Transcript Data types

EU-US eHealth/Health IT
Cooperation Initiative
Interoperability of EHR
Work Group
September 11, 2013
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Agenda
Topic
Time Allotted
General Announcements
5 minutes
Real World Scenarios (1-7)
50 minutes
Next Steps/Questions
5 minutes
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General Announcements
• The Interoperability of EHR Work Group meets every Wednesday from
10:00am – 11:00am ET or 4:00pm-5:00pm CEST
– To participate please see the “Weekly Meetings” Section of the EU-US
eHealth Collaboration Wiki Homepage:
http://wiki.siframework.org/EU-US+eHealth+Cooperation+Initiative
• We will be presenting our work at the EU-US eHealth Conference in
Boston, MA Oct 21-23, 2013 http://b2match.eu/eu-us-ehealthmarketplace-boston2013
Note: Please check the meeting schedule weekly
to get the most up-to-date meeting information
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Join the EU-US eHealth/Health IT
Cooperation Initiative
• We encourage all members to “sign
up” for the initiative. By joining
this ensures you stay up-to-date
with the work being done,
communications and any initiative
activities
• Simply complete the EU-US MOU
Project Signup Form on the Wiki
Page:
http://wiki.siframework.org/EUUS+MOU+Roadmap+Project+Sign+U
p
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Meeting Materials
• For all meeting minutes, presentations, reference materials and
recordings please visit the Materials tab and select “Past Meetings” from
the drop down menu http://wiki.siframework.org/Project+Meeting+Artifacts.
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Real World Scenarios
Working session
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Real World Scenarios
Scenario 1: Moving From Region to Region & Immunizations
Scenario 2: Broken Eyeglasses
Scenario 3: Planned Care
Scenario 4: Patient has a heart attack and ends up in the ER
(or patient is hit by a car)
• Scenario 5: Group of students traveling with chaperone and
chaperone needs to obtain medical records for treatment
• Scenario 6: Ran out of/forgot prescription medication while
on vacation and need it refilled (for example blood pressure
medication)
• Scenario 7: Ambulatory (patient has pre-existing condition
such as diabetes that has been out of control and needs to
fix the
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Summary of Updates
Scenario 1:
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Split into two scenarios to differentiate between Patient Mediated Exchange and Provider to Provider Exchange
– Scenario 1A: Moving from country to country and immunizations (Provider to Provider)
– Scenario 1B: Moving from country to country and immunizations (Patient Mediated Exchange)
Added Immunization Provider as Actor
Added Data Types:
– Scenario 1A: Consent and Privacy and Immunization Records
– Scenario 1B: Immunization Records
Scenario 2:
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Split into two scenarios to differentiate between Provider to Provider Exchange Patient Facilitated Exchange
– Scenario 2A: Broken eyeglasses (Provider to Provider)
– Scenario 2B: Broken eyeglasses (Patient Facilitated Exchange)
Added Data Types:
– Scenario 2A: Prescription including date prescription was written, consent and privacy
– Scenario 2B: Prescription including data prescription was written, evidence that this is a legitimate prescription
Scenario 3:
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Changed illness from Cancer to Diabetes
Removed User Story 2 since it was similar to User Story 1
Added Data Types: Medications, lab results, problem list
Please Note:
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We will post the fully updated Scenarios and User Stories to the WIKI for your comments
Deadline for comments – please submit comments by Monday 9/16
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Scenario 1
Scenario 1A: Moving from Country to Country & Immunizations (Provider to Provider)
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User Story 1: A family with three children moves to a new region within the same country. In order for the
children to be admitted to their new schools they must provide a complete list of immunizations and obtain any
additional immunizations needed. The family has identified a provider in the new region. The new provider
needs to request the immunization records for the children to be sent to her from the previous provider.
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Actors:
– Patient Dependents
– Previous Primary Care Physician (PCP)
– New Selected Primary Care Physician (PCP)
– Immunization Provider
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Data types:
– Consent and privacy
– Immunization records
Scenario 1B: Moving from Country to Country & Immunizations (Patient Mediated)
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User Story 1: A family with three children moves to a new region within the same country. In order for the
children to be admitted to their new schools they must provide a complete list of immunizations and obtain any
additional immunizations needed. The family has identified a provider in the new region. The patient accesses
their PHR and sends the immunization records to the new provider.
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Actors:
– Patient Dependents
– Previous Primary Care Physician (PCP)
– New Selected Primary Care Physician (PCP)
– Immunization Provider
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Data types:
– Immunization records
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Scenario 2
Scenario 2A: Broken Eyeglasses (Provider to Provider)
• User Story: A patient accidentally breaks their glasses while travelling abroad. They need their
home provider to send their eyeglass prescription to their new optometrist. The optometrist
requests the patient’s prescription from their home provider.
• Actors
– Patient
– Provider that originated the eyeglass prescription
– Provider that fills the eyeglass prescription
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Data types
– Prescription including date prescription was written
– Consent and privacy
Scenario 2B: Broken Eyeglasses (Patient Facilitated)
• User Story: A patient accidentally breaks their glasses while travelling abroad. They need their
home provider to send their eyeglass prescription to them. The patient needs to retrieve their
prescription and take the prescription to a prescription eyewear store in Europe to purchase
new glasses without having to have their eyes examined again by a new doctor.
• Actors
– Patient
– Provider that originated the eyeglass prescription
– Provider that fills the eyeglass prescription
• Data types
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Prescription including data prescription was written
Evidence that this is a legitimate prescription
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Scenario 3
Scenario 3: Planned Care
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User Story 1: A couple from France moved to the United States in September 2010. Their
baby was born shortly after in the U.S. in January 2011. The maternal grandparents travel
to the U.S. each year for 6 months to baby-sit. The maternal grandmother had diabetes
that has been treated in Europe but needs monitoring in the U.S. while she is living there.
