Background

Foundational IHE Profiles are required for all of use cases and corresponding sequence diagrams.   They address critical interoperability issues such as user authorization (e.g. IUA), security node and audit records (e.g. ATNA), consistent time (e.g. CT), terminology (e.g. SVCM) and document transformation/formating (e.g. CM-FMT) that are important for sharing of Patient Summaries within and across care networks. 

Assumption

It is assumed that in order to satisfy any of the use cases for the Patient Summary-CA in Release 1, vendors and jurisdictions in the ecosystem must ensure they meet the requirements of the standardized actors and transactions listed in the Cross Cutting IHE Profiles. 

For more background information on the specific IHE profiles, please view this link. 

IHE Profiles Included: IUA, ATNA, CT, SVCM, CA: FMT

Legend

The following diagram is the legend for the sequence diagrams to help readers orient themselves with the diagrams. 

IUA*

The IUA* (Internet User Authorization) provides support for authorization to access resources when using HTTP RESTful transports, by managing authorization tokens.

The Authorization Client must have a valid token that must be presented to resource server with every request

  • Get Access Token [ITI-71] – performed when Client does not yet have a token or when token is expired
  • Incorporate Access Token [ITI-72] – the client must include the token with every request
  • Introspect Token [ITI-102] – the resource server must introspect token at every request

ATNA*

ATNA* (Audit Trail and Node Authentication) provides support for ensuring that that the communicating systems have a level of trust in each other through node authentication, that communications between

the different system components are encrypted (via TLS), and that system activity is audited.

  • ATNA* Authenticate Node [ITI-19]

Before establishing secure communication, mutual authentication is performed between two secure nodes.

A secure pipe will be established through which secure transactions will take place.

Secure Node also authenticates the identity of the user who requests access to the node.

  • ATNA* Record Audit Event [ITI-20]

The Secure Node/App sends auditable events to an Audit Record Repository. The triggers for sending audit logs can vary, the might be specified in other IHE profiles, local law or regulation, or local policy.

CT

CT (Consistent Time) ensures that the system clocks and time stamps of the many computers in a network are well synchronized. Synchronization with a median error less than 1 second is sufficient for most purposes.


SVCM*

SVCM (Sharing Valusets, Codes, and Maps) supports querying for value sets and code systems using the standard HL7 FHIR resources. It also supports looking up and validating codes as well as expanding a value set to list all the available codes.

Optionally concept maps can also be included to translate from one code system or value set to another (e.g. SNOMED CT to LOINC).

*Note: Please refer to the pan-Canadian Patient Summary – FHIR Implementation Guide for the Patient Summary-CA Valuesets

CA:FMT

*Note: Content and specifications for  his Canadian Integration Profile is in development.  More information on the his profile, including introduction, benefits and actor & transaction diagrams can be found below.  This profile has been included in the sequence diagrams of the pan-Canadian Patient Summary – Companion Guide to Reference Architecture v1 as an option for formatting support. 

Introduction

CA:FMT is a Canadian Integration Profile that provides formatting support service. It provides support for transformation of documents between different formats (e.g., from FHIR to PFD, CDA, etc. ).

Benefits of CA:FMT

The following are examples of benefits for the CA:FMT profile

  • Handle transformation from FHIR to PDF
  • Handle transformation from FHIR to CDA 

Actor & Transaction Diagram of CA:FMT


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