Difference between revisions of "Patient Care Workflow"
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==2. The Problem== | ==2. The Problem== | ||
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| + | Chronic disease care delivery requires continuous coordination of the activities of multiple healthcare providers in multiple settings. A patient may see multiple specialist doctors and other clinicians on a recurrent basis along with a Primary Care Provider (PCP). Many patients have more than one chronic problem in additional to acute episodes. In the current, fragmented health care delivery system, each of a patient’s providers may be unaware of other providers that are treating the patient. Testing and therapies are often duplicated, resulting in unnecessary costs and risks to the health of the patient. Lack of coordination can also result in failure to follow-up on the delivery of ordered services, again adding risk to the patient’s health. In some cases, multiple providers receive copies of reports of services performed, such as laboratory tests, but this can cause confusion among providers over who is primarily responsible for addressing the results. | ||
An emerging approach to coordination of health care delivery is intended to address these problems as well as providing additional benefits to the entire system. This approach is commonly called the Patient-Centered Medical Home (PCMH). In this approach, the patient selects a provider who serves as the patient’s medical home. This provider is responsible for keeping track of all of the care a patient is receiving from all of the clinicians with which the patient deals. This model is the very kernel of the activities which the IHE Patient Care Coordination Domain aspires to facilitate. | An emerging approach to coordination of health care delivery is intended to address these problems as well as providing additional benefits to the entire system. This approach is commonly called the Patient-Centered Medical Home (PCMH). In this approach, the patient selects a provider who serves as the patient’s medical home. This provider is responsible for keeping track of all of the care a patient is receiving from all of the clinicians with which the patient deals. This model is the very kernel of the activities which the IHE Patient Care Coordination Domain aspires to facilitate. | ||
Revision as of 12:57, 4 November 2007
1. Proposed Profile: Patient Care Workflow
- Proposal Editor: Kboone
- Profile Editor: TBD
- Date: N/A (Wiki keeps history)
- Version: N/A (Wiki keeps history)
- Domain: PCC
2. The Problem
Chronic disease care delivery requires continuous coordination of the activities of multiple healthcare providers in multiple settings. A patient may see multiple specialist doctors and other clinicians on a recurrent basis along with a Primary Care Provider (PCP). Many patients have more than one chronic problem in additional to acute episodes. In the current, fragmented health care delivery system, each of a patient’s providers may be unaware of other providers that are treating the patient. Testing and therapies are often duplicated, resulting in unnecessary costs and risks to the health of the patient. Lack of coordination can also result in failure to follow-up on the delivery of ordered services, again adding risk to the patient’s health. In some cases, multiple providers receive copies of reports of services performed, such as laboratory tests, but this can cause confusion among providers over who is primarily responsible for addressing the results.
An emerging approach to coordination of health care delivery is intended to address these problems as well as providing additional benefits to the entire system. This approach is commonly called the Patient-Centered Medical Home (PCMH). In this approach, the patient selects a provider who serves as the patient’s medical home. This provider is responsible for keeping track of all of the care a patient is receiving from all of the clinicians with which the patient deals. This model is the very kernel of the activities which the IHE Patient Care Coordination Domain aspires to facilitate.
Successful coordination of a patient’s health care can not be accomplished without IT support for the key workflow steps involved. The patient’s medical home will need the capability to track all of the patient’s providers and all of their care activities. The medical home will also have to serve as a communications hub among all of the patient’s providers, ensuring that each is aware of relevant actions by others. Finally, each provider of care to the patient will need the capability of automatically informing the medical home of actions involving the patient.
3. Key Use Case
"I am ordering something that I can’t do myself, and I what to know what happens . . ."
- Primary Care Provider (PCP) sends order for consult and summary report to Specialist 1.
- Specialist 1 requests additional information from PCP.
- PCP responds with additional information.
- Specialist 1 orders tests.
- Specialist 1 receives results and forwards them to PCP with update note.
- Specialist 1 sends order for consult and summary report to Specialist 2.
- Specialist 1 sends summary report and note to PCP.
- Specialist 2 requests additional information from Specialist 1.
- Specialist 1 responds with additional information.
- Specialist 2 sends report to Specialist 1.
- Specialist 1 sends copy of report and note to PCP.
4. Standards & Systems
Systems
- EHR Systems
- Practice Management Systems
- HIS Systems
- ADT Systems
Standards
- HL7 Version 2.X
- HL7 Version 3.X
- HL7 CDA Release 2.0
- ASTM/HL7 Continuity of Care Document
- Web Services
- SOAP
- HTTP
- DNS
- SMTP
- MIME
- S/MIME
5. Discussion
The workflow for exchange of information between providers needs to address:
- Ordering
- Scheduling
- Communications between Providers
- Task Lists
- Reporting
IHE would be a good venue to solve this problem because it reflects a need to support the integration of several standards together.