6    Interactions

Note:- For CDA domains the interactions are bound to the "NPfIT CDA generic model" and use the "NPfIT CDA generic schema" instead of the "NPfIT Domain CDA model schema".
The CDA Domain models are used for conformance checking of NPfIT templates after transforming the "Generic NPfIT CDA" instance to "NPfIT Domain CDA" instance.

 

The recipient and sender responsibilities stated in sections 6.2 to 6.4 are additional to the standard CDA recipient and originator responsibilities.

An NPfIT perspective of the standard CDA responsibilities are detailed within this section.

6.1    Recipient responsibilities

 

Assume default values where they are defined in this specification, and where the instance does not contain a value :

• Where CDA defines default values, the recipient must assume these values in the event that no value is contained in a CDA instance.

Parse and interpret the complete CDA header :

• A recipient of a CDA document must be able to parse and interpret the complete CDA header.

• Because applications may choose to display demographic and other CDA header data drawn from a central master directory, the rendering of the CDA document header is at the discretion of the recipient.

• An NPfIT style sheet is included within the MIM .Use of this style sheets is at the discretion of the recipient.

Parse and interpret the CDA body sufficiently to be able to render it :

• Where a system receives a document outside of its conformance level it may chose to only render the document

• A recipient of a CDA document must be able to parse and interpret the body of a CDA document sufficiently to be able to render it, using the following rendering rules:

• The CDA structured Body, the label of a section, as conveyed in the Section.title component, must be rendered.

• A recipient of a CDA document is not required to parse and interpret the complete set of CDA entries contained within the CDA body only those applicable to the receiving systems conformance level.

• A recipient of a CDA document on receipt of a document equal to or less than it's conformance level is required to validate a CDA document against referenced templates.

• A recipient of a CDA document on receipt of a document with templates higher than it's conformance is not required process those coded entries and should render the textual representation only.

Error handling

A recipient on receipt of a invalid / incorrect document may deal with errors by either

• Sending an Application Acknowledgement to the originating system stating the error type using one of the error codes from the code list for the domain contained in the relevant External Interface Specification.

or

• The receiving system may nullify the document using a "nullify document" document which MUST be sent to the originating system.
  

Note - Application Acknowledgements are sent to originating systems for notification of successful or failure handling by the receiving application.

6.2    Originator Responsibilities

Properly construct CDA Narrative Blocks :

• An originator of a CDA document must ensure that the attested portion of the document body is structured such that a recipient, adhering to the recipient responsibilities above, will correctly render the document.

The CDA structured Body:

• The label of a section must be conveyed in the Section.title component.

• The attested narrative contents of a section must be placed in the Section.text field, regardless of whether information is also conveyed in CDA entries. Attested multimedia referenced by URL in the narrative must not be carried in the document sent to PSIS.

• An originator of a CDA document is not required to fully encode all narrative into CDA entries within the CDA body only those applicable to the sending systems conformance level.
   

Error handling

An Originating system on receipt of an Application Acknowledgement containing the one of the error codes from the code list for the domain contained in the relevant External Interface Specification should initiate a work stream to rectify any error by either

• Replacing the invalid document with a new correct version
  

or

• by nullifying the invalid document using the "Nullify Document" document which MUST be sent to all recipients.
  It should also nullify any local cache / copy as necessary.
  

An Originating system on receipt of a "Nullify Document" document for any document it has sent, should initiate a work stream to rectify any error including nullifying any local cache / copy as necessary. 

6.3    PSIS Refusal To Seal Report - POCD_IN180001UK05

Communicates a Refusal To Seal Report to PSIS for processing and storage.
 

Sending Role	Refusal to Seal Report originating system	POCD_AR180001UK01
Receiving Role	Refusal to Seal Report receiving system (PSIS)	POCD_AR180002UK01
Trigger Event	Refusal To Seal Report	POCD_TE180001UK01
Transmission Wrapper	Send Message Payload	MCCI_MT010101UK12
Control Act Wrapper	Control Act	MCAI_MT040101UK03
Message Type	Refusal To Seal Report	POCD_MT180001UK05

 

Receiver Responsibilities

Reason	Interaction
On receipt of document	Application Acknowledgement MCCI_IN010000UK13

 

6.4    Nullify Refusal To Seal Report - POCD_IN180002UK05

Communicates the nullification (by replacement) of any Refusal To Seal Report sent to PSIS.

 

 

Sending Role	Refusal to Seal Report originating system	POCD_AR180001UK01
Receiving Role	Refusal to Seal Report receiving system (PSIS)	POCD_AR180002UK01
Trigger Event	Refusal To Seal Report nullify by replacement	POCD_TE180002UK02
Transmission Wrapper	Send Message Payload	MCCI_MT010101UK12
Control Act Wrapper	Trigger Event Control Act	MCAI_MT040101UK03
Message Type	Nullification Document	POCD_MT130001UK05

 

Receiver Responsibilities

Reason	Interaction
On receipt of document	Application Acknowledgement MCCI_IN010000UK13

 

6.5    PSIS Seal Report - POCD_IN180003UK02

Communicates a Seal Report to PSIS for processing and storage.
 

Sending Role	Seal Report originating system	POCD_AR180003UK01
Receiving Role	Seal Report receiving system (PSIS)	POCD_AR180004UK01
Trigger Event	Seal Report	POCD_TE180003UK02
Transmission Wrapper	Send Message Payload	MCCI_MT010101UK12
Control Act Wrapper	Control Act	MCAI_MT040101UK03
Message Type	Seal Report	POCD_MT180002UK02

 

Receiver Responsibilities

Reason	Interaction
On receipt of document	Application Acknowledgement MCCI_IN010000UK13

 

6.6    Nullify Seal Report - POCD_IN180004UK02

Communicates the nullification (by replacement) of any Seal Report sent to PSIS.

