The Shared Health Record (SHR) repository and its associated services are the mechanism for sharing of all person-specific clinically-relevant data not held in other domain repositories. This repository and the services that make it accessible to the EHRi are separate from the PoS applications and their local data stores. The SHR holds a copy of subsets of information captured in the PoS applications. The EHRS Blueprint does not propose mechanisms to ensure active synchronization between information in the SHR and the source PoS applications where that information is sourced. Instead, the responsibility for publication of the clinical information collected in PoS applications lies within the PoS environment and the EHR Infostructure will only become aware of a change if such a publication event occurs. Future generations of EHR Infostructure solutions may evolve to support active synchronisation mechanisms, but for now the complexity of integration and reengineering of PoS applications associated with such features is seen as a limiting factor.

The data maintained in the Shared Health Record (SHR) can grow to be very wide ranging both in terms of scope and volume. In early generations of EHR Infostructure solutions however we expect the scope of this data to be fairly limited and constrained. These limitations are largely due to the need to focus on only clinically relevant data appropriate for sharing, and on the fact that current systems are not engineered to take advantage of more advanced EHR infostructures capabilities. The early definition of this scope includes the following facets of information:

• Encounter Basic Information
• Referral Orders and Referral Notes
• Encounter Summaries
• Clinical Observations primarily focused on critical observations that impact the health status of an individual.
• Problems/Conditions/Diagnosis

As PoS applications become more EHRi-enabled, additional facets of information could include:

• Care Plans
• Care Protocols
• Client Health Status indicators including level of comfort, likelihood to die, function and severity
• And others

In this context, the following service operations allow EHR users / PoS applications to record, list and retrieve Shared Health Record repository information.

Operations
Name	Return Type
Get Encounter()
Get Encounter Summary()
Get Observation()
Get Problem / Condition / Diagnosis()
Get Referral()
Get SHR Complete Record()
List Encounters()
List Observations()
List Problems / Conditions / Diagnosis()
List Referrals()
List Relevant SHR records()
Put Clinical Observation()
Put Encounter()
Put Encounter Summary()
Put Problem / Condition / Diagnosis()
Put Referral()

Relations
Name	Type	Begins	Ends
	generalization	SHR Domain Repository Services	EHR Data and Services

Retrieves a specific encounter record with all of its supporting information.

Retrieves a specific encounter summary entry and all of its supporting information.

Retrieves a specific observation and all of its supporting information.

Retrieves a specific problem, condition or diagnosis record with all of its supporting information.

Retrieves a specific referral event and all of its supporting information.

An extended feature allowing the retrieval of the entire health record maintained in the SHR for a single client. This will return several types of data structures packaged into a single message. The criteria includes client id, date range, last record fetched bookmark and paging size value.

Searches for a range of encounter records based on a set of research criteria including client id, provider id, location id, date range, reason for admission/visit, status.

Searches for a range of observation records in the SHR based on a set of research criteria including client id, provider id, location id, observation type, date range, status.

Searches for a range of problems, conditions or diagnosis records in the SHR based on a set of research criteria including client id, provider id, location id, problem type, condition type, diagnosis type, date range, status.

Searches for a range of referral events in the SHR based a set of research criteria including client id, provider id, location id, date range, status.

An extended feature allowing for a free text search to be launched in the SHR and retrieve any record that match the criteria for a given client, provider or location. Search criteria includes client id, provider id or location id and a text string representing the search criteria as well as last record fetched bookmark and a paging size value.

Records a new observation in the SHR. Both coded and non coded entries are accepted.

Records a new encounter in the SHR with the base information that describes it including start date, planned end date, end date, status, reason for admission/visit.

Records a new encounter summary with all of its supporting information. Both coded and non-coded entries are recognised. An encounter summary should always be associated to at least one Encounter record maintained in the EHR Index.

Records either one of a problem, condition or diagnosis in the SHR. Both coded and non coded entries are accepted.

Records a new referral in the SHR with its supporting information including a type of referral, the date of the referral, referral target service, referral status.