The Cross-Enterprise Document Workflow (XDW) profile enables participants in a multi- organizational environment to manage and track the tasks related to patient-centric workflows as the systems hosting workflow management applications coordinate their activities for the health professionals and patients they support. XDW builds upon the sharing of health documents provided by other IHE profiles such as XDS, adding the means to associate documents conveying clinical facts to a patient-specific workflow. XDW provides a common interoperability infrastructure upon which a wide range of specific workflow definitions may be supported. It is designed to support the complexity of health services delivery with flexibility to adapt as workflows evolve.