Glossary. Audit Registry

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1 Audit Registry Canada Health Infoway (CHI) Client Registry (CR) Clinical Data/Document Repository (CDDR) Consent Registry (CR) Continuum of Care Cross-enterprise Document Sharing for Imaging (XDS-I) Profile Data Query Pattern Data Services A transaction datastore containing immutable and permanent records attributing shared resource access and e-health Solutions interactions with e-health subscribers. Federally-funded, independent, not-for-profit organization whose Members are Canada's 14 federal, provincial and territorial Deputy Ministers of Health. Infoway is Canada's catalyst for collaborative change to accelerate the use of electronic health information systems and electronic health records (EHRs) across the country. A datastore containing the Identity and Personal Characteristics data of all the people who have received health services in Ontario. It also includes all Ontario residents covered by OHIP. ehealth Ontario regional hub service to collect and manage clinically relevant health information in the form of documents, such as discharge summaries, patient assessment forms, clinical notes, and transcribed reports or procedures reports. An example of a regional hub ehealth service. A repository documenting consent directives issued by health services clients. Consent directives are explicit instructions to block access to specified personal health information (as defined under the terms of PHIPA) for specified health care providers (Including individual, classes or groups of providers). The range of services available within the health care sector, and to some extent outside it, available to address health and wellness needs. IHE Integration Profile facilitating the sharing of Imaging Information across health enterprises. Imaging Information includes sets of DICOM instances, diagnostic reports provided in a ready-for-display form and a selection of diagnostically significant images associated with the report content. Typical interaction between a point of service application and registries, repositories and application databases in the ehealth Shared Resources layer. Point of service applications communicating with the ehealth foundation by exchanging data messages. EHR data is transmitted between systems in a structured manner through web services.

2 Digital Imaging and Communications in Medicine (DICOM) Duplication of Services ehealth Blueprint ehealth foundation ehealth Registry Subscriber ehealth Service Standard for handling, storing, printing, and transmitting information in medical imaging. It includes a file format definition and a network communications protocol. The communication protocol is an application protocol using TCP/IP to communicate between systems. DICOM files can be exchanged between two entities capable of receiving image and patient data in DICOM format. Process in which tests are conducted more than once on a patient. A framework for collaboration and communication among electronic health record stakeholders. Launched in 2011, the Blueprint is a conceptual design providing a standard set of architecture principles and guidelines to be used by all participants. With a common set of standards the province will be able to achieve interoperability between systems which is a vital component of realizing electronic health records in Ontario. Also referred to as Ontario s ehealth Blueprint or the Blueprint. Network of systems at a provincial and regional level to keep track and make accessible a comprehensive picture of an individual s Electronic Health Record data. It consists of a number of components such as registries, repositories, business applications and the Health Information Access Layer. A person registered by ehealth Ontario to consume foundation information resources. A subscriber can be either a Client or a Provider. Activity to promote the delivery of health care services in Ontario using electronic systems and processes, information technology and communication technology to facilitate electronic availability and exchange of information related to health matters, including personal information and personal health information, by and among patients, health care providers and other permitted users.

3 Electronic Health Record (EHR) Enterprise Master Patient Index (EMPI) Enterprise Service Bus (ESB) Federated Model Health Client A secure and private lifetime record of key health history and care within the Ontario health system. The record is available electronically to authorized health care providers and the individual anywhere, anytime in support of high quality care. In an EHRi, the EHR is the central component that stores, maintains and manages clinical information about patients/clients. The extent of the clinical information sustained by the EHR component may vary based namely on the presence or absence of Domain Repositories in any given jurisdiction. System which coordinates client identification across multiple systems by collecting and storing IDs and person-identifying demographic information from source systems (track new persons, track changes to existing persons). This system also performs several other tasks and responsibilities associated with client ID management. A distributed integration middleware infrastructure to broker requests and responses between the Point of Service applications and ehealth services within the ehealth foundation. It combines Extensible Markup Language and Web services support, basic transformation, and intelligent routing. It either includes messageoriented middleware (MOM) or wraps other MOM transport mechanisms. Central agency providing mutually supportive standards, principles, policy and procedures governing how the central agency distributes ownership with agreed upon responsibilities. Implementation implications: a federated model supports central and distributed services linked by standards, governance, principles, policy & procedures. Individual who is a recipient of, is eligible to receive, or is acting on behalf of / supporting those receiving health care in Ontario. Also referred to as client or health care client.

