eHealth Exchange

Technical Specifications

Official eHealth Exchange Change/Service Advisory Log

The following specifications have been approved by the eHealth Exchange Coordinating Committee and are not intended to be linked to any particular use case, but are available for implementation across a myriad of use cases.

Current Specifications

Note that Participants should consult with their key Exchange partners to coordinate their adoption of 2010 vs. 2011 specifications.

Initial Production Specifications

These production specifications are in effect now, and are currently being used by a limited number of existing production participants but they are being sunset at a date to be determined by the eHealth Exchange Coordinating Committee.

Direct Secure Messaging

Fast Healthcare Interoperability Resources (HL7 FHIR®)

Personal Health Record (PHR)

Performance and Service Specifications

** Specifications flagged with an asterisk (*) are supported now, and are currently being used by a limited number of existing production participants, but the specification will be sunset at a date to be determined by the eHealth Exchange Coordinating Committee.
Use CaseUse Case HighlightsCoordinating Committee
Use Case Approval1 2
Performance & Service Specifications3, 4Coordinating Committee Performance & Service Specification
Approval
Performance & Service Specification LocationNotes
Query & RetrieveQuery & Retrieve With Consent, No Authorization2009-11-18 Web Services Registry Web Service Interface Specification v 3.12012-03-06https://ehealthexchange.org
Query & Retrieve
(for Social Security Benefits Determination
Query & Retrieve With Authorization2009-11-18 Web Services Registry Web Service Interface Specification v 3.12012-03-06https://ehealthexchange.org
Query & Retrieve
(for Life Insurance Underwriting)
Query & Retrieve With Consent & Authorization2016-12-07 Web Services Registry Web Service Interface Specification v 3.12012-03-06https://ehealthexchange.org
Consumer Access
to Health Information
Consumers (or their vendors with authorization) Query & Retrieve other eHx Participants to populate patients' PHRs & potentially share with other Participants.2016-10-18Web Services Registry Web Service Interface Specification v 3.12012-03-06https://ehealthexchange.org
Image ExchangeQuery to retrieve a link to a full DICOM package, not a compressed image.2016-11-15Web Services Registry Web Service Interface Specification v 3.12012-03-06https://ehealthexchange.org
Query & RetrieveQuery & Retrieve With Consent, No Authorization2009-11-18Sequoia HL7 FHIR® Healthcare Directory, HL7 FHIR Standard for Trial Use (STU3) 2016-10-18http://build.fhir.orgThe Coordinating Committee approved VALIDATING against FHIR R4 consistent with the Carequality FHIR Implementation Guide on 8/18/2020, but the eHealth Exchange technical standard is still FHIR STU3.
Query & Retrieve
(for Social Security
Benefits Determination)
Query & Retrieve With Authorization2009-11-18Sequoia HL7 FHIR® Healthcare Directory, HL7 FHIR Standard for Trial Use (STU3) 2016-10-18http://build.fhir.orgThe Coordinating Committee approved VALIDATING against FHIR R4 consistent with the Carequality FHIR Implementation Guide on 8/18/2020, but the eHealth Exchange technical standard is still FHIR STU3.
Query & Retrieve
(for Life Insurance Underwriting)
Query & Retrieve With Consent & Authorization2016-12-07Sequoia HL7 FHIR® Healthcare Directory, HL7 FHIR Standard for Trial Use (STU3) 2016-10-18http://build.fhir.org/The Coordinating Committee approved VALIDATING against FHIR R4 consistent with the Carequality FHIR Implementation Guide on 8/18/2020, but the eHealth Exchange technical standard is still FHIR STU3.
Consumer Access
to Health Information
Consumers (or their vendors with authorization) Query & Retrieve other eHx Participants to populate patients' PHRs & potentially share with other Participants.2016-10-18Sequoia HL7 FHIR® Healthcare Directory, HL7 FHIR Standard for Trial Use (STU3) 2016-10-18http://build.fhir.orgThe Coordinating Committee approved VALIDATING against FHIR R4 consistent with the Carequality FHIR Implementation Guide on 8/18/2020, but the eHealth Exchange technical standard is still FHIR STU3.
Image ExchangeQuery to retrieve a link to a full DICOM package, not a compressed image.2016-11-15Sequoia HL7 FHIR® Healthcare Directory, HL7 FHIR Standard for Trial Use (STU3) 2016-10-18http://build.fhir.orgThe Coordinating Committee approved VALIDATING against FHIR R4 consistent with the Carequality FHIR Implementation Guide on 8/18/2020, but the eHealth Exchange technical standard is still FHIR STU3.
