Messages Overview

responsibilities of an ihe enabled vendor as previously described, the primary responsibility of an rle requesting location is to submit record requests to the surescripts record locator service (rle) in addition, ihe enabled requesting locations are also asked to be ihe enabled responding locations this involves the following responsibilities provide surescripts access to patient rosters this can be done through the following methods a updating the surescripts master patient index (mpi) through an adt data feed reference the record locator & exchange adt data implementation guide for more information b responding to xcpd requests from surescripts optional send patient activity to surescripts via an adt data feed optional enroll patients for notifications by sending an adt message respond to xca query and retrieve requests from surescripts and other rle customers note certification to addorganization and updateorganization directory messages is required for ihe enabled vendors message descriptions xcpd iti 55 (cross community patient discovery) the ihe xcpd request/response supports the means to locate communities that hold patient records and the translation of patient identifiers across communities holding the same patient's data the request is sent from the requesting location to the surescripts rle to discover if a patient matching the demographics sent from the requester is known the response sent from surescripts to the requesting location indicates if there was a patient match or no match plq iti 56 (patient location query) the optional ihe plq request/response queries for a list of communities that may have records for a patient referenced by a patient identifier the request message is sent from the requesting location after receipt of an xcpd response from surescripts indicating a patient match the response sent from surescripts to the requesting location contains the patient’s record locations xca query iti 38 (cross community access) the ihe xca query request/response supports the means to request retrieval of the list of available documents from responding locations xca retrieve iti 39 (cross community retrieve) the ihe xca retrieve request/response supports the means to obtain documents from rle enabled responding locations surescripts location summary cda surescripts location summary cda contains information on locations where a patient has been seen based on information gathered from the surescripts network per ihe standards, the location summary cda is an on demand document metadata for the document will be returned in response to an xca query transaction the actual cda will be returned in response to an xca retrieve for the location summary cda unique document id as an on demand document, the content of the location summary cda will reflect the most recent data available as of the date and time the xca retrieve transaction is processed rle ihe message flow discover the patient (xcpd) & discover responding patient locations (plq) discover the patient 1a) the requesting location sends an xcpd message to query the surescripts rle and discover if a patient matching the demographics sent is known 1b) rle responds with a patient match or no match discover responding record locations (optional) 2a) the requesting location sends a plq message to retrieve from the rle a list of locations that have records for the patient 2b) the rle responds with record locations identified by home community and patient identification query and obtain patient records message flow when plq is used to discover responding locations rle does not maintain a clinical document repository documents are retrieved from the source there are three possible paths for retrieving documents from the responding locations including the following obtain patient records from rle enabled vendor through surescripts obtain location summary document from surescripts obtain patient records directly from ihe enabled vendor scenario 1 obtain patient records from ihe enabled vendor through surescripts 3a) an xca query request is sent to surescripts requesting patient records from the record location the request is forwarded to the responding location(s) 3b) the responding location sends an xca query response to surescripts, which is forwarded to the requesting location 4a) an xca retrieve request is sent to surescripts requesting retrieval of the patient records the request is forwarded to the responding location 4b) the responding location sends the patient records to surescripts in an xca retrieve response, which is forwarded to the requesting location scenario 2 obtain location summary document from surescripts 3a) an xca query request is sent to surescripts 3b) surescripts sends an xca query response with the document id and metadata of the dynamically generated location summary document 4a) the requesting location sends an xca retrieve request for the patient record locations 4b) surescripts sends the location summary document in the xca retrieve response scenario 3 obtain patient records directly from ihe enabled vendor 3a) an xca query request is sent directly to the ihe enabled responding location requesting patient records 3b) the responding location sends an xca query response to the requesting location 4a) an xca retrieve request is sent to obtain the records from the ihe responding location 4b) the responding location sends the patient records in the xca retrieve response query and obtain patient records message flow without plq rle does not maintain a clinical document repository documents are retrieved from the source for systems that do not utilize plq, surescripts is able to provide the detail of documents available from multiple sources using customized logic when processing an xca query request and response this customized version allows systems to submit an xca query to surescripts using the surescripts assigned patient identifier returned in the xcpd response and receive information on documents available from the following sources patient records from ihe enabled vendors location summary document from surescripts scenario obtain documents from any responder using a single xca query followed by xca retrieve(s) step 1 xca query 1a) an xca query request is sent to surescripts 1b) surescripts requests metadata from all possible responders 1b 1) an xca query is sent to available ihe responders 1b 2) a search is issued for location summary data 1c) surescripts aggregates responses and builds an xca query response containing the combined document ids with metadata for all available documents 1d) surescripts sends the xca query response to the requester step 2 xca retrieve 2a) the requesting location sends an xca retrieve request for the desired documents note it is recommended that each document be requested in a separate xca retrieve request this avoids any issue with a slow responder delaying return of all requested documents 2b) surescripts requests documents from all requested responders 2b 1) an xca retrieve is sent to ihe responders 2b 2) a location summary is generated note surescripts limits the lookback period for xca retrieve requests to 30 days from the last xca query request a best practice is to send an xcpd request, xca query request, and xca retrieve request sequentially within 30 days 2c) surescripts aggregates responses and builds an xca retrieve response containing the requested documents 2d) surescripts sends the xca retrieve response to the requester note documents from ihe enabled vendors may be retrieved directly using peer to peer connectivity, when available