EFA XDS Document Metadata Binding
(→Document Metadata) |
(→Author Institution) |
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|Practice | |Practice | ||
|Telematik ID<br>This ID scheme MUST be preferred only if the Telematik ID is recorded within the SMC-B AUT certificate of the practice. | |Telematik ID<br>This ID scheme MUST be preferred only if the Telematik ID is recorded within the SMC-B AUT certificate of the practice. | ||
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|Practice | |Practice | ||
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|Hospital department or faculty | |Hospital department or faculty | ||
|Telematik ID <br> This ID scheme MUST be preferred only if the Telematik ID is recorded within the SMC-B AUT certificate of the department/faculty. | |Telematik ID <br> This ID scheme MUST be preferred only if the Telematik ID is recorded within the SMC-B AUT certificate of the department/faculty. | ||
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|Hospital department or faculty | |Hospital department or faculty | ||
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|Hospital | |Hospital | ||
|Telematik ID <br> This ID scheme MUST be preferred only if the Telematik ID is recorded within the SMC-B AUT certificate of the hospital. | |Telematik ID <br> This ID scheme MUST be preferred only if the Telematik ID is recorded within the SMC-B AUT certificate of the hospital. | ||
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|Hospital | |Hospital | ||
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|Any internal identification scheme that guarantees a unique identification within the scope of the affinity domain. Identifiers SHALL be resolvable to all EFA participants through public directory services (e.g. HPD, see IHE-Cookbook). | |Any internal identification scheme that guarantees a unique identification within the scope of the affinity domain. Identifiers SHALL be resolvable to all EFA participants through public directory services (e.g. HPD, see IHE-Cookbook). | ||
|''local code system'' | |''local code system'' | ||
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{{AlertBox|Telematik ID and SMC-B certificates will only be available with the Telematik-Infrastruktur. Before the final roll-out of the Telematik-Infrastruktur identifiers based on Telematik ID and SMC-B SHOULD NOT be used.}} | {{AlertBox|Telematik ID and SMC-B certificates will only be available with the Telematik-Infrastruktur. Before the final roll-out of the Telematik-Infrastruktur identifiers based on Telematik ID and SMC-B SHOULD NOT be used.}} | ||
Version vom 14. Februar 2016, 12:04 Uhr
Dieses Material ist Teil des Leitfadens CDA für die elektronische Fallakte.
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Anmerkung: Die Kürzel unter den einzelnen Überschriften dienen der Unterstützung des Kommentierungsverfahrens. Bitte geben Sie bei einem Kommentar oder einem Verbesserungsvorschlag zu dieser Spezifikation immer das Kürzel des Abschnitts an, auf den sich Ihr Kommentar bezieht. Alle Kommentare werden in der Lasche "Diskussion" zu der kommentierten Seite gesammelt und gegenkommentiert.
Hinweise zum Kommentierungsverfahren einschließlich aller Formulare und Kontaktadressen finden Sie auf der Seite "Kommentierung EFAv2.0".
Inhaltsverzeichnis
Document Metadata
Bitte markieren Sie Kommentare zu diesem Abschnitt mit dem Code {EDoct.01}
The table below shows how eCR folder attributes map onto IHE XDS Folder metadata and vice versa:
| EFA Metadata | IHE documentEntry Attribute | Remarks and Usage Constraints |
|---|---|---|
| Verantwortliche Organisation | author | EFA demands for registering the organization that takes responsibility for providing a document while IHE only allows to register the person/device (and organisation) that created the document. As it is assumed that provider of a document either ist the author of the document or acts on behalf the author of the document, the EFA "responsible organization" object is mapped onto an IHE "documentEntry.author" element. In cases these semantics conflict, the IHE semantics of "documentEntry.author" according to IHE ITI TF-3#4.2.3.2.1 shall be followed. |
| Status | availabilityStatus | shall be used according to IHE ITI TF-3#4.2.3.2.2. |
| Dokumentklasse | classCode | see below |
| comments | see below | |
| confidentialityCode | shall always be "N" for EFA | |
