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Subject: RE: [regrep] RE: DNS like distributed search for RegistryObjects


Farrukh,
 
I'm concerned here as part of what John is asking for is NOT a technology solution.
 
Fire, Aim, Point - I suspect we need a little more Point, Aim, Fire - and BCM directed analysis first... as to the business needs and actual service models.
 
The models John is indirectly referencing are basically competing proprietary approaches to this from service providers - there are literally dozens of these competing for market share. http://www.ehto.org/ehto/ehealthrecord.html
 
Paradoxically none of them seem to have the slightest idea (the ones of asked!) about the notion of shared registry services - basically they are "eyes down" - their answer is "Yes - we can do that - just buy our service / install our software".  The notion of supporting an open public API specification is something they do not have time to waste chasing...because their system has all the information you ever need.
 
Now - there is however the IHE/XDS work.  For me this has always been the mostly likely candidate - because the biggest issue here is NOT technology - its policy and security and access models.
 
Who is allowed to see what?  How do you credential the search query?  You certainly cannot just hand out patient information willy-nilly.  The best I think you can hope for is to ascertain that a registry MAY have information that relates to a patient.  Notice - data entry screw-ups happen frequently in busy hospital and care center environments - so matching on Patient Name, Telephone #, Age, Address, SSN with some weighting algorithm may be needed ( I wrote one of these for 3M Healthcare some 10 years ago now to reconcile patient records across city care providers - such as Cincinnatti, Baltimore, Pittsburg and so on where you have same patient going to one or more providers in the same city care group).  Notice even the SAME hospital may have duplicate records for the one patient!
 
Given all these caveats - here's a short list of business factors:
 
1) Security model is essential - who is making query, what information is to be matched, what can be returned?
 
2) Audit trail is essential - who accessed the information and when?
 
3) What certificates and authentication can be applied?  To the patient themselves, and to the requester?
 
4) Who owns the information?  The patient or the care provider?
 
5) What API needs to be defined to support the business requirements?
 
6) How do care providers begin to participate in this?
 
I suspect the answers to much of this lay in a joint collaboration with IHE/XDS, NIST, OHC Project and this TC - to hammer out extensions to the existing IHE/XDS secure server - because that way - whatever is built then becomes immediately accessible to all those currently implementing those servers...
 
See: http://ebxmlforum.blogspot.com/2006/04/open-healthcare-framework-ohf-project.html
 
Thanks, DW


-------- Original Message --------
Subject: [regrep] RE: DNS like distributed search for RegistryObjects
From: "Matt MacKenzie" <mattm@adobe.com>
Date: Thu, April 13, 2006 8:45 am
To: "Farrukh Najmi" <Farrukh.Najmi@Sun.COM>,
<regrep@lists.oasis-open.org>
Cc: <john@maphin.net>

It is possible to represent a classification scheme using DNS-SD...which I
think is a great idea as it would allow for very fine grained partitioning.
Please let me know how I can help, I'll try my best to find some time.
-matt

-----Original Message-----
From: Farrukh Najmi [mailto:Farrukh.Najmi@Sun.COM]
Sent: Thursday, April 13, 2006 8:14 AM
To: regrep@lists.oasis-open.org
Cc: john@maphin.net; Matt MacKenzie
Subject: DNS like distributed search for RegistryObjects


Dear Colleagues,

Attached is an email from John Hardin whom many of you may know already.

John's email has reminded me of the the need for the TC to define a DNS
like distributed search for RegistryObjects.
He shares a very real use case from Electronic Patient Records world on
how important this functionality is.

I share this sense of importance and would like to propose that we as a
TC consider starting a work item focused on
defining a normative spec addressing this requirement. As a starring
point we could study past work by Matt MacKenzie on the subject:

http://www.oasis-open.org/committees/download.php/6852/tn-ebreg-dnssd-02.htm
l


What do Matt and TC colleagues think?

--
Regards,
Farrukh


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