4 Health Information Access Layer (HIAL) Health Level 7 (HL7) Health Level 7 version 2 (HL7 v2) Health Level 7 version 3 (HL7 v3) Hub Independent Hub Service Interoperability Line of Business Application (LOB) A single logical interface designed for ehr interoperability. It facilitates the exchange of information between Point of Service applications and services within the ehealth foundation. The HIAL presents a façade with entry points for Provincial eservices, abstracting the native technologies, interfaces, security mechanisms and topology (locations and partitioning) of the discrete systems and repositories forming the e-health Resources partition. A health care standard for clinical and administrative data exchange amongst healthcare focused computer systems. It includes terminologies for coded data, protocols and technical processes for each Line of Business application. The HL7 organization is one of several ANSI-accredited Standards Developing Organizations. Standard supporting hospital workflows. Created in 1987, it defines electronic messages to support administrative, logistical, financial and clinical processes. Standard supporting healthcare workflows. Development started in1995, resulting in an initial standard publication in HL7 v3 is based on a formal methodology (the HDF HL7 Development Framework) and object oriented principles. A network of systems making up the ehealth foundation at the provincial and regional level. A Hub consists of different registries, repositories and other components giving provincial or regional services focused on specific aspects of the Electronic Health Record. Service exclusive to a specific regional hub. This approach could be used within a regional hub to share data. The ability of systems, units, or forces to provide services to and accept services from other systems, units, or forces and to use the services so exchanged to enable them to operate effectively together. Back end application or repository to apply business rules and data manipulations specific to a business domain such as labs, drugs, digital imaging etc. Including: - OLIS - Drug e-health Program - etc.

5 Location Registry (LR) Message Services Nomenclature Registry Ontario Lab Information System (OLIS) Open System Interconnection Model (OSI) Panorama A repository identifying all health care sites where services are delivered to patients in Ontario, associated with Providers and Organisations. Note: Location is presented as a separate registry for alignment with the Canada Health Infoway Blueprint. Actual implementation of Location will be bundled with Provider Registry. Part of the HIAL Communication Bus, group of services handling messages. Services in this group include parsing, serialization, encryption and decryption, encoding and decoding, transformation and routing. A repository containing official names, categories and descriptions of objects of interest to e-health (e.g. Coding Schemes). As a province-wide, integrated repository of tests and results, OLIS will contribute to fundamental improvements in patient care by providing practitioners with timely access to information that is needed at the time of clinical decision making. OLIS is one component of the overall provincial strategy to improve chronic disease management in Ontario. A reference model for standardized information exchange between systems. It characterizes and standardizes the functions of a communications system in terms of abstraction layers. Similar communication functions are grouped into logical layers. A layer serves the layer above it and is served by the layer below it. OSI provides a common basis for the coordination of standards development for the purpose of systems interconnection, while allowing existing standards to be placed into perspective within the overall Reference Model. The model identifies areas for developing or improving standards. It does not intend to serve as an implementation specification. Panorama, the Pan-Canadian Public Health Surveillance Solution. Panorama will protect Ontarians from emerging and ongoing public health threats to reduce the risk posed from communicable diseases. New pan-canadian surveillance system which will enable health care providers to immediately collect, share and analyze health information that is critical for emerging and ongoing threats to public health.

6 Participatory Medicine Patient-Centred Care (PCC) Personal Information Protection and Electronic Documents Act (PIPEDA) Picture Archiving and Communication System (PACS ) Point of Service Application (PSA) Point-to-Point Protocol (PPP, P2PP) A health care movement in a cooperative model of health care encourages and expects active involvement by all connected parties (patients, caregivers, healthcare professionals, etc.) as integral to the full continuum of care. Care respectful of and responsive to in individual patient preferences, needs, and values, and ensuring that health care client values guide all clinical decisions. An Act to support and promote electronic commerce by protecting personal information collected, used or disclosed in certain circumstances, by providing for the use of electronic means to communicate or record information or transactions and by amending the Canada Evidence Act, the Statutory Instruments Act and the Statute Revision Act. Secure computer systems for patient radiology reports and images such as hospital-based CT scans, ultrasounds, MRIs, mammograms and x-rays. The implementation of these systems has eliminated the need for film and paper diagnostic images. Includes computers or networks dedicated to the storage, retrieval, distribution and presentation of images. The medical images are stored in an independent format. The most common format for image storage is DICOM (Digital Imaging and Communications in Medicine). Application system employing electronic health records in a clinical setting. Eg. Electronic Medical Record system in a health care provider's office, Pharmacy Management System, Laboratory Information System, and Hospital Information System. Standard method for transporting packets between two peer systems. It provides full-duplex simultaneous bi-directional operation, and is assumed to deliver packets in order. It is intended that PPP provide a common solution for easy connection of a wide variety of hosts, bridges and routers.

