Us Case 5

Pulmonologist Referral with Lab,Radiation-Exposure-Monitored Imaging, and Drug Safety Reporting Interchange

Care Theme: Transitions of Care

Use Case 5

Interoperability ShowcaseIn collaboration with IHE

Primary Goal: To demonstrate the cross-community coordination of treatment of a patient with a focus on lab and radiology work, the patient’s exposure to radiation, and coordination of drug reaction reporting during the diagnostic process.

Key Points: The demonstration will use a host of IHE profiles – including PIX, XDS, XDS-I, XCA, XCPD, ATNA, XPHR, and others – in combination with the NwHIN Direct protocol to demonstrate how a patient’s medical history, including images, are shared across multiple providers in multiple communities, and later made available for the patient to review at home. Additionally, the demonstration highlights a new IHE profile, REM, which focuses on measuring a patient’s exposure to radiation during diagnostic procedures.

 Meaningful Use Relevance (MU Objectives):

• Improving quality, safety, efficiency, and reducing health disparities• Engage patients and families in their healthcare• Improve care coordination• Ensure adequate privacy and security protections for personal health information

 Clinical Workflow:

This scenario begins with a patient visit to a lab for blood work, then a visit to the PCP to investigate fatigue and shortness of breath. After imaging and other diagnostic work, the PCP refers the patient to a Pulmonologist for specialty care. Upon completing a Pulmonary study, the patient is diagnosed , sent back to the PCP for follow-up, and finally sent back home to rest and review his/her condition in more detail via a PHR.

Care Theme: Transitions of CareUse Case 5: Pulmonologist Referral with Lab, Radiation-Exposure-Monitored Imaging, and Drug Safety Reporting Interchange

1- The patient visits an outpatient lab using a LIS system

2- The patient visits a PCP using EHR system

3- The patient is sent to an imaging center that uses a RIS, Acquisition Modality, and PACS

4- The patient reviews his images with his PCP, who uses an EHR system

5- The patient is referred to a Pulmonologist, who also uses an EHR system

6- The patient goes home and reviews the information on his PHR system

7- The patient returns to his PCP, for a follow-up visit

Care Theme: Transitions of CareUse Case 5: Cardiologist Referral with Lab and Radiation-Exposure-Monitored Imaging Interchange

1- Laboratory 2- PCP 3- Imaging Center 4- PCP

5- Pulmonologist 6- Home 7- PCP

Clinical Workflow:

1- The patient visits an outpatient lab using a LIS system

2- The patient visits a PCP using EHR system

3- The patient is sent to an imaging center that uses a RIS, Acquisition Modality, and PACS

4- The patient reviews his images with his PCP, who uses an EHR system

5- The patient is referred to a Pulmonologist, who also uses an EHR system

6- The patient is sent to a Bronchoscopy Suite, who uses separate documentation application

7- The patient’s adverse drug reaction is reported to a adverse drug reporting application

8- The patient returns to his PCP, for a follow-up visit

9- The patient goes home and reviews the information on his PHR system

Care Theme: Transitions of CareUse Case 5: Cardiologist Referral with Lab and Radiation-Exposure-Monitored Imaging Interchange

1- Laboratory 2- PCP 3- Imaging Center 4- PCP 5- Pulmonologist

Clinical Workflow:

6- Bronchoscopy Suite 7- Drug Safety Reporting 8.PCP 9. Home

Bronchoscopy Image

Rx safety image

Domain Profile Actors

IT Infrastructure (ITI)

ATNA Repository, Secure Application

CT Time Client, Time Server

HPD Consumer, Source, Directory

PIX, PIXv3 Manager, Consumer, Identity Source

XCA Initiating Gateway, Responding Gateway

XCPD Initiating Gateway, Responding Gateway

XDR Source, Recipient

XDS Consumer, Source, Registry, Repository

XDS-SD Consumer, Creator

Patient Care Coordination (PCC) XPHR Consumer, Creator

Radiology (RAD)XDS-I Consumer, Source, Registry, Repository

REM Register, Reporter, Consumer

Care Theme: Transitions of CareUse Case 5: Pulmonologist Referral with Lab, Radiation-Exposure-Monitored Imaging, and Drug Safety Reporting Interchange

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IHE Profiles & Domains: