Links among documents
Depending on the document type, any instance of epSOS pivot CDA shall have a related
CDA embedding the PDF representation of the original data from which the epSOS pivot
has been derived (also known as “epSOS PDF”). The consumer of the epSOS services shall
be able to access this epSOS PDF – if existing - any time it deems it is necessary
for the document content comprehension. [epSOS PDF – epSOS pivot link]
Moreover countries shall be able: for a given epSOS pivot document, to identify the
original national data/document (i.e. that in use in their national infrastructure)
this CDA comes from [Original document identification]; to trace back from the eD what is the prescription dispensed, and for each dispensed
item what is the prescription item supplied. [eD to eP traceability]
Hereafter how these requirements are fulfilled for the epSOS CDAs.
Original document identification
The relationship between the eP/eD/PS instance and the document (data) in use in the
National Infrastructure (“original Country-A document”) is kept via the XFRM relationship
[XFRM (transform) = “The current document is a transformation of the ParentDocument”].
Where the “national” document is identified by its ID as the parentDocument relatedDocument
association of the (“aa-bb-cc” in the example "Example of national document identified
by its ID").
N.B.: This relationship is mandatory for this guide
NOTE: Even for countries not dealing with real documents in their National Infrastructures
(e.g. data collected from local databases), this mechanism could be useful to identify
the collection of data used for generating the epSOS CDAs, facilitating the information
backtracking. In that case the ID might be that of the epSOS friendly document or
of any other kind of intermediate document used for generating the NCP document input.
epSOS PDF – epSOS pivot link
The link between the epSOS pivot and the epSOS PDF may be derived at the document
level in three ways:
- (1) both have the same relatedDocument (XFRM).parentDocument
- (2) if used, both have the same setId. This value should be equal to the “national
document” setId, if existing.
- (3) the pivot have a relatedDocument relationship with the epSOS PDF.
Even if no one of the allowable relationships defined by the CDA standard (XFRM, RPLC,
APND) fits perfectly with the relationship existing between the pivot and the PDF
CDA; the APND relationship seems to be that better describing the epSOS scenario.
In fact “An addendum is a separate document that references the parent document, and
may extend or alter the observations in the prior document. The parent document remains
a current component of the patient record, and the addendum and its parent are both
read by report recipients.”
This relationship would be therefore represented as presented in example "Example
of append relationship". Where aa1-bb1-cc1 is in this example the ID of the epSOS
PDF.
eD to eP traceability
Each prescription shall have its own identifier recorded in the element section[templateId/@root='1.3.6.1.4.1.12559.11.10.1.3.1.2.1']/id
(see R2.1).
Each prescription item shall have its own identifier recorder in entry/substanceAdministration[templateId/@root='1.3.6.1.4.1.12559.11.10.1.3.1.3.2']/id
(see R2.4)
The prescription ID and prescription item ID must be globally unique. In countries
where there can be only one item per prescription, the prescription item ID must be
the same as the prescription ID
The main mechanism for handling the eD and eP linkage is through the prescription
item ID that can be used by the prescribing system or provider to identify the prescription
to which it belongs. (see section 12.1.3.4.8 Related prescription item).
Moreover the eD document SHALL refer the prescription ID using the InFulfillmentOf
relationship. Please note that the target order.id attribute IS NOT the identifier
of the document instance, but that of the prescription (as order).
Template epSOS CDA relatedDocument
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