Query & RetrieveQuery & Retrieve With Consent, No Authorization2009-11-18Messaging Platform v3.0 approved 6/27/2011 - Required2011-06-27https://ehealthexchange.org
Query & Retrieve
(for Social Security
Benefits Determination)
Query & Retrieve With Authorization2009-11-18Messaging Platform v3.0 approved 6/27/2011 - Required2011-06-27https://ehealthexchange.org
Query & Retrieve
(for Life Insurance Underwriting)
Query & Retrieve With Consent & Authorization2016-12-07Messaging Platform v3.0 approved 6/27/2011 - Required2011-06-27https://ehealthexchange.org
Consumer Access
to Health Information
Consumers (or their vendors with authorization) Query & Retrieve other eHx Participants to populate patients' PHRs & potentially share with other Participants.2016-10-18Messaging Platform v3.0 approved 6/27/2011 - Required2011-06-27https://ehealthexchange.org
Submit Quality DataPush CDAs for quality reporting2009-11-18Messaging Platform v3.0 approved 6/27/2011 - Required2011-06-27https://ehealthexchange.org
Image ExchangeQuery to retrieve a link to a full DICOM package, not a compressed image.2016-11-15Messaging Platform v3.0 approved 6/27/2011 - Required2011-06-27https://ehealthexchange.org
Query & RetrieveQuery & Retrieve With Consent, No Authorization2009-11-18Patient Discovery v2.0 - Required2011-06-27https://ehealthexchange.orgIHE ITI-55
Query & Retrieve
(for Social Security
Benefits Determination)
Query & Retrieve With Authorization2009-11-18Patient Discovery v2.0 - Required2011-06-27https://ehealthexchange.orgIHE ITI-55
Query & Retrieve
(for Life Insurance Underwriting)
Query & Retrieve With Consent & Authorization2016-12-07Patient Discovery v2.0 - Required2011-06-27https://ehealthexchange.orgIHE ITI-55
Consumer Access
to Health Information
Consumers (or their vendors with authorization) Query & Retrieve other eHx Participants to populate patients' PHRs & potentially share with other Participants.2016-10-18Patient Discovery v2.0 - Required2011-06-27https://ehealthexchange.orgIHE ITI-55
Image ExchangeQuery to retrieve a link to a full DICOM package, not a compressed image.2016-11-15Patient Discovery v2.0 - Required2011-06-27https://ehealthexchange.orgIHE ITI-55
Query & RetrieveQuery & Retrieve With Consent, No Authorization2009-11-18Query for Documents v3.0 - Required2011-06-27https://ehealthexchange.orgIHE ITI-38
Query & Retrieve
(for Social Security
Benefits Determination)
Query & Retrieve With Authorization2009-11-18Query for Documents v3.0 - Required2011-06-27https://ehealthexchange.orgIHE ITI-38
Query & Retrieve
(for Life Insurance Underwriting)
Query & Retrieve With Consent & Authorization2016-12-07Query for Documents v3.0 - Required2011-06-27https://ehealthexchange.orgIHE ITI-38
Consumer Access
to Health Information
Consumers (or their vendors with authorization) Query & Retrieve other eHx Participants to populate patients' PHRs & potentially share with other Participants.2016-10-18Query for Documents v3.0 - Required2011-06-27https://ehealthexchange.orgIHE ITI-38
Image ExchangeQuery to retrieve a link to a full DICOM package, not a compressed image.2016-11-15Query for Documents v3.0 - Required2011-06-27https://ehealthexchange.orgLeverages XCA-i
Query & RetrieveQuery & Retrieve With Consent, No Authorization2009-11-18Retrieve Documents v3.0 - Required2011-06-27https://ehealthexchange.orgIHE ITI-39
Query & Retrieve
(for Social Security
Benefits Determination)
Query & Retrieve With Authorization2009-11-18Retrieve Documents v3.0 - Required2011-06-27https://ehealthexchange.orgIHE ITI-39
Query & Retrieve
(for Life Insurance Underwriting)
Query & Retrieve With Consent & Authorization2016-12-07Retrieve Documents v3.0 - Required2011-06-27https://ehealthexchange.orgIHE ITI-39
Consumer Access
to Health Information
Consumers (or their vendors with authorization) Query & Retrieve other eHx Participants to populate patients' PHRs & potentially share with other Participants.2016-10-18Retrieve Documents v3.0 - Required2011-06-27https://ehealthexchange.orgIHE ITI-39
Image ExchangeQuery to retrieve a link to a full DICOM package, not a compressed image.2016-11-16Retrieve Documents v3.0 - Required2011-06-27https://ehealthexchange.orgLeverages XCA-i
Query & RetrieveQuery & Retrieve With Consent, No Authorization2009-11-18Authorization Framework v3.0 – Required2011-06-27https://ehealthexchange.org
