Difference between revisions of "ECON Query Profile"

Revision as of 21:36, 24 October 2007

1. Proposed Profile: Automotive ECON Query Profile for Emergency Responders

Proposal Editor: Lawrence Williams
Profile Editor: Lawrence Williams
Date: N/A (Wiki keeps history)
Version: N/A (Wiki keeps history)
Domain: IT Infrastructure

Summary

There is consensus among the emergency healthcare community that the widespread adoption of health information technology by the automotive industry will lead to safer, more effective health care for crash victims following a motor vehicle traffic crash. The quid pro quo for investing in such systems is the improvement of patient care and safety for the 250,000 crash victims (6,000,000 worldwide) who sustain life-threatening injures annually as a result of motor vehicle crashes.

Specifically, there is a challenge is to get crash victim-specific health information, [e.g.; Emergency Contact / Next-Of-Kin (ECON) data and/or Personal Health Record (PHR) info.], into the hands of on-site emergency responders quickly and securely to support a fully interoperable and mutually supportive response through the continuum of emergency healthcare.

The relevant standard is (IHE PDQ). The CD-TC working on HITSP’s Emergency Responder Use Case has discussed the possibility of a simple IHE PDQ NOK/Emergency Contact extension that would enable emergency responders (Patient Demographics Consumer) to query / retrieve emergency contact / next-of-kin data from a national ECON directory (Patient Demographics Supplier) of motor vehicle owner emergency contact information.

2. The Problem

Contrary to popular belief, emergency responders cannot quickly gain access to a motor vehicle crash victim emergency contact and/or next-of-kin data following a traffic crash, especially in immediacy-type situations.

Typically, emergency responders resort to searching personal belongings (e.g. wallet, glove compartment, cell phone, etc.) for leads to the identity of an emergency contact and/or next-of-kin. Still, many instances involve obstacles, such as unlisted phone numbers which might require a warrant for release in certain jurisdictions. Meanwhile, hours elapse as family members are not notified and crash victims enter the emergency healthcare system without the benefit of family members to advocate on their behalf and/or provide added-value information (medical history, medications, allergies) to enhance the medical care and safety of crash victims.

3. Key Use Case

Due to the absence of an IHE PDQ NOK/Emergency Contact query process enabling on-site emergency responders (Patient Demographics Consumer) to rapidly and securely access the ECON directory (Patient Demographics Supplier), the CD-TC working on HITSP’s Emergency Responder Use Case has listed the ECON query as a capability GAP and is currently seeking the assistance of an appropriate SDO to help harmonize a standard for the ECON query process. The CE-TC has discussed several possibilities for standard harmonization, including the creation of a simple PDQ NOK/Emergency Contact extension for the ECON directory.

The CD-TC believes IHE is the most logical SDO environment to provide the standard harmonization, detailed implementation and testing process (i.e.; 2009 Connectathon) critical for the ECON directory validation and standards-based interoperability for the Emergency Responder Use Case.

The following CD-TC Emergency Responder Use Case workflow and associated sequence diagram explain the emergency responder requirements for the ECON directory as it relates to on-site care at the scene of a motor vehicle crash:

1. On-Site care providers (police, EMS, fire) arrive.
2. Crash victim is seriously injured and unconscious. EMS focus is on the delivery of medical care and police are responsible for confirming the identity of the unidentified crash victim and notifying an emergency contact / next-of-kin.
3. Police query an automotive-based Emergency Contact Registry (ECON) [6.1.3.1 – GAP]. The ECON query is successful and police are able to obtain the motor vehicle owner emergency contact name(s) and phone number(s) to assist with crash victim identification, expedite family member reunification and next-of-kin notification
4. Crash victim identification is confirmed, police pass the crash victim ID information to EMS. EMS sends a query to a Patient Identification Service (PID Service) to determine the crash victim’s ID for the Personal Health Record (PHR) and/or Electronic Health Record (EHR) [HITSP Patient ID Cross-Referencing Transaction Package (HITSP/TP22) (IHE PIX Query). After obtaining the proper ID for the PHR/EHR, EMS queries/retrieves the needed documents [6.1.3.1 – HITSP Manage Sharing of Documents Transaction Package (HITSP/TP13) (IHE XDS)

4. Standards & Systems

The relevant standard is (IHE PDQ). The CD-TC has discussed the possibility of a simple IHE PDQ NOK/Emergency Contact extension that would enable emergency responders (Patient Demographics Consumer) to query / retrieve emergency contact / next-of-kin data from the ECON directory (Patient Demographics Supplier) of motor vehicle owner emergency contact information.