| Zeitpunkt der Bereitstellung | EFA demands for registering the timestamp when a document was provided to an EFA. IHE XDS does not assign this information to single document entry but to the submissions set which was used for registering a set of documents with an XDS Document Registry. EFA implementations SHALL therefore map this logical attribute onto the XDS submission set's submissionTime attribute. | |
| creationTime | shall be used according to IHE ITI TF-3#4.2.3.2.6. | |
| entryUUID | shall be used according to IHE ITI TF-3#4.2.3.2.7. | |
| eventCodeList | shall be used according to IHE ITI TF-3#4.2.3.2.8. | |
| formatCode | shall be used according to IHE ITI TF-3#4.2.3.2.9. | |
| Fehlererkennender Code | hash | shall be used according to IHE ITI TF-3#4.2.3.2.10. |
| healthcareFacilityTypeCode | shall be used according to IHE ITI TF-3#4.2.3.2.11. | |
| homeCommunityId | shall be used according to IHE ITI TF-3#4.2.3.2.12. | |
| languageCode | shall be used according to IHE ITI TF-3#4.2.3.2.13. | |
| legalAuthenticator | shall be used according to IHE ITI TF-3#4.2.3.2.14. For consent documents this element shall record the person/organization that validated the patient's consent and registered it with EFA. | |
| Dokumentformat | mimeType | shall be used according to IHE ITI TF-3#4.2.3.2.15. |
| patientID | patientId | shall be used according to IHE ITI TF-3#4.2.3.2.16. EFA Document Registry actors shall verify that the patient matches the person who gave consent to the respective EFA. |
| practiceSettingCode | shall be used according to IHE ITI TF-3#4.2.3.2.17. | |
| repositoryUniqueId | shall be used according to IHE ITI TF-3#4.2.3.2.18. | |
| Zeitliche Einordnung | serviceStartTime | shall be used according to IHE ITI TF-3#4.2.3.2.19. |
| serviceStopTime | shall be used according to IHE ITI TF-3#4.2.3.2.20. | |
| Dateigröße | size | shall be used according to IHE ITI TF-3#4.2.3.2.21. |
| sourcePatientId | shall be used according to IHE ITI TF-3#4.2.3.2.22. | |
| sourcePatientInfo | This element shall not be used for EFA. | |
| Titel | title | shall be used according to IHE ITI TF-3#4.2.3.2.24. |
| Dokumenttyp | typeCode | see below |
| documentID | uniqueId | shall be used according to IHE ITI TF-3#4.2.3.2.25. |
| URI | shall be used according to IHE ITI TF-3#4.2.3.2.26. | |
| referenceIdList | shall be used according to IHE ITI TF-3#4.2.3.2.27. | |
| limitedMetadata | Limited metadata are not allowed for IHE XDS document sources and therefore the respective option SHALL NOT be used by EFA implementations. | |
| objectType | shall be used according to IHE ITI TF-3#4.2.3.2.29. | |
| Signatur | Documents provided to an EFA may be digitally signed. In this case, the constraints and means defined by the IHE ITI DSG integration profile shall be considered. |
classCode
Bitte markieren Sie Kommentare zu diesem Abschnitt mit dem Code {EDoct.01.01}
The document class shall be taken from a national catalogue. The national catalogue should be a value set on top of LOINC as a reference terminology.
typeCode
Bitte markieren Sie Kommentare zu diesem Abschnitt mit dem Code {EDoct.01.02}
The document type shall be provided as a LOINC code. Document types shall be more specific than document classes. They may be defined per Care Domain.
Example:
<rim:Classification
id="urn:uuid:c33ca26a-29b4-45be-a9b9-de60adca4c64"
lid="urn:uuid:c33ca26a-29b4-45be-a9b9-de60adca4c64"
objectType="urn:oasis:names:tc:ebxml-regrep:ObjectType:RegistryObject:Classification"
classificationScheme="urn:uuid:41a5887f-8865-4c09-adf7-e362475b143a"
classifiedObject="urn:uuid:fbf2ea29-3aa3-4bc5-9187-01d7b6b0f481"
nodeRepresentation="11520-4">
<rim:Slot name="codingScheme">
<rim:ValueList>
<rim:Value>2.16.840.1.113883.6.1</rim:Value>
</rim:ValueList>
</rim:Slot>
<rim:Name>
<rim:LocalizedString xml:lang="de" charset="UTF-8" value="EKG Befund"/>
</rim:Name>
</rim:Classification>
Comments
Bitte markieren Sie Kommentare zu diesem Abschnitt mit dem Code {EDoct.01.03}
This slot is optional. If given, it SHALL hold a summary of the document content.
Example:
<rim:Description>
<rim:LocalizedString xml:lang="de" charset="UTF-8" value = "Befund zur Magenspiegelung vom 3.3.13"/>
</rim:Description>
German Profile
Bitte markieren Sie Kommentare zu diesem Abschnitt mit dem Code {EDoct.02}
For using EFA within the German national healthcare IT infrastructure (Telematikinfrastruktur) the constraints listed below MUST be considered.
