Work in Progress
This document is a work in progress. This dialog will be removed once the community agrees it is complete.
Summary
This use case allows other systems to make requests to a CHIS to follow-up for any reason. A common implementation might be for Lost to Follow-Up whereby a clinic generates a list of patients that have missed appointments and wants community based systems to help find the patient and encourage them to attend their appointment or to understand why they cannot or will not. This might be achieved either by having a health worker physically go find the patient or by other communication protocols (SMS, for example).
High Level Workflow
See diagram below. From a high level, the steps can be summarized as:
- Requesting system system determines which patients need follow-up
- Requesting system creates a "ServiceRequest" for each patient and sends the ServiceRequest to HIE
- CHIS queries the HIE to determine if there are any patients to follow-up with
- Requesting system returns results of query
- CHIS determines where or not to claim the service request
- CHIS "claims" the ServiceRequest to confirm that they will be following up with the patient
- CHIS tasks the appropriate CHW with finding and advising the patient
- CHIS records the results of the CHW's efforts
- CHIS updates the ServiceRequest
- Requesting system receives update
- Requesting system updates itself accordingly
Draft Indicators
Based on the high level workflow mentioned above, the list of transactional indicators are below:
| # | Description | Notes |
|---|---|---|
| 1 | Count of ServiceRequests Created | |
| 2 | Count of ServiceRequests Claimed | |
| 3 | Count of ServiceRequests Completed | |
| 4 | Count of ServiceRequests Completed with Outcome of X | |
| 5 | Count of ServiceRequests Completed with Outcome of Y |
Key FHIR Resources
The essential resources for this workflow are as follows.
| Description | Structure Definition | Samples |
|---|---|---|
| Patient | Patient.StructureDefinition.json | |
| ServiceRequest | ServiceRequest.StructureDefinition.json | |
| Encounter | Encounter.StructureDefinition.json |
Reference Architecture
The proof of concept uses the Instant OpenHIE architecture which utilizes a HAPI FHIR Server as a Shared Health Record component and OpenHIM for the Interoperability Layer. Detailed technical information and instructions for the CoPs shared infrastructure can be found here.
Data Flow Diagram (CHIS Processing Only)
The diagram below illustrates the dataflow between the SHR / FHIR Server and CHISs.
