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Spotlight PEPPOL BIS Billing 3.0 The EU e-invoicing mandate is here — France Sept 2026, Belgium Jan 2026, Germany 2025.

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Foundations

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Standards

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Flagship messages

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Tools

IHE-XCA

IHE XCA cross-community gateway federated XDS query.

Definition

IHE XCA architecture: (1) Initiating Gateway: entity initiates cross-community document query, located in requesting community. (2) Responding Gateway: entity that responds to cross-community query, located in document-holding community, federated forwards to local XDS Registry + Repository. (3) Transactions: ITI-38 Cross-Gateway Query (extends ITI-18 Registry Stored Query across communities), ITI-39 Cross-Gateway Retrieve (extends ITI-43 Retrieve Document Set across communities). (4) Patient identification: XCPD (Cross-Community Patient Discovery) companion profile resolves patient identity across communities. (5) Trust model: SAML 2.0 assertions for user identity + claims (purpose of use, role, organization, jurisdiction), Trust Anchors (X.509 root CAs trusted by communities). (6) Use cases: National HIE (e.g., eHealth Exchange US connects ~70+ communities including VA + DoD + SSA + multiple commercial networks), International HIE (epSOS Europe cross-border health records access), Disaster response (cross-community access during emergencies). (7) Underlying transport: SOAP/MTOM web services HTTPS, response paginated for large result sets. IHE XCA published 2007, multiple revisions. Carequality + CommonWell + eHealth Exchange + epSOS all architecturally XCA-based.

Origin

IHE XCA profile published 2007 ; foundational profile cross-community HIE architectures Carequality + CommonWell + eHealth Exchange + epSOS.

Example in context

Carequality query process: physician in Epic-using hospital queries records from Cerner-using hospital different network via Carequality bridge ; Epic Initiating Gateway issues ITI-38 Cross-Gateway Query to Cerner Responding Gateway via Carequality interconnect, Cerner Responding Gateway forwards to local Cerner XDS Registry + returns matching documents metadata, then ITI-39 Cross-Gateway Retrieve fetches actual CCDA documents.

Last updated: May 16, 2026