The Patient Choice Project
Use Case Working Session
February 12th, 2016
Call Logistics
• If you are not speaking, please keep your phone on mute
• Do not put your phone on hold – if you need to take a call, hang up and dial
in again when finished with your other call
• This meeting is being recorded
• Feel free to use the “Chat” feature for questions, comments or any items
you would like the moderator or participants to know
2
Agenda
Topic
Time Allotted
General Announcements
5 minutes
Pre/Post Conditions
5 minutes
Use Case Document Review
5 minutes
Review “PULL” Use Case Scenarios
• Updated Activity Diagrams
• Finalized Functional Requirements
• Finalized Sequence Diagrams
15 minutes
Revised Push Scenarios
• Notational Diagrams
• Functional Requirements
• Activity Diagrams
25 minutes
Next Steps/Questions
5 minutes
3
General Announcements
• The Patient Choice project will meet weekly on Fridays @ 11 am ET
» The next working group meeting will be on Friday, February 19th , 2016 at 11
am ET
4
Phase 1 - Timeline
(Today)
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
July
Aug
Sept
Oct
Nov
Use Case Working Group Kick Off Session
Review and development of formal use cases
Kick Off Pilot Activities
Conduct Pilots Needs Assessment
Begin Pilot Work
Develop Best Practices IG
Draft Basic Choice
Standard
5
6
Proposed Use Case & Functional
Requirements Development Timeline
Week
Target Date
Working Session Tasks
Review and Provide Comments via
Confluence (due Thursdays @ 11 am ET)
6
1/29
Review: Finalized Pre/Post Conditions, PULL Base Flows
and Information Interchange Requirements
Introduce: PULL Activity Diagrams
Review: PULL Base Flows and
Information Interchange Requirements,
and Activity Diagrams
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2/5
Review: Finalized PULL Base Flows and Information
Interchange Requirements and Activity Diagrams.
Introduce: Revised PUSH User Stories and PULL Functional
Requirements & Sequence Diagram,
Review: Revised PUSH User Stories and
PULL Functional Requirements &
Sequence Diagram
8
2/12
Review: Scenario 5: Activity Diagram and Sequence
Diagram
Introduce: Scenarios 1 and 2
Review: All Scenarios flows and
Diagrams
9
2/19
Review: Finalized Scenarios
Introduce: Dataset Considerations and Risks and Issues
Review: Dataset Considerations and
Risks and Issues
10
2/26
Review: Dataset Considerations and Finalized Risk and
Issues
End-to-end Review
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Section Review
• 1. Discuss and review the following sections:
» Pre/Post Conditions
» PUSH User Stories
– Notational Diagrams
Click the icon to
open the
Word Document
– Base Flows
– Functional Requirements
– Activity Diagrams
» PULL User Stories
–
Activity Diagrams
–
Functional Requirements
–
Sequence Diagram
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Pre-Conditions and Post-Conditions
•
•
Pre Conditions
•
Mechanisms are in place for handling missing or not yet recorded Patient preferences for data
sharing
•
Mechanisms are in place for systems having Patient data have to enforce the appropriate legal
and policy requirements
•
Mechanisms are in place to comply with Privacy Consent Directives and subsequent handling
instructions
•
Requesting system has a pre-existing relationship with the patient for which it requesting data
for
•
All of the patient data is available for a potential query with exception to what is limited by a
patients consent directive
Post Conditions
•
Receiving system complies with ongoing obligations
•
Sending and receiving systems have recorded the transactions in their security audit records
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Push Scenario 1 - Provider pushes Consent Directive to Consent Directive
Repository
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Push Scenario 1 - Provider pushes Consent Directive to Consent Directive
Repository
User Story 1
•
Context
» Alice’s PCP participates in the local HIO
» Alice consents to her PCP sharing all of her records with other providers for Treatment through
the HIO
» The HIO accesses patient consent directives through an affiliated Consent Directive Repository
•
User Story
•
Alice recently moved to a new state and finds a new PCP.
•
Her PCP wants to refer her to a Specialist.
•
The PCP tells Alice about the local HIO and explains how the HIO enables her PCP to share her
health information quickly and securely with this Specialist versus the alternative of using fax or
mailing paper copies.
•
Alice is comfortable with sharing her health information through the HIO for treatment
purposes, so she signs the HIO opt-in consent directive.
•
Alice’s PCP pushes Alice’s consent directive to the HIO’s affiliated Consent Directive Repository.
•
Alice’s PCP makes a referral to her Specialist and informs the Specialist that Alice has consented
to sharing her health information through the HIO.
•
Alice’s Specialist is now able to request health information from the HIO. [Go to PULL use case.]
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Push Scenario 1 - Provider pushes Consent Directive to Consent Directive
Repository
User Story 2(Change Of Mind)
• Alice has signed an opt-in consent directive, allowing the exchange of health
information through the HIE to participating providers. Alice has been receiving
care from a specialist, who is an authorized HIE participant. Alice decides she no
longer wants her health information disclosed to other providers participating in
the HIE. She signs an HIE opt-out consent directive. The specialist pushes Alice’s
opt-out consent directive to the HIE (shown at ①). The HIE replaces her
current opt-in consent directive stored in the consent system with Alice’s optout consent directive (shown at ①), The providers participating in the HIE are
now no longer able to receive Alice’s health information .
•
Alice already had an opt-in in the previous story, if this is a continuation, she
would then opt-out - possibly because she no longer wants the treatment given
by the specialist known to other providers using the HIE.
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Push Scenario 1 - Provider pushes Consent Directive to Consent Directive
Repository
User Story 2
1
Clinical IT
System
Health Information
Exchange
2
Consent
System
HIE Security Domain
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Push Scenario 2 - Provider pushes Consent Directive to HIO and Immunization
Registry
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Push Scenario 2 - Provider pushes Consent Directive to HIO and Immunization
Registry
User Story 1
• User Story 1
• State residents are required to receive immunizations unless the resident
receives a medical or religious exemption. All immunizations must be reported
to the state immunization registry. The Greater Regional Health Information
Exchange (GRHIE) is allowed to access an individual's state immunization
records only if the individual has electronically consented to the sharing of their
state immunization record.
• Patient X has just moved into the Greater Regional area and is receiving an
examination from Dr. Able prior to attending a public school. Patient X is
uncertain which immunizations he may have received while living in another
part of the state. Dr. Able is unable to access Patient X's state immunization
records through GRHIE because there is no consent on file. With the agreement
of Patient X, Dr. Able enters the consent of Patient X on a portal that
communicates the consent to GRHIE. GRHIE records the consent and
electronically sends the consent to the state immunization registry.
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Push Scenario 2 - Provider pushes Consent Directive to HIO and Immunization
Registry
User Story 1
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Next Steps
• Review and provide feedback to posted materials: Push and Pull Scenarios
by the following Thursday at 11am ET
» http://confluence.siframework.org/display/PATCH/Use+Case+Development
• Next meeting is Friday, February 19th , 2016 at 11 am ET
• Reminder: All Patient Choice Announcements, Schedules, Project Materials,
and Use Case will be posted on the Patient Choice Confluence page
» http://confluence.siframework.org/display/PATCH/
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Project Contact Information
OCPO-ONC Lead
Jeremy Maxwell
[email protected]
Project Coordinator
Johnathan Coleman
[email protected]
Project Manager
Ali Khan
[email protected]
Project Support
Taima Gomez
[email protected]
Staff SME
Kathleen Connor
[email protected]
Staff SME
David Staggs
[email protected]
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Thank you for joining!
@ONC_HealthIT
@HHSONC