5. Technical Approach

An operationally logical technical approach to this problem is possible today because of the existence of a North America-wide secure multi-directional communications network for public safety called the National Law Enforcement Telecommunications System (Nlets).

Specifically, the technical approach could work as follows: On-site emergency responders (Patient Demographics Consumer) would be able to run a NOK/Emergency Contact PDQ extension query of the ECON directory (Patient Demographics Supplier) over the Nlets network based upon the Vehicle Identification Number (VIN) and/or Registration Plate as a unique identifier. Nlets will return within seconds (provided the vehicle owner pre-registered their emergency contact / next-of-kin data with the ECON directory) vital data (i.e., emergency contact name(s) phone number(s) to help accomplish unidentified crash victim identification, next-of-kin notification and family member reunification.

This would facilitate rapid acquisition and exchange of data from the ECON directory and give possibility for emergency responders to accomplish family member notifications and reunifications in a timelier manner.

Furthermore, utilizing the same IHE PDQ NOK/Emergency Contact extension query of the ECON directory at Nlets the capability could be expanded at some point in the future to provide the authorization and authentication mechanism for emergency responders to query for a motor vehicle owner’s Personal Health Record (PHR), which has also been identified by HITSP as a capability GAP for the Emergency Responder Use Case.

Existing actors

Patient Demographics Supplier & Patient Demographics Consumer

New actors

None

Existing transactions

<Indicate how existing transactions might be used or might need to be extended.>

New transactions (standards used)

<Describe possible new transactions (indicating what standards would likely be used for each. Transaction diagrams are very helpful here. Feel free to go into as much detail as seems useful.>

Impact on existing integration profiles

<Indicate how existing profiles might need to be modified.>

New integration profiles needed

<Indicate what new profile(s) might need to be created.>

Breakdown of tasks that need to be accomplished

<A list of tasks would be helpful for the technical committee who will have to estimate the effort required to design, review and implement the profile.>

6. Support & Resources

<List groups that have expressed support for the proposal and resources that would be available to accomplish the tasks listed above.>

7. Risks

<List technical or political risks that will need to be considered to successfully field the profile.>

8. Open Issues

<Point out any key issues or design problems. This will be helpful for estimating the amount of work and demonstrates thought has already gone into the candidate profile.>

9. Tech Cmte Evaluation

<The technical committee will use this area to record details of the effort estimation, etc.>

Effort Evaluation (as a % of Tech Cmte Bandwidth):

35% for ...

Responses to Issues:

See italics in Risk and Open Issue sections

Candidate Editor:

