IHE Concrete Implementation Case 3

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Concrete Implementation Workgroup > IHE Implementation Development Team > IHE Concrete Implementation Case 3

Provider to PHR

This case shows the communications between a provider with minimal IT capabilities and a PHR system. The Source uses simple SMTP with a CCD as the attachment.


The roles will be played by an e-mail client (Source), Combined effort by GE and MedAllies as the Source HISP, and Epic as the combined Destination HISP / Destination.


The Source for this scenario is any off the shelf email client capable of being configured with an NHIN Direct-specific account specifying an NHIN Direct SMTP endpoint host and port.

Source HISP

The Source HISP in the scenario is actually implemented in two separate parts. Since our Source HISP is also capable of receiving messages from direct XDR Sources we chose to implement the SMTP demo by simply placing an SMTP to XDR Adapter in front of the same XDR Source HISP endpoint we used in our Case 1 scenario.

Source Configuration

For this demo an e-mail client will need to be configured to point to the SMTP port of the Source HISP. Most e-mail clients allow mutliple accounts each with their own SMTP server configuration.
  1. Create a new e-mail account in your mail client with an easy to recognize name like NHINDirect
  2. Set the SMTP host to ec2-67-202-41-168.compute-1.amazonaws.com
  3. Set the SMTP port to 2525

When sending a CDA attachment the CDA header itself will determine the patient identity and other XDS metadata used. For this demonstration there are some constraints on the patient identifier domains and id format for our demonstration Source HISP, but in a production environment enforcement of such constaints would be HISP-specific. For this demo try using the sample CDA instance(s) below when adding your attachment.

HITSP C32 V2.5 Patient Summary

Troubleshooting SMTP Endpoint IHE Adapter

For this demo the SMTP Source HISP Adapter is deployed as an Apache James Mailet hosted on the Amazon EC2 Cloud. This Apache James SMTP server receives SMTP mail messages, translates them to XDR and passes them directly to the MedAllies Source HISP XDR endpoint for further routing. This step IS NOT part of the demo and represents an internal interface between the adapter and the the XDR routing function of the Source HISP. The mechanism happens to use XDR (just as the HISP-HISP communication does) but this was merely and expedient demo design choice. A production system may separate concerns differently.
As a result there is a communication hop between the SMTP=>XDR adapter and the rest of the Source HISP's XDR handing function that can be a point of failure. After sending your SMTP message to the SMTP endpoint you may check the SMTP Adapter Logs here to look for problems.

Test Data

In order to test this implementation, we will use the following data
Source (aka authorPerson)

NHIN Address

Harry Winston
NHIN-Direct health address&

Destination (aka Intended Recipient)

NHIN Address

Brock Skellington


NHIN-Direct health address&

Patient Information

Brock Skellington
11235 Fibonacci Circle Madison WI 53719

This page is part of the IHE Implementation Development Team work