PSIS Query Implementation Manual
Programme	NPFIT	DOCUMENT NUMBER
Sub-Prog/Project	Comms & Messaging	NPFIT-FNT-TO-DPM-0602
Prog. Director	Paul Jones
Sub-Prog/Proj Mgr	Ken Lunn
Author	C&M Development Team	Version No.	1.7
Contact	Richard Kavanagh	Status	Issued

Contents

Change History

In Version	Author	Date	Amendment Details
1.0	Core Technical Team	10/05/04	First release
1.1	Core Technical Team	25/06/04	Addition of dissent override information. Replacement PSIS Query Response message for all successful responses to PSIS Queries.
1.2	Core Technical Team	17/09/04	PSIS Summary Query removed as not in scope for P1R2. New Queries and Responses for �Event List� and �Event�. Renaming of some existing queries and responses. Alignment of queries with generic control act wrapper. All response interactions and messages are for use in P1R2 only; the new response message types do not have HL7 artefact identifiers.
1.3	Core Technical Team	29/10/04	Change requests MIM-CR-0028, 0034, 0089 - 0091, 0093 - 0094.
1.4	Core Technical Team	6/12/04	Change request MIM-CR-0270. Removed previous Section 8 - Interaction Index.
1.5	Core Technical Team	14/01/05	New versions of Query Response tabular views and examples. Changed lowercase characters in example UUIDs to uppercase.
1.6	Core Technical Team	14/09/05	Removed Clinical Statement and CRE queries to reflect the requirements of Core CRS. Added withdrawingEventID to the query response messages. Corrected the description of the behaviour for the DPA and Event list queries in the storyboards. The vocabulary for eventStatus in the response messages has been updated for Core CRS. interactionID has been renamed to payloadID in the query responses.
1.7	Core Technical Team	21/02/06	No major structural changes. Several minor changes made due to issues raised or existing change requests - See Section 9.

1 Overview

PSIS Queries provide a mechanism for clinicians to gain access to the NHS Care Record Spine for an individual service user (patient). Local systems will query the service user�s NHS Care Record and populate screens with NHS Care Record data.

This version of PSIS-Query relates to Core PSIS.

In Core PSIS there are a number of queries as follows:

PSIS Event List Query - requests a list of Events (message payloads);
PSIS Event Query - data is requested for a single specified Event that has been retrieved in another query;
PSIS DPA Subject Access Query - allows a service user to retrieve ALL data stored against their NHS Care Record via Data Protection Agency guidelines.

2 Storyboards

2.1 Patient Attends an Emergency Department

Mr Frank Smith attends an Emergency Department (ED) at his local hospital as he is suffering from severe back pains. The receptionist books him in on the local system and a Legitimate Relationship (LR) is created so that the ED doctor can view the patient�s information. The receptionist then selects on her local system to retrieve a list of events about the patient � the local system sends the request [PSIS Event List Query] to PSIS.

PSIS compiles a list of all events (including out of date versions), and send this back to the local system [PSIS Event List Query Response].

The patient is seen by the ED doctor who decides to view a summary of events on his local system. His local system then filters out the out-of-date events and displays a list of current events. This list contains the Event ID, Event Type, and Date/Time which PSIS received the event.

On the local system the ED doctor chooses which event to view, a request is then sent to PSIS to retrieve the information requested e.g. a GP Summary [PSIS Event Query]. PSIS returns the appropriate data for that event back to the GP�s system [PSIS Event Query Response] in the same format as it was last uploaded to PSIS. The local system displays the event in a readable format.

2.2 GP Has No Authorised Access To Patient Records

Jane Robinson, who has just moved into the area, is feeling unwell so decides to visit the local GP for the first time. Mrs Robinson attends an appointment with Dr Percy Sugden. As Jane is a new patient to him, Dr Sugden uses his local system to request a list of her previous NHS Care Records from PSIS.

The local system sends a request to PSIS with the patients NHS Number and GP details for a complete list of events for Mrs Robinson [PSIS Event List Query].

PSIS checks to see if the appropriate access rights exist for the GP to be able to view Mrs Robinsons� information however as Mrs Robinson has not yet officially registered with the GP, no Legitimate Relationship (LR) yet exists between the doctor and patient. PSIS returns the appropriate response [Query Act Failed] containing the error �PQR-01 - No Legitimate Relationships exist for the query originator�.

