EFA XDS DocumentRepository

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EFA Document Repository XDS Binding

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Within EFA the actors and transactions of the IHE XDS integration profile are mapped onto EFA Document Repository actors and operations as follows:

Role	EFA Document Repository Service	IHE XDS
Actor	EFA Client	Document Source (for provideData) Document Consumer (for retrieveData)
Actor	EFA Document Repository	XDS Document Repository
Transaction	provideData	Provide and Register Document Set ITI-41
Transaction	retrieveData	Retrieve Document Set ITI-43

EFA XDS Binding: provideData

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Providing a document to an ECR provider's repository service is bound to the IHE Provide and Register Document Set transaction (ITI-41). This ECR binding introduces minor extensions and restrictions on the respective XDS actor and transaction definitions in order to properly cover the EFA use cases and to align with the EFA security framework:

• Documents must be associated with an XDS Folders, i.e an ECR partition, which in turn is part of an ECR that carries the permissions for accessing data.
• The requestor must be capable to register documents to the ECR provider that is targeted by this request. The ECR partition the provided document is associated with must be registered at this ECR provider.
• Additional error messages are defined that cover specific failure conditions of the EFA use cases
• The availability of data fields is aligned to EFA privacy requirements
• The application of security measures and the contents of the SOAP security header are specified normatively

Constraints on the Request Message

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The ProvideAndRegisterDocument request message is issued by an EFA client at the point of care for providing and registering a medical document to an existing ECR partition. Each transmission carries one or more documents. All provided documents will be registered with the same XDS Folder within the same logical EFA.

The request message implements the IHE Provide And Register DocumentSet transaction (ITI-41) request message as profiled in [IHE ITI TF-2b]. Implementations SHALL satisfy

• the Common constraints on ITI-41,
• the distinct set of constraints which trigger this binding, given in the table below (R = required, O = optional, - = forbidden).

Constraints	provideData binding
One XDS Document is a consentInfo which gives a new consent or does not revoke all active consents	-
One XDS Document is a consentInfo, which revokes all active consents	-
The provided XDS Folder and a registered XDS Folder have the XDSFolder.codeList and XDSFolder.patientID in common (i.e. the EFA exists)	R
The XDS Folder is not registered (uniqueID)	-
The XDSFolder is registered (uniqueID)	R

Expected Actions

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The XDS Document Repository SHALL forward the received documents to the EFA Document Registry using the ECR profiled Register Documents transaction.

The EFA Document Registry MUST verify that the requesting service user has sufficient rights to submit the given kind of documents for the identified patient and into the identified XDS Folder.

After processing the request the XDS Document Repository actor SHALL respond to an ProvideAndRegisterDocument request message with the ProvideAndRegisterDocument response message containing a success indicator.

In case of an error that relates to the transmission of the request or the processing of the EFA security token, the EFA Document Registry Service provider MUST respond with a fault message according to section xx.

Response Message (Full Success Scenario)

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If the EFA Document Repository Service provider is able to decode the received message and to properly process/forward all transmitted documents it responds with an ebXML Registry Response with its status set to "urn:oasis:names:tc:ebxml-regrep:ResponseStatusType:Success"

If the service provider wants to respond with further information on the processing of the transmitted data or with a non-critical warning it SHOULD include an additional <RegistryErrorList> element. The severity MUST be set to “urn:oasis:names:tc:ebxml-regrep:ErrorSeverityType:Warning”:

  <rs:RegistryResponse
           status="urn:oasis:names:tc:ebxml-regrep:ResponseStatusType:Success">
     <rs:RegistryErrorList>
       <rs:RegistryError 
           severity=”urn:oasis:names:tc:ebxml-regrep:ErrorSeverityType:Warning” 
           errorCode=”2201”
           codeContext=”Processing deferred” 
           location="" />
     </rs:RegistryErrorList> 
   </rs:RegistryResponse>

The following warning messages and codes are defined:

Condition and Severity	Message	Code	Action to be taken
Documents were received but not processed	Processing deferred	2201	None

Response Message (Failure or Partial Failure Scenario)

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If the EFA Document Repository failed with processing all of the documents or failed with forwarding all documents to the EFA Document Registry, it responds with an ebXML Registry Response that contains a respective status indicator (see below).The response MUST contain a RegistryErrorList element that indicates the failure condition.

If none of the documents was processed succesfully, the response status MUST be set to “urn:oasis:names:tc:ebxml-regrep:ResponseStatusType:Failure”. If at least one document was processed successfully, the response status MUST be set to “urn:ihe:iti:2007:ResponseStatusType:PartialSuccess”. A failure location MUST be provided if the error does not apply to all provided documents. It MUST NOT be given if the error applies to all provided documents.

