Client Registry

• An enterprise master patient index (EMPI), or Client Registry manages the unique identity of citizens receiving health services with the country – “For whom”

Considerations

• Challenge: – Health data generated in many locations with

differing identifiers• Approach(es):– Explore National ID / Healthcare Identifiers– Leverage sophisticated matching algorithms– Develop Policies/processes for reconciling

identities• Close coordination with SHR

Provider Registry

• A Provider Registry is the central authority for maintaining the unique identities of health providers within the country – “By whom”

Considerations

• Challenge: – Providers may have differing identifiers in differing

contexts– Various use cases must be supported

(e.g, ,credentialing, provider quality of care reports) • Approach(es):– Develop a standardized, shared source of canonical

provider ID’s• Close coordination with FR

Facility Registry

• A Health Facility Registry serves as a central authority to uniquely identify all places where health services are administered within the country – “Where?”

Considerations

• Challenge: – Complete and standardized facility data necessary

for a variety of eHealth use cases is often lacking• Approach(es):– Develop standardized Facility identifiers with a

shared source of stakeholder-driven facility metadata.

• Close coordination with PR

Terminology Service

• A Terminology Service serves as a central authority to uniquely identify the clinical activities that occur within the care delivery process by maintaining a terminology set mapped to international standards such as ICD10, LOINC, SNOMED, and others – “What?”

Considerations

• Challenge: – Health data concepts and codes are non standard, which

hinders a comprehensive view of patient-level and system wide outcomes.

• Approach(es):– Recognize need for distinct ‘interface’ and ‘reference’

terminologies– Develop stakeholder driven approach to adopting reference

terminologies– Develop stakeholder driven approach to developing terminology

metadata and term maintenance process• Close coordination with SHR/HIL

Shared Health Record

• A Shared Health Record (SHR) is a repository containing the normalized version of content created within the community, after being validated against each of the previous registries.  It is a collection of person-centric records for patients with information in the exchange.

Considerations

• Challenge: – eHealth data is often stored in differing formats among

disparate systems, limiting availability and usability• Approach(es):– Develop stakeholder driven approach to define data

access requirements– Develop stakeholder driven approach to developing

terminology metadata and term maintenance process• Close coordination with SHR/HIL

Health Interoperability Layer

• A Health Interoperability Layer receives all communications from point of service applications and orchestrates message processing between the point of service application and the hosted infrastructure elements.

Health Interoperability Layer

Considerations

• Challenge: – eHealth data is generated and transmitted often

stored in differing formats among disparate systems, limiting availability and usability

• Approach(es):– Develop stakeholder driven approach to

define/specify information exchange requirements and “bus behavior”

• Close coordination with all components