Query & Retrieve
(for Social Security
Benefits Determination)
Query & Retrieve With Authorization2009-11-18Authorization Framework v3.0 – Required2011-06-27https://ehealthexchange.org
Query & Retrieve
(for Life Insurance Underwriting)
Query & Retrieve With Consent & Authorization2016-12-07Authorization Framework v3.0 – Required2011-06-27https://ehealthexchange.org
Consumer Access
to Health Information
Consumers (or their vendors with authorization) Query & Retrieve other eHx Participants to populate patients' PHRs & potentially share with other Participants.2016-10-18Authorization Framework v3.0 – Required2011-06-27https://ehealthexchange.org
Submit Quality DataPush CDAs for quality reporting2009-11-18Authorization Framework v3.0 – Required2011-06-27https://ehealthexchange.org
Image ExchangeQuery to retrieve a link to a full DICOM package, not a compressed image.2016-11-15Authorization Framework v3.0 – Required2011-06-27https://ehealthexchange.org
Query & RetrieveQuery & Retrieve With Consent, No Authorization2009-11-18NIST Special Publication 800-171 Revision 12019-08-13https://csrc.nist.gov/publications
Query & Retrieve
(for Social Security
Benefits Determination)
Query & Retrieve With Authorization2009-11-18NIST Special Publication 800-171 Revision 12019-08-13https://csrc.nist.gov/publications
Query & Retrieve
(for Life Insurance Underwriting)
Query & Retrieve With Consent & Authorization2016-12-07NIST Special Publication 800-171 Revision 12019-08-13https://csrc.nist.gov/publications
Consumer Access
to Health Information
Consumers (or their vendors with authorization) Query & Retrieve other eHx Participants to populate patients' PHRs & potentially share with other Participants.2016-10-18NIST Special Publication 800-171 Revision 12019-08-13https://csrc.nist.gov/publications
Electronic Case Reporting (eCR)To avoid negotiating and maintaining point to point BAAs, Direct Secure Messaging provided by HISPs leverages the DURSA trust framework. 2019-02-19NIST Special Publication 800-171 Revision 12019-08-13https://csrc.nist.gov/publications
Submit Quality DataPush CDAs for quality reporting2009-11-18NIST Special Publication 800-171 Revision 12019-08-13https://csrc.nist.gov/publications
Immunization Administration PushPush CDAs to communicate immunizations administered2016-10-18NIST Special Publication 800-171 Revision 12019-08-13https://csrc.nist.gov/publications
Encounter NotificationsPushes well-populated post-encounter CDAs to populate HIE longitudinal records & to fulfill other purposes, often after ED visits, inpatient discharges, & ambulatory encounters. This is also used by HIEs to marry unsolicited lab results to longitudinal records in the absence of HL7 v2 ORU order messages. 2016-10-18NIST Special Publication 800-171 Revision 12019-08-13https://csrc.nist.gov/publications
Prescription Drug Monitoring Program (PDMP) Query & retrieve medication lists, toxicology results, etc to marry state opioid repositories with EHRs.2016-10-18NIST Special Publication 800-171 Revision 12019-08-13https://csrc.nist.gov/publications
Electronic Lab Reporting (in support of public health) Push discrete lab results to public health agencies according to Meaningful Use/MACRA requirements.2016-10-18NIST Special Publication 800-171 Revision 12019-08-13https://csrc.nist.gov/publications
Syndromic Surveillance Push non-laboratory communicable diseases, etc to public health agencies according to Meaningful Use/MACRA requirements2016-10-18NIST Special Publication 800-171 Revision 12019-08-13https://csrc.nist.gov/publications
Image ExchangeQuery to retrieve a link to a full DICOM package, not a compressed image.2016-11-15NIST Special Publication 800-171 Revision 12019-08-13https://csrc.nist.gov/publications
Direct Secure MessagingTo avoid negotiating and maintaining point to point BAAs, Direct Secure Messaging provided by HISPs leverages the DURSA trust framework. 4/21/2015 &
10/18/2016
NIST Special Publication 800-171 Revision 12019-08-13https://csrc.nist.gov/publications
Electronic Service Endpoint DiscoveryAllows Participants to query eHx directory.2009-11-18NIST Special Publication 800-171 Revision 12019-08-13https://csrc.nist.gov/publications
Query & RetrieveQuery & Retrieve With Consent, No Authorization2009-11-18C32/CCD, version 2.5 (Meaningful Use, Stage 1 2011 edition Standard) 2017-01-10http://www.hitsp.org/Handlers/HitspFileServer.aspx?FileGuid=e1b99525-a1a5-48f6-a958-4b2fc6d7a5c7