The severity of each registry error message MUST be set to ”urn:oasis:names:tc:ebxml-regrep:ErrorSeverityType:Error”. Multiple registry error messages MAY be included within a single <rs:RegistryErrorList> element. Apart from the XDS-b error messages defined in Table 4.1-11 of [IHE ITI TF-3] the following error codes are defined for EFA:

Condition and Severity	Location	Message	Code	Action to be taken
The EFA provider requests a higher authentication trust level than assigned to the HP (e.g. password-based login is not accepted for the requested operation). (ERROR)	-	Weak Authentication	4702	If possible, the HP SHOULD log in again with a stronger mechansims (e.g. smartcard) and re-issue the request with the respective identity assertion.
The EFA Document Registry service provider only accepts data of the given kind if it is digitally signed by an HCP. (ERROR)	OID of the document that caused the error.	No Signature	4704	If possible, the EFA Client SHOULD re-issue the request with the data signed by an HP.
For data of the given kind the EFA provider only accepts PDF coded documents (ERROR)	OID of the document	PDF required	4107	The provided document MUST NOT be processed by the EFA provider. The EFA Client MUST re-transmit the document in PDF format.
A document of the provided kind does not comply with the EFA policy or the patient consent (ERROR)	OID of the document	Policy Violation	4109	The provided document MUST NOT be processed by the service provider. The HP MAY request the patient to extend the consent.

Security Considerations

See Security Considerations.

EFA XDS Binding: retrieveData

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This EFA binding introduces the following extensions and restrictions on the IHE XDS actor and transaction definitions in order to properly cover the EFA retrieveData operation and to align with the EFA security framework:

• Constraints on the retrieved documents due to the ECR usage conventions for XDS folders
• Additional error messages are defined that cover specific failure conditions of the EFA use cases
• The availability of data fields is aligned to EFA privacy requirements
• The application of security measures and the contents of the SOAP security header are specified normatively

Constraints on the Request Message

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The retrieveData request message implements the IHE Retrieve Document Set transaction (ITI-43) request message.

The following table shows how the retrieveData SFM is mapped onto the ITI-43 transaction's query arguments:

retrieveData	ITI-43	Constraints
context	SAML Identity Assertion within the SOAP Security Header	see IHE Cookbook
documentID	DocumentRequest/RepositoryUniqueId DocumentRequest/DocumentUniqueId	The requestor SHALL provide these unique IDs as obtained when the contents of an ECR partition were intially listed.
docData	DocumentResponse/Document	-

In addition the following constrains must be considered:

• The data to be retrieved SHALL all be associated with the same XDS Folder. It SHALL be classified as an ECR partition.

Example

 
<RetrieveDocumentSetRequest xmlns="urn:ihe:iti:xds-b:2007">
   <DocumentRequest>
      <RepositoryUniqueId>1.19.6.24.109.42.1.5</RepositoryUniqueId>
      <DocumentUniqueId>1.42.20101110141555.15</DocumentUniqueId>
   </DocumentRequest>
</RetrieveDocumentSetRequest>

Expected Actions

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The XDS Document Repository SHALL respond to a Retrieve Document Set request message with the Retrieve Document Set response message containing a success indicator and listing all requested documents. The provider of the XDS Document Repository MUST verify that the requestor has sufficient rights to access the requested documents.

In processing of this request the ECR Provider SHALL

• request the DocumentEntry.availabilityStatus for the given DocumentUniqueId (a health record manager is allowed to access documents with availabilityStatus "Deprecated"),
• assess the access control policy of the ecrRef object that is assigned with the XDS Folder that is associated to the requested documents. If a document is not associated with an XDS Folder or if no ecrRef object is assigned to the XDS Folder, the XDS Document Repository MUST respond with a "policy violation" error.
• respond to the requestor with the requested documents.

In case of an error that relates to the transmission of the request or the processing of the EFA security token, the XDS Document Registry MUST respond with the respective error status.

Response Message (Full Success Scenario)

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If the EFA Document Repository Service provider is able to decode and process the received message it responds with the discovered documents acc. to the specification of the ITI-43 response message.

Response Message (Failure or Partial Failure Scenario)

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If the XDS Document Repository is unable to successfuly process the query request it MUST respond with a RetrieveDocumentSetResponse message that only contains a RegistryResponse element.

If no matching document is discovered or an error occured during the processing of the request, the response status MUST be set to “urn:oasis:names:tc:ebxml-regrep:ResponseStatusType:Failure”. The failure semantics is all-or-nothing; as soon as one of the requested documents cannot be provided the XDS Document Repository responds with a full failure by providing none of the requested documents.

The severity of each registry error message MUST be set to ”urn:oasis:names:tc:ebxml-regrep:ErrorSeverityType:Error”. Multiple registry error messages MAY be included within a single <rs:RegistryErrorList> element. Apart from the XDS-b error messages defined in Table 4.1-11 of [IHE ITI TF-3] the following error codes are defined for ECR:

Condition and Severity	Message	Code	Action to be taken
The EFA provider requests a higher authentication trust level than assigned to the HP (e.g. password-based login is not accepted for the requested operation). (ERROR)	Weak Authentication	4702	If possible, the HP SHOULD log in again with a stronger mechansims (e.g. smartcard) and re-issue the request with the respective identity assertion.
The ECR provider is unable to verify the identity and/or the authenticity of the requestor (ERROR)	Invalid Subject	4703	The request MUST NOT be processed by the service provider.
One or more document identifiers are unknown to the ECR provider.	No Data	1102	-
The requestor has insufficient permissions to access one or more of the requested documents.	No Consent	4701	-
Multiple XDS Folders are associated with the requested documents or at least one of the associated XDS Folders is not classified as an ECR partition.	Policy Violation	4109	-

Security Considerations

See Security Considerations.

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