IHE Patient Care Coordination Technical Framework Vol I

PCC Technical Framework V3.0, vol. 1
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3.1.2.3 Use Case for Unplanned Access to past Medical Summaries
In many cases, a provider may need to assess information from the patient care history,
and patients may have Medical Summaries in the XDS repository from prior visits to
other providers. For example, Medical Summaries, as well as other documents such as
laboratory and radiology reports are critical for emergency physicians and nurses to
provide the best care to patient in acute conditions. The figure below shows the
transactions required for this use case, again, using XDS. Other process flows are
possible using XDM and/or XDR.
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Figure 3.1-2 Unplanned Access Process Flow Diagram
3.1.2.4 Content Interoperability Levels
The use cases described above imply different levels of interoperability. At the lowest
level, a clinician simply needs to be able to access and view some content such as a
medical summary. At this level, minimal structured data elements must be present – just
enough metadata to verify that access to that document can be accessed appropriately
associated with a visual representation of the document.
Beyond this simple metadata, nearly all medical summary documents have organizational
elements that group the relevant parts of the medical summary. For humans this allows
for more rapid review because it is easier to skip to portions of interest for care.
Computers too can take advantage of this structuring. For example, it is relevant to see
the list of discharge medications from a discharge summary in relation to current
medications for comparison and reconciliation.
At a very high level of interoperability, the ability to pass fully structured and codified
data is necessary for computer processing and mapping. For example, the ability to
import medications identified in medical summaries from another institution could have
tremendous potential for ensuring that medication orders are transferred correctly.
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Revision 3.0 Public Comment — June 25, 2007
Copyright © 1997-2007: ACC/HIMSS/RSNA