Query & Retrieve
(for Social Security
Benefits Determination)
Query & Retrieve With Authorization2009-11-18C32/CCD, version 2.5 (Meaningful Use, Stage 1 2011 edition Standard) 2017-01-10http://www.hitsp.org/Handlers/HitspFileServer.aspx?FileGuid=e1b99525-a1a5-48f6-a958-4b2fc6d7a5c7
Query & Retrieve
(for Life Insurance Underwriting)
Query & Retrieve With Consent & Authorization2016-12-07C32/CCD, version 2.5 (Meaningful Use, Stage 1 2011 edition Standard) 2017-01-10http://www.hitsp.org/Handlers/HitspFileServer.aspx?FileGuid=e1b99525-a1a5-48f6-a958-4b2fc6d7a5c7
Consumer Access
to Health Information
Consumers (or their vendors with authorization) Query & Retrieve other eHx Participants to populate patients' PHRs & potentially share with other Participants.2016-10-18C32/CCD, version 2.5 (Meaningful Use, Stage 1 2011 edition Standard) 2017-01-10http://www.hitsp.org/Handlers/HitspFileServer.aspx?FileGuid=e1b99525-a1a5-48f6-a958-4b2fc6d7a5c7
Submit Quality DataPush CDAs for quality reporting2009-11-18C32/CCD, version 2.5 (Meaningful Use, Stage 1 2011 edition Standard) 2017-01-10http://www.hitsp.org/Handlers/HitspFileServer.aspx?FileGuid=e1b99525-a1a5-48f6-a958-4b2fc6d7a5c7
Query & RetrieveQuery & Retrieve With Consent, No Authorization2009-11-18Consolidated CDA (Meaningful Use, Stage 2 – 2014 edition Standard – US Realm Version 1.1) & associated Companion Guides2017-01-10http://www.hl7.org/implement/standards/product_matrix.cfmSpecification approved by Coordinating Committee as a Performance & Service Specification (not a lower level standard) via Validation Plan (e.g. Validation Plan v5)
Query & Retrieve
(for Social Security
Benefits Determination)
Query & Retrieve With Authorization2009-11-18Consolidated CDA (Meaningful Use, Stage 2 – 2014 edition Standard – US Realm Version 1.1) & associated Companion Guides2017-01-10http://www.hl7.org/implement/standards/product_matrix.cfmSpecification approved by Coordinating Committee as a Performance & Service Specification (not a lower level standard) via Validation Plan (e.g. Validation Plan v5)
Query & Retrieve
(for Life Insurance Underwriting)
Query & Retrieve With Consent & Authorization2016-12-07Consolidated CDA (Meaningful Use, Stage 2 – 2014 edition Standard – US Realm Version 1.1) & associated Companion Guides2017-01-10http://www.hl7.org/implement/standards/product_matrix.cfmSpecification approved by Coordinating Committee as a Performance & Service Specification (not a lower level standard) via Validation Plan (e.g. Validation Plan v5)
Consumer Access
to Health Information
Consumers (or their vendors with authorization) Query & Retrieve other eHx Participants to populate patients' PHRs & potentially share with other Participants.2016-10-18Consolidated CDA (Meaningful Use, Stage 2 – 2014 edition Standard – US Realm Version 1.1) & associated Companion Guides2017-01-10http://www.hl7.org/implement/standards/product_matrix.cfmSpecification approved by Coordinating Committee as a Performance & Service Specification (not a lower level standard) via Validation Plan (e.g. Validation Plan v5)
Submit Quality DataPush CDAs for quality reporting2009-11-18Consolidated CDA (Meaningful Use, Stage 2 – 2014 edition Standard – US Realm Version 1.1) & associated Companion Guides2017-01-10http://www.hl7.org/implement/standards/product_matrix.cfmSpecification approved by Coordinating Committee as a Performance & Service Specification (not a lower level standard) via Validation Plan (e.g. Validation Plan v5)
Query & RetrieveQuery & Retrieve With Consent, No Authorization2009-11-18Consolidated CDA (Meaningful Use, Stage 3 – 2015 edition Standard – US Realm Version 2.1) & associated Companion Guides2017-01-10http://www.hl7.org/dstucomments/showdetail.cfm?dstuid=168Specification approved by Coordinating Committee as a Performance & Service Specification (not a lower level standard) via Validation Plan (e.g. Validation Plan v5)
Query & Retrieve
(for Social Security
Benefits Determination)
Query & Retrieve With Authorization2009-11-18Consolidated CDA (Meaningful Use, Stage 3 – 2015 edition Standard – US Realm Version 2.1) & associated Companion Guides2017-01-10http://www.hl7.org/dstucomments/showdetail.cfm?dstuid=168Specification approved by Coordinating Committee as a Performance & Service Specification (not a lower level standard) via Validation Plan (e.g. Validation Plan v5)
Query & Retrieve
(for Life Insurance Underwriting)
