Convert your FHIR JSON -> XML and back here. The CDA Book is sometimes listed for Kindle here and it is also SHIPPING from Amazon! See here for Errata.

Wednesday, January 6, 2010

Where in the World is XDS

This post is sparked in part from comments made at a recent US Federal Advisory Committee meeting on Healthcare IT where one person was reported to have asked:  "Where is XDS used?", and in part from an industry analyst who asked the same question.

The Google Map below shows just some of the places that XDS is being used today. This map is a work in progress.  I'm still recieving requests from people who want to update it (if you want to become a collaborator, e-mail me).

The map currently shows those institutions where an XDS infrastructure is being used to connect provider organizations to other healthcare providers. It does not yet show the geographic regions covered by these implementations (except in one case). Some of these HIEs cover areas as small as a single community and others an entire state, region or even whole country.  This map doesn't cover every XDS implementation in the world, only the ones that I and others have knowledge of.

View Where in the World is XDS/XCA in a larger map

This map originated in a presentation given four years ago at an IHE event, and has since become one of the most reused slides in IHE until now.  I hope the Google Map takes its place going forward. You can see how the map has morphed through the hands of several presenters with access to different and more recent information below. The slides just highlight some of the more well known XDS implementation in the world, they don't cover all of them.  There are a large number of places where providers don't even know that XDS is in use, which is exactly as it should be, and which sometimes makes it difficult to track.

December 2006
May 2008
August 2009
My original notes on these implementation were dated when I transferred them to the Google map, but other collaborators are now updating the details on XDS implementations in their regions. 

The next time someone asks the question, "Where is XDS used?", feel free to point them to this map.  If they happen to be from the US, you might also point them to two webinars HITSP gave on this topic over the past year.  The first discusses real world HIE sites that are using the HITSP specifications in production today.  The other describes the work of the NHIN implementation projects which also use XDS (and appears on the May 2008 slide above).

    -- Keith


  1. My next map will be called 'Where in the World is CDA?'

  2. I put them both on the same map since there is so much overlap.

  3. UMCG (Universitary Medical Center Groningen) in the Netherlands uses CDA and XDS.b and XDS.I.

    The XDS.b registry is virtual. When a DocumentConsumer request the list of documents for a specific patient, several non XDS registries are queried. The results are combined and mapped to XDS. Which registries are queries is controled by the parameters of a StoredQuery.

  4. Hi Keith. I'm a Java developer with basically no experience in health records exchange and I'll be starting a contract to implement some of the XSD.b profile soon. I dont even know what I don't know. Can you point me towards some super high-level books, sites, blogs, etc. that might give me the 900-foot view of what this is all about? I've downloaded the PDF spec and started perusing it, but I want to understand fully, why the spec was even created and what the typical use-cases are before I dig in too deeply on the pure technical spec. Thanks for any help you can provide.


  5. Terry, No books that I know of yet, but as for rationale, this is probably the best explanation as to why it was created. It fills a need.

  6. This is a great post and enjoy the look of your blog very much. Thanks for sharing.