Author Institution
Bitte markieren Sie Kommentare zu diesem Abschnitt mit dem Code {EDoct.02.01}
For the German healthcare system the following identification schemes MUST be used. If multiple schemes are available for an organization, the order in the table denotes the order of preference.
| Organization | Scheme | Code System OID |
|---|---|---|
| Practice | Telematik ID This ID scheme MUST be preferred only if the Telematik ID is recorded within the SMC-B AUT certificate of the practice. |
1.2.276.0.76.4.188 |
| Practice | »Institutskennzeichen (IK)« acc. to § 293 SGB V | 1.2.276.0.76.4.5 |
| Practice | KBV »Arztnummer Praxis« | 1.2.276.0.76.4.10 |
| Practice | Any internal identification scheme that guarantees a unique identification within the scope of the affinity domain. Identifiers SHALL be resolvable to all EFA participants through public directory services (e.g. HPD, see IHE-Cookbook). | local code system |
| Hospital department or faculty | Telematik ID This ID scheme MUST be preferred only if the Telematik ID is recorded within the SMC-B AUT certificate of the department/faculty. |
1.2.276.0.76.4.188 |
| Hospital department or faculty | Any internal identification scheme that guarantees a unique identification within the scope of the affinity domain. Identifiers SHALL be resolvable to all EFA participants through public directory services (e.g. HPD, see IHE-Cookbook). | local code system |
| Hospital | Telematik ID This ID scheme MUST be preferred only if the Telematik ID is recorded within the SMC-B AUT certificate of the hospital. |
1.2.276.0.76.4.188 |
| Hospital | »Institutskennzeichen (IK)« acc. to § 293 SGB V | 1.2.276.0.76.4.5 |
| Hospital | Any internal identification scheme that guarantees a unique identification within the scope of the affinity domain. Identifiers SHALL be resolvable to all EFA participants through public directory services (e.g. HPD, see IHE-Cookbook). | local code system |
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Telematik ID and SMC-B certificates will only be available with the Telematik-Infrastruktur. Before the final roll-out of the Telematik-Infrastruktur identifiers based on Telematik ID and SMC-B SHOULD NOT be used. |
Example:
A resident practice with the Institutskennzeichen 260326822 would be encoded as:
<rim:Slot name="authorInstitution">
<rim:ValueList>
<rim:Value>Name der Praxis^^^^^&1.2.276.0.76.4.5&ISO^^^^260326822</rim:Value>
</rim:ValueList>
</rim:Slot>
Author Person
Bitte markieren Sie Kommentare zu diesem Abschnitt mit dem Code {EDoct.02.02}
For the German healthcare system the following identification schemes MUST be used. If multiple schemes are available for an author's ID, the order in the table denotes the order of preference. If multiple IDs are known, at least two SHOULD be provided (considering the order of preference). An author identifier SHALL NOT be used without additionally providing the full name of the author.
| Person Role | Scheme | Code System OID |
|---|---|---|
| Physician | Telematik ID This ID scheme MUST be preferred only if the Telematik ID is recorded within the HBA AUT certificate of the physician. |
not defined yet |
| Physician | ID of the HBA AUT Certificate | 1.2.276.0.76.4.75 |
| Physician | Lebenslange Arztnummer KV | 1.2.276.0.76.4.16 |
| Physician Hospital Staff Practice Staff |
Any internal identification scheme that guarantees a unique identification within the scope of the identified organization. The <authorInstitution> and an <id> for this organization MUST be recorded. | local code system |
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Telematik ID and HBA certificates will only be available with the Telematik-Infrastruktur. Before the final roll-out of the Telematik-Infrastruktur identifiers based on Telematik ID and HBA SHOULD NOT be used. |
Example:
A physician with the Arztnummer 12345678 would be encoded as:
<rim:Slot name="authorPerson">
<rim:ValueList>
<rim:Value>Name des Arztes^^^^^&1.2.276.0.76.4.16&ISO^^^^12345678</rim:Value>
</rim:ValueList>
</rim:Slot>
HealthcareFacilityTypeCode
Bitte markieren Sie Kommentare zu diesem Abschnitt mit dem Code {EDoct.02.03}
The healthcare facility type code SHALL be encoded as a coded value acc to the KBV Schlüsseltabelle S_VDX_PRAXISTYP ([1]). The root OID 1.2.276.0.76.3.1.1.5.1.4 SHALL be used.
Example:
A hospital facility type would be encoded as:
<rim:Classification classificationScheme="urn:uuid:f33fb8ac-18af-42cc-ae0e-ed0b0bdb91e1"
classifiedObject="theDocument" id=”ID_050"
objectType="urn:oasis:names:tc:ebxml-regrep:ObjectType:RegistryObject:Classification"
nodeRepresentation="50">
<rim:Name>
<rim:LocalizedString xml:lang="de" value="Krankenhaus"/>
</rim:Name>
<rim:Slot name="codingScheme">
<rim:ValueList>
<rim:Value>1.2.276.0.76.3.1.1.5.1.4</rim:Value>
</rim:ValueList>
</rim:Slot>
</rim:Classification>
sourcePatientInfo
Bitte markieren Sie Kommentare zu diesem Abschnitt mit dem Code {EDoct.02.04}
For reasons of protecting the confidentiality of personal medical information this slot SHALL NOT be used. For the identifing the patient the sourcePatientId element SHALL be provided for all documents metadata.
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Referenzen und Querverweise |
