Transcript User Story

EU-US eHealth/Health IT
Cooperation Initiative
Interoperability of EHR
Work Group
September 4, 2013
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Agenda
Topic
Time Allotted
General Announcements
5 minutes
Wiki Overview
5 minutes
Real World Scenarios (1-7)
45 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
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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Visit the EU-US eHealth/Health IT
Cooperation Initiative Wikipage
• For the latest meetings announcements, meeting details and initiative
contacts visit our homepage at http://wiki.siframework.org/EUUS+eHealth+Cooperation+Initiative.
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Locating the Interoperability
Work Group Wikipage
• http://wiki.siframework.org/Interoperability+of
+EHR+Work+Group
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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/forgot of 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)
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Scenario 1
Scenario 1: Moving from Region to Region & Immunizations
• User Story: A family with three children move 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. (maybe do a 1a and a 1B – country and country
and region to region)- patient mediated might be the one facilitated the
exchange – language barriers (cross border) to think about reference
terminologies
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Country to Country (where there are language barriers)
Within a country (may have language considerations)
Are there consents that need to go back and forth
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Language
Privacy (which includes consent)
Legal
Type of exchange
Actors:
– Patient Dependents
– Previous Primary Care Physician (PCP)
– New Selected Primary Care Physician (PCP)
– Immunization Provider (don’t replace one with other use both)
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Scenario 2
Scenario 2: Broken Eyeglasses
•
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. (prescription time limit) –
small limited set of Data Elements – Provider that fills prescription may not have
computers – maybe retrieving from PHR (rather then provider)
– Themes – Patient mediated exchange vs. Query response – Start to create a
framework around this
– Do we want to include insurance information
• we would need to do one around claims – make this a candidate (maybe make this
modular)
• Authenticating credentials
•
Actors
– Patient
– Provider that originated the eyeglass prescription
– Provider that fills the eyeglass 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 breast cancer 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 oncologist in Europe.
User Story 2: An elderly, but not yet retired, man lives 6 months in the U.S.
and 6 months in Europe to care for his elderly mother. He was recently
diagnosed with prostate cancer and had radiation treatment. He also has
advanced degenerative disease and several other health conditions. He needs
regular PSA monitoring, bone scans etc.
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This is a very complex set of user stories - maybe diabetes or blood pressure monitoring – or
making it a very explicit cancer user story
Actors:
– One Patient
– Previous Primary Care Physician (PCP) or Oncologist
– New Selected Primary Care Physician (PCP) or Oncologist
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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
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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)
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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)
• 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
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Scenario 7
Scenario 7: Ambulatory
• 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
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Additional Scenarios
to Consider
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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
• Don’t forget we have a new web meeting tool and you will
have to REGISTER for each meeting before being supplied
the link to access the meeting
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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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