2.3 Patient Has No Records On PSIS

Following on from Section 2.2, Dr Sugden requests and has been authorised the necessary access rights (LR�s) to be able to view Mrs Robinsons� information however her previous GP was not PSIS compliant.

Dr Sugden again uses his local system to request a list of Care Events from PSIS [PSIS Event List Query]. After confirming that the appropriate access rights exist, PSIS attempts to retrieve retrieve a list of all events recorded.

As Mrs Robinsons previous GP was not PSIS compliant PSIS cannot find any events for Mrs Robinson and returns the appropriate error code to the local system [Query Act Failed] � with the appropriate response code. The system displays the response to Dr Sugden in an appropriate format.

2.4 PSIS DPA Subject Access Query

Mr Peter Jones decides that he wants to see what has been recorded in his medical record. He finds out from his GP that he has to write to Dr. Gerald Franks, the local Caldicott Guardian, giving his full name, address, Date of Birth and NHS Number details (if known).
Peter does so.

On receiving the letter from Peter Jones Dr Franks (or an authorised privacy officer) logs onto his local terminal using his �Superuser� access. Using his local system, Dr Franks enters the patient identification details and selects to retrieve all stored information.

Dr Franks local system sends a request to PSIS [PSIS DPA Subject Access Query]. After successfully verifying the patient and Caldicott Guardians� access rights, PSIS sends all of the events (of all status�) back to the local system [PSIS DPA Subject Access Data Response] which is then displayed in a readable format.

Dr Franks checks and filters out any inappropriate third party information and then writes the information to an appropriate format for sending back to the Mr. Jones.

3 Application Roles

The applications involved in the PSIS Query processes play specific roles.� These, along with the interactions associated with each role, are identified below.

3.1 PSIS Query Placer - QUPC_AR090000UK01

The PSIS Query Placer will initiate any one of the PSIS queries.

PSIS Query Placer Interactions

3.2 PSIS Query Fulfiller - QUPC_AR100000UK01

The PSIS Query Fulfiller will respond to any one of the PSIS queries. A response will either carry data as requested or will be an empty response which carries a reason for there being no data returned.

PSIS Query Fulfiller Interactions

4 Trigger Events

4.1 PSIS Event List Query Started - QUPC_TE180000UK01

The PSIS Event List Query Started trigger event indicates that the query originator has initiated a query to obtain a list of Events for a specific service user.

4.2 PSIS Event Query Started - QUPC_TE190000UK01

The PSIS Event Query Started trigger event indicates that the query originator has initiated a query to obtain a specified Event for a specific service user.

4.3 PSIS DPA Subject Access Query Started - QUPC_TE120000UK01

The PSIS DPA Subject Access Query Started trigger event indicates that the query originator has initiated a PSIS DPA Subject Access Query on behalf of a specific service user.

4.4 PSIS Event List Retrieval - QUPC_TE200000UK01

The PSIS Event List Retrieval trigger event indicates that data has been found on PSIS which satisfies the specified criteria defined in the PSIS Event List Query.

4.5 PSIS Event Retrieval - QUPC_TE210000UK01

The PSIS Event Retrieval trigger event indicates that data has been found on PSIS which satisfies the specified criteria defined in the PSIS Event Query.

4.6 PSIS DPA Subject Access Data Retrieval - QUPC_TE160000UK01

The PSIS DPA Subject Access Data Retrieval trigger event indicates that data has been found on PSIS which satisfies the specified criteria defined in the PSIS DPA Subject Access Query.

5 Interaction Diagrams

5.1 PSIS Event List Query Interactions

5.2 PSIS Event Query Interactions

5.3 PSIS DPA Subject Access Query Interactions

6 Interactions

6.1 PSIS Event List Query Started - QUPC_IN180000UK04

The PSIS Event List Query Started interaction occurs when a request for a list of the details of all the messages sent to PSIS for a specific patient is started. The PSIS Query Placer sends a PSIS Event List Query, with specific query parameters, to the PSIS Query Fulfiller.