TBA

@@ Line 1: / Line 1: @@
-''<DO NOT EDIT THIS FILE DIRECTLY.  See '''[[:Category:Templates| Templates]]''' for instructions on using templates.>''
+==1. Proposed Profile: Automotive ECON Query Profile for Emergency Responders==
-''<Delete everything in italics and angle brackets and replace with real text>
+* Proposal Editor: Lawrence Williams
+* Profile Editor: Lawrence Williams
-==1. Proposed Profile: ''<initial working name for profile>''==
-* Proposal Editor: ''<Name of author/editor/contact for the proposal>''
-* Profile Editor: ''<Name of candidate Lead Editor for the Profile, if possible>''
 * Date:    N/A (Wiki keeps history)
 * Version: N/A (Wiki keeps history)
-* Domain: ''<Domain name, E.g. Radiology>''
+* Domain: IT Infrastructure
 ===Summary===
-''<Summarize in a few lines the existing problem . E.g. "It is difficult to monitor radiation dose for individual patients and almost impossible to assemble and compare such statistics for a site or a population.">''
+There is consensus among the emergency healthcare community that the widespread adoption of health information technology by the automotive industry will lead to safer, more effective health care for crash victims following a motor vehicle traffic crash.
+The quid pro quo for investing in such systems is the improvement of patient care and safety for the 250,000 crash victims (6,000,000 worldwide) who sustain life-threatening injures annually as a result of motor vehicle crashes.
-''<Demonstrate in a line or two that the key integration features are available in existing standards. E.g. "DICOM has an SR format for radiation dose events and a protocol for exchanging them.">''
+Specifically, there is a challenge is to get crash victim-specific health information, [e.g.; Emergency Contact / Next-Of-Kin (ECON) data and/or Personal Health Record (PHR) info.], into the hands of on-site emergency responders quickly and securely to support a fully interoperable and mutually supportive response through the continuum of emergency healthcare.
-''<Summarize in a few lines how the problem could be solved.  E.g. "A Radiation Dose profile could require compliant radiating devices to produce such reports and could define transactions to actors that collect, analyze and present such information.">''
-''<Summarize in a line or two market interest & available resources.  E.g. "Euratom and ACR have published guidelines requiring/encouraging dose tracking.  Individuals from SFR are willing to participate in Profile development.">''
-''<Summarize in a line or two why IHE would be a good venue to solve the problem.  E.g. "The main challenges are dealing with the chicken-and-egg problem and avoiding inconsistent implementations.">''
+The relevant standard is (IHE PDQ).  The CD-TC working on HITSP’s Emergency Responder Use Case has discussed the possibility of a simple IHE PDQ NOK/Emergency Contact extension that would enable emergency responders (Patient Demographics Consumer) to query / retrieve emergency contact / next-of-kin data from a national ECON directory (Patient Demographics Supplier) of motor vehicle owner emergency contact information.
 ==2. The Problem==
-''<Summarize the integration problem. What doesn’t work, or what needs to work.>''
+Contrary to popular belief, emergency responders cannot quickly gain access to a motor vehicle crash victim emergency contact and/or next-of-kin data following a traffic crash, especially in immediacy-type situations.
+Typically, emergency responders resort to searching personal belongings (e.g. wallet, glove compartment, cell phone, etc.) for leads to the identity of an emergency contact and/or next-of-kin.  Still, many instances involve obstacles, such as unlisted phone numbers which might require a warrant for release in certain jurisdictions.  Meanwhile, hours elapse as family members are not notified and crash victims enter the emergency healthcare system without the benefit of family members to advocate on their behalf and/or provide added-value information (medical history, medications, allergies) to enhance the medical care and safety of crash victims.
 ==3. Key Use Case==
-''<Describe a short use case scenario from the user perspective.  The use case should demonstrate the integration/workflow problem.>''
+Due to the absence of an IHE PDQ NOK/Emergency Contact query process enabling on-site emergency responders (Patient Demographics Consumer) to rapidly and securely access the ECON directory (Patient Demographics Supplier), the CD-TC working on HITSP’s Emergency Responder Use Case has listed the ECON query as a capability GAP and is currently seeking the assistance of an appropriate SDO to help harmonize a standard for the ECON query process.  The CE-TC has discussed several possibilities for standard harmonization, including the creation of a simple PDQ NOK/Emergency Contact extension for the ECON directory.
-''<Feel free to add a second use case scenario demonstrating how it “should” work.  Try to indicate the people/systems, the tasks they are doing, the information they need, and hopefully where the information should come from.>''
+The CD-TC believes IHE is the most logical SDO environment to provide the standard harmonization, detailed implementation and testing process (i.e.; 2009 Connectathon) critical for the ECON directory validation and standards-based interoperability for the Emergency Responder Use Case.
