This document describes service-based transport of clinical documents using secure message delivery (SMD), endpoint location service (ELS), and clinical document architecture (CDA) packaging. SMD uses web services and reliable message queues to securely transmit CDA packages between endpoints registered in the ELS directory. Standards like AS 5551 and AS 5552 define the SMD and ELS specifications for transporting clinical documents in Australia.
10. SMD Signature
• Digital Signing
• AS 5551—2013: E-health XML secured payload
profiles
• SIGNED CONTAINER (XML) in SMD - transport
• CDA Package eSignature - authentication
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11. SMD Encryption
• AS 5551—2013: E-health XML
secured payload profiles
• Typically based on National PKI
Infrastructure (NASH Cert)
• Typical: Encrypt CDA Package
– CDA Package as binary
– “MessageType” XML wrapper (data is base64)
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17. Retrieve Acknowledgment
• Retrieve Transport Response
• Remove Transport Response (receipted)
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18. ELS Directory
• ATS 5546—2013 E-health endpoint location
service
• Location and capability of (web) services
associated with an identified organisation:
• Lookup entries
– url of services for an organisation
– find capability of the endpoint
• Manage entries
– add/remove entries
– define endpoint url & capability
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19. ELS Interaction
• target – identifier for organisation
e.g HPIO
http://ns.electronichealth.net.au/id/hi/hpio/1.0/8003620000000000
• serviceInterface – defines technical profile
SMD Send: http://ns.electronichealth.net.au/smd/intf/SealedMessageDelivery/TLS/2010
SMD Retrieve: http://ns.electronichealth.net.au/smd/intf/SealedMessageRetrieval/TLS/2010
• payloadScheme – synonym ‘serviceCategory’
e.g. http://ns.ahml.com.au/smd/sc/HL7v2.4~~MDM_T02/DS
• serviceEndpoint – URL normally http
• capability – set of nominated capabilities qualifying payloadScheme
e.g. Support UTF-8, JPG etc…
• ElsCertRefType – certificate/references with use defined e.g
encrypting
• delegate – identity URI that hosts the endpoint;
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20. ELS Governance
• Currently veracity of the entries is
controlled by the ELS service organisation
• Authorisation to manage entries is
controlled by the ELS instance and can be
based on client certificate
• serviceCategory/payloadScheme –
consensus building…
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21. SMX
• Industry consortium
• Exchange between exchanges
• Business model being devised
• Technical demonstrations
• Look to future developments:
– ELS verify entries
– ELS exchange entries
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22. OTS
• Messaging Vendors: ELS + SMD
• ELS: National Health Services Directory
• Applied: SMD ePIP + GP System
Vendors
• SMD ePIP Register
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