Us Case 5

ED Encounter Resulting in with Follow-up Care at Multi-specialty Clinic

Care Theme: Transitions of Care

Use Case 8

Interoperability ShowcaseIn collaboration with IHE

Primary Goal: To demonstrate the transition of care between an emergency room and PCP.

Key Points: The demonstration illustrates how IHE profiles for patient care devices and clinical information exchange can be leveraged to share a patient’s medical history, including device readings and images, across multiple providers. The demonstration has a special focus on Patient Care Devices (PCD), used by the ED’s clinical staff to gather initial readings and continuous bedside readings throughout the patient’s encounter. The demonstration also highlights the Radiology domain profile, Scheduled Workflow (SWF), which defines a framework for coordinating care in a typical imaging encounter.

This scenario begins with a patient arriving in the ED, the nursing staff monitors the patient through a sophisticated set of medical devices that includes a vital signs monitor, a physiologic monitor, infusion pump, and others. After being treated in the ED, the patient is discharged home, to be seen by their primary care physician.. Meaningful Use Relevance (MU Objectives):

• Improving quality, safety, efficiency, and reducing health disparities• Improve care coordination• Ensure adequate privacy and security protections for personal health information

 Clinical Workflow: A patient goes to the Emergency Department due to a general feeling of fatigue and occasional shortness of breath. At the ED, the nursing staff takes patient’s vital signs. The patient is moved to a treatment room where the patient is placed on continuous device monitoring. The attending physician orders a XR of the chest, which is performed by the hospital’s imaging department. Once stabilized, the patient is discharged home. The patient follows up with her PCP for follow-up care, who reviews the patient’s recent encounter history.

Care Theme: Transitions of CareUse Case 8: ED Encounter with Follow-up Care at a Multi-specialty Clinic

1- The patient is seen in the ED – using an EHR system and various patient care devices

2- The patient moves to the ED Treatment Room, also using an EHR system and various patient care devices

3- The patient has a diagnostic imaging study performed at the Imaging Department where the captured images are read on a PACS

4- The patient is stabilized and discharged to home with a follow up visit to a multi-specialty clinic for primary care and outpatient imaging follow-up

1- ED Intake 2- ED Treatment Room 3- Imaging Dept 4- Multi-Specialty Clinic

Care Theme: Transitions of CareUse Case 8: ED Encounter with Follow-up Care by a PCP and Outpatient Imaging

Clinical Workflow:

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

XDR Source, Recipient

XDS Consumer, Source, Registry, Repository

EDPN Consumer, Creator

Patient Care Coordination (PCC) MS Consumer, Creator

Patient Care Devices (PCD) DEC Consumer, Reporter

Radiology (RAD)SWF

Acquisition Modality, Order Filler, Order Placer, Evidence Creator

XDS-I Consumer, Source, Registry, Repository

Care Theme: Transitions of CareUse Case 8: ED Encounter with Follow-up Care by PCP

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IHE Profiles & Domains: