Use Cases
Our overall goal is to develop a reference set of use cases that can support needs of multiple stakeholders.
Personal Health Communication
For example, Care Record Summaries provided to Person or Person's agent (i.e. health record bank). Perhaps should incorporate RHIO's as intermediaries for Person.
Transfer of Care
Transition between care settings and/or care providers
Coordination of Care
Coordination of Care across multiple providers, i.e. shared care
Health Management
Chronic Care Management, Health Monitoring, longitudinal care coordination
Interdisciplinary Care
Sharing of information across interdisciplinary care teams within a care network or provider.
Orders/Consultations
Provision of health record summaries in context of requesting tests, evaluations and other orders. distinguished from transfer and coordination of care because service request does not assume transfer or shared oversight of care. Should we rename as Request Consultation/Prescription?
Administrative Uses
Attachments (Billing), Pre-certification
System Uses
Synchronize health information across an organization's systems
Present views and summaries of health information to caregivers
Research Uses
Communication of deidentified health information for research purposes.(Completed by A. Richard)
Addendum, to be incorporated above
Issues to Address
How to organize?
How many specific "representative use cases" do we need for an area.
Incorporation of boomerang
Comments:
1. The "Personal Health Advocacy and Management" use case is not populated. This seems to be a unique use case in comparison to the other use cases on the list. For example, the exchange of assessments or specific functional status assessment results from providers to a PHR would enable to the individual to create and maintain what could effectively become the longitudinal patient record.
2. The specific use case for “Transfer from Nursing Home to Hospital Use Case” about Mrs. L describes a person with some chronic problems and an acute/emergent event that requires hospitalization. It is unclear to me what the relationship is between the assessments in the catalogue and this use case.
For example, in this use case there is no reference to the completion of date of the MDS. In this instance, transfer of an entire MDS assessment that may have been completed as long as 88 days earlier, may not reflect information about Mrs. L’s current health, functional, and cognitive status. Further, in a study on HIE, receiving ERs indicate that they do not want or need complete assessment forms. Instead they want/need only pertinent clinical data. ERs indicate that receiving “superfluous” information does not fit into the ER workflow.
Is this use case about populating the CCD with pertinent (and current) health and functional status observations extracted from clinical/progress notes in an EHR?
3. The list of use cases does not include a use case on transfer from nursing home to home with home health. This would be a different use case than those otherwise included. In this instance, both providers are required to use different assessment instruments that contain similar, but not comparable content. The receiving setting would like to receive the complete assessment from the referring/sending provider. Exchanging standardized assessments would enable (i) standardized information exchange (including use of CCD), and (ii) re-use of assessment content (e.g., assisting in the production of the assessment in receiving setting), and could improve continuity and quality of care, and increase efficiencies.
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