Sending Role	PSIS Query Placer	QUPC_AR090000UK01
Receiving Role	PSIS Query Fulfiller	QUPC_AR100000UK01
Trigger Event	PSIS Event List Query Started	QUPC_TE180000UK01
Transmission Wrapper	Send Message Payload	MCCI_MT010101UK12
Message Type	PSIS Event List Query	QUPC_MT130101UK04

Receiver Responsibilities

Reason

Interaction

Query Data Found

PSIS Event List Retrieval:

QUPC_IN200000UK04

No Query Data Found

Query Act Failed

QUQI_IN010000UK14

6.2 PSIS Event Query Started - QUPC_IN190000UK04

The PSIS Event Query Started interaction occurs when a request for all the contents of a specified PSIS Event that has been previously discovered by use of a PSIS Event List Query is started. The PSIS Query Placer sends a PSIS Event Query, with specific query parameters, to the PSIS Query Fulfiller.

Sending Role	PSIS Query Placer	QUPC_AR090000UK01
Receiving Role	PSIS Query Fulfiller	QUPC_AR100000UK01
Trigger Event	PSIS Event Query Started	QUPC_TE190000UK01
Transmission Wrapper	Send Message Payload	MCCI_MT010101UK12
Message Type	PSIS Event Query	QUPC_MT140101UK04

Receiver Responsibilities

Reason

Interaction

Query Data Found

PSIS Event Retrieval:

QUPC_IN210000UK04

No Query Data Found

Query Act Failed

QUQI_IN010000UK14

6.3 PSIS DPA Subject Access Query Started - QUPC_IN120000UK06

The PSIS DPA Subject Access Query Started interaction occurs when a request from a service user to return all the care information held on PSIS about him/her is started. The PSIS Query Placer sends a PSIS DPA Subject Access Query, with specific query parameters to the PSIS Query Fulfiller.

Sending Role	PSIS Query Placer	QUPC_AR090000UK01
Receiving Role	PSIS Query Fulfiller	QUPC_AR100000UK01
Trigger Event	PSIS DPA Subject Access Query Started	QUPC_TE120000UK01
Transmission Wrapper	Send Message Payload	MCCI_MT010101UK12
Message Type	PSIS DPA Subject Access Query	QUPC_MT120101UK06

Receiver Responsibilities

Reason

Interaction

Query Data Found

PSIS DPA Subject Access Data Retrieval:

QUPC_IN160000UK06

No Query Data Found

Query Act Failed:

QUQI_IN010000UK14

6.4 PSIS Event List Retrieval - QUPC_IN200000UK04

The PSIS Event List Retrieval interaction occurs when all the PSIS Event List Query criteria are met and there is relevant clinical data present on PSIS. The PSIS Query Fulfiller sends a PSIS Event List Retrieval carrying the requested Event List to the PSIS Query Placer.

Sending Role	PSIS Query Fulfiller	QUPC_AR100000UK01
Receiving Role	PSIS Query Placer	QUPC_AR090000UK01
Trigger Event	PSIS Event List Retrieval	QUPC_TE200000UK01
Transmission Wrapper	Application Acknowledgement	MCCI_MT020101UK12
Control Act Wrapper	Query Acknowledgement Response	QUQI_MT030101UK03
Message Type	PSIS Event List Query Response	queryResponseEventList_02

6.5 PSIS Event Retrieval - QUPC_IN210000UK04

The PSIS Event Retrieval interaction occurs when all the PSIS Event Query criteria are met and there is relevant clinical data present on PSIS. The PSIS Query Fulfiller sends a PSIS Event Response Retrieval carrying the requested Event to the PSIS Query Placer.

Sending Role	PSIS Query Fulfiller	QUPC_AR100000UK01
Receiving Role	PSIS Query Placer	QUPC_AR090000UK01
Trigger Event	PSIS Event Retrieval	QUPC_TE210000UK01
Transmission Wrapper	Application Acknowledgement	MCCI_MT020101UK12
Control Act Wrapper	Query Acknowledgement Response	QUQI_MT030101UK03
Message Type	PSIS Event Query Response	queryResponseEvent_02

6.6 PSIS DPA Subject Access Data Retrieval - QUPC_IN160000UK06

The PSIS DPA Subject Access Data Retrieval interaction occurs when all the PSIS DPA Subject Access Query criteria are met and there is an NHS Care Record for the patient held on PSIS. The PSIS Query Fulfiller sends a PSIS DPA Subject Access Data Retrieval carrying the appropriate Care Record Elements to the PSIS Query Placer.