 

Sending Role	Seal Report originating system	POCD_AR180003UK01
Receiving Role	Seal Report receiving system (PSIS)	POCD_AR180004UK01
Trigger Event	Seal Report nullify by replacement	POCD_TE180004UK01
Transmission Wrapper	Send Message Payload	MCCI_MT010101UK12
Control Act Wrapper	Trigger Event Control Act	MCAI_MT040101UK03
Message Type	Nullification Document	POCD_MT130001UK05

 

Receiver Responsibilities

Reason	Interaction
On receipt of document	Application Acknowledgement MCCI_IN010000UK13

 

6.7    PSIS UnSeal Report - POCD_IN180005UK02

Communicates a UnSeal Report to PSIS for processing and storage.
 

Sending Role	UnSeal Report originating system	POCD_AR180005UK01
Receiving Role	UnSeal Report receiving system (PSIS)	POCD_AR180006UK01
Trigger Event	UnSeal Report	POCD_TE180005UK01
Transmission Wrapper	Send Message Payload	MCCI_MT010101UK12
Control Act Wrapper	Control Act	MCAI_MT040101UK03
Message Type	UnSeal Report	POCD_MT180003UK02

 

Receiver Responsibilities

Reason	Interaction
On receipt of document	Application Acknowledgement MCCI_IN010000UK13

6.8    Nullify UnSeal Report - POCD_IN180006UK02

Communicates the nullification (by replacement) of any UnSeal Report sent to PSIS.

 

 

Sending Role	UnSeal Report originating system	POCD_AR180005UK01
Receiving Role	UnSeal Report receiving system (PSIS)	POCD_AR180006UK01
Trigger Event	UnSeal Report nullify by replacement	POCD_TE180006UK01
Transmission Wrapper	Send Message Payload	MCCI_MT010101UK12
Control Act Wrapper	Trigger Event Control Act	MCAI_MT040101UK03
Message Type	Nullification Document	POCD_MT130001UK05

 

Receiver Responsibilities

Reason	Interaction
On receipt of document	Application Acknowledgement MCCI_IN010000UK13

 

6.9    Notification of Seal Event - PRPA_IN000501UK03

Communicates the Sealing Event message to the receiver (HealthSpace).

 

Sending Role	Notification of Seal Event Originating System	PRPA_AR000501UK01
Receiving Role	Notification of Seal Event Receiving System	PRPA_AR000502UK01
Trigger Event	Change of Sealing Status	PRPA_TE000501UK01
Transmission Wrapper	Send Message Payload	MCCI_MT010101UK12
Control Act Wrapper	Trigger Event Control Act	MCAI_MT040101UK03
Message Type	Notification of Seal Event	PRPA_MT000501UK03

 

Receiver Responsibilities

Reason	Interaction
On receipt of document	Application Acknowledgement MCCI_IN010000UK13

 

7    Message Definitions

There are three CDA documents associated with sealing history which are sent to PSIS.

 

Additionally sealing related events are communicated to patients via the HealthSpace system, using the Notification of Seal Event message.

7.1    Refusal To Seal Report - POCD_MT180001UK05

The Refusal to Seal Report records a refusal by a clinician to seal 1 or more item of information.

 

                   

 

7.1.1    Example for Scenario for Refusal to Seal Report

   

7.2    Seal Report - POCD_MT180002UK02

The Seal Report records details of a sealing event.

 

                   

 

7.2.1    Example for Scenario for Seal Report

   

7.3    UnSeal Report - POCD_MT180003UK02

The UnSeal Report records details Unsealing event.

 

                   

 

7.3.1    Example for Scenario Unseal Report

   

 

7.4    Notification of Seal Event - PRPA_MT000501UK03

The Notification of Seal Event message is used to inform another system (HealthSpace) that an event relating to sealed envelopes has happened. This is typically either some information becoming sealed, locked or unsealed, or a change of who has permission to view sealed data.

 

                   

 

7.4.1    Example for notification of automated accessor group change

   

7.4.2    Example for notification of information being sealed

   

7.4.3    Example for notification of information being unsealed

   

7.4.4    Example for notification of manual accessor change

   

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8    Glossary of Terms

Application Acknowledgement	A response from one application to another indicating that a message has been received and is valid.
Application Role	The role played by the application in a particular interaction.
Data type	The structural format of the data carried in an attribute
Data Type Flavour	A subdivision of a particular data type
DCE UUID	Universally Unique Identifier
ED	Emergency Department. Previously known as Accident & Emergency
EHR	Electronic Healthcare Record
Legitimate Relationship	A Legitimate Relationship is a relationship between a clinician (or NHS organisation work group) and a patient, that gives the clinician, or workgroup member, certain levels of entitlement to access that patient’s health record maintained on National Systems.
NHS CRS	NHS Care Record Service
OID	Object Identifier, a unique identifier e.g. used to identify coding systems
Provider	An alternative term for a fulfiller
PCT	Primary Care Trust, responsible for primary and community health services within a geographical boundary.
PDS	Patient Demographic Service
PSIS	Personal Spine Information Service.
Requestor	The HCP responsible for the request
SDS	Spine Directory Service
Service User	A person who is registered on the PDS