Consolidation Communicable Diseases User Stories: Meeting Consolidation Communicable Diseases User Stories: Meeting AgendaAgenda

1. News from other domains2. Recap of a previous meeting3. Consolidation of three more stories4. Making a consolidated story

Consolidated User Story: Child Health, Inpatient SettingConsolidated User Story: Child Health, Inpatient Setting

Child Health <Immunization, EHDI>Patient, physician, clinician, public health program staff1. Patient comes to Physician for a general check-up and

he/she is due for <immunization, hearing test, etc.>2. Physician orders <immunization, hearing test, etc.>3. Clinician administers an immunization or conducts

hearing test>4. Clinician enter data on the <immunization, hearing test>

in the EHR database5. Clinician sends <immunization, hearing test> report to

the PH IS directly or via HIE 6. PH program IS <IIS, EHDI IS, etc.> receives notification of

report availability7. PH program staff reviews the report and updated PH IS

<IIS, EHDI IS>8. PH IS sends Acknowledgement of Receipt of the Report to

provider EHR directly or via HIE.

Use Case Name:Actors:Flow of Events:

Pre-Conditions:

Post-Conditions:

Preferred Timing for Data exchange

EHR System, Health Information Exchange (HIE)

Public Health Information System <IIS, EHDI IS, etc.>

Daily updates

Data Categories

1. Demographics, Consent 2. Test Order, Referral3. Test Results

4. Test Results

5. Initial PH Report

6. Notification of Report Availability7. Updated PH Record

8. Acknowledgement of receipt

Initial Public Health Reporting: Communicable Diseases

Scenario: Identifying patients that satisfy reporting criteria for communicable diseases and submitting initial reporting to public health agencies.

User Story 1. Initial report from the EHR system Setting 1: Outpatient Visit

Setting 2: Inpatient VisitUser Story 2. Initial report that is based on laboratory results (from Laboratory)

Consolidated User Story 2: Communicable Diseases, Consolidated User Story 2: Communicable Diseases, Inpatient FlowInpatient Flow

Initial report from the EHR system (Communicable Diseases)

Patient, Provider (Hospital, Physician’s office), Laboratory, PH agency

1. Patient was admitted to a hospital ER or came to a provider’s office2. Provider provided clinical examination and assessed medical history. (same info used for reporting to

2 different programs)• [trigger: all ED records sent] If clinician assessment indicates that Patient has symptoms that

should be reported through Syndromic Surveillance (SS) system, a SS report was sent to PH agency. Electronic confirmation was sent from PH agency /SS system to Provider.

• [trigger: clinically significant symptoms of reportable communicable disease – sent before lab results are obtained] If patients’ symptoms require a specific communicable disease PH reporting w/o waiting lab results, a preliminary report was sent to PH agency

• Provider ordered lab tests. Provider staff took samples and sent them to Laboratory.4. Laboratory performed the ordered tests on received specimens. Laboratory send results to Provider

and PH agency (if needed)1. Provider re-examined clinical findings and lab results; he sent a communicable disease preliminary

report to a PH agency (some initial reports require clinical and lab component).2. Electronic message was validated by PH agency/information system3. Electronic confirmation was sent from PH agency to Provider

User Story Names:Actors:

Flow of Events:

Pre-conditionPost-condition

Preferred Timing for Each Event Type

EHR System, Health Information Exchange (HIE)

Public Health Agency’s Information System

Consolidated User Story : Communicable Diseases, Consolidated User Story : Communicable Diseases,

Initial report from the Laboratory system (Communicable Diseases)

Laboratory, PH agency, Provider

1. Laboratory performed the ordered tests on received specimens. Laboratory send results to Provider and positive results to PH agency

2. Electronic message was validated by PH agency/information system3. Electronic confirmation was sent from PH agency to Laboratory

User Story Names:Actors:

Flow of Events:

Pre-condition

Post-condition

Preferred Timing for Each Event Type

Electronic Laboratory System

Public Health Agency’s Information System