Sending Role	PSIS Query Fulfiller	QUPC_AR100000UK01
Receiving Role	PSIS Query Placer	QUPC_AR090000UK01
Trigger Event	PSIS DPA Subject Access Data Retrieval	QUPC_TE160000UK01
Transmission Wrapper	Application Acknowledgement	MCCI_MT020101UK12
Control Act Wrapper	Query Acknowledgement Response	QUQI_MT030101UK03
Message Type	PSIS DPA Subject Access Query Response	queryResponsePatient_02

7 Message Definitions

7.1 PSIS Event List Query - QUPC_MT130101UK04

The PSIS Event List Query message allows the Service User to request a list of the details of all the messages sent to PSIS for a specific patient.

7.2 PSIS Event Query - QUPC_MT140101UK04

The PSIS Event Query message allows the Service User to request all the contents of a specified PSIS Event that has been previously discovered by use of a PSIS Event List Query.

7.3 PSIS DPA Subject Access Query - QUPC_MT120101UK06

The PSIS DPA Subject Access Query requests all the care information held on PSIS about the service user (patient).

7.4 PSIS Event List Query Response - queryResponseEventList_02

The PSIS Event List Query Response is a response to the PSIS Event List Query and provides a list of the details of those messages received by PSIS.

7.5 PSIS Event Query Response - queryResponseEvent_02

The PSIS Event Query Response is a response to the PSIS Event Query and provides the entire contents of the message which is identified by the PSIS Event UUID.

7.6 PSIS DPA Subject Access Query Response - queryResponsePatient_02

The PSIS DPA Subject Access Query Response is a response to the PSIS DPA Subject Access Query and provides ALL the clinical statements from of the service user�s NHS Care Record.

8 Glossary of Terms

Dissent	Dissent refers to an articulated decision by a patient, or their authorised representative, that they do not consent to the patient's sensitive personal data being shared, for the purpose of providing healthcare to that patient, outside the boundary of the legal organisation responsible for creating or maintaining them.
DPA	Data Protection Agency
Event	Corresponds to the whole message payload, which is the record of the business activity conveyed in the message. This is the granularity at which data is added to and cancelled in a patient record; queries are also supported at Event-level.
Event Item	Corresponds to a clinical statement (either simple or compound). This is the granularity at which progression occurs in a patient record; queries are provided at Event Item-level. Event Items are indexed by PSIS using CRE types to facilitate PSIS Query. Note that an Event Item in PSIS may comprise more than one clinical statement - for example, if an Observation statement contains one or more Statement Commentary statements, the PSIS Event Item will be the whole Observation statement including any contained Statement Commentary statements. This is because it is not useful to retrieve or progress a Statement Commentary statement independently of the Observation statement which contains it.
PSIS	Personal Spine Information System
Query Originator	Clinician or Caldicott Guardian initiating the query
Service User	The patient who is the subject of a query

9 Changes from v1.6

9.1 General changes

All of the changes for this version of PSIS-Query have been applied using MIM 4.1.01 / PSIS-Query 1.6 as a baseline.

Most of the changes to the PSIS-Query domain have been superficial with the exception of the following:

The response messages where withdrawinEventID has been made optional. These messages have now a version number associated to differentiate when a new version is released.
The request messages have been constrained so that a person has to exist if dissentOverride is active (or true), although there is no mechanism to enforce this is the schema files.

Details of all changes are listed in the table below:

Section	Artefact ID	Details

5.1	PSIS Event List Query Interactions Diagram	� New diagram generated due to change of artefact version numbers.
5.2	PSIS Event Query Interactions Diagram	� New diagram generated due to change of artefact version numbers.
5.3	PSIS DPA Subject Access Query Interaction Diagram	� New diagram generated due to change of artefact version numbers.