7 Portal Portlet Provider Registry (PR) Provincial Service Publish and Subscribe Pattern Regional Hub Service Web based application presenting information from diverse sources in a unified way. Portals are a specific type of web site that provides the user web experience and user support for access to portlets. It provides an intermediary function that communicates with the portlets presentation-oriented web services on behalf of its users: it gathers and aggregates the markup delivered by the portlets and other view components. It is an alternative way to access the ehealth foundation. An object providing a collection of related services to deliver meaningful functionality to a portal user. Portlets may appear in multiple tabs and other portals, so the same function can serve many different business scenarios. A repository containing an enumeration of all Health Care Organizations and Providers (Identity, Personal Characteristics and Professional Roles) and the associations between them. Component within the provincial hub of the ehealth foundation e.g. a service to share lab results through the provincial lab repository. These services may also be accessed indirectly through the regional hub to accelerate adoption. An example of a provincial service is sharing of lab results through the provincial lab repository. Messaging design pattern in which a person or application publishes information, and an event notification (with or without payload) is broadcast to all authorized subscribers. In general, the relationship between the publisher and subscriber is mediated by a service that receives publication requests, broadcasts event notifications to subscribers, and enables privileged entities to manage lists of people or applications that are authorized to publish or subscribe. The focal point for publication and subscription is a "node" to which publishers send data and from which subscribers receive event notifications. A service fulfilling regional and provincial requirements. A hub service may be implemented for one region or implemented to enable interaction between more than one region, for example to share patient information with another region or aggregate data at a provincial level. These capabilities vary based on regional and provincial requirements.

8 Registry Repository Resource Matching and Referral Application (RM&R) Service Registry Shared Health Record (SHR) Standard ehealth foundation data component acting as the master source for reference information such as client, provider, location or user. ehealth foundation data component acting as a data store for health care clients health characteristics and transactions. Repositories for medication management, lab tests, diagnostic imagining, immunizations, clinical documents and encounter records are planned or have been built. Business application used to match referral requests with available health care resources and to manage the transfer of patients. For example the RM&R application can help users locate a suitable long-term care facility for a client who is currently waiting to be transferred from a hospital. Logically centralized registry to identify all classes of service associated with providers and organizations in Ontario. It allows providers publish and register services and consumers to search and discover services. It should support both manual and programmatical searching and publishing. Client, Provider and Service Registries all interact with each other through standard interfaces for achieving interoperability. This will not be a discreet solution and will be bundled with the provider registry. Information on health service events and the clinical observations associated with those events. It holds a copy of a subset of clinical information captured by point of service systems and is designed to be shared across the continuum of care, have value over time and grow to be very wide ranging both in terms of scope and volume to allow EHR users / POS applications to record, list and retrieve SHR information. Examples include health conditions, diagnoses, observations, adverse reactions, allergies and patient notes. Accepted rule or format used to establish uniformity or consistency, including documented agreements containing specifications, or other precise criteria to be used consistently as rules, guidelines, or definitions. A document established by consensus and approval by a recognized body, providing for common and repeated use, rules, guidelines, or characteristics for activities or their results, aimed at the achievement of the optimum degree or order in a given context.

9 Transaction Pattern User Community User Registry (UR) Web Service (WS) A definition for the processing pathway of system interoperability within the ehealth Logical Architecture setting clear expectations of roles and responsibilities for the different layers of services and application roles expected of different service components. Health care clients and clinicians. An information resource maintaining e-health subscriber data and related security descriptors. software system designed to support interoperable machine-tomachine interaction over a network. Web services are frequently just web enabled APIs accessed over a network, such as the Internet, and executed on a remote system hosting the requested services.

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