Exchanging Images Outside a Specific Health Information Exchange Domain

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Type	Standard / Implementation Specification	Standards Process Maturity	Implementation Maturity	Adoption Level	Federally required	Cost	Test Tool Availability
Standard	Digital Imaging and Communication in Medicine (DICOM)	Final	Production		No	Free	No
Implementation Specification	IHE Cross Community Access for Imaging (XCA-I)	Final	Pilot		No	Free	Yes
Implementation Specification	The combination of IHE-XCPD (Cross-Community Patient Discovery) and IHE-PIX (Patient Identifier Cross-Reference)	Final	Production		No	Free	Yes
Implementation Specification	IHE Portable Data for Imaging (PDI)	Final	Production		No	Free	No

Limitations, Dependencies, and Preconditions for Consideration

Applicable Security Patterns for Consideration

The IHE XCA-I profile can be found in Section 2.1.27 of the IHE Radiology (RAD) linked above.
IHE-PIX and IHE-XCPD are used for the purposes of patient matching and to support this interoperability need.
For IHE-PDI, network transfers are preferable to digital media transfers, though the latter may be used when network solutions are not in place
See IHE projects in the Interoperability Proving Ground.

Secure Message Router – securely route and enforce policy on inbound and outbound messages without interruption of delivery.
Authentication Enforcer – centralized authentication processes.
Authorization Enforcer – specifies access control policies.
Credential Tokenizer – encapsulate credentials as a security token for reuse (e.g., – SAML, Kerberos).

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