Query & Retrieve With Consent & Authorization2016-12-07Consolidated CDA (Meaningful Use, Stage 3 – 2015 edition Standard – US Realm Version 2.1) & associated Companion Guides2017-01-10http://www.hl7.org/dstucomments/showdetail.cfm?dstuid=168Specification approved by Coordinating Committee as a Performance & Service Specification (not a lower level standard) via Validation Plan (e.g. Validation Plan v5)
Consumer Access
to Health Information
Consumers (or their vendors with authorization) Query & Retrieve other eHx Participants to populate patients' PHRs & potentially share with other Participants.2016-10-18Consolidated CDA (Meaningful Use, Stage 3 – 2015 edition Standard – US Realm Version 2.1) & associated Companion Guides2017-01-10http://www.hl7.org/dstucomments/showdetail.cfm?dstuid=168Specification approved by Coordinating Committee as a Performance & Service Specification (not a lower level standard) via Validation Plan (e.g. Validation Plan v5)
Immunization Administration PushPush CDAs to communicate immunizations administered2016-10-18Consolidated CDA (Meaningful Use, Stage 3 – 2015 edition Standard – US Realm Version 2.1) & associated Companion Guides2017-01-10http://www.hl7.org/dstucomments/showdetail.cfm?dstuid=168Specification approved by Coordinating Committee as a Performance & Service Specification (not a lower level standard) via Validation Plan (e.g. Validation Plan v5)
Submit Quality DataPush CDAs for quality reporting2009-11-18Consolidated CDA (Meaningful Use, Stage 3 – 2015 edition Standard – US Realm Version 2.1) & associated Companion Guides2017-01-10http://www.hl7.org/dstucomments/showdetail.cfm?dstuid=168Specification approved by Coordinating Committee as a Performance & Service Specification (not a lower level standard) via Validation Plan (e.g. Validation Plan v5)
Query & RetrieveQuery & Retrieve With Consent, No Authorization2009-11-18Renal Consolidated CCDA2016-10-18http://sequoiaproject.org/wp-content/uploads/2016/09/End-Stage-Renal-Disease-Implementation-Guide-Package.zipSpecification approved by Coordinating Committee as a Performance & Service Specification (not a lower level standard) via Validation Plan (e.g. Validation Plan v5)
Query & Retrieve
(for Social Security
Benefits Determination)
Query & Retrieve With Authorization2009-11-18Renal Consolidated CCDA2016-10-18http://sequoiaproject.org/wp-content/uploads/2016/09/End-Stage-Renal-Disease-Implementation-Guide-Package.zipSpecification approved by Coordinating Committee as a Performance & Service Specification (not a lower level standard) via Validation Plan (e.g. Validation Plan v5)
Query & Retrieve
(for Life Insurance Underwriting)
Query & Retrieve With Consent & Authorization2016-12-07Renal Consolidated CCDA2016-10-18http://sequoiaproject.org/wp-content/uploads/2016/09/End-Stage-Renal-Disease-Implementation-Guide-Package.zipSpecification approved by Coordinating Committee as a Performance & Service Specification (not a lower level standard) via Validation Plan (e.g. Validation Plan v5)
Consumer Access
to Health Information
Consumers (or their vendors with authorization) Query & Retrieve other eHx Participants to populate patients' PHRs & potentially share with other Participants.2016-10-18Renal Consolidated CCDA2016-10-18http://sequoiaproject.org/wp-content/uploads/2016/09/End-Stage-Renal-Disease-Implementation-Guide-Package.zipSpecification approved by Coordinating Committee as a Performance & Service Specification (not a lower level standard) via Validation Plan (e.g. Validation Plan v5)
Submit Quality DataPush CDAs for quality reporting2009-11-18Renal Consolidated CCDA2016-10-18http://sequoiaproject.org/wp-content/uploads/2016/09/End-Stage-Renal-Disease-Implementation-Guide-Package.zipSpecification approved by Coordinating Committee as a Performance & Service Specification (not a lower level standard) via Validation Plan (e.g. Validation Plan v5)
Submit Quality DataPush CDAs for quality reporting2009-11-18Administrative Distribution Production Specification v2.0 2011-06-27https://ehealthexchange.org
Immunization Administration PushPush CDAs to communicate immunizations administered2016-10-18Administrative Distribution Production Specification v2.0 2011-06-27https://ehealthexchange.org
Submit Quality DataPush CDAs for quality reporting2009-11-18Document Submission Production Specification v2.02011-06-27https://ehealthexchange.org
Immunization Administration PushPush CDAs to communicate immunizations administered2016-10-18Document Submission Production Specification v2.02011-06-27https://ehealthexchange.org
