Proposed Baseline for Patient Summary (PS) Use Cases

Good afternoon,
We would like to acknowledge that we have received feedback from Derek, Allison, Lillian and Colin regarding multiple patient summaries. Thank you! Our team will be meeting this week to review your feedback and will post a response here, in the working group, to review and comment on.
Thanks,
Allana

I think this is a very important use case -- and also one of the areas where real challenges can arise (akin to the "version control" challenges addressed in other sectors, such as engineering document control). Using a FHIR-based PS as an example -- there can be multiple documents (bundles), each with similar manifests (the composition) referencing the same set of underlying clinical content (the resources). Unhelpfully, every time a resource is persisted to a new FHIR server it is likely to be given a new "id".

In an ideal scenario, the id of each unique content element would be consistent across all the document instances that include it... and across all the databases where that document may be stored. There should be a defined pattern that well-behaved point-of-service applications can follow so that a proliferation of patient summaries can't become a version control problem... and, potentially, a patient safety concern. Good progress has been made on developing and documenting such a pattern (and on the technical rules that are needed to operationalize it).

Agreed, our experience in SK when we started receiving pt data from providers' EMRs to our provincial repository was that there needs to be some business rules for the "latest and greatest" version of the pt summary. I had shared feedback and suggested this be tagged to UC06 since all the data would go to the EHR and if users wanted to create and/or consume the latest pt summary, then the business rules could be applied at the point.

Hi, Since it is very possible that multiple patient summaries can get created for one patient across multiple providers. Should we add a use case to encompass this scenario?

Hi Colin, great discussion point! I have added this to the use case in the requirements section to be considered during the requirements development.
Thanks!

Yes, looks good.

Is it possible that the patient-viewable summary may be different from the provider-viewable summary? Eg, the provider-viewable summary contains content that providers want to share with one another, but wouldn't be appropriate for the patient to view. Perhaps this doesn't affect the data standards.