SWF.b - IHE

IHE Radiology Technical Framework Supplement – Scheduled Workflow.b (SWF.b)______________________________________________________________________________34.4.2 Use Cases570575580585590595600605This section first describes the process and information flow of patient care as it is defined in theIHE Technical Framework under “normal” circumstances, reflecting a typical patient encounterfrom registration/admission through the performance of an ordered procedure. Next a number ofworkflow variations (patient update, order change, exception management, implicit postprocessingand departmental appointment notification) are described and finally, a variety of usecases related to handling unidentified patients.The unidentified patient cases cover trauma cases or emergency room patients when a patient’scondition requires that a procedure be conducted immediately. This may need to be done beforesteps like proper patient registration, ordering and/or scheduling of the procedure are performed(due to the lack of either information or time or other deviation from the normal process flow). Inthis case patient/study information must be later reconciled and properly updated at the ADT,Order Placer, Department System Scheduler/Order Filler, and Image Manager. There are severalexamples of information flow in this case shown in Uses Cases #7-13.The ADT may utilize a Master Patient Index (MPI) to resolve the patient information to thecorrect Patient ID.The IHE Technical Framework also supports cases when registration or temporary registration ofa patient by ADT is not applicable or desired, for example:• Emergency Department patient can be identified but, due to time or system availabilityconstraints the procedure must be performed before proper order entry and schedulingmay occur.• Patient ID, though valid, has never been propagated to all actors due to communicationfailures, or the wrong patient record was used in ordering/scheduling.• Patient ID, though valid, has been mistyped at the modality.• Patient cannot be registered at the ADT by the time of the procedure. The patient presentsto the Order Filler Actor (Imaging Department) and the order is placed and performed inthe department.Patient reconciliation may also be initiated on the department level. In the case of proceduresperformed on the unidentified patient in multiple departments (e.g., Radiology and Laboratory),this will require reconciliation of patient information in multiple locations.See Appendix C for an overview of the information exchange between the Department SystemScheduler/Order Filler and Image Manager.To support the Scheduled Workflow.b Profile, an actor that claims support of other contentprofiles (Consistent Presentation of Images, Key Image Notes or Evidence Documents) isrequired to support the relevant storage, query and retrieve transactions and manage creation andreconciliation of those objects in the same way images are supported. The following diagramswill mostly show the management of images.__________________________________________________________________________Rev. 1.1 – 2013-06-11 31 Copyright © 2013: IHE International, Inc.Template Rev. 10.3