Immunization Administration PushPush CDAs to communicate immunizations administered2016-10-18Document Submission Production Specification v2.02011-06-27https://ehealthexchange.org
Consumer Access
to Health Information
Consumers (or their vendors with authorization) Query & Retrieve other eHx Participants to populate patients' PHRs & potentially share with other Participants.2016-10-18eHealth Exchange Personal Health Record (PHR) Profile2016-10-18https://ehealthexchange.orgThe PHR specification was approved by the Coordinating Committee on 10/1/2016, and not limited for trial use, but needs to be revisited with additional community input once a real-world implementation is underway.
Immunization Administration PushPush CDAs to communicate immunizations administered2016-10-18Electronic Submission of Medical Documentation (esMD) XDR Production Specification v1.0. Note this use case does leverage the esMD technical specification to push CDAs (not X12 275 lists) even though the use case does not involve submitting data to payers for coverage consideration. 2011-06-27https://ehealthexchange.orgITI-41
(IHE XDR, IHE XDS, IHE XCDR are all approved flavors of IHE ITI-41)
Direct Secure MessagingTo avoid negotiating and maintaining point to point BAAs, Direct Secure Messaging provided by HISPs leverages the DURSA trust framework. 4/21/2015 &
10/18/2016
Direct – Direct Project Applicability Statement for Secure Transport v1.22016-10-18http://wiki.directproject.org/File/view/Applicability%2BStatement%2Bfor%2BSecure%2BHealth%2BTransport%2Bv1.2.pdf
esMD (Electronic Submission of Medical Documentation)This use case (not necessarily the esMD technical specifications) is intended for providers to respond to separately-received requests to payers (typically Medicare MACs) to push data.2009-11-18 CAQH CORE X12 Document Submission Service Interface Specification v1.03/6/20112https://ehealthexchange.orgThis where a provider PUSHES an X12 payload (a X12 275 list of patients & C62s) via a SOAP envelope.
esMD (Electronic Submission of Medical Documentation)This use case (not necessarily the esMD technical specifications) is intended for providers to respond to separately-received requests to payers (typically Medicare MACs) to push data.2009-11-18Electronic Submission of Medical Documentation (esMD) X12 Profile v1.03/6/20112https://ehealthexchange.orgThis where a provider PUSHES an X12 payload (a X12 275 list of patients & C62s) via a SOAP envelope.
esMD (Electronic Submission of Medical Documentation)This use case (not necessarily the esMD technical specifications) is intended for providers to respond to separately-received requests to payers (typically Medicare MACs) to push data.2016-11-15Messaging Platform v3.0 approved 6/27/2011 - Required2011-06-27https://ehealthexchange.org
esMD (Electronic Submission of Medical Documentation)This use case (not necessarily the esMD technical specifications) is intended for providers to respond to separately-received requests to payers (typically Medicare MACs) to push data.2009-11-18Authorization Framework v3.0 – Required2011-06-27 https://ehealthexchange.org
esMD (Electronic Submission of Medical Documentation)This use case (not necessarily the esMD technical specifications) is intended for providers to respond to separately-received requests to payers (typically Medicare MACs) to push data.2009-11-18NIST Special Publication 800-171 Revision 12019-08-13https://csrc.nist.gov/publications
Encounter NotificationsPushes well-populated post-encounter CDAs to populate HIE longitudinal records & to fulfill other purposes, often after ED visits, inpatient discharges, & ambulatory encounters. This is also used by HIEs to marry unsolicited lab results to longitudinal records in the absence of HL7 v2 ORU order messages. 2016-10-18HL7 V2 (content)2016-10-18https://www.hl7.org/implement/standards/product_brief.cfm?product_id=185
Encounter NotificationsPushes well-populated post-encounter CDAs to populate HIE longitudinal records & to fulfill other purposes, often after ED visits, inpatient discharges, & ambulatory encounters. This is also used by HIEs to marry unsolicited lab results to longitudinal records in the absence of HL7 v2 ORU order messages. 2016-10-18Direct – Direct Project Applicability Statement for Secure Transport v1.2 & VPN2016-10-18https://www.hl7.org/implement/standards/product_brief.cfm?product_id=185
