Cross Enterprise Document Share is an IHE profile which is made up of components of the IHE IT Infrastructure domain.

Link to XDS workshop (December 10th 2009 Sydney)
Link to IT Infrastructure Technical Framework
Link to Patient Care Profiles which extend XDS
Link to overview of IT Infrastructure components:
Link to Vendors with XDS capability in Australia
Locations of XDS and HL7 CDA implementations worldwide
HIC 2010 XDS scenario description

Link to XDS educational materials

XDS-I Implementation



Cross Enterprise Document Sharing (XDS) registers and shares electronic health record documents between healthcare enterprises, ranging from physician offices to clinics to acute care in-patient facilities.
Consistent Time (CT) ensures system clocks and time stamps of computers in a network are well synchronized (median error less than 1 second).

Audit Trail and Node Authentication (ATNA) describes authenticating systems using certificates and transmitting PHI-related audit events to a repository. This helps sites implement confidentiality policies.

Request Information for Display (RID) provides simple (browser-based) read-only access to clinical information (e.g. allergies or lab results) located outside the user’s current application.

Enterprise User Authentication (EUA) enables single sign-on by facilitating one name per user for participating devices and software.

Patient Identifier Cross Referencing (PIX) cross-references patient identifiers between hospitals, care sites, health information exchanges, etc.

Patient Synchronized Application (PSA) allows selection of a patient in one application to cause other applications on a workstation to tune to that same patient.

Patient Demographics Query (PDQ) lets applications query a central patient information server and retrieve a patient’s demographic and visit information.

Personnel White Pages (PWP) provides basic directory information on human workforce members to other workforce members and applications.

Cross-Enterprise Document Media Interchange (XDM) transfers XDS documents and metadata over CD-R and USB memory devices, and over email using a ZIP attachment.

Cross-Enterprise Document Reliable Interchange (XDR) provides a standards-based specification for managing the interchange of documents that healthcare enterprises have decided to explicitly exchange using a reliable point-to-point network communication.

Cross-Enterprise Sharing of Scanned Documents (XDS-SD) defines how to couple legacy paper, film, electronic and scanner outputted formats, represented within a structured HL7 CDA R2 header, with a PDF or plaintext formatted document containing clinical information.

Patient Identifier Cross-Reference and Patient Demographics Query for HL7v3 (PIX/PDQ/v3) extends the Patient Identifier Cross-Reference and Patient Demographics Query profiles leveraging HL7 version 3.

Registry Stored Query Transaction for Cross-Enterprise Document Sharing Profile adds a single transaction, Stored Query, to the XDS Profile.

Stored Query is a large improvement over the existing Query Registry transaction since it removes the use of SQL.

Retrieve Form for Data Capture (RFD) enables EHR applications to directly request forms from clinical trial sponsors and public health reporting.


Specific Document types that can be managed in XDS



These profiles represent the IHE Patient Care Coordination Domain.


Medical Summaries (MS) defines the content and format of Discharge Summaries and Referral Notes.

Exchange of Personal Health Record Content (XPHR) describes the content and format of summary information extracted from a PHR system for import into an EHR system, and visa versa.

Emergency Department Referral (EDR) allows clinicians to create electronic referrals to the emergency room including the nature of the current problem, past medical history, and medications. Upon arrival of the patient to the Emergency Department, the patient is identified as a referral, and the transfer document is incorporated into the EDIS. This profile builds on medical summaries by adding structures to pass data specific for ED referrals such as the estimated time of arrival and method of transport.

Basic Patient Privacy Consents (BPPC) enables XDS Affinity Domains to be more flexible in the privacy policies that they support by providing mechanisms to record patient privacy consents, enforce these consents, and create Affinity Domain defined consent vocabularies that identify information sharing policies.

Pre-procedural History and Physical (PPHP) describes the content and format of an electronic Preprocedural History and Physical document.

Antepartum Care Summary (APS) describes the content and format of summary documents used during antepartum care.

Functional Status Assessments (FSA) describes the content and format of Functional Status Assessments that appear within summary documents.

Emergency Department Encounter Record (EDER) describes the content and format of records created during an emergency department visit.

Query for Existing Data (QED) allows information systems to query data repositories for clinical information on vital signs, problems, medications, immunizations, and diagnostic results.


XDS Related/background Material

e-consent