Request Clinical Document References (Patient Identifier/operation params)

R

Client (e.g. EMR)

R

Use Existing Standards Employed by the Clinical System

N/A

Request Clinical Document (Resource ID)

R

Client (e.g. EMR)

R

Use Existing Standards Employed by the Clinical System

N/A

Return Clinical Document ReferencesRData ConsumerRCA:FeXRefer to CA:FeX 2B: Generate or Retrieve a DocumentReference using $docRef Operation section in the CA:FeX FHIR Implementation Guide.
Return Clinical DocumentRData ConsumerRCA:FeXRefer to CA:FeX 3A in the Retrieve a Document section in the CA:FeX FHIR Implementation Guide.

Responder



Return Clinical Document References

R

Data Responder

R

CA:FeX

Refer to CA:FeX 2B: Generate or Retrieve a DocumentReference using $docRef Operation section in the CA:FeX FHIR Implementation Guide.

Return Clinical Document

R

Data Responder

R

CA:FeX

Refer to CA:FeX 3A in the Retrieve a Document section in the CA:FeX FHIR Implementation Guide.

Central Infrastructure

Identify Patient

O

Patient Identity Registry

O

PMIR

Refer to PMIR within the RA v0.2.0 DFT-preBallot.
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