-<To focus on the end user requirements, and not just the solution mechanism, and to give people trying to understand the applications concrete examples of the problems existing and the nature of the solution required.  State the problem domain and outline the workflows in terms of the people, tasks, systems and information involved.  Feel free to describe both the current “problematic” workflow as well as a desirable future workflow where appropriate. Remember that other committee members reviewing the proposal may or may not have a detailed familiarity with this problem.  Where appropriate, define terms.>
+The following CD-TC Emergency Responder Use Case workflow and associated sequence diagram explain the emergency responder requirements for the ECON directory as it relates to on-site care at the scene of a motor vehicle crash:
+*1.	On-Site care providers (police, EMS, fire) arrive.
+*2.	Crash victim is seriously injured and unconscious.  EMS focus is on the delivery of medical care and police are responsible for confirming the identity of the unidentified crash victim and notifying an emergency contact / next-of-kin.
+*3.	Police query an automotive-based Emergency Contact Registry (ECON) [6.1.3.1 – GAP].  The ECON query is successful and police are able to obtain the motor vehicle owner emergency contact name(s) and phone number(s) to assist with crash victim identification, expedite family member reunification and next-of-kin notification
+*4.	Crash victim identification is confirmed, police pass the crash victim ID information to EMS.  EMS sends a query to a Patient Identification Service (PID Service) to determine the crash victim’s ID for the Personal Health Record (PHR) and/or Electronic Health Record (EHR) [HITSP Patient ID Cross-Referencing Transaction Package (HITSP/TP22) (IHE PIX Query).  After obtaining the proper ID for the PHR/EHR, EMS queries/retrieves the needed documents [6.1.3.1 – HITSP Manage Sharing of Documents Transaction Package (HITSP/TP13) (IHE XDS)
 ==4. Standards & Systems==
-''<List existing systems that are/could be involved in the problem/solution.>''
+The relevant standard is (IHE PDQ).  The CD-TC has discussed the possibility of a simple IHE PDQ NOK/Emergency Contact extension that would enable emergency responders (Patient Demographics Consumer) to query / retrieve emergency contact / next-of-kin data from the ECON directory (Patient Demographics Supplier) of motor vehicle owner emergency contact information.
-''<List relevant standards, where possible giving current version numbers, level of support by system vendors, and references for obtaining detailed information.>''
+==5. Technical Approach==
+An operationally logical technical approach to this problem is possible today because of the existence of a North America-wide secure multi-directional communications network for public safety called the National Law Enforcement Telecommunications System (Nlets).
-==5. Technical Approach==
+Specifically, the technical approach could work as follows:  On-site emergency responders (Patient Demographics Consumer) would be able to run a NOK/Emergency Contact PDQ extension query of the ECON directory (Patient Demographics Supplier) over the Nlets network based upon the Vehicle Identification Number (VIN) and/or Registration Plate as a unique identifier. Nlets will return within seconds (provided the vehicle owner pre-registered their emergency contact / next-of-kin data with the ECON directory) vital data (i.e., emergency contact name(s) phone number(s) to help accomplish unidentified crash victim identification, next-of-kin notification and family member reunification.
-''<This section can be very short but include as much detail as you like.  The Technical Committee will flesh it out when doing the effort estimation.>''
-''<Outline how the standards could be used/refined to solve the problems in the Use Cases.  The Technical Committee will be responsible for the full design and may choose to take a different approach, but a sample design is a good indication of feasibility.>''
+This would facilitate rapid acquisition and exchange of data from the ECON directory and give possibility for emergency responders to accomplish family member notifications and reunifications in a timelier manner.
-''<If a phased approach would make sense indicate some logical phases.  This may be because standards are evolving, because the problem is too big to solve at once, or because there are unknowns that won’t be resolved soon.>''
+Furthermore, utilizing the same IHE PDQ NOK/Emergency Contact extension query of the ECON directory at Nlets the capability could be expanded at some point in the future to provide the authorization and authentication mechanism for emergency responders to query for a motor vehicle owner’s Personal Health Record (PHR), which has also been identified by HITSP as a capability GAP for the Emergency Responder Use Case.
 ===Existing actors===
-''<Indicate what existing actors could be used or might be affected by the profile.>''
+Patient Demographics Supplier & Patient Demographics Consumer
 ===New actors===
-''<List possible new actors>''
+None
 ===Existing transactions===