The VPN specification was approved by the Coordinating Committee on 10/1/2016, and not limited for trial use, but needs to be revisited with additional community input once a real-world implementation is underway.
Prescription Drug Monitoring Program (PDMP) Query & retrieve medication lists, toxicology results, etc to marry state opioid repositories with EHRs.2016-10-18NCPDP SCRIPT v 10.6
NIEM's PMIX
HL7 v2 / CCDA
Add NIST 800-171
2016-10-18https://www.ncpdp.org/NCPDP/media/pdf/NCPDPEprescribing101.pdfThe PDMP specification was approved by the Coordinating Committee on 10/1/2016, and not limited for trial use, but needs to be revisited with additional community input once a real-world implementation is underway. Precise versions will be identified after pilot implementation.
Prescription Drug Monitoring Program (PDMP) Query & retrieve medication lists, toxicology results, etc to marry state opioid repositories with EHRs.2016-10-18NIEM's PMIX
2016-10-18https://www.niem.gov/about-niem/success-stories/pilot-project-prescription-monitoring-information-exchange-pmixThe PDMP specification was approved by the Coordinating Committee on 10/1/2016, and not limited for trial use, but needs to be revisited with additional community input once a real-world implementation is underway. Precise versions will be identified After pilot implementation.
Prescription Drug Monitoring Program (PDMP) Query & retrieve medication lists, toxicology results, etc to marry state opioid repositories with EHRs.2016-10-18HL7 v2 / CCDA2016-10-18https://www.hl7.org/implement/standards/product_brief.cfm?product_id=185
The PDMP specification was approved by the Coordinating Committee on 10/1/2016, and not limited for trial use, but needs to be revisited with additional community input once a real-world implementation is underway. Precise versions will be identified after pilot implementation.
Electronic Lab Reporting (in support of public health) Push discrete lab results to public health agencies according to Meaningful Use/MACRA requirements.2016-10-18HL7 V 2.5.12016-10-18http://www.hl7.org/implement/standards/product_brief.cfm?product_id=98
Syndromic Surveillance Push non-laboratory communicable diseases, etc to public health agencies according to Meaningful Use/MACRA requirements2016-10-18HL7 V 2.5.12016-10-18https://cdn.ymaws.com/www.healthsurveillance.org/resource/resmgr/docs/Group_Files/Message_Guide/IG_SyS_Release_1.pdf
Electronic Case Reporting (eCR)To avoid negotiating and maintaining point to point BAAs, Direct Secure Messaging provided by HISPs leverages the DURSA trust framework. 2019-02-19Direct – Direct Project Applicability Statement for Secure Transport v1.22016-10-18http://wiki.directproject.org/File/view/Applicability%2BStatement%2Bfor%2BSecure%2BHealth%2BTransport%2Bv1.2.pdf eCR might also be deployed in the future using XDR using same specs as Walgreens immunization push
Image ExchangeQuery to retrieve a link to a full DICOM package, not a compressed image.2016-11-15DICOM2016-11-15https://www.dicomstandard.org/current/
Electronic Service Endpoint DiscoveryAllows Participants to query eHx directory.2009-11-18Web Services Registry Web Service Interface Specification v 3.12012-03-06https://ehealthexchange.org
Electronic Service Endpoint DiscoveryAllows Participants to query eHx directory.2009-11-18Sequoia HL7 FHIR® Healthcare Directory, HL7 FHIR Standard for Trial Use (STU3) 2016-10-18http://build.fhir.orgThe Coordinating Committee approved VALIDATING against FHIR R4 consistent with the Carequality FHIR Implementation Guide on 8/18/2020, but the eHealth Exchange technical standard is still FHIR STU3.
Consumer Access
to Health Information
Consumers (or their vendors with authorization) Query & Retrieve other eHx Participants to populate patients' PHRs & potentially share with other Participants.2016-10-18Access Consent Policies (ACP) Production Specification – v1.0 2011-06-27https://ehealthexchange.org
Query & Retrieve
(for Life Insurance Underwriting)
Query & Retrieve With Consent & Authorization2016-12-07Access Consent Policies (ACP) Production Specification – v1.0 2011-06-27https://ehealthexchange.org
Query & Retrieve
(for Social Security
Benefits Determination)
Query & Retrieve With Authorization2009-11-18Access Consent Policies (ACP) Production Specification – v1.0 2011-06-27https://ehealthexchange.org
