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Cross-Enterprise Document Sharing (IHE XDS.b)

Name: Cross-Enterprise Document Sharing (XDS.b)

Identifier: IHE XDS.b

Issuing Organisation: Integrating the Healthcare Enterprise (IHE)

Country: International

Language: English

Organization website (opens in new window):

Link to standard (opens in new window):

Availability: Free to Access

Type: IHE Profile

Issue Year: unknown

Forward Review Date: Not known

Fields: Communication and Information  Digital Health  Health and Wellbeing 

Intended Audiences: Private Sector Bodies, Professional and Trade Bodies, and Governmental and Public Sector Bodies


Cross-Enterprise Document Sharing (XDS) is focused on providing a standards-based specification for managing the sharing of documents between any healthcare enterprise, ranging from a private physician office to a clinic to an acute care in-patient facility and personal health record systems. This is managed through federated document repositories and a document registry to create a longitudinal record of information about a patient within a given clinical affinity domain. These are distinct entities with separate responsibilities:

A Document Repository is responsible for storing documents in a transparent, secure, reliable and persistent manner and responding to document retrieval requests.
A Document Registry is responsible for storing information about those documents so that the documents of interest for the care of a patient may be easily found, selected and retrieved irrespective of the repository where they are actually stored.
Documents are provided by one or more Document Sources
They are then accessed by one or more Document Consumers

The Cross-Enterprise Document Sharing (XDS) Integration Profile:

assumes that the enterprises belong to one or more XDS Affinity Domains. An XDS Affinity Domain is a group of healthcare enterprises that have agreed to work together using a common set of policies and share a common infrastructure.

Examples of XDS Affinity Domains include:

Community of Care supported by a regional health information organizations in order to serve all patients in a given region.
Nationwide EHR
Specialized or Disease-oriented Care

Cardiology Specialists and an Acute Cardiology Center
Oncology network
Diabetes network

Federation of enterprises

A regional federation made up of several local hospitals and healthcare providers

Government sponsored facilities (e.g., VA or Military)
Insurance Provider Supported Communities

The concept of a document in XDS is not limited to textual information. As XDS is document content neutral, any type of clinical information without regard to content and representation is supported. This makes the XDS IHE Integration Profile equally able to handle documents containing simple text, formatted text (e.g., HL7 CDA Release 1), images (e.g., DICOM) or structured and vocabulary coded clinical information (e.g., CDA Release 2, CCR, CEN ENV 13606, DICOM SR). In order to ensure the necessary interoperability between the document sources and the document consumers, the XDS Affinity Domain must adopt policies concerning document format, structure and content.

Relevance to Active and Healthy Ageing: Medium

Older Person Specific: No

Usage / Adoption status: IHE Profile endorsed by European Commission for Public Procurement


This IHE Profile is an essential building block in establishing interoperable digital tools in support of healthcare, thereby supporting seamless integrated healthcare for all generations incl. the elderly. This IHE Profile is mentioned in COMMISSION DECISION (EU) 2015/1302 of 28 July 2015 on the identification of ‘Integrating the Healthcare Enterprise’ profiles for referencing in public procurement (see Official Journal of the European Union, L199/43): (7) On 2 October 2014, the European multi-stakeholder platform on ICT standardisation evaluated 27 ‘Integrating the Healthcare Enterprise’ (IHE) profiles against the requirements set out in Annex II to Regulation (EU) No 1025/2012 and gave a positive advice to their identification for referencing in public procurement. The evaluation of the 27 IHE profiles was subsequently submitted to consultation of the eHealth network established by Article 14 of Directive 2011/24/EU of the European Parliament and of the Council (2) that confirmed the positive advice to their identification. (8) IHE develops ICT technical specifications in the field of healthcare information technology. The 27 IHE profiles are detailed specifications developed over a period of 15 years within the committees of IHE that optimise the selection of well-established standards describing the different layers of interoperability (i.e. protocol communication, technical, syntactical, semantic and application levels) with a view to find interoperability solutions for exchanging or sharing medical data. (9) The 27 IHE profiles have the potential to increase interoperability of eHealth services and applications to the benefit of patients and medical community. The 27 IHE profiles should therefore be identified as ICT technical specifications eligible for referencing in public procurement.

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