6.1	QUPC_IN180000UK03 up-versioned to QUPC_IN180000UK04	� Interaction up-versioned due to message constraint being added.
6.2	QUPC_IN190000UK03 up-versioned to QUPC_IN190000UK04	� Interaction up-versioned due to message constraint being added.
6.3	QUPC_IN120000UK05 up-versioned to QUPC_IN120000UK06	� Interaction up-versioned due to message constraint being added.
6.4	QUPC_IN200000UK03 up-versioned to QUPC_IN200000UK04	� Interaction up-versioned due to message constraint being added.
6.5	QUPC_IN210000UK03 up-versioned to QUPC_IN210000UK04	� Interaction up-versioned due to message constraint being added.
6.6	QUPC_IN160000UK05 up-versioned to QUPC_IN160000UK06	� Interaction up-versioned due to message constraint being added.
Section	Artefact ID	Details
7.1 RMIM	QUPC_RM130000UK03 up-versioned to QUPC_RM130000UK04	� Constraint added for CMET PersonSDS to exist if dissentOverride is true.
7.1 Tab View	QUPC_HD130100UK03 up-versioned to QUPC_HD130100UK04	� DissentOverride.value changed to CNE from CWE (due to a bug in the tool) � Constraint for CMET- PersonSDS existing added when dissentOverride is true � NHS Number example changed to value listed in approved list.
7.1 XSD	QUPC_MT130101UK03 up-versioned to QUPC_MT130101UK04	� Changed due to new RMIM being generated.
7.1 XML	QUPC_EX130101UK03 up-versioned to QUPC_EX130101UK04	� NHS Number example changed to value listed in approved list. � Message referenced an old non-existent schema. � Example OID for workstationID updated to correct number that ref any ext w/station - 2.16.840.1.113883.2.1.3.2.4.18.5
Section	Artefact ID	Details
7.2 RMIM	QUPC_RM140000UK03 up-versioned to QUPC_RM140000UK04	� Constraint added for CMET PersonSDS to exist if dissentOverride is true.
7.2 Tab View	QUPC_HD140100UK03 up-versioned to QUPC_HD140100UK04	� DissentOverride.value changed to CNE from CWE (due to a bug in the tool) � Constraint for CMET-PersonSDS existing added when dissentOverride is true � NHS Number example changed to value listed in approved list.
7.2 XSD	QUPC_MT140101UK03 up-versioned to QUPC_MT140101UK04	� Changed due to new RMIM being generated.
7.2 XML	QUPC_EX140101UK04 up-versioned to QUPC_EX140101UK05	� NHS Number example changed to value listed in approved list. � Message referenced an old non-existent schema. � Example OID for workstationID updated to correct number that ref any ext w/station - 2.16.840.1.113883.2.1.3.2.4.18.5
Section	Artefact ID	Details
7.3 RMIM	QUPC_RM120000UK05 up-versioned to QUPC_RM120000UK06	� Constraint added for CMET PersonSDS to exist if dissentOverride is true.
7.3 Tab View	QUPC_HD120100UK05 up-versioned to QUPC_HD120100UK06	� DissentOverride.value changed to CNE from CWE (due to a bug in the tool) � Constraint for CMET-PersonSDS existing added when dissentOverride is true � NHS Number example changed to value listed in approved list.
7.3 XSD	QUPC_MT120101UK05 up-versioned to QUPC_MT120101UK06	� Changed due to new RMIM being generated.
7.3 XML	QUPC_EX120101UK04 up-versioned to QUPC_EX120101UK06	� Message incomplete - did not include DissentOverride � although this is required. � NHS Number example changed to value listed in approved list. � Message referenced an old non-existent schema (QUPC_MT12010101UK03.xsd) � Example OID for workstationID updated to correct number that ref any ext w/station - 2.16.840.1.113883.2.1.3.2.4.18.5 � Inserted correct structure for Author CMET - was incomplete.
Section	Artefact ID	Details
7.4 Tab View	EventListQueryResponse up-versioned to EventListQueryResponse_02	� updated documentation to reference correct CMET numbers for Author (was Visio, now XSD No.). � Link to PSISDataStatus vocab inserted. � Now states that 'Nullified' is changed to 'Withdrawn' (at message level).
7.4 XSD	queryResponseEventList up-versioned to queryResponseEventList_02	� WithdrawingEventID constrained to optional (was mandatory) as per Tabular View specification. � updated documentation to state that only 1 OID for NHS No. is used (not three). � Updated documentation to reference correct CMET numbers for Author (was Visio, now XSD No.). � Updated example message type to GP Summary not Care Event Report / Med Update. � Changed 'Nullified' to 'Withdrawn'.
7.4 XML	queryResponseEventList up-versioned to queryResponseEventList_02	� Removed suggestion that 3 types of NHS Number OID�s could be used. � Changed example NHS number to agreed test data (9900002784). � Updated example message type to GP Summary not Care Event Report / Med Update. � Changed interactionID to payloadID. � Updated documentation to reference correct CMET numbers for Author (Visio was referenced, now XSD as in IM files). � Changed 'Nullified' to 'Withdrawn'.
Section	Artefact ID	Details
7.5 Tab View	EventQueryResponse up-versioned to EventQueryResponse_02	� Link to PSISDataStatus vocab inserted. � Now states that 'Nullified' is changed to 'Withdrawn' (at message level).
7.5 XSD	queryResponseEvent up-versioned to queryResponseEvent_02	� *Unlike the other query responses, withdrawingEventID is not an issue as this schema references the queryResponsePatient_02 schema for most of its structure.* � Updated to include new queryResponsePatient_02 version. � NOTE: As a result of the above, all changes made to queryResponsePatient_02 are inherited by this schema.
7.5 XML	queryResponseEvent up-versioned to queryResponseEvent_02	� Removed suggestion that 3 types of NHS Number OID�s could be used. � Changed example NHS number to agreed test data (9900002784). � Updated example message type to GP Summary not Care Event Report / Med Update. � Changed interactionID to payloadID. � Commented out example CareEventReport as no specs for this are agreed and this is for illustration of a payload only. � Changed 'Nullified' to 'Withdrawn'.
Section	Artefact ID	Details
7.6 Tab View	QueryResponsePatient up-versioned to QueryResponsePatient_02	� File renamed from PSISPatiengtQueryResponse.html To PSISDPASubjectAccessQueryResponse.html � Link to PSISDataStatus vocab inserted. � Updated example message type to GP Summary not Care Event Report / Med Update. � Now states that 'Nullified' is changed to 'Withdrawn' (at message level).
7.6 XSD	QueryResponsePatient up-versioned to QueryResponsePatient_02	� WithdrawingEventID constrained to optional (was mandatory) as per Tabular View specification. � Changed 'Nullified' to 'Withdrawn'.
7.6 XML	QueryResponsePatient up-versioned to QueryResponsePatient_02	� Removed suggestion that 3 types of NHS Number OID�s could be used. � Changed example NHS number to agreed test data (9900002784). � Updated example message type to GP Summary not Care Event Report / Med Update. � Changed interactionID to payloadID. � Commented out example CareEventReport as no specs for this are agreed. � Changed 'Nullified' to 'Withdrawn'.

