Cross-Enterprise Document Networking (XDN)

• Problem– Legacy decommissioning produces large static collections of

patient-related documents requiring long-term retention.– Hospitals want solutions for access to these documents

without long term dependence on a vendor.• Opportunity

– Networked storage systems can store the documents.– Missing is a standard resource for managing the metadata.

• Solution– XDS registry provides such a metadata resource.– Add an optional URI slot (already present in XDM) to XDS

Registry, pointing to each stored document.

XDN extends XDS.b by:

• Extending XDS.b Registry to – Allow XDS documents to be addressed as files or

objects in network storage systems, using the URI slot already defined for the Cross-Enterprise Document Media Sharing (XDM) Profile.

– Define a storage mapping resource enabling storage locations to be changed without updating registry entries for all documents.

– Define repository behavior that includes the above mentioned externally referenced documents.

Patient Identity Source

Document Registry Document Consumer

Imaging Document Consumer

Document RepositoryDocument Source

Imaging Document Source

Register Document Set–b [ITI-42]

Registry Stored Query [ITI-18]

Patient Identity Feed [ITI-8] Patient Identity Feed HL7v3 [ITI-44]

Retrieve Document Set [ITI-43] Provide & Register

Imaging Document Set – MTOM/XOP [RAD-68]

Provide&RegisterDocument Set – b [ITI-41]

StandardXDS.b and XDS.b-I

WADO Retrieve [RAD-55] Retrieve Doc. Set [RAD-69] DICOM Retrieves [RAD-16, 17, 27, 31, 45]

Patient Identity Source

Networked Storage

Document Registry Document Consumer

Imaging Document Consumer

Document RepositoryDocument Source

Imaging Document Source

XDN Document Consumer

Register Document Set–b [ITI-42]

Registry Stored Query [ITI-18]

Patient Identity Feed [ITI-8] Patient Identity Feed HL7v3 [ITI-44]

Retrieve Document Set [ITI-43] Provide & Register

Imaging Document Set – MTOM/XOP [RAD-68]

Provide&RegisterDocument Set – b [ITI-41]

XDN Storage Broker ¬ Retrieve XDN Storage Map

¬ Retrieve Mapped XDN DICOM Instances

¯ Direct Retrieve XDN Documents

XDN Document Repository Retrieve XDN Storage Map

Retrieve Mapped XDN Documents

Store XDN Documents Direct Retrieve XDN Documents

Brokered RetrieveXDN Instances

WADO Retrieve [RAD-55] Retrieve Doc. Set [RAD-69] DICOM Retrieve s [RAD-16, 17, 27, 31, 45]

StandardXDS.b and XDS.b-I

plus XDN

XDN Storage Broker

• Web server hosting the storage mapping table• A broker providing http access to XDN Storage• URIs in the Registry point to the broker. A client can

directly access the URI at the Broker, or can use the storage mapping table and directly access the resource.

• A basic XDN Storage Broker, capable of accessing NAS-based storage, can be implemented by configuring an Apache Web server, and including a hand-crafted Storage Mapping Table.

Example XDN Storage Broker

Apache httpd Web Server

XDN Storage Mapping Table

(XML)

Apache configuration

file

XDN Storage (EMC

Centera)

XDN Storage (RESTful object

storage)

XDN Storage (NAS

partitions)

…

Apache Module for

Centera

Apache Module for

RESTful

XDN Storage Mapping Table

<StorageResource><resource>

<resourceId>docs11</resourceId><type>CIFS</type><path>//10.34.122.60/PACS/PACSARC001</path><repositoryId>1.2.840.26636366.2344.44.33.4</repositoryId>

</resource>……</StorageResource>

URI in Registry:http://xdnstorage.ourhospital.org/xdn/docs11/20140504/2345671.pdf

Root Resource Path