The grandmother has healthcare insurance in the U.S. but she needs her U.S. physician to
interact with her provider in Europe.
Actors:
– One Patient
– Previous Primary Care Physician (PCP) or Oncologist
– New Selected Primary Care Physician (PCP) or Oncologist
Data Types:
– Medications
– Lab results
– Problem list
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Scenario 4
Scenario 4: Emergency and Inpatient Care
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User Story 1: Patient has a heart attack and is taken to the ER. When returning home information from
the ER must be transferred to their PCP.
User Story 2: A student is studying abroad in Italy and they are hit by a car towards the end of their stay.
They are taken to a nearby hospital for treatment for head trauma. The patient is admitted and treated
for approximately two weeks before they are discharged. The patient is cleared for travel back to the
U.S., however, they will need to check in with their PCP back home for any side effects from the
medication or additional treatments or radiology scans needed as a precaution. As per new policy at the
Italian hospital they must send a summary of the hospitalization stay including treatment plans to the PCP
identified by the patient.
Actors:
– Patient
– Hospital Emergency Department
– Hospital Inpatient Services
– PCP in home country
Data Types:
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Scenario 5
Scenario 5: Group of students traveling with chaperone and
chaperone needs to obtain medical records for treatment
• User Story:
• Actors:
– One Patient
– Previous Primary Care Physician (PCP)
– New Selected Primary Care Physician (PCP)
• Data types:
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Scenario 6
Scenario 6: Patient runs out of/forgets prescription medication while on vacation
and needs a refill (for example blood pressure medication)
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User Story: A patient is travelling through Europe and left their prescription blood
pressure medication at their previous hotel in Germany. They are unable to get in touch
with the hotel staff in Germany to have their prescription mailed to them. Therefore, they
visit a pharmacy in Spain to see if they can request the medication from the patient’s
cardiac specialist back home who wrote the prescription for the medication. The pharmacy
has the medication that the patient has been prescribed. The pharmacist in Spain needs to
validate the prescription with the patient’s cardiac specialist before they can dispense it.
Actors
– Patient
– Physician who wrote the prescription
– Pharmacy seeking to fill the prescription
Data types:
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Scenario 7
Scenario 7: Ambulatory
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User Story: A patient who has a history of poorly managing their diabetes is traveling in a
different country. After hiking the Swiss Alps the patient experiences numbness and
tingling in their feet. The patient disregards these symptoms attributing them to the
recent hike and exhaustion from the trip. Five days later the patient steps on a nail,
however, does not realize this until someone informs him that his right foot is bleeding.
The patient goes to an urgent care center to treat his injury and to see a diabetic
counselor to determine how best to manage his fluctuating diabetes condition. The urgent
care center needs to obtain a copy of the patient’s medical history from the past five
years including any medications the patient has been taking to manage their diabetes.
Actors:
– One Patient
– Physician Treating Patient’s Diabetes
– Urgent Care Center Physician in Switzerland
Data types:
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Additional Scenarios
to Consider
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Billings, claims
Quarantine situation and public health entity that this is happening
Blue Button
– Portal being able to access by both patient and provider
– Cell phone to hold the records
Immunizations (tetanus)- if someone is in a different country - how can
they or their provider that is treating them access their immunization
records to date?
A real world scenario of interest to us at King’s College London is where
EU & US universities collaborate in health research studies and clinical
trials: it would be excellent to have the semantic and syntactic means to
reduce or eliminate the extra work to harmonize data sets.
Querying population for outbreak - Public Health scenario. Rather than
being patient specific this scenario is more of a public health option.
Querying the population regarding an outbreak or querying for recalling a
prescription.
– Query for recalled prescription
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Next Steps
• Interoperability of EHR Work Group will continue to meet
every Wednesday from 10:00am - 11:00am (ET)/4:00pm 5:00 pm (CEST)
• Check the Interoperability of EHR Work Group Wikipage
regularly for updates:
http://wiki.siframework.org/Interoperability+of+EHR+Work+
Group
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Upcoming Meetings
Date
Meeting Topics
Sept. 18th, 2013
• Final Discussion on Proposed Scenarios
• Discussion on Selection Criteria
Sept. 25th , 2013
• Selection of Scenario(s)
• Identifying Assumptions
• Identifying “In Scope” and “Out of Scope” items
Oct. 2nd, 2013
• Identify Actors and Roles
• Identify Transactions of the Actors
Oct 9th, 2013
• Continuation of discussion on Transactions
• Functional Requirements
Oct 16th, 2013
• Finalizing Assumptions, In Scope, Out of Scope, Actors, Roles,
Transactions, Functional requirements in preparation for Boston
Meeting
Oct 23rd, 2013
• Face to Face Working Session at the Boston EU-US eHealth
Conference to finalize Use Case
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Interoperability Support Leads
• US Point of Contacts
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Mera Choi, [email protected]
Jamie Parker, [email protected]
Gayathri Jayawardena, [email protected]
Amanda Merrill, [email protected]
Emily Mitchell, [email protected]
• EU Point of Contacts
– Benoit Abeloos, [email protected]
– Frank Cunningham, [email protected]
– Catherine Chronaki, [email protected]
• UK Point of Contacts
– Pending
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Questions
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Resources
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•
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EU US Wiki Homepage
– http://wiki.siframework.org/EU-US+eHealth+Cooperation+Initiative
Join the Initiative
– http://wiki.siframework.org/EU-US+MOU+Roadmap+Project+Sign+Up
Reference Materials
– http://wiki.siframework.org/EUUS+MOU+Roadmap+Project+Reference+Materials
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