Encounter NotificationsPushes well-populated post-encounter CDAs to populate HIE longitudinal records & to fulfill other purposes, often after ED visits, inpatient discharges, & ambulatory encounters. This is also used by HIEs to marry unsolicited lab results to longitudinal records in the absence of HL7 v2 ORU order messages. 2016-10-18Electronic Submission of Medical Documentation (esMD) XDR Production Specification v1.0. Note this use case does leverage the esMD technical specification to push CDAs (not X12 275 lists) even though the use case does not involve submitting data to payers for coverage consideration. 2011-06-27https://ehealthexchange.orgITI-41 or IHE ITI-80 (XCDR)
(IHE XDR, IHE XDS are both approved flavors of IHE ITI-41)
Electronic Lab Reporting (in support of public health) Push discrete lab results to public health agencies according to Meaningful Use/MACRA requirements.2016-10-18Direct Project Applicability Statement for Secure Transport v1.2 & VPN2016-10-18http://wiki.directproject.org/File/view/Applicability%2BStatement%2Bfor%2BSecure%2BHealth%2BTransport%2Bv1.2.pdf
Syndromic Surveillance Push non-laboratory communicable diseases, etc to public health agencies according to Meaningful Use/MACRA requirements2016-10-18Direct – Direct Project Applicability Statement for Secure Transport v1.22016-10-18 http://wiki.directproject.org/File/view/Applicability%2BStatement%2Bfor%2BSecure%2BHealth%2BTransport%2Bv1.2.pdf See Electronic Case Reporting (eCR) Use Case
Push ImagesPush Images2016-10-18NIST Special Publication 800-171 Revision 12019-08-13https://csrc.nist.gov/publications
Push ImagesPush Images2016-10-18Consolidated CDA (Meaningful Use, Stage 3 – 2015 edition Standard – US Realm Version 2.1) & associated Companion Guides2017-01-10http://www.hl7.org/dstucomments/showdetail.cfm?dstuid=168Specification approved by Coordinating Committee as a Performance & Service Specification (not a lower level standard) via Validation Plan (e.g. Validation Plan v5)
Push ImagesPush Images2016-10-18Administrative Distribution Production Specification v2.0 2011-06-27https://ehealthexchange.org
Push ImagesPush Images2016-10-18Document Submission Production Specification v2.02011-06-27https://ehealthexchange.org
Push ImagesPush Images2016-10-18Electronic Submission of Medical Documentation (esMD) XDR Production Specification v1.0. Note this use case does leverage the esMD technical specification to push CDAs (not X12 275 lists) even though the use case does not involve submitting data to payers for coverage consideration. 2011-06-27https://ehealthexchange.orgITI-41
(IHE XDR, IHE XDS, IHE XCDR are all approved flavors of IHE ITI-41)
Push ImagesPush Images2016-11-15DICOM2016-11-15https://www.dicomstandard.org/current/
Consumer Access
to Health Information
Consumers (or their vendors with authorization) Query & Retrieve other eHx Participants to populate patients' PHRs & potentially share with other Participants.2016-10-18Identity Assurance Level (IAL) Level 2 or Level 3 as described in NIST Special Publication 800-63A (Digital Identity Guidelines)2020-08-18https://pages.nist.gov/800-63-3/sp800-63a.htmlIAL Level 2 & Level 3 help confirm the requestor is really the patient in question. Participants supporting consumer-directed queries may choose IAL Level 2 or IAL Level 3.
Electronic Case Reporting (eCR)Pushes electronic case reports to public health authorities.2016-10-18Electronic Submission of Medical Documentation (esMD) XDR Production Specification v1.0. Note this use case does leverage the esMD technical specification to push CDAs (not X12 275 lists) even though the use case does not involve submitting data to payers for coverage consideration. 2011-06-27https://ehealthexchange.orgITI-41 or IHE ITI-80 (XCDR)
(IHE XDR, IHE XDS are both approved flavors of IHE ITI-41)

eHealth Exchange Document Submission Web Services Specification – Final

FINAL eHealth Exchange Document Submission Web Service Specification 3.0 specification for review and comment. This significant update adds support for IHE ITI-80 and for FHIR-based push transactions. eHealth Exchange staff are seeking any objections per the DURSA 10.03 through June 30, 2021. Please send your objections via email to administrator@ehealthexchange.org.

Official eHealth Exchange Errata and Change Log

Hub message transformation Inventory

Directory implementation guides

Since the eHealth Exchange FHIR R4 Implementation Guide references the foundational Sequoia Project FHIR R4 Implementation Guide, you might find it helpful to access the two artifacts simultaneously.