The following internal NPfIT Change Requests (Raised Issues) have been addressed in this release.

CR-0658 - Tabular views and schemas updated so that withdrawingEventId is not optional (15915) and DissentOverride is not CNE not CWE (15071).
CR-0322 - Corrected definition of Dissent.
CR-0339 - (10027) Constraint added to 'request' queries so that a person MUST be stated when DissentOverride is overridden.
CR-0658 - (8084, 10170, 15152) Links to example messages and schemas now corrected.
CR-0341 - (10088, 15402, 15405, 15429, 15615) All storyboards have been updated to reflect the requirements of CORE PSIS.
CR-0340/0616 - (14092) Schema versions now corrected and referenced by example messages.
CR-0658 - (14091, 14093, 14094) Examples also corrected.
CR-0655 - (15196) Font updated for this document.
CR-0658 - (14096) Links to response messages and schemas now added to this document.
CR-0658 - (15070, 15151)Link to PSIS Data Status vocab now added.
CR-0658 - (15430) Pink to PSIS Error Code vocab corrected.
CR-0658 - (14888) Query response tabular views corrected so that only 1 NHS Number OID is now referenced.

The query messages in the PSIS Query domain use the HL7 standard but aren't derived from messages in the ballot. The query response messages use a locally defined return format that is not based on the HL7 RIM.