cdaefa:ECR Participating Healthcare Providers Content Module

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The Participating Healthcare Providers Content Module records the persons and organizations that are nominated by the patient as participants in a care event that is documentend by the CDA document.

Logical View

This specification follows the IHE 5-Domain-Modell (see IHE White Paper on “Access Control”) and separates between the static structural role a user has within a certain medical facility (subject domain) and his/her functional role within the current context (context domain). Permissions are solely bound to functional roles. This allows for a coarse grainded assignment of roles and a fine grained enforcement of permissions (simplicity and flexibility):

• Functional roles are defined based on a specific application semantics (e.g. electronic CaseRecord or Booking System). A functional role integrates typical working tasks of the application which are usually performed by a single person (see HL7 role engineering for how to analyse functional roles). Functional roles may be medical roles (e.g. “treating physician”) or administraive roles (e.g. “privacy commissionar”).
• Permissions are bound to functional roles and reflect the rights on data and services a holder of that role requires to perform his/her assigned tasks. A functional role’s permissions are encoded as a policy (which MAY even be implizit; e.g. as in IHE BPPC).
• During authorization concrete persons/organizations instantiate the functional roles for a certain (instance of an) application (e.g. Dr. Schmidt taking the role of a case manager for a certain case record instance).
• When a user tries to perform a protected operation the policy that is assigned to his/her assigned functional role is assessed and enforced.

This specification defines how the assignment of functional roles to persons/organizations can be encoded within a CDA document. By this a document can describe its context in terms of the authorized user. This allows the receiver – and further processors – of this document to enforce access restrictions even outside the document’s original context. With the eCR this feature is used to define the participants who are acting within the patient’s treatment context and their respective functional roles as defined for eCR use cases.

Standards

• IHE PCC Healthcare Providers and Pharmacies (1.3.6.1.4.1.19376.1.5.3.1.2.3)

Template

  <documentationOf>
     <serviceEvent classCode="PCPR">
        <effectiveTime value="..."/>
        <performer typeCode="PRF">
           <templateId root='1.3.6.1.4.1.19376.1.5.3.1.2.3'/>
           <functionCode code= displayName=    
                  codeSystem='1.2.276.0.76.3.1.81.81.5.2' 
                  codeSystemName='eCR Participant Function Code'/>
           <low value=/><high value=/>
           <assignedEntity>
              <templateId root='1.2.276.0.76.3.1.81.81.6.2.2|3'/>
              <id root= extension= />
              ...
              <sdtc:patient>
                 <sdtc:id root= extension= />
              </sdtc:patient>
           </assignedEntity>
        </performer>
     </serviceEvent>
  <documentationOf>

<effectivetime value=' ...'/>

This element records the date when the setup of the care team was last modified.

<functionCode code= displayName=

codeSystem='1.2.276.0.76.3.1.81.81.5.2' codeSystemName='eCR Participant Function Code'/>

This element defines the functional role of a healthcare provider (organization) within the documented clinical setting. Roles MUST be encoded using a code system with clearly defined semantics and responsibilities of the different functional roles.

An example for such a code system is the eCR Participant Function (1.2.276.0.76.3.1.81.81.5.2) code system.

<low value=' '/><high value=' '/>

This element MUST record the validity timespan of the authorization. The maximum validity time of a consent/authorization MUST be defined depending on the diagnosis and the contractual setting.

<assignedEntity>

<templateId root='1.2.276.0.76.3.1.81.81.6.2.2|3'/>

This entry MUST comply with the Assigned Human Entity Content Module (1.2.276.0.76.3.1.81.81.6.2.2) as defined in this document or with the Assigned Organizational Entity Content Module (1.2.276.0.76.3.1.81.81.6.2.3) as defined in this document.

<sdtc:patient>

<sdtc:id root= extension= />

This element is optional for the underlying IHE PCC content module and SHOULD NOT be used unless there is a clear reason for disclosing local patient identifers. If used, it MUST hold the organization’s local identifier of the patient who is identified in the <patientRole> entry.

Example

   <documentationOf>
      <serviceEvent classCode="PCPR">
         <effectiveTime value="..."/>
         <performer typeCode="PRF">
            <templateId root='1.3.6.1.4.1.19376.1.5.3.1.2.3'/>
      		
<!—Dr. Musterarzt is registered as the operative case manager -->
            <functionCode code='OPCMGR' displayName='Case Manager' 
               codeSystem='1.2.276.0.76.3.1.81.81.5.2' 
               codeSystemName='eCR Participant Function Code'/>

<!-- the authorization is valid for 2 weeks -->
            <time><low value='20110909'/><high value='20120923'/></time>

            <assignedEntity>
<!-- the authorized physician as a healthcare professional -->
               <templateId root='1.2.276.0.76.3.1.81.81.6.2.2'/>
               <id extension='HPC-Physician-1' root='1.2.276.0.76.4.75'/>
               <addr>Kardiologie, Klinikum Berlin</addr>
               <telecom value='tel:+49(30)234-5678'/>
               <assignedPerson>
                  <name>Dr. John Musterarzt</name>
               </assignedPerson>
               <representedOrganization>
<!-- the department Dr. Musterarzt works with -->
                  <templateId root='1.2.276.0.76.3.1.81.81.6.2.5'/>
                  <name>Kardiologie, Prof. Schulz</name>
                  <telecom value=' tel:+49(30)234-5600'/>
                  <addr>Muellerstr. 4</addr>
                  <asOrganizationPartOf>
<!-- the hospital Dr. Musterarzt works with -->
                     <templateId root='1.2.276.0.76.3.1.81.81.6.4.2'/>
                     <code code='P301'/>
	             <wholeOrganization>
                        <id extension='SMC-Hospital-1' root='1.2.276.0.76.4.77'/>
                        <name>Klinikum Berlin</name>
                     </wholeOrganization>
                  </asOrganizationPartOf>    				
               </representedOrganization>
            </assignedEntity>
         </performer>
      </serviceEvent>		
   </documentationOf>