Patient Care Workflow

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

Presently, there is no established and uniform mechanism for the interchange of orders for consultations or referals across organizational boundaries. As part of this problem, information about where the patient's medical home also needs to be communicated, to facilitate communication between the consulting provider with the patient's primary care team. Along the way, various communications need to occur between specialists, treating physicians, and the patient's primary care team. These communications are often relatively simple requests, which should be able to be automated via modest workflow.

3. Key Use Case

"I am ordering something that I can’t do myself, and I what to know that 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 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.